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occasioned by the admission during the last five years into the Board's hospitals of some
10,000 cases not suffering from diseases for which these hospitals are provided, and
suggest a conference between the Board and the several Metropolitan Borough Councils
to consider the subject.
"As regards the financial statement, the Holborn Borough Council seems to
have been misled. The Accountant of the Board has estimated that the extra cost
to which the Board has been put by the admission of these patients would not exceed
an average sum of £3,200 per annum.
"As regards the matter which it is proposed to discuss, it is undeniable that in
the earlier stages of many cases of infectious disorder there can be no absolute
certainty of diagnosis, and that to detain at home every patient until such certainty is
attained must frequently result in the spread of infection, the prevention of which
is the primary object of the Board's hospitals.
"It must, therefore, be always wiser to remove a doubtful case than to leave it
outside with the danger of infecting others, which, if done, would of necessity increase
the number of admissions, and thus cause a very considerable expenditure of the
rates.
"The business of the Managers is to receive cases which are certified by a
qualified practitioner, provide proper accommodation, and then leave them in the
experienced hands of the medical superintendents.
"In our opinion, the Managers would be going quite beyond the scope of their
functions if they took any step which would have the effect of discouraging medical
practitioners from freely exercising their judgment in seeking for their patients
admission to the Board's hospitals.
"The suggestion that the Medical Officer of Health should confirm the diagnosis
is not one for the Board; but in our opinion it is very doubtful whether such a
proceeding would be of any value, and it certainly would be attended with distinct
disadvantages.
"We do not see that any useful purpose would be served by such a conference as
the Borough of Holborn suggest, and we cannot recommend the Managers to take any
part therein."
The Public Health Committee finally decided not to hold the Conference, and the
matter was referred to the Metropolitan Borough Councils Association, who after due
consideration gave a similar reply to that of the Metropolitan Asylums Board.
I fully agree with the opinion of the Metropolitan Asylums Board and the
Metropolitan Borough Councils Association, as I have always been in the habit of
seeing doubtful cases when asked to do so by doctors in attendance, and therefore fully
appreciate the extreme difficulty and sometimes impossibility of making a certain
diagnosis.