TUBERCULOSIS

Evening Post, Volume CXIV, Issue 42, 18 August 1932, Page 12

TUBERCULOSIS

"BOARDS APATHETIC"

COULD BE STAMPED OUT

IN ONE GENERATION

Allegations that hospital board members generally are apathetic towards the problem of tuberculosis, and that the boards had quite candidly admitted having adopted from purely mercenary motives a policy of not sending tuber-" cular eases forward for treatment at sanatoria, were made by Dr. G. MacLean, who for the past eight years has been medical supervisor in charge of Pukeora Sanatorium, in an address to the Hastings Rotary Club, reports the "Tribune."

The doctor expressed his belief that if a proper system of treatment were carried out, tuberculosis would disappear from among the people of New Zealand in a single generation. Also, he advocated the establishment of a lay organisation, founded on the lines of the Plunket Society, to co-operate with the modieal profession in attempting to bring about the adoption of an adequate system of treatment. Dr. MaeLeau compared the North Island system with that followed in the South Island, greatly to the disadvantage of the north. •

After sketching historically the struggle against tuberculosis, Dr. MacLean said that sanatorium ■ treatment was first put into real practice in 1900, and since that year there had been a great fall in the death-rate from tubercular disease in every country in the world. The significant factors that had halved the tuberculosis death-rate in New Zealand during the last twentynine years were the application of the sanatorium principle of treatment which taught the patient to live in an open-air environment day and night, the amount of rest required, the correct choice of foods, the correct occupation of the mind, and the teaching of hygienic principles that would enable the patient to recover his capacity of engaging in mental and manual labour, a proper mental outlook towards his disease, both as an individual and from the' point of view of the community's health.

GREAT PROGRESS, MORE AHEAD,

The death rate from tubercular disease in New1 Zealand,, said the doctor, had remained fairly stable for a period of twenty-five years from 1875 to 1900. In tho second period from 1900 to 1025 the death rate had been reduced by one-half, and- what occurred in New Zealand occurred in every country where the people concerned had participated in the struggle.

Any properly adequate scheme in the struggle against tuberculosis should consist, of what might be described as a front-line post of chest clinics, then the hospital, then the sanatorium, and last of all a camp or settlement where the-patient would be given teaching in some useful occupation that would enable him afterwards to make a living. Finally, there should be an after-care unit. All those requirements must necessarily form.a part of any adequate scheme of battle against the disease. ..■"-.

In the North Island there were two sanatoria, and the people seemed to look upon the problem as being only the concern of those two institutipns. As for continuity of treatment, $few Zealand was not doing a great deal. Contacts were being followed up by the Health Department, aiid the Education Department was watching the schools and was even following sus-pected-children into adolescence. That, however, was merely touching the work. The North Island was not doing as well as the South Island. Dunedin provided an excellent example of a compact system of treatment and aftertreatment. The hospital was used as an educative unit, there was supervision in the city by nurses, and tho people were being actively taught to apply the teaching that they had/been given in the sanatorium.

In New Zealand the system of treatment was inclined to be one of teaching in isolated units, a"nd the time was ripe "for reconstruction. A reconstructed system would not require more money than was being spent on the present system; money would be saved if the system were put upon a proper footing.

ATTITUDE OF HOSPITAL BOARDS,

Criticising the attitude o,£ the hospital boards Dr. Mac Lean said that the average hospital board obtained what it could from the sanatoria and then was done with the matter. There was considerable apathy among the hospital boards; their attitude' was that the Government had provided an institution and that all they had to do was to send tubercular patients there, pay so much, and then leave it at that. To his mind, that was not the right conception of the duty of hospital board members, even though they might have high ideals with regard to health matters. One ver£ unfortunate aspect of the present system was a sort of bargaining between the hospital boards and the Government over what should be done with regard to a man in need of treatment. That bargaining undoubtedly produced antipathy. At Pukeroa admissions had fallen off, and the hospital boards had been quite frank about the matter. He had received from the boards letters admitting that it was not now their policy to send tubercular men to Pukeroa, and the reasons given were purely mercenary. It was not a right attitude for men serving on a hospital board, or for men who should be interested in the health of the community that they were elected to represent. LAY ORGANISATION SUGGESTED.

As long ago as 1898 a society for the prevention of tuberculosis was formed m England, but in New Zealand there was nothing of that kind unless one excepted the sunshine associations in; some of the cities of the Dominion. Tne_time is ripe," sa i d the doctor, for the establishment of a lay organisation which could co-operate with the medical profession in fighting tuberculosis and which might follow the lines of the Plunket Society. Such a step would be to the benefit of the whole community, and do a great deal to forward the struggle againlt the disease. It would back up those who are so earnestly trying to put the fight on a proper basis, it would influence public frnment »* W°UW influence the Gov-