How the Rushden Tuberculosis After-Care Committee has met the war conditions and retained its independence was described at the annual meeting on Tuesday evening, when a sound financial position was disclosed.

Mr. F. J. Sharwood, C.C., was in the chair, supported by Miss A. M. Sharwood (secretary) and Councillor W. E. Capon (treasurer).

At the commencement of the meeting the chairman said he was sorry that Dr. D. G. Greenfield, their chairman, was absent. He also regretted the absence of Dr. J. H. Crane.

They all knew of the programme of development which was taking place at the Rushden House Sanatorium. The County Council committee had received a great shock soon after war had been declared when they had wanted a loan to complete their programme by building the last block of 20 beds. The Ministry of Health had turned their application down at first, but after pressure had been applied through the County Council Public Health Committee, the loan had been obtained. There had also been more difficulty recently over the question of roofing materials for the new block.

He was pleased to be able to say that the Rushden After-Care Committee was held up as an example throughout the county by the County Council Public Health Committee.

Miss Sharwood presented the secretarial report. She said that during the past year decisions had been made affecting the committee’s future activities. After the crisis of September, 1938, the National Tuberculosis Association, of which they were affiliated members, gave a great deal of time and consideration to the position of voluntary care committees in the event of war. It had been feared that in the stress of an emergency voluntary committees might disappear or become eclipsed by the more obvious demands of war, and that voluntary help might be lost altogether.

A meeting had been held in London to discuss the problem and it was suggested that a general committee should be formed in a town comprising all social services. The Rushden committee recognised the advantages of this, but they felt that there would be a big tuberculosis problem among civilians during a war due to the lowering of the standard of living and the longer working hours. Therefore, after-care work would be needed more than in times of peace, and so it was their duty to carry on. This decision was endorsed by the National Association, and the committee was pleased to report that their activities had not been curtailed in any way.

During the past twelve months the committee had lost two of its members – the Rev. C. J. Keeler and Mr. A. Wilby. Both were members of the Finance and Executive Committees, and Mr. Keeler had been associated with them for ten years.

There were 77 reported cases of tuberculosis in the town, this being the highest number since 1934. The increase might in some measure be attributed to the fact that the disease had been discovered and notified in its earlier stages. Since February, 1939, 24 fresh cases had been notified by the Health Department of the County Council, nine patients had died, and four had been removed from the dispensary register as “recovered,” so that there had been an increase during the year of 11.

Fourteen patients had received treatment at the Rushden House Sanatorium, ten being there at the present time. Two patients had been to Creaton Sanatorium.

After the outbreak of war and the evacuation, the homes of tubercular patients were visited, and where, in one or two isolated cases, it was found that evacuees had been billeted there, arrangements were at once made for the removal of the children.

The members of the Visiting Committee had endeavoured to see all patients at least once during the year, whilst in 16 cases, where the disease was more active, monthly visits had been paid.

Where the family income was under the standard recognised by the committee, grants of dairy produce had been made, and where necessary dairy produce had been supplied to the family while the breadwinner was a patient at the Sanatorium.

The full grant of dairy produce had again been seven pints of milk, half a score of eggs, and a pound of butter per week. On an average 11 patients had been receiving the full grant each month and four had had part-grants. Approximately 661 pounds of butter, 330 score of eggs, and 600 gallons of milk had been supplied. The committee had also sanctioned the provision of home help where there was a tubercular mother, and the Health Department of the County Council had made a grant of milk to one patient.

As soon as it became known that butter was to be one of the rationed foods, application was made to the local Food Controller, but, in common with other after-care committees, they had not been successful in obtaining the necessary permit for the supply of butter. Meanwhile their patients were being supplied with good brands of margarine.

Christmas parcels were again sent to patients. Formerly Dr. Muriset had superintended the arrangements for the distribution, but this year the duties were carried out by a committee of ladies.

The committee acknowledged with thanks a gift of eggs from the Yelden Methodist Sunday School and also clothing supplied by the British Legion to ex-Service men entering the Sanatorium.

The Finance Committee was very grateful for the support received from the Rushden Query Motor Club, the Town Cricket Club, and other societies which had organised efforts or given donations.

The Christmas Seal Sale Committee was delighted to be able to report that a record sum had been raised by their effort. In Mr. Colton they had a very enterprising and energetic chairman. Splendid help was also given by Dr. Crane, the Nursing Sisters, Scouts, Toc H, the manager of the “Ritz” cinema, churches and clubs, and by members of the general committee.

The Executive Committee was again much indebted to Mrs. Hensman and Mr. Colton for their continued interest and work in connection with the Hand-craft Centre.

During the year contact with the National Association of Tuberculosis had been maintained.

In times of war the work of tuberculosis committees was more essential than in peace-time. A struggle was being waged against an enemy at home, and in this struggle everyone counted. Each one had to do his or her part to see that when the war was won their health was not shattered.

In presenting the Handcraft Centre report, Miss Sharwood said that only a few patients were now attending the Centre, and the amount of leather work which had been done was small. A dividend of 5s. was paid to each patient at Christmas, and the Centre’s finances were in a healthy position.

Before he presented the balance sheet, Councillor Capon asked the members to cast their minds back to 1931 when they held a fete at which £234 was raised. He mentioned this because of the passing of Mr. E. L. Brightwell, who, with Mr. Gardam, had been almost wholly responsible for the success of that fete. These efforts had put them on their feet financially.

The balance sheet, which the treasurer described as “healthy” showed that cash in hand amounted to over £139, this being £20 more than the previous year’s balance. The Rushden Query Motor Club had made two donations totalling £35, and the 1939 Seal Sale had brought in £107. The deposit account was £106.

Dr. D. Greenfield was elected president of the committee, and Councillor A. C. A. Colton was elected chairman, the other officers being re-elected.

Messrs. A. Thomas, G. Stokes and G. Marriott, and Miss Abrams replace Messrs. G. W. Timpson, A. Wilby and H. Whiting, and Mrs. Sargent on the General Committee. Messrs. G. Marriott and G. Stokes, and Miss Abrams replace Messrs. H. Whiting and A. Wilby, and Mrs. Sargent on the Executive Committee. Dr. D. A. McCracken and Mr. H. Whiting also becoming members of this committee. Councillor Colton, Messrs. H. Whiting, G. Marriott and G. Stokes will serve on the Finance Committee in addition to the present members, and Mrs. Tye takes the place of Mrs. Tassell on the Visiting Committee.

Thanks were accorded to the Council for the use of rooms for the committee’s meetings, and the Press was also thanked.

Family income inquiries in the homes of tuberculous people were warmly defended by County Council doctors after some sharp criticisms had been advanced during a county conference of after-care committees at Rushden on Saturday.

The conference had been called to discuss after-care problems in war-time, and Dr. Harley Williams, senior medical commissioner and secretary-general of the National Association for the Prevention of Tuberculosis, was the leading speaker, Lord Henley presiding over a large company.

Lord Henley said that Rushden people were imbued with the qualities which were the foundation for care and after-care work. One could not do very much in public health without a personal interest in the patients – in those who lived around them and in their neighbours.

Lord Henley described the late Dr. J. H. Crane, who was medical superintendent at Rushden House Sanatorium, as “one who was outstanding in these qualities.” Dr. Crane, he said, was a man – a dear old friend of many of them – who devoted his life to the welfare of the patients in the sanatorium.

He had a personal interest and affection for all those who came in contact with him; he did not regard them as cases – they were real live men and women that he was able to encourage, help and give consolation to. He was a warm-hearted, warm-blooded man – there was something very human about him, and everyone who came under his care was encouraged to get better.

The chairman suggested that after-care workers who visited people in their homes and saw their difficulties could help the public authorities in the future when they were trying to get improved housing, better food conditions, and all the improvements they were so anxious to get in order to secure an efficient and healthy population.

Having referred to the pre-eminent success of the Rushden Welfare Centre, Lord Henley spoke of the work of the County Council officers – of its extent and range. It was a tremendous encouragement to professional workers, he said, to know that the general public were getting to understand their work.

Reviewing the health services of the county, he mentioned that Mr. Frank Sharwood had had a great deal to do with initiating the improvements now nearly completed at Rushden House Sanatorium.

When these were finished they would be able to take in about 70 patients at a time. In 1939, 210 patients were treated there, and that work cost about £10,000.

A great many cases of surgical tuberculosis were treated in the county, and there were some quite marvellous cures of cripples at the Manfield Hospital, where 57 cases were treated, the county spending about £4,000on this service.

Nearly 1,600 patients made nearly 4,000 visits to the dispensaries at Northampton, Kettering and Wellingborough:

The Tuberculosis Officer paid nearly 700 visits to patients in their own houses:

There were 1,100 consultations by the County Tuberculosis Officer with medical men:

The health visitors paid more than 3,500 visits:

X-ray apparatus was now available at all the clinics; and

The County Council spent over £700 a year on extra nourishment and assistance for recommended patients.

It was a very complete service of which they should be proud. The outlook of the care committee should be a very wide one, and it was hoped that in future they would be helpful in every branch of public life. At Rushden very good work had been done.

Dr. Harley Williams said he was last in Rushden about eight years ago and since then he had always associated Dr. Crane with some of the best inspirations in the tuberculosis movement. Dr. Crane was not only a good doctor and a good man, but a man of intense humour, and he managed to lighten the burden of many people by that quality of humour.

People did not think about consumption in the ordinary way, said Dr. Williams; they hoped it would never come to them, and they were rather inclined to let it alone. In fact, it was not entirely different from their attitude a year or two ago towards war. They hoped devoutly it would not come to them, and sometimes they were inclined not to see things which might have been seen; yet when it came to them they accepted it with a courage and knowledge greater than any other nation, he thought, was capable of doing.

The war was teaching us certain things about our social life; it was teaching us that some things were not right in England, and we looked forward to the time when we should be able to go ahead with some of our social work after the war.

In this country, said Dr. Williams, they had had for many years what he had always thought was the ideal method of dealing with the social side of tuberculosis. They had a committee of the County Council to supervise the work generally, and there were care committees about the county which knew the patients and knew their needs and the ways in which some of those needs could be met. Where there was a strong local committee the work would be left to them, and people who knew the tuberculous family would sometimes be able to do more than people living at a distance.

Tuberculosis had got to be tackled from a great variety of points of view. There were some constructive things which did not involve merely giving money into a household for milk and eggs and so forth. There were sometimes other things they could do to set a whole family on its feet, and he hoped they would give particular care to such cases.

Sometimes they could help a family best by not spending their money on the sick person, but by spending it on some other member of the family who was perfectly well, to put him into a better position to earn. This was work that a local committee could do and that an official body could not do.

Tuberculosis was fortunately not a painful disease, but it lasted a long time and people got very tired and fed up, and their spirits might be depressed. When a tuberculous person lost his hope and courage and his way of looking at life in a positive fashion, then he began to go downhill, and all the operations and treatment would be a disappointment unless they helped on his will to recovery. If this was done merely in a routine fashion, then it was something they might just as well leave undone.

Dr. Williams said his own association were trying to foresee what would happen as a result of the war. They hoped there would not be a great rise in the disease, but they did not know.

Speaking of the great importance of early detection, Dr. Williams said that in America, Germany, France and other countries they had developed an idea of examining large numbers of people between 15 and 30, which were the worst times of life for the disease, and in every group they found perhaps one in 100, or more, who had active tuberculosis without noticing it. That was the stage at which people could be treated with a much greater prospect of success and with a shorter course of treatment.

This was one of the things he would like to see arise in Britain after the war. They had not been able to get the Ministry of Labour to do it among recruits, and that was a great opportunity missed.

On this “vexed question” of free and cheap milk Dr. Williams pleaded; “Tuberculosis people are not so many in the country. Their economic position is not good. They could easily be put in.”

Dr. Williams also spoke about the Christmas Seal Campaign, urging committees to take up the idea. The seal, he said, told people that there was such a thing going on against it.

Replying to Mr. F.J. Sharwood, C.C., Dr. Harley Williams said the medical examination of all industrial workers was a thing which was coming – he was sure of that.

He did not see why in time everyone should not be examined with tuberculosis in view. Children were examined in school, but he did not think the older children were examined enough, and he hoped the time was coming when large numbers of children were going to be examined with X-rays at the time they were about to leave school.

Dr. C. M. Smith, County Medical Officer, said that all recruits to the Australian Expeditionary Force were examined by a new method. Money and time were saved by taking X-ray pictures on a cinematograph film and projecting them on a screen, hundreds of cases being recorded on one film.

Nine thousand men examined by this method had all previously been examined by a medical board and passed as fit in Class I. It was found, however, that one in every 200 was suffering from active signs of pulmonary tuberculosis. The saving which accrued from the detection of those cases far outweighed the initial cost. They had good prospects of initial cures, and they had removed the danger of infection for others.

“I hope,” said Dr. Smith, “that the National Association will shame the Minister of Labour into adopting these new methods for the examination of recruits.

We have had young soldiers in the sanatorium who have been passed for service and have broken down in a comparatively short time.

“It is nobody’s fault. However skilful the doctor may be, he cannot guarantee to detect the presence of tuberculosis by ordinary clinical examination.”

Dr. Smith said he hoped the conference would also deplore the fact that the Minister of Food had had no regard at all for the health aspects of the new milk scheme, in that there was no selection of milk as regards safety. Medical officers had for years been preaching the gospel of safe milk, but now, to a large extent, their good work was being placed in jeopardy.

Forty per cent of the cows in this country reacted to the tuberculin test, and the number of people who died every year in this country as the result of tuberculosis attributable to the bovine tubercle in milk was 2,000 – out of full tubercle death total of 40,000.

Dr. Smith said he was hoping that they could do something even yet to advice people that children should never be given milk unless it was tuberculin tested, pasteurised or boiled.

Mr. J. Bettles (Kettering) said his experience as a visitor was that when an application was made to the County Council “they absolutely put the family on the means test before you get anything.” This was wrong entirely. They were not considering the family at all; it was their work to consider the one who was suffering from tuberculosis. Instead of making it a means test for the family they should make it a test only for the one who was ill.

Dr. Harley Williams said he was afraid they could not escape the fact of public assistance whether they liked it or not, though personally he deplored it very much.

Mr. F. E. Ball (Wellingborough) said there were cases when the family did everything they could to help the man, and he did not think they should be asked to do more. It was not a question of how much they had got coming in, but of how little.

“We find,” added Mr. Ball, “that whatever we do, the family will supplement it right up to the hilt. I could give you many cases where the hardship is hellish. It saps the vitality of the mother; if plays the deuce with the father, and so the home is wrecked. When they can’t get help unless the whole of their income is exposed, the family is brought down to the very dregs.”

Dr. G. B. Lord, County Tuberculosis Officer, said it was a fundamental thing in tuberculosis that the whole family must be dealt with as a unit.

“I vehemently deny,” he continued, “that this is a means test in anyway whatever. In a few instances we do write friendly letters with the form asking them to return it to us, but in the great majority of cases I do it myself, or ask visitors to do it for me. I get the information from the patient in a friendly way. I am quite convinced that there is no harshness in the collection of these details from these patients.

“If voluntary care committees wish to apply for relief to a particular patient without reference to the circumstances of the rest of the household, they are entitled to do so.”

Lord Henley said he had never yet known a case in which the committee seemed hard.

Dr. Smith said that there was a world of difference between the rigorous and harsh inquiry which savoured of bumbledom and a sympathetic inquiry as made by Dr. Lord and his health visitors. Dr. Lord was not an administrative officer, and his main interest was in his patients.

He had been Tuberculosis Officer in the county for ten years, and in that time he had never had one complaint from his patients that they resented filling in the form.

“I have been here three years,” added Dr. Smith, “and in that time I have never had a complaint.”

Miss E. Capron, C.C., said she agreed about the importance of having tuberculin tested milk, but the trouble was the expense. If they were going to have it on a large scale then perhaps the Ministry of Health might bring pressure to bear upon the Ministry of Agriculture to assist farmers more than they did.

Dr. Harley Williams said he hoped they were getting towards the day when all cows would be subjected to the test. Admittedly it was expensive, but the Milk Marketing Board, he believed, had given 2d a gallon.

Miss Capon: When you have got it, yes!

Two resolutions were passed. The first, moved by Mr. F.E. Ball, advocated the special examination of all recruits for tuberculosis and of blocks of the public up to the age of 30. The other, moved by Mrs. Martin, Kettering, and seconded by Ald. H. Martin, Kettering, favoured the extension of the free and cheap milk scheme to the tuberculous.

Dr. Harley Williams was thanked by Coun. A. C .A. Colton (Higham Ferrers) and Mr. Sharwood, who is chairman of the Rushden House Sanatorium Committee, Coun. W. E. Capon (Rushden), treasurer of the Rushden After-Care Committee, thanked Lord Henley for presiding.

Counc. and Mrs. Capon afterwards entertained the delegates to tea at the Waverley Hotel and were warmly thanked by several speakers. The visitors went on to the Rushden House Sanatorium and inspected the various departments.

The local arrangements were made by Miss A. M. Sharwood, secretary of the Rushden Tuberculosis After-Care Committee.