Yes, and I am sure that I shall do that. I come now to the novel provision in this Bill—a provision which, I think, is no less important than the provision with which I have dealt. With regard to Section 3 of the Bill, consideration has been given to the question of improving the living conditions in the homes of persons undergoing treatment for pulmonary tuberculosis in cases where the accommodation in the home is inadequate for the proper segregation of the patient from other members of the family. The section provides that on the certification of the appropriate medical officer of health the local authority may, and if required by the Minister, shall, make to the owner or occupiers of the house a grant towards the cost of the provision of an additional room in or attached to the house. A grant of the full cost may be made by the local authority, and two-thirds of the grant or £100, whichever is the less, will be recouped to the local authority by the Minister. Where the Minister is of opinion that the provision of a hut or chalet within the curtilage of a house would serve the same purpose, Section 4 enables the provisions of Section 3 to be applied accordingly.
Section 3 of this Bill may be regarded as a further step in the campaign against tuberculosis. The Tuberculosis (Establishment of Sanatoria) Act, which, the House will recall, was enacted by the Oireachtas early this year, aimed at the provision of additional sanatorium accommodation for patients who need it, and I am happy to inform the House that very satisfactory progress is being made with the planning of these new institutions, but these institutions will provide only for those cases which require institutional treatment. Further provision is required to deal with the cases of persons who, although suffering from the disease, do not require active treatment in sanatoria. It is very difficult to say how many persons in this country are suffering from tuberculosis. It is known that 22,879 persons received treatment under the various local authority schemes in 1944. No doubt, there are many others who are being treated by private practitioners, and also there is a large number of people who, unfortunately, unknown to themselves, are suffering from the disease.
Tuberculosis is an infectious disease, and therefore the first measure to be taken to combat it is to limit the spread of infection. It is hoped, at an early date, to put into operation an organisation which will enable us to deal with those persons who are anxious to undergo examination and satisfy themselves as to whether they are suffering from the disease or not. In the case of an infectious disease, isolation of the known open infectious case is a matter of prime importance. Infection is spread by careless coughing and spitting by persons who are known as sputum-positive cases; that is, persons who exhale the tuberculosis germ in large quantities. The incidence of tuberculosis infection and disease is, therefore, higher amongst persons who come into daily or perhaps hourly contact with infective patients in their own homes. It follows, therefore, that the incidence of the disease is higher amongst contacts under conditions of overcrowding both in the home and at work, because of the increased exposure to the sputum of persons suffering from the disease. We have to recognise that fact, if the disease is to be prevented from increasing. I am sure that there is probably no Deputy in the House who has not known or heard of a family, three or four, or perhaps more, of the members of which have died from tuberculosis.
It is this high mortality in certain families which has given rise to the delusion that tuberculosis is "in the family", as the saying is. Now, it can be definitely stated that tuberculosis is not hereditary and is not, therefore, "in the family". The reason why three, four, or more members of the family have died from tuberculosis is that, in their own homes, they have been constantly exposed to infection and "cross-infection" from one another. Section 3 of this Bill aims at reducing as far as possible this exposure to infection.
It is not necessary that every person who has contracted tuberculosis should be treated in an institution. In fact, there is a very large number of persons suffering from tuberculosis who do not actually require active sanatorium treatment. What they need is good food, rest, and fresh air. But, if we are to counteract their influence as a source of infection, it is essential that the conditions of the homes in which they live shall be such as will permit of segregated accommodation. If this accommodation can be provided, domiciliary treatment, that is, visits at frequent intervals to the patient's home by the tuberculosis medical officer, will meet the case and the person concerned will make satisfactory progress without entering a sanatorium.
During the last year over 8,000 persons suffering from tuberculosis received institutional treatment. It is highly probable that a considerable number of those persons did not, in fact, require such treatment. But, because their home conditions did not permit of segregated accommodation being provided for them, it was deemed prudent to have them admitted to sanatoria in order to protect the other members of their families. If treatment can be provided, say, for 1,000 such persons, as we anticipate under this Bill it will be provided, it must follow that the pressure on the bed accommodation in existing tuberculosis institutions will be relieved to that extent. Consequently, by the operation of Section 3 of this measure, which, I am sure, will become an Act, the existing shortage of bed accommodation will be relieved, which is naturally a very important consideration, and, as well as that, we shall have an additional safeguard against the spread of the disease and the infection of new persons by reason of the additional accommodation which we provide in the patients' homes.
When addressing the House on the occasion of the Second Reading of the measure to which I referred earlier, the Tuberculosis (Establishment of Sanatoria) Act, 1945, the Parliamentary Secretary (Dr. Ward) intimated that housing conditions had been advanced as being partly responsible for the rise in the death-rate from tuberculosis. He then informed the House that we had instituted an inquiry, which superintendent and county medical officers of health had already carried out, to determine the extent of overcrowding amongst those persons who were known to suffer from the disease. At the time when the Parliamentary Secretary was putting the Sanatoria Act through the House an analysis of the results obtained as a result of the inquiry was being carried out and the Parliamentary Secretary then intimated that we should have to consider every possible means by which segregation could be provided within the home for those persons who have undergone institutional treatment and have returned to their homes and are being looked after by the local tuberculosis officers. The survey and the analysis have now been completed, and as a result we have come to the conclusion that about 1,000 cases would secure the benefit of this new provision. That will mean that in 1,000 cases we are attacking this source of infection. That will mean that not only will there be 1,000 individuals for whose cure better provision will be made, but there will be a considerable number of other individuals, as yet uninfected by these, who will be protected against the spread of the disease.
The Government accordingly proposes in this Bill to permit, in fact almost require, local authorities to make grants for the provision of an extra room, as I have said, in the case of a house where the conditions admit of extension of the living accommodation and where the county medical officer of health or the superintendent medical officer of health, as the case may be, certifies that a member of the household is suffering from pulmonary tuberculosis and is undergoing treatment and that the existing accommodation is inadequate for the proper segregation of that person from other members of that family. I think it would be no harm in this connection to emphasise that those persons who may seek or may desire to avail themselves of the benefit of this section must be persons who are actually undergoing treatment and, of course, they must be persons who cannot provide this proper accommodation for themselves.
Towards the cost of the operation of this section the Government propose to give a very generous contribution, a more generous contribution, in fact, than was given in respect of any other housing activity. The maximum amount provided under the Act of 1932 to assist local authorities to carry out slum clearance schemes was, I think, 60 per cent. In the case of this measure, the Government will contribute towards the cost of providing this separate accommodation two-thirds of the total cost or £100, whichever is the less. That contribution will, of course, relate not only to the provision of the extra room attached to the dwelling-house, but will also apply in cases in which it is thought better that a but or chalet detached from the dwelling-house should be provided within the curtilage or garden of the original hereditament.
The Bill also provides that the valuation of the building consisting of or including the house shall not, on any valuation or revision of the valuation coming into force within seven years after the additional accommodation has been provided, be increased on account of any increase in the value of the hereditament or tenement by reason of the addition of the extra room or chalet.
These are the main purposes of the Bill. I am sure I do not have to say anything more to recommend them to the House. We regard Section 3 as providing a very important instrument in the campaign which we are waging against tuberculosis. The Government hopes, at a very early date, to circulate a White Paper giving a much more comprehensive review of the measures which we are taking to deal with that scourge than I am able to do within the narrow ambit of this measure. That will indicate that the Government's plans in relation to this particular problem are very well advanced. When the White Paper itself is in the hands of Deputies, they may take the opportunity, perhaps in the debate on the Public Health Bill which is now before the Dáil—or on another more suitable occasion, if the time which the House can devote to the Second Reading of that measure should be inadequate for the purpose—to debate the whole question at length. I have only to add that, if it would be acceptable to the House, I should like to get all stages of this measure to-day or, at the latest, to-morrow.