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72
providing for the election of a certain proportion of the Managers
by the several Sanitary Authorites, i.e., the Vestries and District
Boards of Works."
My own views were set out in a Report dated 10th
January, 1877, at a time when small-pox was severely epidemic
in the Metropolis. With reference to
HOSPITALS FOR INFECTIOUS DISEASES,
I contended that the provision of them should be regarded
as a Metropolitan question, and opposed the local or
district Hospital system. The Local Government Board had
advised the Vestries and District Boards to provide hospital
accommodation for "that large class of persons not needing
relief, but whose isolation in hospitals is necessary for preventing
the spread of the disease"—although it was known that not
ten per cent. of the persons admitted into the Asylums Board
Hospitals had previously been in receipt of "parochial relief."
The Vestries had power to do as advised under the provisions of
section 37 of the Sanitary Act, 1866. The Asylums Board
constituted under the Poor Law Act, 1867, were legally bound
to provide for the needs of the pauper class only. But the
Managers had provided accommodation nearly sufficient for all
classes of the population, and were able by extension to provide,
as they have since done, for the exigencies of the severest
epidemics. My contention was, that "the work of hospital
provision can be done more cheaply, more speedily, and more
efficiently by one Central Board than by numerous local Sanitary
Authorities." I contended, moreover, that not only was it
undesirable upon sanitary grounds to multiply hospitals, but also
that local opposition would defeat any attempts in that direction,
as subsequent experience amply proved. These views, regarded
with little favour at the time, have gradually prevailed, and
now, practically, there is no difference of opinion on the subject,
the Asylums Board being regarded as the Central Hospital
Authority.