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144. The total number of exposures rose again by almost 10% to 194.181. of which 128,894 were on large papers or films.

Bacteriological Examinations

145. The bacteriological work done for the Tuberculosis Service is carried out under the direction of the Government Pathologist. The total number of sputum smears examined was 44,785, a rise of 1,714 as compared with last year. Gastric cultures totalled 186 while laryngeal cultures, which have largely replaced gastric cultures, reached a total of 1.131.

146. Wide publicity is being given to the occurrence of atypical acid fast organisms in various parts of the world and the culture procedure in the laboratories has been adjusted to find examples in Hong Kong. Already a few have been isolated but the present indications are that this is likely to be a curiosity rather than a local problem.

Hospital Treatment

147. The detailed distribution of beds for tuberculosis in the civil hospitals throughout the Colony is shown in Appendix 5 and the total figure can be accepted as the average number of beds set aside through- out the year for the in-patient treatment of tuberculosis. Of this number 252 beds are maintained in Government Hospitals. 876 in hospitals managed by the Hong Kong Anti-Tuberculosis Association, 200 are in the Tung Wah Group of Hospitals and 180 in the Haven of Hope Sanatorium. This number may fluctuate from time to time particularly in the Government Hospital a Lai Chi Kok where this year the greatly increased diphtheria incidence called for a temporary re- distribution of convalescent and tuberculosis beds, over a period of two months, for the nursing of cases of severe diphtheria,

148. In addition to the beds available to the Tuberculosis Service in Government Hospitals, there are 444 beds in the Grantham Hospital and 336 beds in the Ruttonjee Sanatorium, which includes the Freni Memorial Convalescent Home. Admission is governed by the policy of utilizing the beds to the best possible advantage of patients whose recovery can be hastened by medical, pulmonary surgical or orthopaedic treatment or who require emergency admission for complications arising during ambulatory chemotherapy. It is not yet possible to use hospital beds entirely for the segregation of open cases whose home conditions are such that isolation is desirable. This aspect of the control pro- gramme is being investigated with a view to providing an institution for

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the open chronic cases who do not respond to chemotherapy. Unfortun- ately staff and financial considerations have so far prevented the formulation of any positive steps in this direction.

The Hong Kong Anti-Tuberculosis Association

149. Incorporated by statute, the Association administers two Hospitals, a Convalescent Home, a B.C.G. Clinic, & Tuberculosis Insurance Scheme and a Health Education Service. The two hospitals are the Grantham Hospital and the Ruttonjee Sanatorium: the Freni Memorial Convalescent Home is adjacent to the Ruttonjec Sanatorium and the two institutions are managed as one. The Hong Kong Anti- Tuberculosis Association Board is the governing body of the Associa- tion: the Grantham Hospital is the responsibility of the Grantham Hospital Management Board and the Ruttonjec Sanatorium and Freni Memorial Home are managed by the Ruttonjee Sanatorium Management Board. The Hospitals Management Boards are appointed annually by the Board of the Association and consist of nominated members of the Association Board; members of the staff of each institution attend the respective Management Board meetings.

150. The Association's work receives considerable voluntary sup- port and the hospitals are generously subsidized by Government. Treatment at the Ruttonjee Sanatorium and the Freni Memorial Home is entirely free; at the Grantham Hospital maintenance fees are charged on a non-profit making basis and Government now subsidizes 444 of the beds at the rate of $18 per day for each bed occupied by a Government-sponsored non-fee-paying patient.

Ruttonjee Sanatorium & Freni Memorial Convalescent Home

151. Operated as a single unit by a Board of Management these two institutions accommodate 336 beds of which 120 are in the Convalescent Home. Treatment is free and 42 beds are maintained by sponsoring bodies at an annual endowment cost of $3,500 per bed per annum. A Government subvention of $1,346,979 towards capital and main- tenance costs was made during the year.

152. Medical and senior nursing staff are provided by the Sisters of the St. Columban Roman Catholic Mission and staff of the Medical Faculty of the Hong Kong University act in a consultant capacity. Full medical and surgical treatment are given free of charge and there is a close liaison with the neighbouring Wan Chai Government Chest Clinic. Admission is through the sponsoring agencies. the University Clinical Units and the Government Chest Clinic.

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