Final report of the Departmental Committee on Tuberculosis.
- Great Britain. Treasury. Committee on Tuberculosis.
- Date:
- 1913
Licence: Public Domain Mark
Credit: Final report of the Departmental Committee on Tuberculosis. Source: Wellcome Collection.
184/226 page 166
![to sanitary reform. The needs of the community eall for a more liberal-minded treatment, than is likely to be secured from officers to whom the removal of manure heaps and the protection of open wells have appealed as the main sphere of their sanitary activities ; a wider area of administration is needed, and a_ higher type of man than is to be found in the average candidate for a dispensary appointment. With this end in view, county councils should be required to appoint county medical officers of health to supervise the entire sanitary administration within each county. They should be whole-time officers and should possess the same professional qualification as is now prescribed for the office of Medical Superintendent Officer of Health. It is to be remembered that, at present, county councils in Ireland have no functions in relation to sanitary administration, and further legislation will be required to empower them to appoint and pay county medical officers of health. INCIDENCE OF TUBERCULOSIS IN IRELAND. The accompanying diagram depicts the curve of the mortality rate from all forms of tuberculosis in England, Scotland and Ireland for the period, 1864 to 1909. So fax as Ireland is concerned, the general effect is unfavourable, inasmuch as up to the year 1906 tuberculosis had actually gained ground, the rate rising from 2°4 per thousand in the year 1864 to 2°6 in 1906. In comparison with England and Scotland, Ireland, which in the past possessed the lowest death- rate from tubercular disease, now possesses the highest rate. The downward tendency, which is to be observed in the incidence of tuberculosis in England and Scot- land, has up to 1904 been replaced in Ireland by an upward tendency, and even the improvements effected during the past five or six years have only left this country upon the same level from which she started 45 years ago. In the progressive reduction of tubercular mor- tality, Ireland stands 10 years behind Scotland and 19 years behind England.. For the year 1909, the English death-rate from tuberculosis disease was 374 per cent. below the Irish rate. Scotland occupies an intermediate position. Upon the basis of these figures Ireland is called on to provide for and treat eight tubercular patients for every five that occur among an equivalent population in England. It is thus clear that in the distribution of the sanatorium grant accord- ing to the standard of population, Ireland fares badly, taking into account the greater prevalence of tuber- cular disease. If the needs of the Irish population are to be dealt; with on equitable lines, an additional grant of 84,0001. would do no more than provide for the excess incidence of tuberculosis in Lreland, quite apart from any question that might be raised as to the relative resources of the two countries. A broad comparison between England and Ireland, in point of weekly agricultural wages and of the gross income tax assessment, gross capital (for death duty purposes), and railway traffic receipts, per head of population, seems to suggest the conclusion that the average resources of the population of Ireland do not amount to more than one-half the resources of the population of England. According to the present allocation of the sana- torium grant under the National Insurance Act, Ire- land’s share will amount to 145,000/. in round figures. That sum would, at 701. a bed, represent institutional accommodation for 2,000 tuberculous patients at any given time, or a total of 8,000 individuals in a year, taking three months as the average duration of each patient’s course of treatment. The recorded deaths in Ireland from tubercular diseases amount to over 10,000 a year. Assuming that 2,000 beds are required and are provided, there will be no/surplus funds to apply towards the establishment of dispensaries or other forms of non-institutional treatment and pre- vention of tuberculosis. It will be evident from the foregoing remarks that the cireumstances of Ireland in regard to the pre- valence of tuberculosis require to be specially con- sidered, and it is to be apprehended that unless financial facilities are afforded for the adoption of exceptional measures for the treatment and prevention of tuberculosis, serious embarrassment may arise in the administration of the sanatorium benefit under the Act in Ireland owing to its financial provisions being based upon a normal incidence of tubercular disease. In particular, in order that a reasonable standard of health may be secured among young persons passing to the insurance age, much will need to be done to improve the physical conditions of children attending at national schools, and this aspect of the case is dealt with more fully in a separate memorandum. SUMMARY. ~ So far as Ireland is concerned, the following are needs of pressing importance :— (1) Legislation prescribing the universal notification of tuberculosis. (2) Legislation requiring the appointment of county medical officers of health. (3) Arrangements for the medical inspection and treatment of school children. (4) A special grant towards the expenses of Nos. (2) and (3). TUBERCULOSIS. Voluntary Work in Ireland. Work of great value and of a varied character has been carried out in the campaign against tuberculosis by voluntary effort, under the auspices of Her Excellency the Countess of Aberdeen. The following memorandum contains a record of the diverse activities of the Women’s National Health Association of Ireland, of which the Countess of Aberdeen is president:— — MEMORANDUM on the ANTI-TUBERCULOSIS WorRK of the Women’s NationaL HEALTH ASSOCIATION oF IRELAND submitted to the Members of the Departmental Committee on Tuberculosis, by the COUNTESS OF ABERDEEN, President of the W.N.H.A., by request of T. J. Starrorp, C.B., F.R.C.8.1, Medical Commissioner of the Local Government Board for Jreland. The Women’s National Health Association of Ireland was formed in 1907, with the following objects :-— J. To arouse public opinion, and especially that of the women of Ireland, to a sense of responsi- bility regarding the public health. 2. To spread the knowledge of what may be done in every home, and by every householder, to euard against disease, and to eradicate it when it appears. 3. To promote the upbringing of a healthy and vigorous race. Its formation was largely due to the impression made by the grave warnings issued in successive years by the Registrar General, the Irish Local Government Board, and the medical profession as to the distinct tendency to an increase in the already high death-rate from tuberculosis in Ireland. . In 1864, when the registered births and deaths was first started on a regular footing, Ireland had a lower derth-rate than either England or Scotland. Since that time, up to 1907, owing to active measures of re- pression being taken in the latter two countries, the death-rate steadily went down, while Ireland remained about the same, but with an upward trend. See following diagram :— Tuberculosis. * Diagram No. 3, showing the Deuticratt in Frelanea, as compared with England and Scotland, during each of the 43 years 1864-1906. [Reproduced from the 43rd Annual Report of the Registrar-General for Ireland, by permission of the Controller of His Majesty’s Stationery Office. ] at This diagram has already been published by His Majesty’s Stationery Office, and is consequently not re-printed in this volume, ‘](https://iiif.wellcomecollection.org/image/b32182041_0184.jp2/full/800%2C/0/default.jpg)
