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64
The conditions which at present regulate the admission of
patients at the various infectious hospitals under the Board's control,
are specified in the Order of the Local Government Board, dated
the 10th February, 1875. The patient, called “ pauper” in the
Order (but admission no longer pauperises), is admitted upon
an order filled up and signed by a Relieving Officer, or a
Master of a Workhouse, of the union or parish from which he is
sent to the Asylum ; the said order being accompanied by a
certificate signed by the Medical Officer either of the Workhouse
or District, as the case may be (Article 3). In a valuable report
prepared by the Ambulance Committee for the guidance of the
General Purposes Committee, which comprises the whole Board,
it is pointed out that the above Article and others “were framed
in view of arrangements essentially different from those now in
force.“ Reference is made to the fact that previous to 1881, in
which year the Ambulance system of the Board was brought into
working, patients were brought to the hospitals in parish ambulances,
“ and it was at the door of the hospital that their contact
with the Asylums Board commenced." Now, however, " the door
of the ambulance carnage has taken the place of the door of the
hospital," and the hospital officials have " no choice but to receive
as patients all persons brought in by the ambulances of the
Managers." The parish ambulances, moreover, have for the
most part ceased to exist. Formerly they were, in some cases at
least, available for the removal of " non-pauper " patients. After
their abolition Nuisance Authorities were wont to apply to the
Managers for the removal of their patients. " To these applications
the Managers, in the first instance, declined to accede."
But in 1883 the Managers acceded to a request by the Port
Sanitary Authority for permission for the Board's ambulances to
be used on the receipt of a telegraphic request from the Port
Medical Officer, without previous application being made to the
Relieving Officer; the Port Sanitary Authority agreeing to pay the
cost of maintenance, etc., of all patients removed. A similar
application made by the Fulham Board of Works was subsequently
acceded to. In 1884, when small-pox was prevalent, and upon the