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But although this increase in the actual number of cases removed has been
taking the number of cases notified has increased still more greatly, so that
the proportion of cases removed to the number notified has been diminishing,
as shown by the percentage figures:—

During the last three years the total annual admissions from all London to
the hospitals of the Metropolitan Asylums Board has been 7,873, 16,624,
and 21,129 respectively, compelling the Managers to provide additional
accommodation.
This accommodation has been provided by the erection of temporary
hospital structures at Tottenham and at Lower Tooting. Sites for hospitals
have also been sanctioned by the Local Government Board at Hither Green
and Shooter's Hill, whilst the re-construction of portions of several existing
hospitals—such as Hampstead, Fulham, and Deptford is being proceeded
with, and an increase of the permanent accommodation at the Gore Farm
Small-Pox Hospital is also being carried out.
In my Annual Report for 1891, in recording an outbreak of Scarlet Fever,
I commented adversely upon the situation of the sick wards at the Orphan
Working School, and expressed the opinion that every large school should
provide a separate isolated building for sick children, and that infirmary wards
on the topmost floor of the building are not satisfactorily situated for many
reasons. I regret to say that the condition remains the same.
In a Special Report upon Enteric Fever in the same year, I also commented
upon the sick wards at the Foundling Hospital, which were also situated at
the top of the building, and again expressed the opinion that the infirmaries
of all public institutions should be isolated buildings. In this instance I am
happy to say that the Governors of the Foundling Hospital have constructed a
convenient isolated infirmary in the grounds of the Institution.
VACCINATION.
The usual returns kindly supplied by the Vaccination Officers, Messrs.
Richards and Webb, are here inserted :—