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50
THE METROPOLITAN ASYLUMS BOARD.
Under the provisions of the (now repealed) Sanitary Act, 1866, the local sanitary authority
was endowed with power to provide, for the use of the inhabitants of their district, hospitals for the
reception of the sick; a provision re-enacted in section 75 of the Public Health (London) Act, 1891.*
But, excepting in a few districts, and for a limited period in time of emergency; e.g., when smallpox
was epidemic, this power was not exercised, despite official pressure brought to bear to induce
sanitary authorities to erect local hospitals. The late Vestry led the opposition to the establishment
of such hospitals, with little support at first, but ultimately with complete success; and no one
now doubts that the policy of that body was wise, and fruitful of benefit to the entire Metropolis.
In 1867 the Metropolitan Poor Act brought the Asylums Board into existence, and this body set to
work forthwith to provide infectious disease hospitals, nominally for paupers only. As a matter of
fact, however, and despite the disabilities attaching, in theory, to the use of the hospitals, they were
largely used from the beginning by non-paupers; and in course of time legislation secured to the
inhabitants of the Metropolis all of the advantages contended for by the late Vestry, at my instance,
from 1877 onwards. The hospitals are now free to all, no disability attaching to the use of them
by any person whatsoever. The Managers, as the central authority, have fulfilled their duties
admirably, and have created for London a hospital system unequalled elsewhere, and which, it is
perhaps not too much to say, is the admiration of foreign nations. Be this as it may, the Managers
fulfil the duties originally devolving upon the local sanitary authorities; duties which those
authorities would undoubtedly have had to perform but for the creation of the Board, and the subsequent
legislation which has so enhanced their powers as to leave little or nothing to be desired.
Details of the work of the Managers as hospital and ambulance authority in respect to
infectious disease, are set out in their annual report, which had not been published when this report
went to press.
AMBULANCE SERVICE.
Ambulance Arrangements.—Kensington patients are removed to hospital by the staff at
the Western Station, which adjoins the Western Hospital, Seagrave Road, Fulham. In the
early part of 1900, the Managers, on removing to their new offices, Victoria Embankment (corner of
Carmelite Street), E.C., arranged for the reception of applications for the removal of the sick to
hospital between the hours of 9 in the morning and 8 in the evening, on all days of the year, so that
it is now necessary to apply at the ambulance stations between 8 in the evening and 9 in the
morning, only. It cannot be too widely known that the sick are admitted on the application of any
person whatsoever, the sole condition being the presentation of a certificate signed by a registered
medical practitioner as evidence of the nature of the disease and the fitness of the patient for
removal. The application may be made personally, or by letter, or by telegraph, or by telephone.
The telegraphic address is "Asylums Board, London": the telephone numbers are 1601 and 1602,
" Holborn."
Removal of the Sick to Hospital.—The removal of the sick to hospital, whether by land
or by water, is now effected in a satisfactory manner. The use of public vehicles by persons
suffering from infectious disease is unlawful. Very rarely do we now hear of the use of a cab, wittingly
or unwittingly, for this purpose. In any such case the vehicle is usually lost sight of before
discovery of the nature of the illness, and so does not get disinfected. This is no doubt a danger to
the public, but it is of extremely rare occurrence compared with the time before the passing of the
Public Health (London) Act, 1891, the 70th section of which forbids the employment of public
vehicles. No breach of the law came to my knowledge last year.
Transport of Small-pox Patients from London to the Small-Pox Hospitals.—In
1902 the Asylums Board adopted a recommendation of the Ambulance Committee authorising the
Committee—
"To take all the necessary preliminary steps with the view of securing sufficient freehold
land for the purpose of an ambulance station and shelter for patients midway between
Loudon and Gore Farm Hospital."
• Vide page 37.