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10
ment Board could only offer advice. The weight of public opinion
might control the action of Guardians: but nothing short of
legislation could set matters right in such an assumed difficulty.
While therefore cordially acknowledging the generally satisfactory
working of the present system, I cannot too strongly advocate a
change that shall either place the hospitals under the charge of
the local Sanitary Authorities (i.e. the Vestries and District Boards
of Works) in some shape or other; or, at the least, give the Sanitary
Authorities the absolute right of sending to the hospitals (on
payment) any cases they may deem it necessary to isolate away
from home. This question of
HOSPITAL ACCOMMODATION FOR THE NONPAUPER
INFECTIOUS SICK
has of late been raised and discussed in a spirit which seems to
hold out a prospect of an early and a satisfactory settlement. It is
so important that I offer no apology for putting a brief resume
of facts on record, the more particularly as there is now a
pretty general consensus of opinion in favour of views I have all
along advocated, of the necessity of making provision for isolating
in hospitals all proper cases, and of placing hospital relief on the
same footing as vaccination, i.e., by depauperising it.
In January of the present year the epidemic showing no signs of
abatement, and the new hospitals of the Managers at Fulham and
Deptford being not nearly ready for occupation, the Local Government
Board addressed a communication to the several sanitary authorities,
in which they said "looking to the present crowded state of
the hospitals: to the extension of the disease in the Metropolis,
and to the proportions the epidemic is likely to assume," the Yestries,
&c., should provide hospital accommodation for "that large
class of persons not needing relief, but whose isolation in hospitals
is necessary for preventing the spread of the disease." They stated
"that the hospitals provided for the reception of cases of small pox
by the Metropolitan Asylums Board were essentially intended to
meet the requirements of the destitute class, and that the admission
into these hospitals of persons not in need of poor relief
was altogether exceptional, and only allowable upon condition—
(1) that the individual case is one of urgency, and (2) that there is
sufficient accommodation for the patient without infringing upon
the space required for paupers." The Board expressed their
fear, which the event has not justified, that the accommodation at
the disposal of the Asylums Board would not exceed the amount
required for this class, and they requested to be informed what
provision your Yestry had made, or proposed to make, for the
non-pauper class of the sick poor under section 37 of the Sanitary
Act, 1866 ?
This question of hospital accommodation for non-pauper sick