CAMPAIGN AGAINST CONSUMPTION.

Nelson Evening Mail, Volume XLV, Issue XLV, 16 August 1910, Page 5

CAMPAIGN AGAINST CONSUMPTION.

EXAMPLE OF GERMANY. The "Spectator" of April 30, in discussing the measures friendly societies should take in Great Britain to prevent the spreading of consumption, gives the following account of the means whereby the disease is fought in Germany : "At- the very early stages of the working of the German insurance system its authors realised that it was more economical to try to cure sickness than to subsidise the sick man and his family. In the case of the particular disease of consumption the baaiks which are entrusted with the working of the sickness insurance have power to remove patients to sanatoria, where they are maintained out of the insurajice funds, while an. allowance is made to their families. A good deal of elasticity appears to be permitted in the working of the institution 60 as to enable the managers, where circumstances demand it, to give to the patient treatment in excess of that to which he would be entitled under the terms of his insurance. This is done on the broad principle that in the long run it would be cheaper for the insurance agency to cure the man thoroughly than to send-him back patched up. probably to com e upon the funds again a few months later. Still more is this the case with the institutions which manage the invalidity insurance. As many of our readers are aware, there are in Germany three sets of industrial insurance—the validity and old-age insurance, which is paid for entirely by the -employers ; the sickness insurance, of which two-thirds of the cost falls upon the workman and one-t'hird on the employer; and the invalidit- and old-age insurance, which is borne in -equal proportions by employer and employed, a fixed contribution being subsequently added by the empire and ( charged to the taxpayer. The invalidity insurance institutions are bound to maintain a man for life if at any age he, through illness, falls into euch condition as to be unable to earn more than a third of the •normal wage in his trade. It is therefore obvious that these institutions have a very great pecuniary motive, for trying to cure every patient who has a reasonable chance of recovery. "Witih this object in view, large sums have been expended by the invalidity insurance institutions in constructing sanatoria and. speaial hospitals, and the results of this expenditure have been most satisfactory. A very interesting report of what has been done in this direction was published by the medical officer of the Local Government Board, and incorporated in. the board's annual repoz-t for the year 1905-6. This report gives. among- other things, figures showing the extent to which the German, papulation has availed itself of these methods of treatment. In the year 1897, 2cCO males were treated; in the year 1904, neaa-ly 17.C00. The corresponding iTgures for females were 736 and 6520. The duration of treatment appears to average about seventy or eighty days. The insuraince institutions are not content, however, with merelv trying to cure their members in these special, hospitals or sanatoria. Experience has shown that it is highly dangerous for a partial cured tuberculous workman to return at once to a former occupation which has perhaps been the cause of his illness. 'Consequently the committees of the insurance institutions endeavour to procure from the employers special consideration for the discharged patients, and by way of furthering this object a commencement has been made in certain sanatoria in providing light work for the patients towads tlhe termination of their treatment.' This method of dealing with the disease has already been tried i n England, and its success has been proved by the zeal of the patients themselves to do even more work than is offered to them. At an establishment in Surrey—the Frimley Sanatorium of the Brompton Consumption . Hospital—the patient? recently completed a large Teservoir by their own- labour, and then petitioned to be allowed to build a chapel for themselves. The point, however, with which we are here concerned is that the whole of this scientific treatment of consumption in Germany hinges upon the .system of industrial insurance. In the words of Hen- Bielefeldt, who has taken a leading part in the German campaign against -consumption, the organisations of the invalidity insurance have become since 1895 the centre of the anti-tuber-culosis movement in Germany. Mjuiymillions have already been spent out of the insurance funds in constructing sanatoria.-special hosoitals, and convalescent homes."