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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    required impulse by certain addresses delivered to the medical societies of Berlin in 1888 and 1889, in which he treated of the prevalence of consumption among the working population as a matter of national concern, and insisted on the necessity of establishing sanatoria for the poor as the only means by which it could be combated. The result of these discussions, and more particularly of that which took place at the International Congress in 1890, was that von Leyden’s suggestions were warmly taken up by leading men in and out of the profession, who at once set to work to devise practical ways of carrying the principle of sanatoria for the poor into, effect. At the present moment sanatoria of this kind for men and women exist throughout the German Empire. Their number is still far below the requirement, but every year new institutions are added to the list. The success with which the work has been carried out can be best judged of by the following figures : At the date of the last International Medical Congress (August, 1900) there were in the German Empire 49 sanatoria for the poor, of which the plans of 41 were exhibited in the Department of Hygiene of the Great Exhibition. There were at that time n others in course of construction1 (besides 28 projected), so that there are probably about 60 of these insti- tutions in operation at the present moment. The 49 sanatoria which were open a year ago contained 4,000 beds. The cost of their erection amounted to about a million pounds, so that the cost per bed, including all internal fittings, may be esti- mated at ^250. It is, however, held that in future this initial cost will not exceed ^200 per bed. The yearly expenditure for each occupied bed is estimated at ^65, but about a fifth of this sum is not expended within the walls of the sanatorium, but goes to the maintenance when necessary of the families of the occupants during their period of residence. From this it follows that the total annual expenditure for maintaining the sanatoria was a year ago about a quarter of a million. It is anticipated that when the system is complete its maintenance will cost about five times as much-from a million to a million and a-lialf annually, that is, that this enormous sum will be required to bring within the reach of every working man and woman in Ger- many who is threatened with phthisis the means of doing the best that can be done for the maintenance of his earning capacity. Compulsory Insurance. As I have already indicated, the reason why we in England have not followed the example which we have had before us for so many years is that in Germany facilities exist for organising a sanatorial system, which we are deprived of. The nature of these facilities I must now explain. The questions which present themselves in limine are: First, where does the money come from ? and secondly, How is the system brought into relation with the right people? The first question may be answei’ed at once by saying that the re- sources of the sanatoria are derived partly from organised charity, but chiefly from contributions of the workmen them- selves—that, in short, the whole explanation of the success is expressed by the two words, compulsory insurance.3 In Ger- many every workman whose income is less than ^100 a year is required by a law which came into full oper-