The Chest Department under review consists of Rushden House Sanatorium and associated Clinics, and serves a population of about 250,000, representing the greater part of the County of Northampton.

This area comprises the whole of the population served by the Kettering Hospital Management Committee, and a section of the population served by the Northampton Hospital Management Committee.  That part of the area under the administration of the Northampton Hospital Management Committee was, however, handed over to the Creaton Chest Service at the end of the year.

The headquarters are at Rushden House Sanatorium which has 71 beds for the treatment of tuberculous and non-tuberculous chest patients, and which also serves as the base for the administration of the Clinic services.

Clinics are established as follows :
St Mary’s Hospital, Kettering
Rock Street, Wellingborough
Rushden House Sanatorium
Nuffield Diagnostic Centre, Corby
11, St Matthew’s Parade, Northampton.  (Transferred to Creaton Chest Service on 31.12.61).


Kettering Chest Clinic

In the Annual Report for 1960, Dr Lord drew attention to the unsatisfactory premises and obsolete X‑ray equipment at the Kettering Chest Clinic.  I am pleased to report that in August, 1961, this Clinic was transferred to the X‑ray Department at St Mary’s Hospital, Kettering.  These premises are somewhat cramped, but the arrangement is working very satisfactorily, and it is of course an enormous advance to have the exclusive use of an up-to-date X‑ray department for the Chest Clinic sessions.  This arrangement is for an interim period only, as the Chest Clinic will eventually be transferred to the new out-patient department that is being planned at Kettering General Hospital.


Medical Staff

The authorised establishment is as follows :

On 30th November, 1961, Dr G.B. Lord, Consultant Chest Physician in charge of the department, retired, after 31 years continuous service in tuberculosis and diseases of the chest in Northamptonshire.  During this long period there have, of course, been vast changes both in the pattern of chest diseases and in the structure of the Health Service which have called for an extensive re‑organisation of the chest services.  In Northamptonshire Dr Lord has been the chief architect of this successful reorganisation and his name will long be remembered with affection and respect in the County.

Reference is made later in this report to the proposed reorganisation of the department following Dr Lord’s retirement, and to the interim arrangements made to carry on the service pending the appointment of Dr Lord’s successor.


Rushden House Sanatorium

During 1961 there were 248 admissions into the chest section, of which 81 were tuberculous and 167 cases were non-tuberculous.  In 1960 the total admissions were 274 so there have been 26 fewer admissions this year due to a drop of 37 in tuberculous admissions, non-tuberculous admissions having risen by 11.  The proportion of non-tuberculous to tuberculous admissions is the highest ever, two-thirds of the cases now being non-tuberculous.  The quicker turnover of non-tuberculous patients and the more elaborate investigation and treatment that these patients require, entails more intensive medical and nursing care than in the days when the Sanatorium treated tuberculosis only.

The changed pattern of work is illustrated by comparing last year’s admissions with those of 10 years ago.  Although we then had nine more beds than now, admissions have almost doubled, and there has been a fourteenfold increase in non-tuberculous admissions.


Admissions

A much more significant pattern of Sanatorium mortality figures is obtained by comparing deaths in 1961 with those in the Sanatorium in 1949, the last full year before chemotherapy was widely used in tuberculosis.

In 1961 the average age of the 5 patients dying from Pulmonary Tuberculosis was 65.

In 1949 the average age of the 23 patients dying from Pulmonary Tuberculosis was 33.

Another significant difference is that no female patient died from Pulmonary Tuberculosis in 1961.  In 1949 there were 12 female deaths and 11 males.  In fact there have been no female deaths from Pulmonary Tuberculosis in the Sanatorium for the past two years.


Minor Operations

These proposals were discussed at a meeting held at the Regional Board’s offices on 30th October 1961, when the following were present:-

Dr Fisher, who at present holds a Consultant post on the establishment, but who is graded as an S.H.M.O., will be an applicant for the post.  No firm recommendations can be made on the future establishment in the Kettering area until the new Consultant is appointed.

These proposals have been approved by the Regional Establishment Committee at their meeting on 17.11.61, but have not yet been implemented.


Interim Arrangements for carrying on the Service since Dr Lord’s retirement

Since Dr Lord left on 17.11.61, Dr Fisher and Dr Gerrard have maintained the service at Rushden House Sanatorium, and associated Chest clinics in conformity with the recommendations of the area Department as follows:-

Since Dr Lord’s retirement, these arrangements have been well tested, as during the past three months the turnover of both in‑patients and outpatients has been exceptionally heavy.  Moreover, we have had to cope with the Mass Radiography Survey at Wellingborough (9,497 examinations).

These arrangements have now been working smoothly for 5 months, during the season when Chest Clinics and hospitals are busiest.  I submit that they provide a satisfactory solution for a permanent reorganisation of the Rushden Chest Service.


O.E. Fisher