Tuberculosis (Diagnosis and Treatment)

Oral Answers to Questions — Public Health – in the House of Commons on 8th October 1942.

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Photo of Mr James Griffiths Mr James Griffiths , Llanelly

asked the Minister of Health whether he is in a position to make any further statement on tuberculosis?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

Yes, Sir. As the answer is rather long, I will, with permission, make a statement at the end of Questions.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

Has the Minister taken joint action with the Minister of Food, with a view to decreasing the incidence of non-pulmonary tuberculosis of bovine origin?

Later——

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I am grateful that the committee which was appointed by the Medical Research Council at my request, has completed its report, which was published to-day. I have kept in touch with the committee and have already taken action on a number of points which are included in their recommendations. To facilitate early diagnosis we obtained priority for the supply of some 30 sets of equipment for mass radiography. We are allocating them to large centres of population where they can be used to the best advantage. In consultation with local authorities and with the assistance of an expert committee we have arranged for the training of the necessary expert staff for the operation of this equipment. Deliveries of the equipment will be gradual and arrangements for operation in the individual districts and for cooperation between authorities must be worked out in detail but I expect that an effective start will be made in the New Year.

The extended arrangements for diagnosis will mean some increase in the need for accommodation. Additional beds are being allocated to meet this need and action is being taken to meet the needs for nursing and domestic staff. Domestic and nursing work in hospitals, including sanatoria, is regarded as war service for which suitable women of any age group may volunteer and to which they may be allocated by the Ministry of Labour and National Service and I have been in consultation with my colleague with a view to special attention to districts where the working of sanatoria is being hampered by a lack of the necessary staff. Immediate needs in regard to trained nurses can only be met by a better distribution of the trained nurses available. Detailed plans to facilitate such a distribution and, in particular, to secure the most effective use of nurses who are completing their training, members of the Civil Nursing Reserve, and nurses who can be temporarily spared without prejudice to the current efficiency of the hospital to which they are attached, will be worked out by my regional officers in consultation with representatives of the hospitals and of the nurses.

Where facilities for diagnosis and treatment are available it is important that those who give up work temporarily for treatment, which is in the interest of the public health no less than their own, should be able to do so without financial anxiety as to the maintenance of their dependants. Local authorities are accordingly being authorised to grant financial assistance in such cases to provide for the maintenance of the dependants and to avoid the break up of the home while the breadwinner is undergoing treatment. This assistance will be administered by the public health authorities as a part of the approved treatment under the tuberculosis scheme, and the cost incurred by them in accordance with detailed arrangements which I am now working out with their representatives will be repaid from Exchequer funds.

The Secretary of State for Scotland authorises me to say that he is making similar arrangements in Scotland.

Photo of Mr James Griffiths Mr James Griffiths , Llanelly

May I thank the Minister for his reply and ask whether he is satisfied that he will be able to secure the necessary number of nurses to provide the service that he has outlined, and, in regard to the payment of dependants, since the payment will come out of the Exchequer, will it be by scale determined nationally?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

The flat scale will, but the plan is a flat rate for maintenance and extra grants for standing charges, such as educational costs and rents and things of that kind. I am now discussing the details with representatives of the Association of Municipal Corporations, the County Councils Association and the London County Council, and after I have completed the discussion perhaps my hon. Friend will put down another Question. As regards the first Supplementary Question, we are drawing up in the light of local knowledge of my regional staffs a priority list of the hospitals in which the need for nurses is urgent. It will include a large proportion of the sanitoria, and we shall then ask the various training schools to provide a quota of the nurses coming out of training for allocation to these hospitals. We shall also review the Civil Nursing Reserve and nursing staffs in hospitals for current needs with a view-to allocating them and attaining the end we all want.

Photo of Mr George Griffiths Mr George Griffiths , Hemsworth

Will there be any means test for this maintenance while a man is in a sanatorium?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I shall be prepared to make a full statement when details are worked out. I will make it clear that it is to be done not on that basis at all but as part of the public health service.

Photo of Dr Edith Summerskill Dr Edith Summerskill , Fulham West

What is the right hon. Gentleman doing to reduce the incidence of non-pulmonary tuberculosis which can be traced to infected milk?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

We are in touch with other Ministries concerned on this matter.

Photo of Mr Evelyn Walkden Mr Evelyn Walkden , Doncaster

Are you going to take a stand on the question of the pasteurisation of milk?

Photo of Mr George Buchanan Mr George Buchanan , Glasgow Gorbals

Seeing that the Minister of Health said that he was authorised to speak for the Secretary of State for Scotland, may I ask the right hon. Gentleman, in view of the very large increase of tuberculosis in Scotland, which is higher proportionately than it is in England, whether he is taking any additional steps to those that have been announced; and is he consulting with local authorities and other people, and, if so, who are the people apart from the local authorities he is consulting?

Photo of Mr Thomas Johnston Mr Thomas Johnston , Stirlingshire and Clackmannanshire Western

I am consulting in the meantime with local authorities, and I shall be prepared to consult with any other people who can give us advice and assistance in combating this disease.

Photo of Captain Sir George Elliston Captain Sir George Elliston , Blackburn

May I congratulate the right hon. Gentleman the Minister of Health upon his announcement and upon the establishment of the necessary radiologist service, which will prove of great advantage, and ask him whether these mass radiography sets will be available for selected counties and county boroughs where the medical officer of health has submitted an approved scheme?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

We shall work in cooperation with the authorities. As my hon. and gallant Friend knows, the sets are transportable but are best kept at places where they can be used for a period.

Photo of Mr Frederick Bellenger Mr Frederick Bellenger , Bassetlaw

Will these facilities both for treatment and for maintenance of dependants apply to that large number of men who will be discharged from the Services as a result of this disease?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

They will apply to all who are concerned with common tuberculosis and the work done in connection with the arrangements at local sanatoria.

Photo of Mr Frederick Bellenger Mr Frederick Bellenger , Bassetlaw

Will these facilities apply to discharged Service men and their dependants?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

We have a number of discharged Service men in the sanatoria.

Photo of Sir Francis Fremantle Sir Francis Fremantle , St Albans

Will my right hon. Friend be in touch with the Ministries of the Fighting Services so that they may use these facilities to prevent tuberculous men from getting into the Services and then having to be invalided out later on?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

As my hon. Friend knows, the initiative in the use of mass radiology was taken by the Services.

Photo of Mr Evelyn Walkden Mr Evelyn Walkden , Doncaster

Will the Minister make a statement at a later date on the reconstruction of those very important organisations, the after-care committees, because they not only need encourage- ment but the whole scheme itself requires overhauling and much help from his Department?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

We have that under consideration.

Photo of Mr David Adams Mr David Adams , Consett

Has it been decided to pasteurise all milk, thus preventing the conveyance of milk-borne disease to the population?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

I would refer my hon. Friend to the numerous answers I have given in the last year on that issue.

Photo of Mr Wilfrid Burke Mr Wilfrid Burke , Burnley

Will men discharged from the Army who are tuberculous come under the scheme?

Photo of Mr Ernest Brown Mr Ernest Brown , Leith

They will come under the general arrangements of the scheme.

Mr. De la Bère:

What has been done about the shortage of nurses?

Photo of Mr George Buchanan Mr George Buchanan , Glasgow Gorbals

In view of the fact of the terrible increase of tuberculosis in Scotland and that the right hon. Gentleman does not quite cover the Scottish issue, would the Secretary of State for Scotland at an early stage give an account of the actual work in reference to Scotland, particularly with regard to the training and utilisation of our nursing staffs?

Photo of Mr Thomas Johnston Mr Thomas Johnston , Stirlingshire and Clackmannanshire Western

It would be far better to make a statement after I have consulted with the local authorities and health authorities on the subject.

Photo of Mr Andrew MacLaren Mr Andrew MacLaren , Stoke-on-Trent Burslem

May I ask whether it is not present in the mind of the Minister of Health that all of this expense could more or less become abortive under the present housing conditions obtaining in this country and that something must immediately be done to remove the horrible conditions owing to bad housing, as no houses have been provided since the war?