ECONOMICS OF TUBERCULOSIS COLONIES.

816 Le attacked first are those of school age. Notification approximately 2403, and these houses are let at ,of the occurrence of measles amongst these might with rentals varying from 4s. to 9s. per week inclusive of of the estate are also let to local advantage be followed by the prompt injection of rates. Portions The excess of income over expenditure those members of the family below school age, the aim farmers. on this section for the four years under review has being not prevention but attenuation. been ;S978. In the industries section the total capital expenditure- has been B17,544. At the moment, 145 settlers are earning their living at Preston Hall. The total sales during the four years period have realised .8198,024 ; salaries, wages, and commission amounted to 66,160. The balance-sheet of this " Ne quid nimis." section shows an average loss per annum of job1080, or 1-8 per cent. on the turn-over. That is an ECONOMICS OF TUBERCULOSIS COLONIES. average loss of £ 11 7s. 4d. a year per settler since the AT the annual conference of the Tuberculosis British Legion assumed control of the enterprise. In our last issue Dr. E. L. Sandiland, medical Association, held in Oxford last week, a report of which will be found on p. 804, a session was devoted superintendent of the East Lancashire Tuberculosis to a consideration of the tuberculosis colony and Colony at Barrowmore Hall, gave some figures village settlement. The day has gone by when these illustrating the employment of ex-tuberculous patients institutions had to justify their existence on medical in colonies, and showed that the breakdowns and or sociological grounds. Almost every Continental texttime lost by the workers-2-2 per cent.-compared "book on the antituberculosis campaign contains an favourably with those in other communities. In spite account of Papworth, and it is the proud boast of of this, the colony has not yet reached the stages of a that pioneer colony that no child born and brought up satisfactory balance. The last annual report of the in the village has so far developed tuberculosis, colony states that there were then 25 settlers employed though born of tuberculous parent or parents. The with a net loss in the industries section of products of the various industries from village 22479 18s. 8d. The Preston Hall figures suggest, settlements have further demonstrated a high degree however, that a loss in the industries section may be of skill and workmanship. But a tuberculosis made up for by a profit in the sanatorium section, colony like every other institution nowadays must although at the moment there are no materials for either pay its way or give good reasons why it does a strict comparison between the losses on industries not. Dr. Bardswell puts the matter tersely at Oxford in one colony and those in another. Probably one when he asked " Why has no public authority under- of the advances likely to be made in the near future taken a settlement ? " Various specious answers will be some agreed comparable system of keeping could be supplied to this question. Public authorities accounts. As time goes on, also, the size of a village in this country do not make pioneer efforts, nor have settlement will presumably be adapted to the they been charged with possessing imagination. economic problem of the area it serves. Here the spade But Dr. Bardswell himself supplied the true one : work done during the experimental years should " The financial position has never been clearly put prove invaluable. Dr. McDougall proposes accomin 1924, Dr. F. N. Kay modation for 200 patients in the sanatorium and before them." Menzies said: " I am not in a position to give you any 50 settlers in the industries section, and if such a accurate figures with regard to either the Papworth or ratio as this were found workable the hope of making Preston Hall Settlements, but it is probably fair to ends meet with even a small margin for contingencies say that the capital expenditure in each case is not would be brought one step nearer. Be this as it may, less than ;6250,000. Apart, therefore, from the it seems hardly fair at the moment to saddle the heavy annual cost of maintenance, it is difficult to village settlements with all the responsibility of their deficits. Apart from the inestimable value of their see how the erection of a number of such settlements by local authorities could be justified as a practical work on the medical and sociological side, they proposition." This statement has found its way into contribute perhaps more than is realised to the at least one American text-book, but we are not relief of the burden of public authorities. Thus, aware that it has ever been verified or disproved by Dr. McDougall pointed out that at Preston Hall accountant’s figures. The colony has hitherto been one authority had at the present time 27 ex-patients widely regarded as a luxurious and expensive method in residence as settlers and the financial saving to of dealing with the problem of tuberculosis and one that particular authority must be considerable. which no public authority can face. As Dr. McDougall, Again, there must be many tuberculous patients medical director of the British Legion Village at receiving more per annum from approved societies Preston Hall, said at the conference the failure to put and disablement benefit than would be necessary the financial facts before the public had done more to keep them at work as productive units in a settlethan anything else to discourage the progress of village ment. And finally, the colony industries maintain their workers through bad times and good, and when, settlements. The facts as he gave them are these. When the as recently at Preston Hall, untoward circumstances, British Legion took over Preston Hall in 1925 such as a fire or breakdown in the works, throw the the total initial capital expenditure, as estimated by workers out of employment, they are not forthwith -a competent firm of valuers, was ;638,970. Since that placed upon the dole, as they would be in many date money has been spent on developments which industries, but their maintenance is accepted as bring the capital outlay up to a round figure part of the liability of the industry. From the of :S100,000. Dr. McDougall emphasised the taxpayer’s point of view, then, the colony is a better importance of making the financial returns of a contribution to the tuberculosis problem than is colony under the three separate headings of sana- often supposed. Colony finance has been described torium, estate, and industries. Only in this way as robbing Peter to pay Paul; but Paul may prefer can the financial position be properly understood. to be robbed by subsidising a man who can retain In the sanatorium section at Preston Hall the his self-respect by working four hours a day rather accommodation has been provided at a cost of about than by leaving him to be entirely unproductive. jE178 a bed, which, even when allowance is made for The immediate difficulties-namely, the capital cost the fact that much of it consists of hostels and huts, of the settlement and the small percentage of the is exceptionally low. On the maintenance side, tuberculous population who are fit to avail themPreston Hall has been able, in spite of the inevitable selves of. its help-are enough to prevent public fluctuations of the bed list, to preserve a financial authorities from spending ratepayers’ money in balance by charging local authorities jB2 12s. 6d. this way, but there seems no reason why the colonies, In 1927-28 there was a profit which are voluntary institutions, should not receive a patient per week. of 2105 and in 1928-29 one of jE195. In the estate subsidies in proportion to the extent to which they section the average cost per settler’s house has been relieve public authorities of their statutory obligations.

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