T.B. CASES

New Zealand Times, Volume XLVI, Issue 10604, 1 June 1920, Page 7

T.B. CASES

DEPUTATION TO PREMIER N.Z.B.S.A. FORMULATE THEIR, . PROPOSALS. MR MASSEY'3 SYMPATHETIC BEPLY A d-eputation from the N.Z.R.S.A. Conference, now meeting in Wellington, waited upon tho Primo Minister yesterday morning to lay before him the T.B. resolutions (published in yesterday's "Times") passed by tho conference. "With Mr Massey were the Hon. D. H. Guthrie (Minister for Lands and a member of the Ministerial Repatriation Board;, Sur-geon-General McGavin (Director-General of Medical Services), Mr J. li Samson (Director of Repatriation), Mr G. C. l'sche (Commissioner of Pensions), and I>r Izard (medical member of the Pensions Board). Tho medical remits were taken first. A BASIC PRINCIPLE.

Dr Boxer (president of the N.Z.R.S.A.), in his introductory remarks, etrphasisoi the fact that as a basic principle the conference considered it advisable that each tubercular patient should as iar as possible bo made his own employer when ho returned to civil life, as it had been found in so many cases that an employer could not put up with a man being off duty so often because of his T-B. handicap, and so the tul>ercuiar man got tho-sack. Tho eoiifereme nsked, also, that on disuhargo the T.B. men should be provided with a permanent shelter, not merely a tent, bed and bedding aud furniture; because the men were sent out as "cases," and it was left to Nature <>nd to themselves to complete the cure.

, Mr Drummond stated that tho underlying motive of all tho remits was to assist the Government in assisting tho tubercular man who was trying to assist him«es! The tonference had- no time for what was known, as the wastrel, for the Alcoholic man, or-for the man who in hospital had refused treatment; but they asked that these men should not be allowed io roam at Isfrgo, a menace to the community. Mr Aekins stressed tho necessity for sending an expert medical officei throughout the Dominion to examine discharged men, so that any cheat cases could be sent at once into the sanatoria to give them the best chance of recovery. D.G.M.S. ON MEDICAL REMITS.

Surgeon-General McGavin, who was asked by the Prime Minister to reply on the technical patters raised in the various remits, said that T.B. men were being provided with suitable shelters on their discharge. It was true that tents were being supplied in certain cases. But they wore special tents designed by Dr Blackmore, and had wooden floors '"ellraised from the ground, double flies, etc., and he stated that they were ar. good a 3 permanent shelters, if not better. He had discussed the matter of beds i-nd bedding with General Richardson, and tohad decided that the Defence Department could easily supply inoxpendable items* ol furniture, such as beds, ohaire, etc., but not blankets and bedding, because they had the former stores in hand. The glassing in of verandahs at T.B. patients' homes, which had been suggested, bad already been done in certain cases some five months ago. With reference to the j request tbat n.c.o. orderlies in T.B. hosI pitals and sanatoria should be ex-T.B. I men. he stated that tho policy of the department was, as far as possible, to displace all male personnel and supply V.A.D.'s, whom it found were much more satisfactory. But when that could not be done, the department was employing as far as it could ex-T.B. men, where they had the necessary skill and knowledge. Preforenc© would always bo given to T.B. men when they had the necess--ary qualifications. As soon as it was known that a man was to be discharged I notice was sent to the Pension* Board. bo <that there might be no unnecessary Idolav in dealing with his case. The re- ! examination of T.B. patients was also provided for; bui the difficulty was not Iso much in arranging for examination ;by a specialist as in getting the men to i come up for examination. Mr Drummond pointed out that the .remit asked that the re-examinatioi. should be made compulsory, and if a man then did not come up for re-ex-amination it would affect hi* pension. General McGavin said that the department did not care to use that weapon, as it was mostly the man's wife und family who suifered if he was penalised by withholding or reducing his pension. Mr Drummond .said if they did not suffer tho community would through the man goimj back in health. Mr Massey held that thev must be veTy careful about using tho pension in that wav.as a means of penalising a man. General McGavin istated that somo time ago he had sent experts throughout the Dominion to get in not only all tho T.B. men, but others who required treatment. But the difficulty was to get hold of the men to re-examine them. The department had done everything possible. It wna only too anxious to do so. INCURAHLE CASES.-

It was not intended, ho added, to tako chronic, advanced, or incurable cases into the sanatoria, as these institutions wore so high placed that they were not euitablo for such cases. Provision was

made for them either by supplying shelters at their homes or by sending them to hospitals. . Tlio presonco oi eucli men in 'Sanatoria was only temporary and incidental. Tho department kept them in the. sanatoria for a time to teach them how to treat themselves and prevent danger to others. Ho could not arrange lor the incurables at Cashmere- to bf transferred to the incurable home at tho foot of tho hills, as that was now full. The department was, however, completing a special institution in Dunedin for such cases, and it would be possible soon to transfer the Otago cases there. Exception had been taken to Treiitham as not a proper place for T.B. men, but he ! had been advised that Trentham was qui'te suitable for T.B. patients; and, us a. matter of fact, the men had improved there. The men now at Trentham could not be accommodated at tho shelters erected in the Auckland Domain, as ' thev naturally wanted to bo noar their homes.

PAIiM TRAINING AND SUSTENANCE.

Mr Knox urged that Pukeora should j bo made into a proper training farm as at Tauheronikau for T.B.'s who intended to tako up poultry farming, pig-breed-ing, orchard work, bee-farming, etc. Mr Aekins urged that vocational training should be transferred from the Defence Department to the Repatriation Department, as the former could not give sustenance allowance, but the Repatriation Department could. Tho Hon. D. H. Guthrie said that the suggestion as to vocational;training had been made some timo ago; but at first tho difficulty was that when undischarged a man was under tho Defence Department. But now there was very little difficulty in that way', as so few were undischarged, except in tho case of men who neodod to be kept under military control and discipline for their own sake <jnd for that of the general public. Mr Samson said that there should be no difficulty about the Repatriation Department paying sustenanco to) these men; but, before the department could pay them sustenanco it must bo able to see that the men were getjng a proper training, and must have control of the farm. The department was paying sustenanco to men at Cashmere, although they were not under the department's control, but the departments officers saw that tho men got a proper training. Tho department could not pay sustenance at Pukeora, until it was certain that the men would be properly trained. The department was quite prepared to got T.B. men five to ton acre sections and start them on their own account after they had completed t their training; and this had already | been done in some caseß,

Mr Massey said that the question of transferring the control of tho farm was a matter for Cabinet, but the suggestion would go before Cabinet with the other recommendations in the ordinary way. General McGavin said that up to the present much of the training referred to was occupational training— to give the men occupation as part of their medical treatment —rather than vocational training.

Mr Knox urged that the training on tho farm should be vocational as well as medical. PENSIONS MATTERS.

Dealing- with tho question of pensions, Mr Loadley stressed the necessity that where a specialist certified a man as incurable, the man should bo granted a full pension for life. Thero were not many of these cases, ho said. The conference desired, also, that a full and supplementary pension should be given for twelve months to all T.B. men on their discharge; and that when their cases were reviewed they should be reviewed by a specialist, and that tho recommendation of the specialist should be taken, and not that of the Pensions Board.

Mr Massey: What do you mean by "full and supplementary pension"? Mr Leadley: The pension is £% but sve want a supplementary pension also to meet additional expenses, for special food, etc., to which T.B. men are put. You must admit that £2 a week as not enough for a man who cannot work. Ho know of cases of men who had gone to work because of insufficiency of pension, had had a haemorrhage, and had had to go back to hospital. Dr IzaTd, to whom tho Prime. Minister referred the matter, said he did not think it advisable that men should bo granted) permanent pensions, as there waj a danger of losing sight of them it thoy had not to come up tor xe-oxamina. tkm. Further, if they gave tubercular mon a permanent pension, and told them that the incurable cases were to bo given permanent pensions, it would destroy the men's one hop& ot recovery. On discharge from hospital, tho men wero receiving a full pension for twelve months, and supplementary pensions were given at the discretion of tho board. He had never seen a ginglocaso in which Dr Blackmore or one of the specialists had returned a man as incurable. Mr Aekins: Well, thero is one coming- this week. Will yon aee that he gets sympathetic treatment? I>r Izard: Yes.

Mr Drummond said that Dr Blackmoro had told him of cases where men had not roceived full pension* on discharge. Dr Izard: Will you let mo have their names P Mr Drummond: Yes. Replying to a question, Dr Izard said that in only two cases had the boarl reduced the pension, and that was on isocount of misbehaviour—men who would not go for treatment; men who brought liquor into hospital, or would go bathing. There were' only four or five such cases in all.

T.B. MEN TO CARE FOB T.B. MEN. Mr Aekins urged that the Repa'riition Department ehonJr) find light employment tor T.B. men before thoy were actually discharged. If a man "had to wander round those- days looking for a job it" would undo the resuH of two months' treatment in the nanntorlum. Ho contended, also, that the Government should appoint four T.B. men to tho after-care branch of the Repatriation Department, one for each of tho biff centres. None of the five after-oaro officers so far appointed had had sanatorium experience. "(To had just completed a'tour of tho four chief centres for tho association.' and had found that tho T.B. men would como forward much more readily in the case of a man who had had sanatorium experience and was thus more in sympathy With them. That was why the conference stressed the point. Ho had found many men.in need of treatment. Mr Samson said the last return showed that there were only nine men on tho unemployment Btuiteuan.ee list- Tho difficulty was that employers wanted to .=oo the men be-fore they employed them; but tho department, could undertake to End suitable work for the men within a woek of their discharge. Mr Aekins stated that if -tho Reparation Department would employ for three months he would find 800 men who wore xmenndoycd or in unsuitablo employment. Mr Maspcv t. I hop© it is not. so bad as that. Mr Samson said that tho department bad already assisted scores of T.B. men Ic settle on bee farms and so forth.- They Mime in contact with scores of cases even' day of T.B- men and others who required 'treatment There seemed to bo no reason why T.B. men should bo employed for that particular work. Tie contended that the present officers were nuite as sympathetic ns any that could bo found anywhere, and thoy had had two or throe years' training in the work. It was nccessarv to appoint 0 man to control the farm at Tanhwn-ikau ami nfter-caro assistants in Auckland and Wellington; and ho would havo no objection to insisting that thoy should be T.B. tmen. But aftor-caTO men must bo assistants to the men wTio had already had ■ two or three years' experience- Tho department could not nlways have T.B. men to look after T.B. men. They might as well say that thoy should have limbless men to look after limbless men.

neurasthenics to look after neurasthenics, and so on.

Mr Pirani complained that tho present repatriation scheme put the unlit tteii on tho same basis as the fit, and thus ■the fit men were being repatriated at the expense of the unfit. If, ho urged, the men were provided with suitable farm areas, and deferred interest, or reduced rates of interest, to givo thorn a start, it would put them in the way of becoming assets to the country. MINISTER FOR LANDS REIPLEES. Mr Guthrie said that the points referred to were very important, but they had not been overlooked. Mr Pirani had stressed the points particularly in regard to T.B. cases, but the department made no difference in regard to T.B. men and other returned soldiers. Full provision was made for all men who were not able to make full payments of interest. The departmont was helping tho men ovor tho early 'stages of fettlement by postponing their rent without interest. Then, at the end of two or three years, after tho mem had got on their feet, tho department would either (1) take their postponed rent in instalments spread over from two to five years; or (2) it would capitalise the amount that was owing on to tho land; or' (3), in very special and very urgent cases, it would remit the back rent altogether, and give th© men a fresh start. This was done, not simply for T.B. cases, but for all who really required it. "WOULD STAGGER COUNTRY." Replying to Mx Massey, Dr. Boxer said that rio estimated that 90 per cent, ot the T.B. men would »ot back, to a reasonably good life, but not to normal. If a compulsory census was taken he thought that the number of T.B. men would stagger the country. Tho C.P.D.I. cases were, he believed, a happy huntingground for T.B. germs, also chest cases, even cases of wounds in, the chest, and so on. He feared that T.B. cases so arising would in the future prove a heavy burden upon the country. General McGavin said that thero wpro difficulties in tho wa-r of T.B. men going to other countries, as they would not admit them unless they had previously been domiciled there. Canada-vand South Africa would not admit T. 8.. cases. The department was in communication with Australia, asking under what terms Australia would admit our T.B. men. Wo had «, reciprocal arrangement with Australia as to the treatment .of men, a"nd the department would be prepared to pay men's fares to Australia and back, if the Commonwealth Government would give them reciprocal treatment in the sanatoria in the Blue Mountains. PREMIER IN REPLY.

Mr Massey stated that, already the question of refusing admission to / 1.8. cases had been before the Commonwealth Parliament, but he could not say as yet with what result. It had -been a very valuable conference or deputation that they had had that morning. A number of grievances " had been ventilated. In some cases both sides of the question had been stated, and he thought that the rn earners of the deputation must have picked up what would be to them very valuable information. He assured them that the work of repatriation was in good hands. Possibly the cases of the T.B. men were the worst and most difficult of ail to deal with; .but both the Government and the people of the Dominion, ho was sure, recognised that thev owed a duty to the men who had contracted this disease in war service. The Government • was determined to do its best for 'them; and if any suggestion put forward could be given effect to by tho department concerned, he assured thorn that everything possible would be done. He could assure, them, from his knowledge of General McGavin and those associated with him, that the tubercular soldiers were in very sympathetic hands. One thing the Government contemplated doing was the setting up of a special board to. deal with special cases of hardships in regard to pensions. The board would consider such cases, and if they recommended that an additional pension was necessary ho had no doubt that it would be given. He had been very glad to meet the deputation; and assured them that the Government would do everything it' possibly could to assist tho mon who had fought for their country in its hour of danger.