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effected by replacing the existing arrangements by a uniform
system, which the Managers are ready and willing to organize
when called upon? The ambulances at the London Fields
station are eleven in number, some being used exclusively for
cases of small-pox, and others for "fever." Each ambulance is
disinfected before it leaves the hospital, and good care is taken
to guard against irregularity such as has been so often complained
of in the conduct of drivers of parochial ambulances, viz., of stoppage
on the road for refreshment. The Managers, it should be added,
have done what they could to prevent this practice on the part
of the servants of Local Boards by supplying them with food and
drink while the ambulance is undergoing disinfection within the
hospital precincts.
Increased Facilities for Removal of the Infectious
Sick.—In my last annual report I referred to the action taken
by the Board of Guardians in evidence of their desire to facilitate
the removal of the sick: in an instructional letter addressed to
the Relieving Officers, their Clerk, Mr. J. H. Rutherglen, wrote
as follows:—
"The Guardians having recently had urged upon them by the
"Medical Officer of Health the importance of facilitating
"in every way possible, the immediate removal to hospitals
of cases of infectious disease, have directed me
"to instruct the Relieving Officers to abstain generally
"from taking any steps for obtaining payment in cases
" sent to the Metropolitan District Fever and Small-pox
" Hospitals."
The carrying out of these instructions has been attended
with the best possible results, for since they were issued I have
not heard of a single case prevented from going to hospital on
grounds of inability or unwillingness to pay for maintenance and
treatment. Having always held that the removal to hospital of
the non-isolated infectious sick, at whatever cost to the public, is
justifiable on strictly economical grounds, it is a source of much
satisfaction to me to know that this view is shared by the Guardians,
equally with your Vestry. Practically, moreover, very little is lost