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74
Medical Officer, or the Sanitary Inspector, or the private medical
practitioner. But in 1884 more than one of the Boards of
Guardians having refused to remove non-pauper patients, and the
Managers themselves having been reproached for "extravagance
" by some of the Sanitary Authorities who had benefited
largely by their liberality, the Asylums Board sought to reduce
the expenses chargeable to the poor-rate, by transferring the
cost of treatment of non-paupers to the general rate, viz., by
making contracts with the Vestries under the provisions of the
Act above cited. Recognising the danger thus likely to arise
from conflict of opinion, as to what patients were to be regarded
as paupers, and what as non-paupers—a conflict which would
inevitably have led to delay in the removal of the sick — I opposed
the proposal. Your Vestry adopted my views, and communicated
to the Managers, to the Local Government Board, and to
the Sanitary Authorities generally, the report in which they
were set out, the result being that the proposal to contract fell
through, and has not hitherto been revived.
CENTRAL HOSPITAL AUTHORITY.
In the same report (January 10th, 1877), I wrote "The
present outcry is for a 'Central Health Board for the Metropolis.'
The Asylums Managers practically constitute such a
Board, and they could be endowed with legal powers to provide
all the hospital accommodation required for the safe treatment
of the infectious diseases A measure to extend their
powers in this direction would be tantamount to a consolidation
of Sanitary Authorities—a Central Board to provide Hospitals,
Local Boards with an efficient staff to carry out the details of
Sanitary work, to visit the sick, to remove suitable cases to the
hospitals, and to see to disinfection The benefit to the
Metropolis would be incalculable." In a communication to the
Asylums Board (March, 1877), I said, "Seeing that 90 per
cent. of the sick in the Asylums are not paupers, I should