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104
METROPOLITAN AMBULANCE SERVICE.
Before submitting an abstract of the annual report of
the Ambulance Committee, it may be mentioned that Section
16 of the Poor Law Act, 1879, the provisions of which
are now incorporated in the Public Health (London) Act,
1891, conferred on the Metropolitan Asylums Board
one of its most valuable powers, that namely, of providing
ambulances for the conveyance of the infectious sick to
the hospitals of the Managers. Previously to 1879 the
Boards of Guardians had removed the sick, under conditions
occasionally prejudicial to the public health. The work of
removal—whether by land or water—is now effected in an unexceptionable
manner. In a former report, I had to observe
that this remark was applicable only in the case of patients in
course of transit to or from the Managers' hospitals. It was
often quite otherwise in respect of private patients, who were
but too frequently removed in public vehicles, cabs, &c. The
law did not forbid the use of a public vehicle for this purpose,
provided that the vehicle was afterwards disinfected. But
the driver of a cab was often unaware of the nature of his
fare's illness ; the efficacy of any practicable disinfection,
moreover, may be reasonably doubted Consideration of
these and other objections to the existing law, led me to the
conclusion that public vehicles should never be used for this
purpose, and that it would be to the public advantage,
were the Asylums Board made the Ambulance Authority for
the removal of the infectious sick of all classes. In 1884, therefore,
I addressed a communication to the Managers proposing
that they should place their ambulances at the service of the
medical profession, and Medical Officers of Health, with or
without payment, for the conveyance infectious sick persons.
The Managers replied that they were, at that time, " not in a
position to undertake the removal of any cases of infectious
disease beyond those which are to be received into hospitals
under their own control." Commenting on this reply in my