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40
It was anticipated that, the desired " general consensus of opinion " having been attained, the
Managers, on further consideration of the subject, in November, 1903, would have applied to the
Local Government Board for the necessary powers; but whilst recognising the " vital and farreaching
importance of the proposal to the community at large," they then resolved to " take no
further steps in regard to it," without an " authoritative expression of opinion by the Chief Health
Authority of the Country, the Local Government Board."* This decision was communicated to the
Board, and to the local authorities, in December, 1903. The Board did not at that time disclose
their views in regard to the matter.
The Public Health Authorities continued their efforts; and at a conference of the representatives
of the Borough Councils, convened by the County Council, for the consideration of the
Administration of the Public Health (London), Act, 1891, held at the County Hall, in July, 1904,
the subjoined resolution was unanimously adopted-
" That it is desirable to make provision of sanatoria for the isolation and treatment of
persons suffering from consumption, for the Metropolis, as a whole, and under one
authority; and that, in the opinion of this conference, the Metropolitan Asylums Board
should be such authority."
By desire of the conference the resolution was forwarded by the County Council to the Local
Government Board, with a request that the matter might receive their immediate attention.
The views of the conference were in harmony with those of the Society of Medical Officers of
Health (Metropolitan Branch), who by an unanimous vote in October, 1903, had adopted a resolution
to the effect that—
" By reason of practical experience in regard to provision of hospitals, and the treatment
of the infectious sick, the Asylums Board were eminently qualified for the discharge
of the duty [of sanatorium authority]. the effective performance of which, by any competent
authority, could not fail to be attended with great advantages in the interests of public
health."
In 1904 increased attention was being given to the question, and the Council of the Charity
Organisation Society honoured me with an invitation to read a paper on " The need, of Sanatoria
for Persons suffering from Consumption, and how it may be supplied."]
The discussion which followed the reading of this paper led to important results, having determined
the Society of Medical Officers of Health (Metropolitan Branch) to memorialise the Asylums
Board to give effect to their views, and the views of the great majority of the Public Health
and Poor Law Authorities, on the subject. The Memorial, which I had been requested to draft, is
subjoined, as a succinct statement of the case for sanatoria. It showed—
1. That between 7,000 and 8,000 persons (of whom the large majority are adults in
the prime of life) die every year in London from pulmonary phthisis (consumption), the
mortality in the male sex being some 40 per cent, greater than in the female sex; and that
a much larger number of persons (also chiefly adults) suffer from ill-health arising from
the same disease.
fin 1899 (the only year for which reliable statistics J are available) a third of the deaths
in London from pulmonary phthisis (consumption) occurred in Poor Law Institutions. Many
of the sufferers might have been cured could they have obtained sanatorium treatment at
the beginning of their illnesses, and a large amount of poverty and charge on the rates
been thereby avoided. It is well known that many persons reduced by consumption to a
state of poverty, drift into the workhouses, and become a permanent charge upon the rates,
often leaving widows and orphans in a state of destitution; whereas many such persons
might be cured if sanatorium treatment were made available for them in the early stages
of the disease.]
* The immediate occasion of this resolution was the receipt of a letter from the Local Government Board, asking to be
" furnished with the Managers' observations on a suggestion, made by the Poplar Board of Guardians, that the Asylums Board
be authorised to establish sanatoria for the treatment of persons suffering from phthisis, who are chargeable to the Metropolitan
Unions and Parishes." The Managers'did not reply, directly, to this request; nor did the Local Government Board afford
them the desired " authoritative expression " of their views on the subject.
† The paper was printed in my Annual Report for 1904, page 33.
‡ The statistics were obtained by Dr. Downes, Medical Inspector of the Local Government Board for Poor Law
purposes, and were communicated by him to the conference of Poor Law Authorities, in 1900, vide page 39.