TUBERCULAR SOLDIERS

Dominion, Volume 13, Issue 211, 1 June 1920, Page 6

TUBERCULAR SOLDIERS

DIFFICULT PROBLEMS SUGGESTIONS FROM THE R.S.A. DEPUTATION TO MINISTERS. Representatives of the conference of the New Zealand Returned Soldiers' Association, now sitting in Wellington, waited yesterday on the Prime Minister and tho Hon. D. 11. Guthrie with a number of requests concerning the treatment of returned men suffering from tuberculosis. Present also at the conference were General M'Gnvin (Director-General of Medical Services), Mr. Samson (head of the Repatriation Department), Mr. G. C. Fache (Commissioner of Pensions), and Dr. A. W. Izard (representing the War Pensions Board). Most of the talk was really between the Departmental officials and the members of the deputation. Itappeared that few, if as*-, of the points raised were new to thrj Departments concerned, and either that the things asked for had already been granted or that there were reasons against their granted. The soldiers' deputation was in charge of Dr. Boxer, Dominion president of the association.

Medical Questions. General M'Gaviu, replying on bctalf of tho medical branch, said that already men were being provided on dischnrgo from sanatoria with suitable shelters. Complaint had bfen made as to the suitability of the tents, but they had been devised by Dr. Blackmore. tlito first expert in tubercular disease in the country, and Dr. Blackmore declared that they were very suitable. With regard to tho supply of bed and bedding by the Defence Department for discharged 1.8. men, ho had discussed this matter with General Richardson, and it had 'been agreed that it would be possible for the Department to supply tho men with beds mattresses, and bedside tables. It would not be possible to supply bedclothes. The suggestion that i lie Department should undertake the altering of a patient's house to fit up a shelter on a verandah had already been ngreed to by the Department fivo months ago. As to tho request that the n.c.o.'s at sanatoria should be ex-T.B. patients, tho Department had to consider the patients under treatment as well as the men ready for discharge, and it was necessary to have n c o.'s who were fit for the duties. The men must be efficient, and they must not have the disease in nil infectious state, otherwise there would be danger of their infecting the rest of the staff. It; would perhaps be possible to employ some expatients for the work, but they could not take rank over other men who hnd had tho benefit of years of training, and who did know the work.

"Compulsion" not Possible, The difficulty about the proposal for the compulsory examination of all outpatients was that it was not possible to Ket all the men to attend. Otherwise it could easily be arranged. It was nil very well to say that tho men should be compolled to attend, but the Department had no means of compelling them except under threat of stopping pensions. Tins was not a clean weapon for the Department to use, and it had to be used, if at .■ill, with the grentest care. Usually it was thivwifo and family of the man who suffered if the pension were stopped. The same applied to the proposal that specialists should be sent round to examine all chest eases, which it was suggested were potential T.B. cases. The difficulty was not in sending- round the specialist but in frettine the men to come to him. He believed that there were a number of men in the country who required treatment, and who had not come up for it, and he did not think that thev would como up if a specialist were sent round. The Department heard of such cases only incidentally, and when it did get information it acted upon it. Requests had btcn made for different treatment for incurables in sanatoria. The truth was that incurables ,camo into sanatoria only when thev developed into tho incurable stage within the institution. Incurables were not received into sanatoria, except for a course of instruction in tho treatment themselves, and they were not held in sanatoria. Other provision was made for incurable cases.

Vocational Training. Another suggestion, was that T.B. men at the Pnkeura Sanatorium should bo given more vocational training in outdoor occupations, and that to this end the farm of': 3111 acres attached to tho institution should be -worked to full _ advantage. It appeared from observations of officeis present that the farm is scarcely worked at all, and that the work given to patients to do is not vocational training, but is simply given to them to provide them with an occupation, this being desirable from a medical point, of view. There was a further prr-posal that all the vocational training should bo taken over by the Repatriation. Department, some of this being still under the Defence Department. At present the practice is for the Defence Department to deal with some of the men and iho Repatriation Department with tho remainder. The Hon. D. H. Guthrie and Mr. Samson both informed the deputation that there was little objection to the Repatriation Department taking over the vocational training of T.B. cases at the sanatoria, provided they could be satisfied that the men were being really trained. It might be necessary for the Repatriation Department to take over for this purpose full control of tho farm at Pukeura. "Incurables."

It was asked that incurable T.B. men should in all eases be given the permanent pension of £Z per week, and the supplementary pension of £\ per week. Dr Izard said he did not think it was desirable that T.B. men should be given a permanent pension, the reason being that if this., were the practice these cases would be lost altogether, to the detriment of the men themselves. When tlfe pensions were brought up for annual review, it was possible to keep (ouch with the mon, and review their cases from time to time. The full pension was always given for tho first twelve months, but the supplementary pension was at the discretion of tho board, and lie thought it should remain so. J.te knew of oiio T.B. case in which the man concerned had an income of .£11)00 a year. It could not lie contended thnt his was a case for the supple-' mentary pension. As to the suggestion incurables should.not be subjected to this annual review, he said that he had never yet met with a case in which the expert iiad declared a- man to be incurable. ; Work for T.B. Men. The deputation pressed their demand that something more should 'bo done to find employment for T.B. mon on discharge from sanatorium. It, was urged that instead of the men having to go about for weeks in search of work, with the result that through inadequacy of pension they might in the end lie forced to take up unsuitable work, tho Repatriation Department should be notified in advance of tho impending dischargo of patients, and should endeavour to havo positions waiting for the men. It was made clear that the practice at present is to give the repatriation authorities notice of discharges to come, but in somo : cases it was not possible to give long I notice. ,111". Samson, in reply to this demand, said'that it, was not easy to get work for T.B. men, and almost impossible to get work for a man until he presented himself. An employer would seldom agree to take a man without first having a talk with him. He did not think there were many men unemployed at present. Only to nine men was unemployment sustenance being paid. Mr. Aekins, a member of the deputation, retorted: "If the Repatriation Department wHI employ me I guarantee to find in three months SflO men unemployed or in unsuitable employment."

Mr. Samson did not receive with approval the request that he should ba compelled to employ none but T.D. men in tho After-Caro Branch. He did not iiccept the statement of the deputation that none but an ex-patient could deal with the cases of the T.B. men, or that they would nevor give their confidence except to an ex-patient as a man who did understand their special wants. Some assistant officers wcro to be ap. pointed to tho After-Care Branch, and

he had no objection to these being cspatients. But he <lid not think it would 'be good policy for the Department to put ex-patients in the place of tried and experienced officers. Already Arranged. A. series of suggestions were made for special treatment in repatriation for T.B. cases. The Minister (Mr. Guthrie) was able to show that all the special treatment asked for was already being given, not only to tuberculosis cases, but to all necessitous cases. The requests were for deferred payment of rent or interest charges, or for lower interest, rates for the first few years. Mr. Guthrie explained that there was full provision for this already, and many soldiers had been given the concessions. At present the Minister had power to postpone the payment of rent or interest. At the end of three years the Minister could do one of three things: lie conld arrange for the soldier to repay the postponed rent in instalments, capitalise the amount of the postponed rent by adding it to the amount of the loan, or in very special cases, remit the payments altogether. A request was made that in the case of a patient desiring to go for treatment to Australia, tho Defence Department should pay the expenses of his transport a'nd bo responsible for his treatment in a Government institution there, Dr. M'Gavin pointed out that the first difficulty was that Australia, like Canada and South Africa, would not allow T.B. cases to ■ come into the country unless the men had been previously domiciled there. As to tho claim for treatment costs abroad, Dr. M'Gavin thought thnt if the first and inert serious difficulty ho had men-

tioned could bo got over, some reciprocal arrangement might be possible between the Governments of New Zealand and Australia, but tho Defence Department could not undertake to pay for the privato treatment of a patient in Australia. A Profitable Talk. The Prime Minister said that the discussion had been a very profitable one. Ho agreed that tho problems connected with tho future of the tubercular men might be the most difficult of all repatriation (iii'-'stions, but the Government would have to do its duty by tho men He could assure the deputation that the suggestions made would be given effect to if this should prove to bo no* sible. With regard to pensions, the Government proposed to win;: down legislation next session providing for tho setting up of a special pensions appeal board to deal with special cases of hardship. Ho thought that tins board would meet the cases of tho tuberoular i men.