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This communication was referred to your Medical Officer of Health, who
reported as follows to the Sanitary Committee on the 25th July, 1905:—
"PROPOSED SANATORIA FOR CONSUMPTIVES.
"This is a matter of the highest importance from a public health point of view,
"and one that has been under consideration for some considerable period. Involv"ing,
as it must of necessity do, the expenditure of a very large sum of money, and
"that obtainable only from the ratepayer, it is essential that the most careful
"consideration be given to the scheme. It is scarcely needful to refer to the
"necessity for some such provision. The fact alone that the deaths from Phthisis in
"London amount to between 7,000 and 8,000 every year is sufficient to show the
"vital importance of the question. Seven thousand deaths per annum would mean
"approximately that 50,000 people are actually suffering from the disease in
"London at the same time, and for these the only provision are four Consumption
"Hospitals.
"Hospital provision is required for two classes of cases. Firstly, those in the
"early stages of the disease, which should be isolated for the purpose of bringing
"them under hygienic conditions and treatment with a view to the cure or arrest of
"the disease; and, secondly, those in a more advanced stage, where the risk of
"infection is most marked, and which should be isolated so far as possible to
"prevent danger to their fellow-creatures.
"Both classes require consideration. It is not suggested (and it certainly is not
"advisable), that costly and palatial hospitals be provided for these cases, but rather
"that inexpensive buildings situated in healthy neighbourhoods at some little
"distance from the Metropolis be erected for their accommodation. The use of
"such sanatoria as suggested is twofold. In the first place the patient is removed
"from conditions in which he may be a serious danger to others; and, secondly,
"during the stay in such institution he is accustomed to hospital discipline, and is
"instructed as to the best methods of preserving his own health and minimising
"the possible danger to others. In other words, the object of the treatment is both
"remedial and preventive.
"It has been estimated that every bed provided will accommodate two persons
"per annum, and that of the 50,000 who are suffering from Tuberculosis at any
"given time, there are probably 10,000 to whom remedial treatment is of value,
"therefore 5,000 beds would be sufficient to deal with these cases. The maintenance
"alone of these would cost— at an estimated expenditure of 25s. per week per head—
"£325,000 per annum. There is also the cost of provision of the buildings, which
"would probably be covered by £100 for each bed— i.e., a capital expenditure of at
"least £500,000. As to the question of the authority by whom this work
"should be undertaken, only two such have been suggested, viz., the Metro"politan
Asylums Board and the London County Council, and there can,
"I think, be no difference of opinion as to the suitability of the Metropolitan
"Asylums Board rather than the London County Council being entrusted with this
"if it be undertaken. In the first place because the London County Council,
"already overburdened with work, have no power under the Isolation Hospitals
"Act, 1893, which does not apply to London, and, moreover, is not a sanitary
"authority. The Metropolitan Asylums Board have, further, had great experience
"in dealing with epidemic diseases, and have carried out this large and responsible
"work for a long period to the satisfaction of the ratepayers of the Metropolis