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41
is of greater interest than that of the Statistical Committee; and the
information it contains is likely, with time, to become of increasing
value to *11 interested in matters relating to infectious disease.
METROPOLITAN AMBULANCE SERVICE.
The Poor Law Act, 1879, sec. 16, conferred on the Asylums
Board one of its most valuable powers, that of providing ambulances
for the conveyance of the infectious sick to the Hospitals
of the Managers. Previously, the Boards of Guardians had
removed the sick in carriages few of which were wholly satisfactory,
and under conditions occasionally prejudicial to the public
health. The work of removal—whether by land or water—is now
effected in an unexceptionable manner. In my last report, I
observed that this remark was applicable only in the case of
.patients in course of transit to or from the Managers' Hospitals.
It was often quite otherwise in respect of private patients. The
law does not forbid the use of public vehicles (cabs) for the
.removal of infectious persons, provided that the vehicles are
afterwards disinfected. But the driver of a cab may be unaware
of his fare's illness: the efficacy of any practicable disinfection,
.moreover, may be reasonably doubted. Consideration of these
and other objections to the existing law, led me to the conclusion
.that cabs, etc., should never be used for this purpose, and that
it would be to the public advantage to make the Asylums Board
the Ambulance Authority for removal of the infectious sick of all
classes. In 1884, therefore, I addressed a communication to the
Managers, proposing that they should place their ambulances at
the service of the medical profession and Medical Officers of
Health, with or without payment, for the conveyance of infectious
sick persons. The Managers replied that they were, at that
time, " not 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 on this reply
in my Annual Report for 1884, I ventured to express a conviction
that the Managers would, in course of time, recognize the