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The Council referred to the Public Health Committee my sixth report, in which this
transport question was discussed, and for the further information of that body I prepared
a Memorandum, as follows :—
" The proposal of the Ambulance Committee is to provide a road service, on a scale which
they themselves characterise as " enormous," for the conveyance to Gore Farm and Long
Reach of small-pox patients, to be brought into use should fog or frost at any time close the
river to the ambulance steamers. To this proposal an alternative has been suggested, that
namely of a railway service, which deserves examination.
"Apart from this immediate question, I desire to suggest that instead of the proposed road
service, for an emergency seldom likely to arise, it would be better to make provision for the
temporary detention of patients by enlarging the South Wharf Shelters, a course which is not
likely to be detrimental to the locality. The outlay for the large establishment of ambulances,
etc., contemplated, and in providing and maintaining an ambulance station midway between
London and Dartford, would be great—probably much greater than that involved in the
alternative suggested. The ambulance steamers, which are fitted as hospitals, would, with the
present shelters, accommodate, on occasion, some 250 patients, and the necessary further
accommodation could be provided, on land, or possibly on the river itself, if thought desirable.
It may be objected that it would not be right to expose the Sufferers to the risk of
catching small-pox at the South Wharf Shelters. But, subject to suitable arrangements, I
believe the danger would be remote, even to the extent of negligibility. Lest this expression of
opinion should be thought too absolute, I think it well to add that I have indisputable authority
for saying that there has been no spread of small-pox in the neighbourhood ot the Shelters due
to the transit or detention of patients. The immediate vicinity has been singularly free from
small-pox; freer, indeed, than many other parts of the Borough of Bermondsey, although
within the last few months upwards of 8 000 patients have passed through the Shelters. Not
long since some 140 workmen were employed in erecting an extension to the Shelters, at a time
when 80 cases per diem wore being admitted, and although they were uecessarily brought into
close proximity to the sick, and were generally unprotected by vaccination, only one of them
fell ill—about a week or two before their work ended ; and of him all that could be said was that
it was not known whether he had contracted the disease there or elsewhere. The Shelters hold
25 patients, and on one occasion, fog having stopped the river traffic, 120 patients were detained
therein, and on the steamers, without ill-effect to the locality. Barges constantly anchor close
to the Shelters, but I cannot learn of complaint having ever been made of any spread of disease
to the crews The Managers, moreover, have another pier and landing stage adjacent to the
Mead Ambulance Station, near Wandsworth Bridge, constructed many years since, but never
yet brought into use. The locality would be convenient for Shelters for the Western Districts;
and to the use of the wharf as a place of embarkation, there would appear to be no objection,
except that the pier is available only when the tide serves : a fact which surely ought not to
constitute an insurmountable difficulty."
The report of the Public Health Committee on the reference was as follows:—
" Upon the reference by the Council we have considered a letter from the Metropolitan
Asylums Board, and a report which the Managers have received from the Ambulance Committee,
•relative to certain representations made with respect to the proposal of the Committee to
obtain land between London and the small-pox hospitals on which to establish a midway
ambulance station in connection with the road-transport of patients.
"We have also considered paragraph 3 of the sixth report of the Medical Officer of Health,
dated 19th June, 1902, dealing with the subject, under the heading " Transport of Small-pox
Patients from London to the Small-pox Hospitals," and we concur with the view therein
expressed that the proposal of the Ambulance Committee is not a desirable one, and that it
would be preferable to provide extended shelters for the temporary accommodation of patients,
should frost or fog close the river to traffic.
" We hope that the proposals of the Ambulance Committee may not be approved by the
Managers, but should they be, we are of opinion that the Local Government Board should be
asked to hold an inquiry before giving sanction to a scheme which would be costly and of
doubtful benefit to the Metropolis.
" We accordingly recommend that the matter be referred back to us with power to make
representations to the Local Government Board, with a view to the holding of such inquiry,
should it become necessary, and to invite the co-operation of the Sanitary and Poor Law
Authorities of the Metropolis generally."
Happily, the occasion for the action recommended by the Committee did not arise; the
Managers having rejected the proposal of the Ambulance Committee to purchase land for a
station intermediate between the Shelters at the Wharves and the Country Hospitals, the scheme
of a large installation of vehicles, etc., fell through. Subsequently the Managers obtained the sanction
of the Local Government Board to the provision of a motor ambulance calculated to make
the journey, to and fro, between the London hospitals and Gore Farm in one day. This vehicle
has been provided, but is not likely to be required for the conveyance of small-pox patients.