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109
maximum requirements, seeing that the need for hospitals is always
most pronounced when infectious disease is epidemic, the liability of
any such disease to spread being then greatest. The Committee
advert to the reduction of accommodation in existing hospitals, during
1893, as compared with that provided in 1892, which had created
some surprise. The accommodation in 1893 was for 3,468 patients
only, a decrease therefore of 1,179 beds as compared with the number
in 1892; due, as the Committee state in respect of fever hospitals,
to the demolition of certain wooden huts; demolition of wards to
make way for new administrative buildings, and the reduction of the
number of beds in the permanent wards under medical advice. A
decrease of 636 beds at Gore Farm (included in the total decrease)
arose from the relegation of the Upper Hospital there to its proper
use for small-pox cases. "The opening of the Fountain Hospital
has reduced the nett loss of beds to 773, and this figure will shortly
be further reduced, by the provision of additional beds at the
Eastern, the South-Western and the Western Hospitals."
The Committee explain the system of selecting patients for
admission to the hospitals, necessitated by the insufficiency of accommodation,
efforts having been made to secure admission of the most
urgent cases. It was the practice, when no bed could be obtained,
to require the application "to be renewed from day to day, with a
statement of the circumstances appearing to render the case one of
urgency, and then each day a selection was made, by the officers
employed in the Ambulance Department, of those cases which
appeared to be most in need of hospital treatment and isolation."
In respect of our own cases, I may mention that the work of removal
was much facilitated by the use of the telephone, which led, moreover,
to the removal of many cases that would have been left at
home, had we been dependent on less rapid means of communication
with the offices of the Board. The removal of many of our cases,
prior to 1893, had been furthered by the use of the notification
certificate, as the "medical certificate" without which the Managers
will not remove any patient. In 1893, the Committee, "with a view
of facilitating prompt removal, and of avoiding delay in the preliminaries,"
influenced, moreover, by representations made on behalf