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HOSPITAL ACCOMMODATION.
In my Annual Report for 1893 (pages 117 to 130 inclusive),
I spoke of the needs of the Metropolis in respect of
hospital accommodation for the infectious sick, and detailed
the steps taken by the Asylums Board to supply the then
existing deficiencies, and the difficulties by which their efforts
had been confronted and, to a certain extent, foiled. Those
difficulties, I am glad to report, have now been largely overcome,
for the needs of the Metropolis, in this regard, are at
last fully recognised, and will ere long be met to the full
extent of the estimate of them made by me in my tenth
monthly report for 1893, which, at that time, was thought to
be excessive, viz.: of "at least 5,000 beds for scarlet fever,
fever, diphtheria, and isolation."
It is an accepted axiom that provision for the isolation
of infectious disease should be at the rate of not less than one
bed for each thousand of the population. The subject, as
regards the Metropolis, was considered by the Royal Commission
in 1881-82, and the Commissioners stated in their report
(1882) that the then provision of hospitals should be extended
so as to provide 5,700 beds at the least; viz.: 3,000 nominally
for "Fever," and 2,700 for Small-pox. Diphtheria cases were
not at that time admissible to the hospitals. The population
of London in 1882 was a little under 4,000,000. Consequently,
the recommendation of the Commissioners went, to the extent
of 1,700 beds,beyond the theoretical requirements of the day.
Naturally, however, the Commissioners intended to make provision
for a lengthened period in advance, and the amount of
accommodation they advised to be provided is even now ahead
of the standard requirement. But circumstances have arisen
that they could scarcely have anticipated, and which have
led to largely increased demands on the Managers' resources ;
not only by the Sanitary Authorities, but also by private
medical practitioners and others. Among these circumstances