Tuberculosis.

Press, Volume LVIII, Issue 17470, 2 June 1922, Page 6

Tuberculosis.

After an interval of four weeks. Dr. Valiutine, the Director-General of Health, has submitted what he describes as "the Department's reply" to Dr. Blackmore's strictures on its "laissez faire" attitude in connexion with the campaign against tuberculosis, as Bet forth in a letter to "The Press" on May 4th. Most people, we imagine, will agreo that Dr Valintinc"s statements would- have carried more conviction if they had been less combative; flat contradictions and accusations of untruthfulness are not necessarily "re- " plies" to charges, and are certainly not so in the present case, and Dr. Blackmore's remarks in the interview which he gave to our representative, printed in this issue, effectually dispose, by force of reasoning, of all the more serious allegations made by his opponent in this controversy. Despite what Dr. Valintine says, the Government subsidy for the Fresh Air Home for children lias not yet been paid over, and the Board is stiii pressing for it. The accuracy or otherwise of his further assertion that "the erection of the "home is not a matter of urgency," depends upon the view one takes as to the importance of taking the disease in hand perhaps before it has actually manifested itself. If prevention is better than cure, if it is better to fence off the top of a precipice than to provide a stretcher at the bottom, in case of accidents, then a home designed for the purpose of enabling children to live under special conditions unfavourable to the development of the disease must, one would think, be one of the most urgently needed works that can be imagined. Dr. Valintine's attempted disproof of Dr. Blackmore's statement, that generally no real progress has been made in the Dominion's campaign against tuberculosis in the past twelve years, is extremely unconvincing. He blames the war for the fact that, comparatively speaking, so few of the recommendations of the conference on tuberculosis held in Wellington eleven years ago have been carried into effect. Yet the war occupied only five of those yearn: something

more, surely, should have been done in the three years before it broke out and the difficulties of the peace hare offered no insurmountable obstacle to the prosecution of the campaign, if only the needed inspiring force had been in existence Dr. Valintine points out that there was accommodation in the two North Island sanatoria for 97 patients in 1914, whereas now 215 can be accommodated, but he omits to mention that the institution at Pukeora was erected by the Defence Department for military cases and were it not that it is larger than was required for soldiers, there would have been little room for civilians. As for his boast that "so far "we have been able to deal promptly " with all the demands for admission "which come from the hospital districts of the North Island," that is effectively answered by the fact that within the last fortnight Dr. Blackmore received an application for admission to the Cashmere sanatorium of a patient from the North Island who had been told that the Pukeora institution could not receive him for two months. That hardly comes up to any accepted understanding of what is meant by "prompt " admission.'' nor does it go far to warrant Dr. Valintine's rather remarkable attitude, denned in his remark that "the present state of tuberculosis in "the Dominion. . . . does not demand '' any more to-day than since the de- " cline in tuberculosis started, drastic ' ; and necessarily expensive measures "for combating tuberculosis." It is almost inconceivable that the DirectorGeneral of Health should adopt such a complaisant attitude in regard to a disease which Dr. Blackmore tells us kills between 700 and 800 people every year in the Dominion, and lowers the health and vigour of a great many more. To combat such a disease, a strong national policy is urgently required, and to pretend, as Dr. Valintine does, that Dr. Blackmore's appeal that such a policy should be drawn up and carried out suggested that the measures taken by the North Canterbury Board against tuberculosis were ineffectual, is ridiculously untenable. Dr. Valintine, as he admits, knows better. "What is really needed is that other Boards, and above all the Public Health Department, shall be filled with the zeal with which the antituberculosis campaign has been waged by Dr. Blackmore, supported by the North Canterbury Board. In conclusion, we must express our disapproval of Dr. Valintine's controversial methods. The tone of his letter to us was far from becoming, and it will not help the public to respect the Health Department to know that the Director-General of Health relies upon mere strength of assertion and flat unjustified contradiction in defending his Department. At Timaru he went even further, and made a serious charge against the medical profession. Editors and critics he regards as iiars, and private practitioners, apparently, as sordid criminals. Some doctors, he said, keep their patients from going to institutions for proper treatment, and do so in order tp get the last penny out of them. We do not believe this, and we are not surprised that the local branch of the British Medical Association has passed a resolution rebuking the DirectorGeneral of Health.