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those expenses, as a simple contract debt, from the patient, or
from any person liable by law to maintain him. But (and here is
the crucial point) " the said expenses, so far as the same are not
so recoverable by the Guardians, shall be repaid to them out of
the Metropolitan Common Poor Fund." It is scarcely probable
(nor is it to be desired in the interests of public health) that the
Guardians will take the trouble of trying to recover moneys from
individuals which they can, without trouble, obtain from the
Common Poor Fund. Here, then, we have the practical concession
of two great principles : (1) Free admission to the
hospitals of infectious sick persons in need of isolation, and
(2) devolution upon the Metropolitan Common Poor Fund of all
charges incurred in the maintenance of the sick. It is now
rather more than twelve years since I first formally submitted
reports to your Vestry and to the Asylums Board, urging the
adoption of these principles. The same section (3) enables the
Local Government Board to issue an order authorising the
Managers to receive into their hospitals pauper-patients suffering
from diphtheria. Section 4 conditionally authorises the use
of the hospitals for medical instruction, an extension of the
original purposes of the hospitals contemplated by the promoters
of the Metropolitan Poor Act, 1867, but one now
rendered necessary by the practical exclusion of infectious
diseases from general hospitals. Section 5 gives the Managers
full power, with the consent of the Local Government Board,
to purchase such land adjoining any of their hospitals or asylums,
as is required for the purposes of any such institution; and for
the purpose of such purchase, certain sections of the Public
Health Act, 1875, are made to apply " as if they were herein reenacted."
Under the power thus conferred the Managers will
probably take steps to extend the site of the Western Fever
Hospital as already stated. Section 6 enables the Managers to
allow their ambulances to be used for the conveyance of persons
suffering from any dangerous infectious disorder, to and from
hospitals and places other than hospitals provided by themselves,
and to make (if they think fit) reasonable charge for that use.
D