TUBERCULOSIS.

Press, Volume LVIII, Issue 17469, 1 June 1922, Page 7

TUBERCULOSIS.

I DEPARTMENT IN DEFENCE. n ■',' i, , = .,..' i,, Oiaki lor i'mi-i;. l>atiBiuiuM. ""'I f«'"'-"ll> , B ntr.rmni near Cain.two patu-nt,. we ha.-e j jumi sanatoria in the | (,'reat improvements td out at the Otaki \ rc-fcntlv a resident | is ni'P oi,it <\ ou 'V lp to I tof lee i'nke-iru Sana | U-cn possible to c!o«e costly institution near :h by "the way was not e Department, as Dr. t 17') beds for maio ora and 40 beds for te- ; Otaki. a total of 21-5 th i>'2 for males at T'e J at Otaki. a total of id, though Dr. Blackquibble that most ot ikeom are for soldier are at least 70" beds liable for civilians, and been ar)le to deal 11 the demands for ad jmo from the hospital North Island. Th« have :r. the North lsdoublq the amount of that, we had in 1914. I am not including tho ;ell«it accommodation . patients by the A-cfc-Hawke s Bay, PalmerWellington Hospital from this accommodu th Island, the Nelson, and Southland Boards Island have provided idation. in connexion itaia for the treatment iring from tuberculosis lore's gUtement: "That mte national policy, no hersal scheme for dealulosis in New Zealand, measure* «& «r* being «d out in a piecemeal iy inefficient fashion."' . Dr. Diackmore knows al policy tb to the Hosin "Tuberculosis in Now [ethods Adopted lor its feitioß" was, as stated, held in fcgtoa «!tren yean back. At that pot much thkt saon.d be efft-ct-I tta future was given voice. Dr. iwm is one of those short-mem-•ftople who forget that tic great rudtfet peace— vhioh ii not yet—- * ictwMv occupied most of tho «W01&* amm*, and have »eaud mar. tea many, beneficial I that the pre- \ th rate trom j een maintain-1 the incidence j by war activity from tuber--1 reached its thero was tho 121 the'deaihi 0.65 per 1000 he second best own country, hat should, be ?d. I entirely has been negne in the past re Dr. Blackon, and much losis is a conveil intentionthe Hospital the establishof an exteaium building. in this Dome to-day than ulosis started, pensive measead of other > of hospital tives per head spite the fact ulosis in New mo countries, conveniently »re. New ZeaZealand are and that 'no th Island has ir tuberculous have pravidre two sanaro&s mis-state-

Auckland ig Wellington '"' 44 '>"»?}« ..I 10 W aikato t 26 £ew Plymouth .'.'* 6 Palmerston X. ~, g Thames " a Waihi ;;; J Total 124 ,la^oft»?- USed£orthafoUowiß ß (a) Those in the advanced stages of the disease. & <b> Those requiring observation with ■i view to determining their suitability ior sanatorium treatment or otherwise. 'M L-ases waiting for admission to a sanatorium. Dr. Blackmore's statement:—"Some years ago the Auckland Hospital Board «as very keen on providing a sanatorium of its own, and it proposed to spend ijuite a large sum in building an up-to-date, institution. Discussion took place t«r some time, then the matter dropped Perhaps the Auckland people will say whether they voluntarily abandoned their project, or whether thev did so t-ecauso the Health Department wished the sanatorium to be built on an absolutely unsuitable site, at an utterly impossible- cost- that is, at a cost which could not provide a proper institution. ' 1 absolutely deny that the Auckland Hospital Board has at any time brought forward a definite propcs.il to er:ct a panati.riunt in the Auckland dirtrict. The matter iuis been discussed by departmental office i\s with the of the lizard, and a site has been procured in the neighbourhood of Auckland for further hospital activities. But if I w:\s asked to encourage the erection of a sanatorium in the neighboinv.ood ol' j Auckland, or for that matter in the j Auckland province, 1 would not do so, j the climate, in the opinion of depart- \ mental officer"), net being suitable, and j in that opinion I believe 1 would have the support of the majority of the Auckland members of the profession, and also of Dr. Blackmore himself. Dr. Biackiuoro's.stateuient :". . . the Tiniaru and A'hburton Boards decided to build a sanatorium. They bought a site at l'"airiie. About a year ago they .sold that site in disgust, because, although in season and out of sea on they had pressed their claim for accommodation for their consumptive.*, the Government, acting on the advice of tho Health Department, bad consistently refused permission for the-sanatorium to be erected. Timc.ru people are still asking for their sanatorium." 1 admit that I discouraged tho idea, and am glad I did so. In my opinion it would have been absurd to have tub sanatoria within about 120 mile-: of each other, and in practically the smite cvimate. Dr. Blackmore knows very well that I tried to get South Canterbury and Ashburton to join with North Canterbury in the extension and maintenance of tihe institution on the Cashmere Hilh. I had hopes, and still hope, that this scheme may be brought about.. It may be said here that for years past departmental officers have been very anxious to establish a sanatorium in Central Otago. the climate being considered particularly suitable for the treatment of consumptives. A site was selected near Waipiata, and a year ago certain boards were circularised as to the proposal, but only a few Boards agreed to contribute their quota towards the erection and upkeep of such ah institution. It is to be hoped that tho forthcoming meeting at Timaru will bring about the fruition of a scheme that has been in the minds of those who have long had the scheme at heart. . There is, however, a most disquieting aspect revealed by Dr. Blackmore's contentions. Jfiveryono can see on page 102 of the 1921-22 Year Book, a chart in the form an Xon its side, the falling line since 1875 represents the decline in tuberculosis; the rising line, the increase in deaths from cancer. In 1875 there were approximately 16 deaths per 10,000 of mean population; in Wil there were 6.5 deathß per j 10,000. Notwithstanding this, the North Canterbury Hospital Board, basing its views on tho generally acknowledged unreliable figures of notifications, refers to the undoubted increase in tne number of tuberculosis cases. .My Department has always been ready to admit, and has held up to praise and for examplo to other Boards, the very extensive, indeed almost complete, measures that Board has provided—in sanatorium and hospital equipment, in its tuberculosis dispensary, and its specialists and nurses—for the prevention, combating, and treatment of tuberculosis. Now, if despite all these measures thero is, as apparently Dr. Blackmore wishes to emphasise, no improvement in the tuberculosis state in that area, the queßtiou before me and my officers must be; "Are all these meusures of little or no avail 't Must wo not search for some alternative and better means for coping with this scourge r"' Laymen are not all fools. Hospital Boards in general are more anxious than Dr. Blackmore gives them credit for to do what they can to curtail tuberculosis. It is not sufficient to pool all our * thoughts and movements on the opinion of just one professional man. .Before the public and Hospital Board will agree to a costly outlay, I must satisfy thorn that more than a scintilla of satisfactory results is obtainable for their afflicted patients, and for the control of the disease. Ot what use asking other districts to do Canterbury has done if the incidence of the disease in their less fully, equipped districts at present is no greuter than in Canterbury with its plentitude. Dr. Blackmore's pronouncement, if it was in accordance with facts, and coming from that very place where the anti-tuberculosis programme is most complete and welladministered, would make the Department's hopes for progress still less rea.itmble. Anyhow it must 6et ail hospital boards and medical men athinkNeither myself, nor my officers, intend to be misled by w. Blackmore's ill-founded judgment. The proof that the measures so far taKen have had the desired effect is in the statistical figures I have quoted. To remove the uneasy feeling created, ur. Blackmore would be more helpful to other boards and the Department if he will give definite facts and figures showing that the full measures in North Canterbury have had a beneficial result. If ho cannot do so then for the sake of the sufferers let him hold his peace. Unless they are by way of merely abusing his professional colleagues of the Health Department, it is difficult to understand Dr. Blackmore's strictures in view of: (1) The proved declining death rate from tuberculosis in New. Zealand. (3) The exceptionally low death fat* from this disease in New Zealand in comparison with other countries. (3) The fact that tne campaign against tuberculosis xa by no means discontinued. . In conclusion may 1 say that in my twenty-one years of acquaintance with activities in the prevention of disease in this Dominion, I have never known any good" results arise from an owstatement of the case . .Dr Blackmore's weeping generalisations and insufficient particulars are jurt the kuid of propaganda which retard rather than 9 help on the good cause he and XTbSA and the have 80 much Director-General of Health. •nfr>Hington. May 26th.