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alternative to the use of the Managers' Hospitals would have
been the provision of another set of Local or District Hospitals
by the forty Sanitary Authorities, acting singly or in such combinations
as could have been voluntarily brought about under
the provisions of the Act of 1866. And this is the course,
apparently, that the "economists" at the Asylums Board would
have the Sanitary Authorities take. It would be interesting to
calculate the amount saved to the Metropolis by the success of the
opposition which your Vestry,at my instance, invariably opposed
to the proposal—even when, as in January, 1877, it was recommended
by the Local Government Board to each local authority,
small-pox being widely prevalent at the time. Had Local
Hospitals been provided they must have been made adequate for
the reception of all cla sses of patients, fever and small-pox, and
they must have been large enough to provide for the maximum
needs of the several districts. The cost of building—say twenty
hospitals, would have been great, and the cost of maintenance,
if the hospitals were to be kept in constant readiness for
use, would have been considerable. So far from "economy"
resulting from the multiple-hospital system, there cannot be a
doubt that it would have involved such an immensely enhanced
expenditure,in first cost and annual outlay, as would have brought
down endless reproaches upon the Authorities who had been so
imprudent as to obey the (permissive) letter of the law when there
was so obvious and common-sense an alternative in the system
which is actually in use and works so well. The same ratepayers, as
I have before observed, would have had to pay for both sets of
hospitals; and if they have complained—not without reason in
the past—of the expense entailed on them by the action of the
Asylums Board, what would they have said had expenditure been
needlessly increased, to an indefinite extent, by the suggested
action on the part of the Vestries and District Boards? There
is another consideration not to be lost sight of, moreover; viz.,
that any attempt to erect a number of local hospitals would have
been opposed, thus leading to still further expense by costly
litigation. Nobody is better informed on this subject than the
Managers, by whom the accuracy of the statement, after their