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54
HOSPITAL ACCOMMODATION.
It is an accepted axiom that provision for the isolation of infectious disease should be made
at the rate of not less than one bed for each thousand of the population. The subject, as regards
the Metropolis, was dealt with by the Royal Commission in 1881-2, and the Commissioners stated
in their Report (1882) that the provision of hospitals should be extended so as to provide 5,700
beds; viz.: 3,000 nominally for "fever," and 2,700* for small-pox. Diphtheria cases were not at
that time admissible to the hospitals. The population of London in 1882 was a little over
3,860,000; consequently the recommendation of the Commissioners went, to the extent of 1,740
beds (at the least), beyond the theoretical requirements of the day. The Commissioners,
presumably, desired that provision should be made for a lengthened period in advance, and the
amount of accommodation they advised, as being necessary, is even now in excess of the standard
requirement, the estimated population being under 4,600,000; but circumstances they did not
anticipate have led to largely increased demands on the resources of the Asylums Board; not only
by the sanitary authorities, but also by private medical practitioners and others. Among these
circumstances may be mentioned, the depauperization of medical relief in the hospitals, and the
opening of the several institutions to all classes of the people (measures advocated in these reports
many years before they formed the subject of legislation); the admission of patients, on whatever
form of application, subject only to the production of a medical certificate; gratuitous treatment;
the popularity of the hospitals themselves; and the increasing recognition by the public of
the advantages accruing from the isolation of the infectious sick. Compulsory notification,
moreover, has been very effective; for now that the sanitary authorities become acquainted with,
practically, all cases of infectious disease, they are able to secure the admittance to hospital of
numbers of cases, of which in pre-notification days they would probably never have heard.
1 am indebted to Mr. Duncombe Mann, Clerk to the Metropolitan Asylums Board, for the
subjoined statement, showing the existing and projected accommodation: it leaves out of
consideration the Gore Farm Hospitals (1,850 beds), not now in occupation, and in regard to
which no decision has as yet been arrived at as to their future use.
"Return showing the permanent Fever Hospital Accommodation existing and projected:—
(i.) Accommodation existing— Beds.
Eastern Hospital 362
North-Eastern Hospital 596
North-Western Hospital 460
Western Hospital 452
South-Western Hospital 345
Fountain Hospital 402
Grove Hospital 518
Park Hospital 548
Brook Hospital 560
Northern Hospital 748
Total 4,991
(ii.) Accommodation projected—
Southern Hospital 800
South-Eastern Hospital (now being reconstructed) 488
Grand Total 6,279
"For Small-pox Patients the existing accommodation is as follows: —
Beds.
Long Reach Hospital 300
Orchard Hospital 800
Joyce Green Hospital 940
2,040
It is thus seen that the accommodation far exceeds the theoretical requirement of one bed
for each thousand of the population. On that scale London would require not more than 4,600
beds, and it has, or soon will have, 10,000.
* The ordinary provision for small-pox was to be of 2,100 beds, but capable of being'increased, on an emergency, to 2,700.