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85
THE
TWENTY-NINTH ANNUAL REPORT
FOR THE
Year ending 31st December, 1920,
ON THE
MUNICIPAL HOSPITAL,
BY
W. J. J. STEWART, M.D., D.P.H.
To the Chairman and Members of the Willesden Urban District Council.
Ladies and Gentlemen,
I beg to submit the Annual Hospital Report for 1920, the Twenty-ninth of the Series.
The Report must necessarily take the form of last year's to a great extent, for there is little
fresh matter to be introduced. Except for fresh statistical figures, it is rather an exact repetition,
for I have again to refer to those matters I particularly drew your attention to a year ago. I refer
to the want of proper ward accommodation for patients, and especially small ward accommodation,
to the inadequate bedroom, mess room and recreation room accommodation for Staff, to the small
number of Nurses you employ relative to the number of patients treated and similarly to the insufficient
number of resident medical officers. All of these matters remain as a year ago, it is therefore
my duty to bring them again to your notice for such consideration as you think they now require.
During the year just completed, 2,608 patients were admitted. Never in the history of the
hospital has it been called upon to deal with such a number of cases. Moreover, it is very questionable
if any hospital of its character, limited as it is in respect to accommodation and to staff, has accomplished
or even attempted such a task. When a hospital of this size (199 beds) is called on to deal
with 2,608 cases, of all kinds of disease, in the year, a figure equal to if not in excess of the number
of cases customarily admitted to a hospital double its size, some idea of the enormous strain on its
limited resources can be realised.
When I say the hospital has limited resources, I do not think I am overstating the case. Instead
of the hospital accommodation increasing along with the size of the district, it has certainly for the
last 9 years very decidedly decreased. It is just 9 years ago since Kingsbury Hospital, used as an
overflow hospital, was burned down. That building contained 32 beds, which to this day have not
been made good. Again in 1912, W. Block (12 beds) had to be given up temporarily to accommodate
staff, and though it reverted to its original use late in 1913, it finally was converted into staff quarters
in 1918, since when it has not been available. The loss of these two buildings means a reduction
of 44 beds. This is a very important point to bear in mind when the question of the hospital extensions
is under consideration at any time. If it should be necessary to further accentuate the
decrease as regards accommodation that has taken place, I would mention that in 1903, when first
I took charge of the hospital, it then consisted of 8 ward pavilions and Kingsbury Hospital. Today
it is minus two of these ward pavilions or blocks (S. ward and W. ward) given over to Staff, and
Kingsbury Hospital, and therefore consists of 6 ward blocks only. The hospital really has never had
adequate accommodation since I entered your service, even during the years it remained an isolation
hospital purely. In 1908 for instance there was actually insufficient room for Scarlet Fever cases,
a small number of cases of that disease being transferred to a Convalescent Fever hospital at Stanmore.
These facts, I think, clearly show how the accommodation has not only not been maintained,
but has actually been reduced.
A year ago in my report for 1919, a year in which 1,703 cases were admitted, I pointed out that
the nursing staff was insufficient and it was not possible for the required amount of treatment to
be carried out without imposing great hardship on your nurses. Abundant evidence of the truth
of that statement has been forthcoming during the twelve months now under review. The sickness
rate amongst nurses has been very high, and a clean bill of health at any time has been unknown.
On more than one occasion, 6 nurses have been laid up at one time with ailments, most of which
in my opinion were the result of overwork. It is true that private nurses have been engaged to
fill their places, but inasmuch as there is not sufficient accommodation for the permanent staff even,
it has never been possible to engage the required number to fill the gaps, with the result that even