TUBERCULOSIS.

Press, Volume LVIII, Issue 17470, 2 June 1922, Page 10

TUBERCULOSIS.

DR. BLACKMORE'S REPLY TO DR. VALINTINE. WHEBE IS THE NATIONAL POLICY ? Dr. G. J. Blackmore, Medical Director of Tuberculosis Institutions under tin; North Canterbury Hospital Board, made the following statement yesterday to representative of "The Press'' in reply to th<; letter (published in yesterday's issue) in which Dr. T. H. A. Valintino, Director-General of Health, :;.i-.'.r,-ecl Dr. Blackmore's reply to the rejoinder made bv Dr. V'alintine to Dr. lilaekmore's strictures, in his annual report to the Board, regarding the ab--.•iK-e of a national programme for the •.rvatrr.e.'it of tuberculosis. Children's Fresh Air Homes. i>;. Blackmore said that Dr. Valintir.e ■ "--'/' iii his reply to his criticism by saying that his statement was not true ii.-'t promises made to the public eight .wars ago with regard to the erection .1 tiie Fresh Air Home for Children had iioi I.*-cri hi.'tilled, although the prevention oi tuberculosis in children is a matter of absolutely supremo importance. '"Tiie only meaning to be attached to this statement," I>r. Blackmore said, ''is that the promises have been ful-lille-'l, that the Home has been erected, and that the prevention of tuberculosis in children is not a matter of supreme importance. When I read Dr. Valintine's statement I wondered whether my failing eyesight had deceived me in regard to the building; but I have gone carefully over the site and cannot find any trace of a building. I can only conclude that it was built and somehow became mislaid while I was away for a short holiday. Dr. Valintine's implied denial of the importance of preventing tuberculosis in children is one which fits ir. very well with the statement, which he makes later on in his letter, ■with regard to the sufficiency of present measures. The subsidy for the Homo was promised by the Government pome time after the war ceased, and measures were taken by the Board to prepare plans according to the original suggestions as to the kind of Home needed It was found that this could not bo carried out owing to the increased cost of building, and by the time plans had been produced, which would enable the building to be put up for something like the amount available, the Government subsidy wns refused. Dr. AVylie personally told the members of the Board, in my presence, two or three months ago that he was sorry the Government would not bo able to pay the subsidy this year. Nothing was said either by Dr. "Wylie, or the members, about the Board having suggested, as said by Dr. Valintine, that it would be wiser to put off the building for at least a year, as it was not a matter of urgency. Further, at the next meeting of the Board several members protested against the subsidy« being withheld, and at the last meeting the Board passed a motion asking the Minister of Health to grant the subsidy as a matter of urgency *, and agreed that if the request was declined, a deputation should wait on the Prime Minister, when he was in Christchurch, and ask that the money be paid to the Board.

Campaign Against Consumption. "Again according to Dr. Valintine my statement is not true that in the past twelve years no real progress has been made in the campaign againßt consumption in New Zealand generally; and he proceeds to show the untruth of the statement by explaining that the accommodation at Otaki has been increased from thirty to forty beds, and that the Pukeora sanatorium, with 75 beds available for civilians, has taken the place of the and generally unsatisfactory sanatorium near Cambridge " This is. indeed, a prodigious progress! It is a little discounted by tne or two facts that Dr. Valintine has omitted to mention. These are that the "unsuitable and generally unsatisfactory nanatorium near Cambridge" was carried on bv the Department for something like' twenty years, and was not given up until a month or two ago when the sanatorium at Pukeora was handed over to the Health Department. This sanatorium was not built by the lastmentioned Department, but by the Defence Department, and wa9 a soldiers' sanatorium pure and simple: most or it is still occupied bv soldiers. Although Dr. Valintine states that seventy-five of the beds are available for civilian patients, he has not given the number of civilian patients in the institution, though this would show,' quite conclusively, what use is being made of this military sanatorium by ;the North Island Hospital Boards. Dr. Valintine says that the sanatorium near I >mhndge was not "erected" by the; Health Department, as stated by me. I hasten to admit that I gave the Department too much credit. I should ..ave said that a farm homesteal was bought by the Department, and that this building was converted into an "unsuitable and generally unsatisfactory sanatorium,' to use Dr. Valintine's own words. Where is the National Policy ? "Another of my statements which Dr. Valintine declares to be untrue is that there is no definite" national policy—no uniform, universal scheme—for dealing with tuberculosis; and that such measures as are being taken are carried out in a piecemeal and, consequently, inefficient fashion. He then proceeds to give many particulars of the piecemeal measures which he says do not exist. If there is a definite national policy, •ltd &'uniform and universal scheme for dealing with tuberculosis, where is it? What object can there be in Dr. Valintine so carefully and successfully concealing it from the pub.ic? Dr. Valintine says: 'What I do insist upon is that the present state of tuberculosis in this Dominion, apart from the financial ' state, does not demand any more to-day than since the decline in tuberculosis started, drastic and necessarily expensive measures for combatting tuberculosis.' This can only mean that Dr. Valintine is auite content to so on allowing tuberculosis to kill between seven hundred and eight hundred peojpl© in New Zealand every year, and tnaim a great many more, rather than ■■take drastic measures to combat the disease. No comment from me en this amasing statement is necessary. I merely point out that this is the attitude of the man charged with the conservation of public liealth in New Zealand. Sufficiency of Accommodation. "In one part of his statement Dr. Valintine says: '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.' About a fortnight ago a North Island patient who came to see me stated that he had made application for admission to the Pukeora Sanatorium, and had been told that he could not be admitted for two months. In another part of his statement Dr Valintine says that the beds provided as annexes to the different hospitals in the North Island are used, among other things, for eases waiting for treatment at a sanatorium. If patients oun be admitted to Inakeora Sanatorium as promptly as is igMJedby Dr. Valintine, what necessity •jSJ* TJlfPi* fo' ***> these hospital annexes IgafHsraig pjacoaP It is perfectly well * Syfjft.fo y' those having anything to "m wttn tubercrfosis that nearly afl of "* baling amply with J&3Kr22?»?S*,oi consumption' which SfflSajhSfc^ 6 ordinary sanatorium g^j^'^S^SS? l '* Sanatorium. *°. "V statement about the &IlSfißii^«3&r^ am at Auckland, Dr. MOST? •**** * "fcWoWr deny that

the Auckland Hospital BoaTtl has at any time brought forward a definite proposal to erect a sanatorium in the Auckland district ' At the conference of Hospital Boards, held in Wellington in June, 1911, Dr. Vaiintine informed the delegates that the Auckland B>ard was about to erect a sanatorium to accommodate no fewer than fifty patients. (See page 177 of the Public Health Department's liepoxt for 1911.) I don't know how Dr. Valintine succeeds in squaring these two statements. "Dr. Valintir.e'b reference to the 'New Zealand Year Book' and to the effect of the measures taken by the North Canterbury Hospital Board to combat tuberculosis, are so mixed that I have some difficulty in disentangling them. He states that- cancer is increasing and that tuberculosis is declining, that the Hospital Board states that there is a noted increase in the number of tuberculosis cases, and ho implies that the present measures for dealing with the disease are not providing good results: he even suggests that I am responsible for this latter statement! He then savs that he must satisfy the public and hospital boards that more than a scintilla of satisfactory results can be obtained before they will agree to a costly outlay, and tjiat if I cannot show, by facts and figures, that the measures taken in North Canterbury have had! a beneficial effect, it would be better for the sake of the suffering, for me to hold my peace. In reply to this I may say that, having come to this conclusion about the uselessness of the measures adopted here, Dr. Valintine straightway proceeds to Timaru and advocates to the delegates there assembled that similar measures should be instituted by them! "As regards the success, or otherwise, of the measures adopted in Christchurch, I would refer you to my report to the Hospital Board for tiie year ended March 31st, 1921, in which I rpviewed the results of tlie treatment of the first 1030 persons admitted to the sanatorium. I showed that four hundred of the total were admitted with more or less advanced disease and that out of the 1030 patients I was in actual touch with C 46 and that no fewer than 740 ex-patients were still alive and nearly all m good health, or doing well under treatment. If these results are not' considered satisfactory, perhaps Dr. Valintine will produce others from other institutions in any part of the world which he considers really are satisfactory. I venture to say that he will find no better results recorded anywhere! •'I am sorry," said Dr Blackmore in concluding, "that Dr. Valintine has thought it necessary to make a more or less attack on me and my veracity. Ido not prouose to emulate him in that respect. 1 think the matter of dealing with tuberculosis, and trying to eradicate it, is too important to" be dealt with by indulging .m personalities, and that no good purpose is served by anything in the nature of personal abuse." B.M.A. RESOLUTION. At a meeting of the local branch of the British iledical Association last evening, the following resolution was passed:— "That the Canterbury division of the isritish Medical Association wished to express its surprise and regret that the Director-General of Health should have met Dr. Blackmore's specific charges, which we regard as substantially correct, by merely casting unpleasant aspersions on the medical profession generally. It is a matter of common knowledge t-hat there is always a waiting list for admission to the Canterbury sanatorium, frequently including urgent cases."