The patients in institutions at (a) and (e) are admitted through the Government Anti-tuberculosis Scheme, and those at (b) are admitted principally by direct admission, or by transfer from other institutions- mainly advanced cases.
OUT PATIENT DIAGNOSIS AND TREATMENT.
During 1950, the Harcourt Tuberculosis Clinic, opened in 1947 by the Government for the diagnosis and treatment of pulmonary tuber- culosis, was the only institution offering such service to the general public. The building was adapted for the purpose and despite its unsuitability and small floor space, has continued to operate fairly smoothly. The total number of attendances in 1950 increased by 20% over last years figures, the main increase being in return visits. There are subsidiary clinics operated by the staff of Harcourt Clinic in outlying districts for the convenience of the patients in these areas. A composite report of the activities of all these clinics is shown below.
A second tuberculosis clinic was opened in February, 1951 în Kowloon for the convenience of patients living on the mainland. This clinic was designed and built for the purpose, with the object in mind of dealing with large numbers as smoothly as possible and to ensure maximum protection of staff. It was hoped that this venture would relieve the pressure on Harcourt Clínic but, at least in the beginning, the attendances have been greater than those at Harcourt, while the latter has shown no drop in the anticipated attendances.
The clinics of the Tuberculosia Service give attention free of charge to all comers, irrespective of status or origin. Hospital treatment is available for only a small proportion of cases, selected purely on clinical grounds. Only ambulatory or domiciliary treatment is possible for the majority. A successful trial of P.A.S. for selected out-patients has encouraged the belief that much useful work can be done in this way. At the same time it has been found that some success can be achieved by a modified way of living. Employers too are becoming more cooperative in allowing their employees sickleave with pay although as yet the numbers are relatively small.
A certain amount of collapse treatment is done for patients after discharge from hospital and for individuals who have been previously treated elsewhere.
All patients in the Ruttonjee Sanatorium are followed up subse- quent to discharge by the medical staff there.
20
HARCOURT AND SUBSIDIARY CLINICS.
1950
1949
Attendances
(a) First Visits (b) Return Visits
19,282 18,606 40,324 30,666
Total:
59,606 49,272
Voluntary attenders
16,358
13,322
Origin of
Referred by private practitioners Referred by Hoapitals
321
182
1,041
878
Contacts
632
386
Surveys
930
3,972
19,282
18,135
new
patients
Total:
It will be noted that the number of new patients and old patients slike has increased substantially. Particularly gratifying is the number of revisits recorded, a fair indication of the growing confidence of the public in the service given by the clinics.
The drop in the number attending as a result of Surveys is due
to a change in the policy in regard to Surveys.
STATE OF DISEASE, IF ANY, ON FIRST ATTENDANCE.
Not Tubercular
Active tuberculosis
Quiescent tuberculosis
Arrested tuberculosis
Diagnosis incomplete
Total:
9,551
4,584
1,906
454
2,787
19,282
Of the 4,584 patients suffering from active disease the classification according to the British System was as follows:
Class I
1,904
A (Sputum negative)
Clase II
929
❘ Class III
695
f Class I
189
B (Sputum positive)
Class 11
440
❘ Class III
527
81
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