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in efficacy to notification, is the provision of hospital accommodation
by the Asylums Board, under the provisions of the
Metropolitan Poor Act, 1867. So highly, indeed, do I
value this provision, that, were I offered a choice between
hospitals and notification, I should unhesitatingly choose
hospitals; for this reason, among others, that provision of
hospital accommodation leads, almost inevitably, to voluntary
notification; whereas, even compulsory notification has comparatively
little value if hospital accommodation be wanting.
Increased Facilities for Removal of the Infectious
Sick.—In 1880 the Board of Guardians manifested their
desire to promote the removal of cases, by instructing 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 happiest results, not a single case having since been
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 nonisolated
infectious sick, at whatever cost to the public, is
justifiable on economical grounds, it is a source of satisfaction
to me to know that this view is shared by the Guardians
equally with your Vestry. Practically, moreover, nothing
is lost in money through the enlightened action of the
Guardians; for, as the result of an enquiry made in view of
the Conference of Sanitary Authorities held at the Town
Hall in March, 1881, I ascertained that less than £60 had
been paid to some twenty Boards of Guardians, in respect
of 79 patients who contributed something towards their own
maintenance, out of 3,100, the number of patients removed
to hospitals in a little less than one year. Objection had
been raised to the principle of "free hospital treatment," on
the ground that many patients contributed towards their
maintenance a sum considerable in the aggregate, it being
contended, also, that patients able to pay should be made to