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hospitals should be managed by a legally-constituted Metropolitan
Sanitary Authority. No such authority now exists, but when the
promised Municipality shall have been formed, it will doubtless
take over the functions of the Asylums Board qua hospitals. In
a maimer this Board have always discharged the functions of a
Central Sanitary Authority, by providing hospitals adequate for the
Metropolis, and by treating in them persons of all classes, including
ratepayers by whom the hospitals are maintained. But for
the difficulty so needlessly raised the system might have been
perfected. It is worthy of note in passing that in the event of
an epidemic of Cholera the Managers will, by an Order of the Local
Government Board, be clothed with all the powers of a Local
Authority under the Diseases Prevention Act, 1855, and that all
expenses to be incurred by them in providing hospitals, in every
part of London alike, will form a charge upon the Common Poor
Fund. It is to be regretted that the Board should have taken up
a position which tends to limit their usefulness and importance.
Meanwhile, the Sanitary Authorities are, in a measure, at
their mercy; for, notwithstanding the complaints made against
those bodies, of having neglected their duty of providing
hospitals, they would never be suffered to incur an expense which
has been rendered unnecessary by the action of the Asylums Board.
The " duty " of providing local hospitals for 39 districts is one
that the Sanitary Authorities could not perform, even if they were
grouped for the purpose. It would be impossible to obtain sites ;
and if sites could be obtained, the attempt to set up such hospitals
would entail endless litigation, with the result that, in all probability,
the buildings would have to be closed. Such a course, moreover,
if it were practicable, would not merely, by its incidents, lead to
greatly increased expense, but would also tend, by the multiplication
of centres of infection, to increase the spread of disease.
The existing hospital system, regarded in the light of a
provision against epidemics, would be all that could be desired
under arrangements, such as proposed, for facilitating the free
admission of the sick, and for defraying the cost of maintaining
the hospitals out of a Common Fund. That Kensington has