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50
would involve* the acquisition of additional land, as no more
accommodation can be provided on the existing site. The
hospital contains at present only 262 beds, and the experience
gained during the prevalence of scarlatina in 1887 shews that
it is not large enough to receive all the cases arising in the
district allocated to it, inasmuch as, after the Hospital was filled,
cases to the number of 355, that should have been admitted,
had to be taken to other Hospitals—a course which necessarily
occasioned great loss of time and waste of labour, as well as an
increased expense to the Ambulance Department. The administration
of the hospital is very expensive pro rata with the
number of patients: the present staff, with a few additional
nurses and other subordinate officers, would be sufficient for a
Hospital twice the size. Therefore, and taking into account the
large and increasing population of the district, as well as the
increasing use made of the hospitals, the Committee considered
it advisable to add considerably to the existing accommodation
and they submitted that beds should be provided for at least 400
fever cases, irrespective of those to be allotted to small-pox.
Application was made to the Local Government Board, with a
view to the compulsory acquisition of the Lillie Bridge grounds
adjoining the Ambulance Station, to the extent of four acres.
Ultimately, the Local Government Board informed the Managers
that there was no authority under which an Order could beissued,
authorizing them to acquire land compulsorily ; and as the
freeholder refused to sell, nothing could be done. Considerable
opposition was offered to the proposal to enlarge the hospital,
and meanwhile the London and North-Western Railway Company
made arrangements for securing the land for their own purposes.
By the Poor Law Act, 1889, however, as I have stated elsewhere,*'
the Managers have obtained power, subject to the approval of
the Local Government Board, to acquire land compulsorily for
the purpose of extending the site of any of their hospitals, and
it is probable that this power will be exercised in the course
of the present year, with the object of enlarging the Western
* Vide page 64.