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87
be practicable to place disengaged ambulances at the service of
tbe medical profession and Medical Officers of Health for the
conveyance of such cases—either with or without payment" ?
The cases (I added) "are few, and this is the cause of the difficulty,
for if the cases were numerous demand would create supply,
ambulances would be provided, and there would be no need for
this communication."
The Managers in their reply stated that they were "not
yet in a position to undertake the removal of any cases of
infectious disease beyond those which are to be received into
hospitals under their own control." Commenting in my Annual
Report for 1884 (page 86) on this reply, I said, "I do not
doubt that the Managers will, in course of time, recognize the
desirableness, and, I may say, the propriety of doing what I
suggested." The time has now arrived, the Managers having
recently (April, 1888) adopted a report on the subject by the
Ambulance Committee, in which they observe that "The
Managers cannot, with their present powers, undertake the
removal of all infectious cases; but taking into consideration
the various circumstances under which, owing to the absence of
specially provided vehicles, infection may be and undoubtedly
is spread in the Metropolis, and believing that a large proportion
of patients requiring such conveyances would be found to
be in a position to pay any reasonable charge for such service,
your Committee are of opinion that it would be in the interests
of the public health if some Central Authority were empowered
to undertake the conveyance of all persons suffering from infectious
disorders within the Metropolitan District, with power to
make such charges as might appear to it reasonable for such
conveyance and to recover payment thereof. The Asylums
Board having the appliances necessary for the purpose, are in
the opinion of your Committee the Authority able to do this
work with economy and efficiency, and your Committee recommend
that these views be submitted to the Local Government
Board."