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135
provided on the existing sites? as the more economical plan,
obviously, would be that of enlarging the existing hospitals."
I did not elaborate the subject, for, as I said, " it is one for
inquiry by a responsible authority." Such inquiry has yet
to be taken in hand.
INCREASED FACILITIES FOR THE REMOVAL
OF THE INFECTIOUS SICK.
Until within the last few years, persons suffering from
infectious disease were inadmissible to the Asylums Board
Hospitals unless provided with the certificate of a Poor Law
Medical Officer, in addition to the order of the Relieving
Officer. In 1875, I recommended that the certificate of any
registered medical practitioner should be made available for
the purpose. The Local Government Board did not fall in
with my views then, but twelve years later they issued an
Order in conformity therewith. For some time, however,
before 1887, the Asylums Board had adopted the practice of
accepting the certificate of any properly qualified medical
man, as evidence of the nature of the infectious illness, in lieu
of the Poor-Law Medical Officer's certificate, with much
advantage to the interests of public health. Your Vestry,
moreover, authorised the payment of a fee to any medical
man who, by giving such certificate, should hasten the
removal to hospital of the infectious sick person. Some time
after the Infectious Disease (Notification) Act, 1889, came
into operation, I began to make use of the notification certificate,
as a medical certificate to be handed to the nurse in
charge of the ambulance sent to fetch the patient, thus
avoiding the necessity of applying to medical men for special
certificates—a course which sometimes occasioned delay. In
June last year, the Asylums Board gave their official sanction
to the use of the notification certificate, having issued a
circular letter to the effect that the Ambulance Committee,
" with the view of facilitating the prompt removal of patients,