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Health for Paddington, in a report to the Public Health Committee of that borough, in which (inter
alia) an attempt was made to forecast the probable requirements of ambulances, horses, drivers,
etc., to enable the Managers to deal with the "problem," the "enormous" proportions of which
are foreshadowed in the part of the Ambulance Committee's report which I have italicised above.
The Ambulance Committee, in a subsequent report (5th May), communicated to the Borough
Councils and the Boards of Guardians, disclaimed any intention of submitting to the Managers "a
proposal to make provision for the gigantic staff of nurses, men, vehicles and horses " indicated as
what would be necessary to give effect to the scheme outlined in their first report, summarised
above. They said that they only " proposed the institution of a scheme of road transport which
should be available whenever river transport was impossible ; " but such a " scheme " really did
involve the provision of a " number of vehicles, horses, drivers, and nurses " on a scale which they
themselves had described as "enormous." They appeared, however, to have no settled ideas as to the
practical working of the "scheme," for in the later report (5th May) they said " We have not yet
determined what means of traction, or what kind of vehicle, shall be recommended to the Managers
for use in the road service."
Reporting on the proposal, I observed that " the position in which the Managers would be
placed, should fog or frost interrupt the river transport service at a time of great prevalence of
small-pox, would no doubt be serious. But would road transport enable them to cope with it ?
Were the interruption due to frost, in clear weather, the thing would be physically possible—at
a risk to the patients which is hardly measurable. But if dense fog stopped river traffic, what
guarantee was there that London streets and country roads would be passable at any reasonable .
rate of speed ? And who could doubt that long detention, en route, would be detrimental to the
sufferers, who, the Ambulance Committee estimated, might be as many as one hundred, to be
despatched in the latter part of the day, possibly a winter day ? Was it to be supposed that
patients' friends would suffer them to be exposed to such a risk ? And, if not, what might not be
the consequences of their detention at home ? Obviously, the Managers were well advised to
' contemplate the desirability of providing a system of transport which would enable them, under
great emergency, to convey,' not 'some,' but 'all their patients safely out of London' (were it
practicable); if, as they said, ' the necessity of clearing London of small-pox day-by-day is
admitted." But the real ' necessity,' is that of ' clearing' the houses of London day-by-day of smallpox.
What the Ambulance Committee proposed was, in principle, excellent: the question w as,
whether the proposed means of carrying out the ' scheme' was the best ? They alleged it to be
the only one available, as any scheme of railway transport would meet with the greatest opposition
from the Companies and the travelling public. But what about that greater public on the line ot
route ? What would they say to a constant stream of small-pox passing through their midst,
causing panic, to say the least of it, and probably ruin to the tradesmen frontagers ? But this by
the way.
There was, however, as I pointed out, an antecedent question; viz., whether it would be
necessary, under emergent circumstances, to use the road at all ? Could not provision be made for
accommodating the sufferers for a short time at (or in the vicinity of) the "Shelters?" Upwards
of 8,000 patients passed through the South Wharf Shelters between August 1901 and June 1902
(and the Shelters during an epidemic are rarely empty of small-pox)*; but no harm ensued either
from the detention of patients, or from the constant stream, day and night, of small-pox into the
district. This being so, I asked, why, instead of incurring a vast expense on a new system of
transport—which, in any case, would rarely be brought into action—to say nothing of the risk to
the sick—why not make provision for temporarily housing the patients in enlarged Shelters on land
or water? If the fear of aerial convection of contagiun were dismissed, nothing seemed to stand in
the way of such a scheme but a certain amount of expenditure—a fairly large outlay, it might be,
of capital which, should it lie for ever "dead," by reason of non-necessity for use of the temporary
accommodation, need give no concern to a Board which, with splendid audacity, had not hesitated,
in what they believed to be the interests of London, to spend hundreds of thousands upon temporary
hospitals at Gore Farm, Long Reach, and Joyce Green.
The scheme propounded by the Ambulance Committee came before the Managers again in
June, on a recommendation for the purchase, subject to the approval of the Local Government
Board, for the sum of £6,000, of 13 acres of land on the Bexley Road, near Blendon, as a site for
the proposed ambulance station, midway between London and the hospitals at Gore Farm and Long
Reach. The recommendation was referred back to the Committee.
* The Local Government Board,.(3rd February) in a letter to the Managers, drew attention to the detention (in January)
at the South Whart Shelters of numbers of cases of small-pox, considering it to be " most important that no acute cases of
small pox should be allowed to remain at the wharves any longer than is absolutely necsssary, and that the cases should be
transferred to a hospital with the least possible delay "—a view with which the Ambulance Committee expressed concurrence.
(Report of the Ambulance Committee, 24th February).