The facts as to Pulmonary Tuberculosis are even more significant:
In the year 1911
in England and Wales 34% of male 22% of female
and in London 59% of male and 48% of female
deaths from pulmonary tuberculosis occurred in public institutions; and as each of these patients spent on an average several months in hospital, at the most infectious stage of their illness, a material annual reduction in the possibility of massive infection of relatives and others has been secured.
Hospitals Important Housing Auxiliaries
This institutional treatment of the sick has been one of the chief influences counteracting the pernicious effects of industrialism and urbanization. It has relieved housing difficulties at a time when insufficient bedroom accommodation is most injurious; and it has secured year by year for a steadily increasing proportion of the total population the improvements of modern surgery and medicine as practised in institutions, which permit of the poor thus treated receiving more satisfactory and more hopeful treatment than is obtainable for a large proportion of other classes of society.
My address is already too long. Other opportunities will be taken of explaining the rapidly increasing part which the State and Public Health Authorities are taking in the hygiene and care of motherhood and childhood and of school children; in the provision of additional nursing services for the sick, in the rapid growth in numbers of public health nurses, health visitors, school nurses, etc.; in special schemes for the treatment of tuberculosis and of venereal diseases; and the circumstances under which the Central Government are to a rapidly increasing extent paying half (or in certain instances three-fourths) of approved local expenditure on the provision of hygienic, nursing and medical services; and I do not therefore dwell on these points further.
Nor need I comment here on the remarkable fact that the British Government under present circumstances have departed from the economic position that houses built by local authorities must be able to be let at a rental covering all outgoings.
In Lecture II I shall deal with problems of local and central government, and with the training and appointment of medical officers of health; but the present review, if it omitted from consideration on the one hand the value of specially trained whole-time health officers, and on the other hand the health significance of the general advance in the standard of medical treatment, as factors of prime importance in securing the already achieved improvement in human life and health, would give a most imperfect picture of the actual facts.