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exercised very great care will be taken, so that payment may be exacted
of those only who are well able to pay, and who may have sought
the assistance of the Yestry, &c., in the removal of their sick.
There is, however, really no reason why any person so situated
should seek the assistance of the sanitary authority at all, for it is
quite certain that the expenses incurred at any one of the
hospitals belonging to the Managers in the treatment of a case
of fever or small-pox, would, in a majority of instances, unless
the patient died very speedily after admittance, considerably exceed
the charge made at the London Fever Hospital, or at the London
Small-Pox Hospital (which are not pauper establishments), viz., two
guineas and four guineas, respectively, per case, irrespective of the
duration of the patient's illness.
The 14th section of the Act seems to have been dosigned to afford
the means of doing the same for rural sanitary districts that the 15th
will do for the Metropolis if carried out, viz., depauperise relief in
"infection hospitals," as it enables the Guardians of any Union, who
are also the sanitary authority, to transfer any hospital or building for
the reception of persons suffering from infectious diseases, vested in them
as guardians under the Acts relating to the relief of the poor, so that
it shall be vested in them as the rural sanitary authority of the
union. In urban districts, where the sanitary authority is distinct from
the poor law authority, the admittance of patients into hospitals supported
out of the rates does not entail pauperisation.
Ambulances (vide page 29).—The 16th section of the Act confers
on the M etropolitan Asylums Board power to provide ambulances for
the conveyance of the infectious sick to the hospitals belonging to the
managers ; and all expenses incurred by them in the execution of this
section, to sucli extent as the Local Government Board may sanction,
will be paid out of the Metropolitan Common Poor Fund. At the
present time, and in some parishes and districts of the Metropolis, the
Vestries, &c., possess ambulances as well as the Boards of Guardians;
in others (as in Kensington) the Guardians alone possess ambulances;
and there may be some in which the Vestries, &c., only possess
ambulances. As there are 39 sanitary authorities within the Metropolis
and 30 Boards of Guardians, it would appear that should the
Managers see fit, and find it practicable, to give effect to this section, a
considerable economy might possibly be effected by substituting for
the present scattered arrangements an establishment of ambulances
connected with the existing hospitals, which are only five in number.
rlhe subject will in due time, I have no doubt, receive that careful
attention from the Managers which its importance demands.
August, 1879. T.O. D.