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in Bermondeey was increased from live to ten. Several younger
doctors replaced some of the odder practitioners, and showed themselves
anxious to undertake midwifery cases, and Guy's Charity
was extended by the Governors to cover about four-fifths of the
Borough. In addition, the Bermondsey and Rotherhithe Hospital
decided to open a large maternity ward, and as the work there
was done on a much larger scale than our own, they could afford
to take patients at a much lower fee than we could. The result
of all this was that in 1923 the number of applications for confinement
in our hostel had fallen considerably. In the first full year
of the working of the hostel 155 maternity cases were admitted,
and for the year ending March 31st, 1923, the number was 138.
The bookings decreased from 75 in March, 1921, down to 28 in
1923. For the year ending March 31st, 1923, only 66 per cent,
of the beds in the hostel were occupied. It was also found that
the total net cost per patient was £7 2s. 8d. per week, and that
the average receipts from patient was £1 14s. 4d. a week, showing
a loss of £5 8s. 4d. per week for every patient, or a total loss of
£10 16s. 8d per fortnight. As a result of this state of affairs
the Council thought that 110, Grange Road, could be used to much
greater advantage as a Maternity and Child Welfare and Dental
Central, and decided to close it as a lying-in hostel.
In the meantime "Fairby Grange" was presented to us as a
convalescent home, and it was thought a good opportunity to
transfer those members of the staff to "Fairby Grange" who could
not be kept on owing to the closing of the hostel. Miss A. E. Sewell
the matron of the hostel, was offered the post of matron at
"Fairby Grange," and decided to take it. Miss Boutcher, the
cook at the hostel, also decided to go with the matron to the convalescent
home.
The experiment of providing a lying-in hostel was a most
useful one, the special value being that it showed the difficulties
of running an institution of that kind on so small a scale. The
larger the number of beds, within certain limit, the cheaper the
cost per patient, and at is only by providing a minimum number
of beds, say about 20, that expenses can be kept within reasonable
limits. One great difficulty in providing institutional treat-