An address on our duty to the consumptive breadearner : delivered to the Oxford and District and Reading and Upper Thames Branches of the British Medical Association, June 28th, 1901 / by Sir J. Burdon-Sanderson.

  • Burdon-Sanderson, John Scott, 1828-1905.
Date:
1901
Catalogue details

Licence: In copyright

Credit: An address on our duty to the consumptive breadearner : delivered to the Oxford and District and Reading and Upper Thames Branches of the British Medical Association, June 28th, 1901 / by Sir J. Burdon-Sanderson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Many will, I know, bo inclined to shelve the question, con- sidering it scarcely worth while to prolong a struggle which in each case must eventually and at no distant period end in death, or that no practical result can come of discussing it; but those who admit that human life is of more value than anything else in the world, and that we have to gather up the fragments that remain even of consumptive life, that nothing be lost, will join with me in considering calmly and without prejudice whether there is any way by which the consumptive toiler can be effectually helped to keep hold of that remainder. I do not recommend that we should imitate what has been done in Germany, but that we should ascertain what have been the essential conditions of success, and what are the reasons why they should not be realised in this country. These essential conditions relate : 1. To the choice of suitable sites and the erection and maintenance of suitable buildings. 2. To the selection of suitable cases, and to their prompt admission. 3. To the regulation under medical supervision of the time of residence of each invalid; and 4. To the medical supervision of invalids after their dis- charge from the sanatorium. It is obvious that the carrying out of these indications all over England could not fail to require an enormous initial and annual expenditure of money. We have seen that German sanatoria have already cost more than a million for building and installation, and that their maintenance already costs a quarter of a million, and will soon cost three or four times as much, There is no reason for supposing that if we followed their example we should do so more economically. It may, perhaps, facilitate the consideration of the subject if we assume, as I think we may, that the cost of erection of sanatoria might be met by grants from public bodies or by private benevolence. But it can scarcely be supposed that the current expenditure of these institutions could be sup- plied by voluntary contributions. Here, as in Germany, the. sanatoria ought to be self-supporting; they must depend for their maintenance on the earnings of those benefited by them. The German system of compulsory insurance against sick- ness is in reality a tax on labour, to the payment of which employers and employed contribute in something like equal proportion. Although, however, in principle there can be no more objection to the imposition of a tax on the earning of a workman who receives under £2 a week than to the tax which those whose incomes are not so very much larger submit to at the present moment with so little grumbling, it is not the less certain that in England any attempt to levy such a tax on the working man would not be tolerated. The most feasible way of accomplishing the end in view seems to be that the employers of labour should consent to levy upon themselves a contribution of which the amount would be proportional to and deductible in whole or in part from the wages paid to their workmen, on whom therefore their due share of the burden would ultimately fall. Such a system would be but a poor substitute for a compulsory system including earners of every class. Within its limited scope it would give equal or greater advantages to the insured, and would probably yield the means of maintaining a sufficient number of sanatoria for their reception when incapacitated by illness. But so far from n