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With respect to the arrangements for the removal of the
sick, I may mention that this important duty, 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. many
years ago, 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 of
infectious sick persons. The Managers replied that they
were, " not in a position to undertake the removal of any
cases of infectious disease beyond those which are to be
received into the hospitals under their own control"; but in
1888 they came to the conclusion " that the conveyance of
infectious cases by public vehicles should be prohibited by law;"
and having expressed willingness to " use the machinery they
possess for the prompt and economical removal of infectious
cases," the Local Government Board obtained from
Parliament the desired powers, in a section of the Poor Law
Act, 1889, the provisions of which, as already mentioned, are
now incorporated in the Public Health (London) Act, 1891.
Strange to say the provisions of law with regard to this
matter are still unknown to many persons, who might natur-