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59
prepared to go much further. For an obvious reason they
decline to admit a patient to the Ambulance without the production
of a medical certificate, but they are "by no means
satisfied that any useful purpose is now served
by the intervention of the Relieving Officer as an admitting, or
rather removing, authority," while the Managers now see (what I
pointed out in my report for 1884) that the "necessity of obtaining
the Relieving Officer's order prior to removal, if insisted on in
every case, would prevent some cases from being removed at all,
and in many others must interpose a delay prejudicial to the
patient, distressing to his friends, and dangerous to the health of
the locality." The Managers, moreover, recognise the fact that
"delay means largely increased expense to the Ambulance
Service," while ''the performance of a formal and unnecessary
function entails waste of valuable time on the Relieving Officer."
And having regard to the fact that “it has in practice been
found impossible for the Managers to distinguish between,
'pauper' and 'non-pauper' patients," and to the benefits to be
derived from the early isolation of cases of infectious disease,
the Managers, as already stated, have unanimously resolved to
"apply to the Local Government Board for, or to obtain,
authority to remove all persons suffering from fever or smallpox
whose removal shall be applied for by duly qualified
(registered) medical practitioners; the practice of at once,
communicating the removal of every patient to the Clerks of
Guardians being of course continued."
With the view to facilitate the admission of patients without
unnecessary delay, the Managers had long been content to
accept the certificate of any legally qualified medical practitioner
combined with the order of a relieving officer. In
June last they went a step further by the adoption of new
"Regulations for the Removal of Small-pox and Fever
Patients," which were framed so as to allow of the admission
of patients upon the direct application of Medical Officers of
Health, Medical Practitioners, and Sanitary Inspectors, subject
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