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46
and they have often been blamed for not exercising the power.
But, by the Metropolitan Poor Act, 1867, the Asylums Board were
authorised to erect hospitals for the "sick poor," and they have
actually provided, or are in course of providing, sufficient accommodation
for the requirements of the whole Metropolis. It follows
that no necessity would exist for hospital-building by the Sanitary
Authorities, provided satisfactory arrangements could be made for
utilising the Board's Hospitals. Admittance to these hospitals is
obtained, legally, by the order of a relieving officer, or master of a
workhouse, given upon the certificate of a poor-law medical officer.
The Board never goes behind the " order," and thus it has happened,
in this parish, and in some other parishes where the sanitary and
the poor-law authorities work together for the common good, that
persons suffering from infectious disease have been removed by
the Guardians without any difficulty. But in some districts the
Guardians refuse to assist the Sanitary Authority, by removing
so-called " non-pauper " cases, and thus in the absence, on the one
hand, of non-pauper hospitals, and, on the other hand, of legal power
on the part of the Managers of the (Asylums Board to admit any
but so-called "paupers," the sanitary authorities of the districts
referred to were placed in great difficulty. With a view to remove
this difficulty, provision was made in the Poor Law Act, 1879, to
enable the Managers, with the approval of the Local Government
Board, to contract with anyr vestry for the reception into their
hospitals of any person suffering from a dangerous infectious
disease, within the district, and at the cost, of the Vestry, which,
moreover, may recover the expenses incurred, from the sick
person or his representatives, at any time within six months
after his discharge from hospital or after his death. For
several years the Act was allowed to remain in abeyance, and
year by year the Board acquired more and more the position of a
" central hospital authority " for all London, the restrictions on
admittance being more and more relaxed. To such an extent was
this politic system of ready admittance and free treatment ultimately
carried, that in the summer of 1884, when small-pox was
prevalent, and by favour of the chairman of the Ambulance