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The claims of the Association which has undertaken this great work were advocated at a public
dinner on the 14th May, at which the Prince of Wales took the chair. His Royal Highness, in the
course of his speech, explained the position of the Societies. They can, he said, legally maintain beds
in sanatoria, but cannot draw upon their capital for building purposes. If the new institution
proved to be a financial, as well as an educational success, inducement would be given to form
branches of the Association around London, and in different parts of the country. The after-care
farm colony was an important department of the sanatorium, enabling the patient to be gradually
hardened, so that he may resume full work on his discharge, with the least risk of another break
down in health. 'I he working man was paying for his own cure and so rendering himself independent
of charity. There were less than a thousand beds in the country for the open-air treatment
of working-class sufferers, yet the fatality among the fifteen millions who were members
of the friendly societies and the trade unions, was upwards of 28,000 lives per year, from the
disease which slowly sapped the vitality of the bread winner: its victims in London alone being
counted by thousands. Tuberculosis was a greater disaster to the national life than any war, for
it caused a perennial loss. Moreover, it robbed the sufferer of his means of living; it was estimated
that the working classes of London lost annually four millions in wages from this terrible scourge,
which entailed misery in thousands of homes, and brought, too often, the individual sufferer to end
his days in abject poverty. His Royal Highness, acclaiming the " high ideals of this great enterprise,"
declared that he had " never pleaded for a cause more noble and more righteous."
This very interesting occurrence recalled to mind the abortive efforts of the Council, and other
Public Health Authorities (1901-1905), to bring about the establishment of metropolitan sanatoria
for poor persons suffering from consumption, and there having been reason in May, 1907, for
thinking.that those efforts, suspended two years before, might then be renewed with more prospect
of success, a resume of former proceedings was given under several headings.
ACTION OF THE POOR LAW AUTHORITIES.
The first step was taken, on the initiative of the Managers of the Poplar Sick Asylum District,
who, in 1900, sought authority from the Local Government Board, to provide for the open-air treatment
of chargeable sufferers from consumption. The Board were of opinion that if work of this
sort were to be undertaken, it should be by a metropolitan authority, and for the whole of the Metropolis
; they suggested, therefore, the convening of a conference of the Boards of Guardians for
consideration of the question. The conference was held in October, 1900, no fewer than 77 delegates,
representing 26 out of the 32 Poor Law Authorities, being present. Perhaps the most
significant incident was a speech by the chief medical inspector for Poor Law purposes of the Local
Government Board ^present unofficially), who, premising that in July, 1899, there were upwards of
1,500 consumptives in the Metropolitan workhouse infirmaries, etc., of whom 400 were in the early
stage of the disease, said that if sanatoria should be provided by the guardians, and he was favourable
to it being done, they should be made available not only for the chargeable poor, but also
" for that class above the very poor who were not able to pay for sanatorium treatment." Chargeable
patients not likely to recover (he added), should be sent to institutions where facilities could
be given for their friends to visit them. As an outcome of this pronouncement, provision has
since been made for these hapless sufferers; some 1,500 beds, in separate wards, (including 85
in Kensington), having been allocated to their use at the Poor Law infirmaries.t The conference,
by a unanimous vote, expressed the opinion that " the time had come when provision
should be made for the open-air treatment of consumption " ; and " recommended the matter to the
consideration of the Local Government Board, with a view to the necessary steps being taken for
the carrying out of the proposal. The resolution was transmitted to the Board, who intimated that
it, together with other communications of a similar nature, would receivc their consideration.
ACTION OF THE PUBLIC HEALTH AUTHORITIES.
At one time or another, since 1901, the Borough Councils, with a very few (neutral) exceptions
I have addressed communications to the Local Government Board intimating their desire that
the Metropolitan Asylums Board should be constituted Sanatorium Authority, with power to utilise
their superfluous hospital accommodation for sanatorium purposes. Formal acknowledgments only
were received from Whitehall; but the Managers of the Asylums Board manifested, from time to
time, considerable interest in the proposal; § and in November, 1902, they signified their willingness
to entertain the request that they should become the Sanatorium Authority for London, on an
assurance being forthcoming that there was a " general consensus of opinion among the local
authorities " that they should do so ; further consideration of the subject, meantime, being adjourned
for twelve months.
* What follows is mainly excerpts from a " Report of the Medical Officer of Health, on the Prevention of Consumption,
and the Sanatorium Question, together with suggestions for the Utilization of the 'Southern Hospital' at Carshalton for
Sufferers from Pulmonary Tuberculosis." (No. 5 Monthly Report, May 28th, 1907.J
† Detailed information as to this accommodation was given in my annual Report for 1905, page 48.
‡ The list of assenting, dissenting and neutral authorities was given in my Annual Report for 1905, page 47.
§ The Managers it may here be mentioned have assented to the principle involved in the proposal, by establishing (with
the sanction of the Local Government Board) Homes at Rustington and Margate, for the treatment of children—i.e., persons
under 16 years of age, suffering from tuberculosis; medical and surgical cases respectively.