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74
HOSPITAL ACCOMMODATION.
In the annual report for 1893 (pages 117 to 130 inclusive),
I dealt with "The needs of the metropolis in respect of Hospital
Accommodation for the Infectious Sickdetailed the
steps taken by the Asylums Board to supply the then existing
deficiencies, and referred to the difficulties by which their
efforts had been confronted and, to a certain extent, foiled.
Those difficulties have now been largely overcome; and the
needs of the metropolis, which are now fully recognised, have
been met to an extent beyond the estimate of them made in
my tenth monthly report for 1892, which, at the time, was
thought to be excessive, viz.: "at least 5,000 beds for scarlet
fever, 'fever,' diphtheria, and isolation."
Fever 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 considered by the Royal Commission in
1881-82, and the Commissioners stated in their report (1882)
that the then provision of hospitals should be extended so as
to provide 5,700 beds at the least; 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 under 4,000,000; consequently
the recommendation of the Commissioners went, to the extent
of 1,700 beds, beyond the theoretical requirements of the day.
The commissioners, doubtless, desired that provision should
be made for a lengthened period in advance, and the amount
of accommodation they advised as necessary, is even now in
advance of the standard requirement. But circumstances
have since arisen that they could scarcely have anticipated,
and which have led to largely increased demands on the
Managers' resources; not only by the sanitary authorities,