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From Sir William J. Thompson
NATIONAL
INSURANCE
AND TUBERCULOSIS
165
FROM SIR W I L L I A M J. T H O M P S O N , B.A.~ M.D., F.R.C.P.I., Registrar-General for Ireland; Chairman, Census Commission~ Ireland, I9II ; Physician-in-Ordinary to the Lord-Lieutenant of Ireland ; Consulting Physician' to the National Hospital for Consumption. T h e National Insurance Bill, as regards the clauses relating to the prevention and cure of sickness, is generally deserving of approval a n d support, but certain modifications are necessary which doubtless will be inserted. T h e scheme for the provision and upkeep of sanatoria, as outlined in the Bill, will enable all persons who are insured in the manner provided by the Act to receive the benefits of sanatorium treatment when suffering from tuberculosis, if the local Health Committee considers the cases suitable for such treatment. T o grapple with this problem, the eradication of tuberculosis, two other institutions must go hand in hand with the sanatorium-namely : (I) the Dispensary, and (2) Homes for advanced cases. The dispensary acts, so to speak, as a central bureau ; by its means cases fit for sanatorinnl treatment are found, those sharing the homes of consumptive patients are examined, and incipient cases, some of which may be suitable for home treatment, discovered; while advanced cases become known, and opportunity is afforded to segregate such in Homes. In addition, it is necessary that some system should be introduced for the subsequent care, for a certain time, of patients discharged from a sanatorium. There is no doubt that a great deal of the benefit of the treatment is lost by patients being obliged to return to their homes and resume their former work immediately. The W o m e n ' s National Health Association of Ireland, founded in 19o7 by Her Excellency the Countess of Aberdeen, is working on lines somewhat similar to those indicated; and it is gratifying to Observe that within the past three years the number of deaths in Ireland from all forms of tuberculosis has been reduced by about oneseventh (i,663) , and that the rate of mortality per I,OOO living has fallen from 2"7 to 2"3 . It is to be hoped that the Government may extend the scheme under discussion so as to embrace already existing tuberculosis dispensaries, public sanatoria, homes for advanced cases, and the care of patients subsequent to their discharge from a sanatorium.
INSURANCE
AND TUBERCULOSIS
165
FROM SIR W I L L I A M J. T H O M P S O N , B.A.~ M.D., F.R.C.P.I., Registrar-General for Ireland; Chairman, Census Commission~ Ireland, I9II ; Physician-in-Ordinary to the Lord-Lieutenant of Ireland ; Consulting Physician' to the National Hospital for Consumption. T h e National Insurance Bill, as regards the clauses relating to the prevention and cure of sickness, is generally deserving of approval a n d support, but certain modifications are necessary which doubtless will be inserted. T h e scheme for the provision and upkeep of sanatoria, as outlined in the Bill, will enable all persons who are insured in the manner provided by the Act to receive the benefits of sanatorium treatment when suffering from tuberculosis, if the local Health Committee considers the cases suitable for such treatment. T o grapple with this problem, the eradication of tuberculosis, two other institutions must go hand in hand with the sanatorium-namely : (I) the Dispensary, and (2) Homes for advanced cases. The dispensary acts, so to speak, as a central bureau ; by its means cases fit for sanatorinnl treatment are found, those sharing the homes of consumptive patients are examined, and incipient cases, some of which may be suitable for home treatment, discovered; while advanced cases become known, and opportunity is afforded to segregate such in Homes. In addition, it is necessary that some system should be introduced for the subsequent care, for a certain time, of patients discharged from a sanatorium. There is no doubt that a great deal of the benefit of the treatment is lost by patients being obliged to return to their homes and resume their former work immediately. The W o m e n ' s National Health Association of Ireland, founded in 19o7 by Her Excellency the Countess of Aberdeen, is working on lines somewhat similar to those indicated; and it is gratifying to Observe that within the past three years the number of deaths in Ireland from all forms of tuberculosis has been reduced by about oneseventh (i,663) , and that the rate of mortality per I,OOO living has fallen from 2"7 to 2"3 . It is to be hoped that the Government may extend the scheme under discussion so as to embrace already existing tuberculosis dispensaries, public sanatoria, homes for advanced cases, and the care of patients subsequent to their discharge from a sanatorium.