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without making any allowance for enteric cases,* or providing for increase of population. The
permanent fever hospital accommodation, existing or projected at the time, was 6,050 beds, but some
5,400 beds would approximately represent the number available, including the Southern Convalescent
Hospital, at Carshalton, when completed.†
The Hospitals Committee, reporting on the subject, recommended (a) That in the opinion
of the Managers additional accommodation is required for the isolation of fever and diphtheria
patients; and (b) That it be referred to the Hospitals Committee to make inquiries with the view
to the acquisition of more land for hospital purposes, and to submit a scheme to the Board for
their consideration.
With reference to this proposal the Chairman of the Finance Committee furnished statistics
in support of the contention that further hospital accommodation was not required, and asked the
Board to review their position before entering into larger financial responsibilities.
It was pointed out that the Board had never, since 1871, had to deal with more than 2,000
cases of small-pox at any one time, and that the surplus accommodation provided for this disease
could be made available for fever and diphtheria.
The Council having referred to the Public Health Committee my sixth report (June 19th,
p. 113), in which the matter was dealt with, I prepared a memorandum showing that the scheme
approved by the Hospitals Committee pointed to a deficiency of some 1,600 beds for fever and
diphtheria. On this basis (I observed), three additional hospitals would be required, if it were decided
to build in London ; as apparently contemplated by the Committee, who desired to be authorised
" to make inquiries with the view to the acquisition of more land for hospital purposes, and to
submit a scheme to the Board for their consideration."
The report of the Public Health Committee, after some preliminary observations, was to the
following effect: —
" The deficiency of accommodation appears to be to the extent of 1,600 beds—or about as
many as are comprised in the last three hospitals erected by the Board. Judging from the cost of
those establishments, it would appear not unreasonable to assume that three new hospitals, on the
scale of the " Brook," the "Grove," and the " Hither Green" Hospitals, including sites, furnishing,
etc., would involve an approximate expenditure of £800,000, of which about one-sixteenth, or £50,000
would fall upon Kensington. Great as the outlay would be we should not feel justified in objecting
to it, could it be proved to be necessary. But we think the Medical Officer has shown prima facie
reason for doubting the necessity, and that before such a great additional burden is imposed upon
the ratepayers of the Metropolis, the need of it should be conclusively demonstrated. At present
the Board have not assented to the proposals of the Hospitals Committee and we hope they will
not find it necessary to do so; but should this step be taken, we are of opinion that the Local
Government Board, before they shall have given sanction to any scheme, should be asked to
institute an inquiry directed to ascertain the feasibility of the suggested alternative of utilising the
surplus accommodation at the small-pox hospitals for fever and diphtheria patients. We recommend
therefore that the matter be referred back to us with power to make a representation to the
Local Government Board with a view to the holding of an inquiry, should occasion arise, and to
invite the co-operation of the Sanitary and Poor Law Authorities of the Metropolis generally."
The Managers, however, referred back the report of the Hospitals Committee, and no further
action appears to have been taken. . .
The present hospital state of the Metropolis with respect to fever and diphtheria accommodation
is as follows : the ten town hospitals contain some 4,600 beds; the Northern Convalescent
Hospital 650; total 5,250. The Southern Convalescent Hospital, now in course of construction,
will contain 800 beds ; so that ere long the Managers will have accommodation for about 6,050
patients.
Small-pox Hospital Accommodation.—The subject of hospital provision for small-pox,
referred to incidentally in the preceding paragraph, occupied a considerable share of the attention
of the Asylums Board towards the close 1901, in connection with a report of the Hospitals
Committee, dated 2nd November. In view of the necessity for making increased provision for
acute cases with the utmost rapidity, the Committee recommended the erection of a temporary
hospital on the Managers land at Long Reach, near the Ships, for 300 patients, so as to raise
the accommodation in that locality to 550 beds. The Managers adopted the recommendation and
* In 1899, 4,460 cases of enteric fever were notified; in 1901 about 25 per cent. of cases notified were admitted to hospital,
† The beds reserved in June were, for isolation 463, and for plague 196—say 660.