View report page

much success, and with manifest advantage to the public health
interests of London.
The Act referred to does not apply to the Metropolis, for the
simple reason that, long before it was passed, the powers which it
confers on County Councils, other than the London County Council,
had been exercised by the Metropolitan Asylums Board.
The Question of Local Hospitals. — In passing, it may be mentioned
that the Sanitary Authorities might, singly, or in any degree of combination,
provide hospitals for the inhabitants of their several districts
( Public Health (London) Act. 1891, section 75); but no action has
hitherto been taken to exercise this power. Some of the South
Eastern Borough Councils did attempt to form a combination, but it
fell through; and I fear that it would be found impracticable to
make any arrangement of the sort which would prove permanent or
ent irely satisfactory.
The Need of a Central Authority.- The work is one that can be
carried out, effectively, only by a Metropolitan Authority, as the
Local Government Board plainly intimated to the promoters of the
Conference of 1900, held at their suggestion. Were hospitals provided,
by a single Sanitary Authority, or a combination of Authorities,
it is more than likely that persons suffering from consumption would
flock to the district in the hope of getting admitted: surely an undesirable
effect of what could not be described, otherwise, than as a legal
and justifiable course of proceeding, were it reasonably practicable.
The desiderated "General Consensus of Opinion" Attained. — It has
long been believed that the Asylums Board are willing to take up
the work, and are only waiting for evidence of a "general consensus
of opinion on the part of the Metropolitan Authorities" in favour of
their so doing. In their annual report for 1902, after referring to
the "diversity of opinion" amongst the Boards of Guardians, as to
the desirability of the Board undertaking the treatment of the tubercular
disease "Lupus," they went on to state that "there was a
nearer approach to unanimity on the part of the Boards of Guardians,
as well as on the part of the Sanitary Authorities of the Metropolis,
on the suggestion that the Board should provide Sanatoria for Consumption."
Is not the "consensus of opinion" now "general" enough ? Reference
has already been made to the unanimity of the Conference of
Guardians. May it not suffice, then, that Public Health Authorities
such as those of the boroughs of St. Pancras, St. Marylebone, Lambeth.
Poplar. Shoreditch, Battersea, Finsbury, Fulham, Stepney,
Stoke Newington, Kensington; and Boards of Guardians such as
those of Paddington, Chelsea, Hammersmith, Holborn, Poplar, Step-