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48
The Authority must evidently be sought elsewhere. There are many hundreds of members
of the industrial classes lying dying in their homes from consumption. Impoverished by
the disease, they cannot be properly fed and cared for themselves, and they are preparing fresh
victims in their families by the double process of privation and contagion. A great deal could
be done to diminish this suffering and waste of life at very little expense. The agencies are in
existence; all that is needed is to combine and direct their efforts.
(Sd.) W. H. Broadbent.
The Right Hon. John Burns, M.P.
With reference to the letter from Sir William Broadbent, it is necessary to remember that
in his speech, as representative of the National Association for the Prevention of Consumption, at
the Deputation to the Asylums Board, and in his Memorial* subsequently addressed to the
Managers, he went beyond the proposal of the Medical- Officers—desiring the Managers to constitute
themselves the " Tuberculosis Authority" for London—for a variety of purposes outside
their present duties, and any that Parliament is likely to impose on them. For the rest, I have
no reason to doubt but that Sir William Broadbent is still in sympathy with the proposal to obtain
for the Asylums Board power to utilise their vacant accommodation for sanatorium purposes.
As above stated, the Local Government Board informed the Managers, in June, 1905, that they
were " obtaining information on the subject," and were not then " in a position to express an
opinion on the question as to whether the Managers should undertake the new duties suggested." In
this connection it is interesting to note that it was the information at present {i.e. in March, 1906)
before the Board, which " did not appear to afford sufficient justification for the very heavy outlay
which would be involved " in giving effect to the prayer of the Memorial of the Metropolitan
Medical Officers of Health. It is needless to say that the Board's decision, as set out in their letter to
the Managers, was the cause of grievous disappointment to the memorialists, and to the other bodies
who assisted at the presentation of the Memorial.
On the question of outlay, it will be remembered that the proposal of the Deputation
was, that vacant accommodation at the Manager's hospitals should be utilised for the treatment
and isolation of persons suffering from consumption ; the only capital expenditure contemplated
being for adaptation of existing buildings. The expenditure for maintenance
—assuming a thousand beds (providing for, say, 2,000 patients yearly, to be allocated
to this use, at a cost of twenty-five shillings a week per patient—would be £65,000
per annum; much of which would be a transfer from the Poor Law Infirmaries' account to the
Sanatorium account. On the other hand, the cost of tuberculosis to the community, in London
alone, runs into millions annually; the great majority of the sufferers—no estimate placing the
number of them below thirty thousand—belong ing to the poorer classes, who are unable to defray
the expense of sanatorium treatment, or to obtain adequate medical assistance until, by reason of
incapacitating illness, they become " chargeable," and so qualify, all too late, for admittance to
the Poor Law Infirmaries.
Gore Farm Hospitals and the Sanatorium Question.—Some five years since, the Council
recommended that the then unoccupied hospitals at Gore Farm, Dartford (of which a description
was given in my annual report for 1904, page 39) should be utilised for the treatment of persons
suffering from pulmonary consumption. The recommendation was endorsed by many Metropolitan
Public Health and Poor Law Authorities, and, by the entire body of Medical Officers
of Health. It was hoped that the representations made to the Metropolitan Asylums
Board would have borne fruit, they having decided, in June, 1903, that those hospitals should " no
longer be recognised as Small-pox hospitals;" but the Managers, acting upon the advice of the
Hospitals Committee, decided in 1905 to use the hospitals (Upper and Lower) for patients convalescent
from scarlet-fever and diphtheria ; thus extinguishing the hope that they would comply
with the recommendation to devote them to sanatorium purposes.
Southern Convalescent Hospital.—The Managers possess another hospital,at Carshalton,
in the County of Surrey, recently taken over from the builders, which might be utilised as a
sanatorium, not being required for its intended use. And that it is not likely to be so
required, is highly probable: at any rate, it was characterised by a Manager at a recent meeting
of the Boai d as a " white elephant," and unnecessary. This institution would seem to be capable of
•The " Memorial," printed in The Times, February 2nd, 1906, formed the subject of a leading article in that journal on
the following day.