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common to tuberculosis mortality statistics in Hong Kong for many years. Estimates, based on sampling, indicate that there is a relatively small preponderance of males in the population which suggests that tuberculosis is not only more prevalent in men in Hong Kong but that it is more lethal, especially in middle life. A noticeable feature is the small number of 10 deaths from tuberculosis in the 15 to 19 age group, the smallest number of any age group of comparable size. The ratio of notifications to deaths in this age group is 41:1 but it falls rapidly and progressively to 2:7 in the age group 60 to 64.

153. The total notifications of tuberculosis and the pattem of dis- tribution remain comparatively unchanged except that an increasing proportion of the total originates from official sources. Notifications during 1937 and 1958 have been as follows:

TABLE &

1957

1958

Government Chest Clinics...

8,194

6,787

Other Government Institutions

2017

2,366

Non-Government Institutions including Tung

Wah Group of Hospitals

2,298

1,709

Private Practitioners

656

13,665

623

13.485

Agencies dealing with Tuberculosis control

Government Tuberculosis Service

154. Government maintains both clinic and hospital services and subsidizes largely the voluntary and missionary bodies engaged in tuberculosis work.

135. The Government Tuberculosis Service of the Medical and Health Department maintains three whole-time chest clinics, two in Kowloon and one on Hong Kong Island, at which morning, afternoon and evening sessions are conducted. A fourth major chest clinic will be opened on the Island at the new Sai Ying Pun Polyclinic during 1959. At these clinics the full range of diagnostic services is available, including radiology.

156. Part-time chest clinic sessions are also held once weekly at nine centres throughout the Colony, one of which is conducted at the Stanley Prison, Radiological work for these part-time clinics has to be carried out at the main clinics or by the use of the mobile X-ray unit.

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157.

Treatment at the Government Chest Clinics is free of charge to members of the public. Cases referred to the clinics are seen without limil and, in addition, 60 voluntary first attendances each day can be handled at each whole-time clinic; there is no limit to the number of first voluntary attendance seen at the part-time clinics. Ambulatory chemotherapy is started as soon as a diagnosis of active disease has been made; thereafter cases are selected for admission to hospital as beds become available in the Government Hospitals, the Grantham Hospital and the Ruttonjee Sanatorium. There are 182 beds for the treatment of tuberculosis in Government Hospitals.

The Hong Kong Anti-Tuberculosis Association

158. Incorporated by statute, the Association administers two Hospitals, a Convalescent Home, a B.C.G. Clinic, a Tuberculosis Insurance Scheme and a Health Education Service. The two hospitals are the Grantham Hospital of $40 beds and the Ruttonjee Sanatorium of 230 beds; the Freni Memorial Convalescent Home of 106 beds is adjacent to the Rutlonjee Sanatorium and the two institutions are managed as one. The Hong Kong Anti-Tuberculosis Association Board is the governing body of the Association; the Grantham Hospital is the responsibility of the Grantham Hospital Management Board and the Ruttonjes 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.

159. The Association's work receives considerable voluntary support and the bospitals are generously subsidized by Government. Treatment at the Ruttonjee Sanatoriom and the Freni Memorial Home is entirely free; al 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 patient.

160. The Grantham Hospital was opened in June 1957, but owing to the shortage of trained nursing staff, the full complement of 540 beds was not in use until November 1958. It is a modern and well-appointed hospital, which offers the full range of medical and surgical treatment. 161. The after-care of patients discharged from Government- sponsored beds is carried out by the Government Chest Clinics but

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