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the sea, the hospital will be the pilot to guide them past the shoals which
abound in the first few weeks of life and only leave them when fairly
and healthily set on their voyage.
Two other advances in health services are the institution of private
wards at St. Peter's Hospital, male, 1 ward (7 beds) and 2 private rooms
(2 beds), female (2 beds), and a new system of contributory beds in
Westminster Hospital. There have been private wards at the latter hospital
since 1924, but the contributory scheme is designed still further to
meet the needs of those who, while they are not eligible for ordinary
hospital beds, are unable to afford the cost of treatment in the private
department of the hospital. The scheme is a notable advance in the
provision of treatment for a large class of the population which, by
reason of its uncomplaining submission to the stresses and hardships of
present economic conditions, has been sadly neglected and ignored.
Wealthy patients are well catered for in private nursing homes and can
command the best treatment that money can buy. The poor, owing
largely to the philanthropic traditions which inspire our great voluntary
hospitals have likewise at their disposal expert nursing and treatment.
But heretofore the hapless indigent middle class have been denied these
special services which modern medicine can provide. These contributory
wards in Westminster Hospital make good that deficiency. The patient
must pay a standard fee of five guineas per week for hospital maintenance
and also an arranged fee, which will be an inclusive one, to cover all
necessary medical or surgical treatment during the patient's stay in
hospital which, in the case of a private bed, is limited to a period of not
more than eight consecutive weeks.
Mention has been made in previous reports of the excellent work,
particularly in the way of domiciliary treatment, carried on by the
provident dispensaries, of which there are four in the City. Since the
operation of National Health Insurance their sphere of work has been
somewhat curtailed, but still greater opportunities await them if it were
possible to link up their work with that of the out-patient departments of
the great voluntary hospitals. They would be the outposts of a complete
hospital service, clearing stations dealing with all cases not sufficiently
serious to warrant hospital treatment or investigation, while they would
continue the following up and treatment at home of cases discharged from
hospital. The possibilities for co-ordinating and completing the work
done in the hospitals are obvious, while the advantage of instruction and
training of medical students in home visiting and treatment are equally
cogent. Such proposals could be rendered practicable without additional
cost and require only some reorganisation and initiative.