T.B. CLINIC IN H.B.

Hawke's Bay Tribune, Volume XXV, Issue 232, 17 September 1935, Page 11

T.B. CLINIC IN H.B.

TRAVELLING SPECIALIST Combating Tuberculosis BOARD EXPRESSES APPROVAL As part of the campaign to combat tuberculosis in the North Island, and to institute dispensaries in this area, Dr. K. A. Shore, as-sistant-Director-General of Health, and Mr W. H. Kathbone, chairman of the Waipawa Hospital Board, addressed members of the Hawke's Bay Hospital Board yesterday afternoon. The board approved the suggestion to appoint a T.B. clinic in Hawke’s Bay at which a travelling specialist will act as consultant.

This consultant will co-operate with local doctors and advise courses of action in T.B. cases, and the dispensary will act as a clearing house, to which the Hawke’s Bay Hospital Board will not be called upon to make compulsory financial contributions.

In attendance with Dr. Shore and Mr Rathbone was Mr P. R. Smyrk, secretary to the Waipawa Hospital Board Dr. Shore said that he and Mr W. H. Rathbone were present to intensify the campaign against T.B. There had been a very marked decline in the death rate of patients suffering from pulmonary tuberculosis in the last JO years, and the improvement started from the time of the first clinic at Cambridge in 1901. In 1932 the death rate was 3.32 pe 10.000. Although the North Island started the campaign, at the present time it lagged behind the South Island CONTROLLING THE DISEASE. The setting up of institutions would not do everything to control the disease. To stamp it out it would be necessary to have an intensive and continual campaign. The main agency would be a T.B dispensary to act as a clearing house for a sanatorium in each area, to act as an. agent for the following up of cases after discharge, and to examine contacts of these cases. “Unless we can get cases early, they will not have the full benefit of sanatorium treatment,” said Dr. Shore. “Unless we can get supervisory control of contact cases, we shall never have a chance of eradicating this disease.

“It is proposed that the Palmerston North and Waipawa Hospital boards should unite in employing a recognised T.B. expert. It is not proposed that there should be any charge for any person in any condition, in any state of life, attending that T.B. dispensary. All examinations and consultations should be free. “The two boards running the Pukeora and Otaki Sanatoria are prepared to pay the salary of the T.B. expert. He will visit the various districts and draw up a scheme to have cases sent to a dispensary, and he would recommend cases for sanatorium treatment. Co-operation with the board.would be sought in surgical cases, and the expert would be required to keep a friendly eye upon such cases, and in full co-operation with the doctors.

HEALTH DEPARTMENT'S COOPERATION.

“Behind this campaign is the Department of Health, which carries 50 per cent of the expense, for it is realised that without any expense there will not be any progress. How otherwise can we save the country from a great economic loss?” In response to questions by Dr H. M. Wilson, Dr Shore said that, so far as the admitting of T.B. cases into general wards of hospitals, the department was insisting upon a rigid nursing technique, to reduce the risk to nurses to a minimum. It was desirable to have T.B. cases in side wards —if too numerous to have them in special annexes —but if the nursing- technique in general wards resulted in complete asepsis, then some T.B. eases could be admitted, though there still remained some risk. In answer to a question from Mr S. .1. McKee, the doctor said that the control of the Pukeora Sanatorium was entirely in the hands of the Waipawa Hospital Board. SANATORIA CONTROL. Details respecting sanatoria control generally were outlined by Mr Rathbone, who commenced by saying that he trusted that in the near .future district tuberculosis clinics in the North Island would be established on a really sound footing. “Most of you are aware that in 1926 at a conference of hospital boards, held at Palmerston North, it was agreed that hospital boards should take over control of sanatoria in the North Island, such work being considered as part of their functions, the South Island boards for many years past having been in control of sanatoria and tuberculosis preventive measures generally, and their organisation was, and still is, considered much ahead of that of the North Island,” he added. “However, when a conference of North Island boards was later called to further discuss the matter, the previous decision was reserved, and the control of sanatoria still remained with the Health Department, until the year 1933, when, as the result of a direction from the National Expenditure Commission, the administration of sanatoria, and for that matter, all hospital functions, were taken out of the hands of the Health Department and placed with hospital boards.” BACKWARD STATE OK REPAIR. When the Waipawa Hospital Board took over the Pukeora Sanatorium, it was in a very backward state of repair, he went on, and although a grant of £lOOO was given in 1933, with a further £250 per year for four years, that money was nowhere near sufficient to meet the requirements. The board had since then expended £l5OO on buildings, plant and equipment, over and above the money provided by the department. The average number of beds occupied at the present time was about 85, ami as from October 1, the board had pro vided for a reduction of 1/- per day in the fees scale to all hospital boards. The Pukeora Sanatorium was taking a large number of patients from the Auckland Hospital Board’s district.

“Auckland will, of course, eventually have to have its own chest hospital but we have received a definite assur-

ance that suitable types will still be sent to Pukeora and Otaki,” Mr Rathbone said.

“I do appeal to boards to do their best for these unfortunate people, aud when I make this appeal, 1 do so, not in any way as a canvasser on behalf of Pukeora Sanatorium, but as oim who, having been in direct contact with the situation, realises what fine results can be obtained in stamping out this terrible scourge, if the disease is cheeked in its infancy by sufferers being given the earliest possible opportunity for receiving proper treatment and the right surroundings.

“You are aware that iu Dr. Maclean, medical superintendent at Pukeora Sanatorium, we have an officer Highly qualified in his work, aud who within the past few years has been to tho Old Country to obtain the most up-to-date methods. Both Otaki and Pukeora Sanatorium have also lately obtained the services of Dr. Hugh Short, of Wellington, as consultant physician.

“You are fully aware that Dr. Short is recognised as one of the lending authorities on tuberculosis in this Dominion. He visits both institutions once monthly, and consults with Dr. Maclean on every case. “The Palmerston North representatives have, together with Dr. Shore, recently visited several of the districts on the West Coast, and while I have uot yet had a full report, I understand that the necessary steps are being taken to establish clinics in those areas. If your board agrees to a similar measure, then it is proposed that an officer of the department, together with Dr. Hugh Short, will visit your district again to consult with your medical officers and medical practitioners with a view to arranging a proper organisation. “In putting forward this scheme, the sanatoria boards -offer a constructive suggestion regarding the financing of same. We do not propose that hospital boards should be burdened with any additional expenditure, but that the costs of the visits of the tuberculoris officer to the clinics, shall be free to the boards in the individual districts, the cost being borne from the sanatoria accounts by the Palmerston North and Waipawa Boards.” LOCAL SUPPORT. Mr H. V. Hoadley said it was a wonderful thing for the country to have a scheme with such possibilities placed before it. He was fully in accord with the project. Mr 0. Duff warmly concurred, and said he felt the board should support the suggestion. He said that Dr. Shore had clearly shown the desirability of setting up a clinic in each district. Other members spoke on the subject, and added their desire to -have the board support the plan outlined by Dr. Shore. “On behalf of the board I wish to thank you. Dr. Shore, for putting the position before us so clearly,” said tho chairman of the Hawke’s Bay Hospital Board, Mr C. O. Morse. ‘“I think I am expressing the feeling of this board when I say that you can go away with the knowledge that we are behind you with our support. “I would be very pleased if our members would take advantage of your invitation and visit the Pukeora Sanatorium—and also the Otaki institution. We fee! sure that the control of Pukeora is in safe and efficient hands, and I compliment you, Mr Rathbone, on this. ’ ’ A resolution was then unanimously adopted to the effect that the Hawke’s Bay Hospital Board support the scheme outlined.