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THE METROPOLITAN ASYLUMS BOARD.
The work of the Asylums Board has of late years assumed
increased importance to Sanitary Authorities, by reason of the
legislation which has conferred power on the Managers, enabling
them to discharge for the Metropolis, as a whole, the functions
which, under the provisions of the Sanitary Act, 1866 (now
incorporated in the Public Health Act, 1891), formerly
devolved upon the 43 Vestries and District Boards in their
several districts. The Board are now the central authority
for providing hospital accommodation, and an ambulance
service, by land and water, for the infectious sick —by warrant
of law, as they previously had been in fact; for it is well
known that legislation has, during many years, followed in the
steps of the Managers' practice in regard to all that concerns
the removal of the sick and their admittance to hospital. The
ambulance arrangements leave nothing to desire; the accommodation
for the sick, moreover, was always sufficient until
within the last few years, but the increased and increasing
disposition of the public to make use of the hospitals, which
dates from the scarlet fever epidemic of 1887, together with
the enlarged demands on the resources of the Managers consequent
on .compulsory notification of infectious disease, have
given rise to difficulties to which reference has frequently been
made in these reports. Happily, the steps taken by the
Managers, with the approval of the Local Government Board,
encourage the belief that ere long the provision of accommodation
will be equal to the demand. The work of the Board is
summarised in three reports, issued annually, by the Chairman
(Sir E. H. Galsworthy), by the Statistical Committee, and by
the Ambulance Committee. These documents, which have
great interest for all who are concerned in the good sanitary
government of London, and the several sanitary districts
thereof, had not been published when this report had to go to
press. I am, therefore, unable to follow my usual practice of
summarising their contents for the information of your Vestry.