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cases distributed between the Forest Gate Hospital, Queen Mary's
Hospital and the Maternity Hospital, Balaam Street. It is a
matter for consideration whether the present arrangements should
be continued or whether a new municipal maternity home should
be built.
The policy of the closing of the Dagenham Sanatorium and
the building of a new sanatorium for adults suffering from Pulmonary
Tuberculosis on the Council's site at Langdon Hills is one
already under the consideration of this Authority.
The accommodation for nurses and for maids at several of the
institutions is insufficient.
The Mental Deficiency Committee are at present considering
the question of Day Occupation and Training Centres for mental
defectives under Statutory Supervision.
It is probable that the advisability of establishing a Rheumatic
Clinic will be considered soon.
The amount of extra accommodation stated above to be necessary
is estimated on the assumption that about sixty per cent. of
the beds in the local voluntary hospitals will continue to be occupied
by West Ham patients and that full use will be made of the
present accommodation.
An essential feature of any co-ordination of grouping of institutional
accommodation is a comprehensive out-patient department
(with specialised clinics) from where cases can be drafted to various
appropriate institutions and to which cases can be referred, if
necessary, on being discharged from institutions. This establishment
might be directly attached to one of the large hospitals. The
Medical staff might be drawn from the various institutions.
It is a matter for consideration and collaboration as to
whether the existing institutions under the Public Assistance Conmittee
should be designated as municipal hospitals and administered
by one Committee and also as to whether the necessary
increased accommodation (a) should be provided (for the most
part) in one or in various institutions, (b) should be built on separate
sites, or (c) should form an extension of one or more existing
institutions either voluntary or municipal.
In order that the fullest possible use may be made of all hospital
accommodation provided, very careful thought will need to
be given to the problem of the amount to be charged, and the
mode of recovery from the patients of the expenses incurred in
their maintenance and treatment, as laid down under Section 16
of the Local Government Act, 1929.
In the foregoing report I have set out all the essential points
(from a medical aspect) that it is necessary for this Authority to
consider in regard to the provision of institutional accommodation.
I am unable, at present, to envisage any development likely
to occur which would necessitate further accommodation of any
appreciable magnitude.
The detailed administration of any accommodation provided
is a matter for further reports after the broad principles have been
settled.
F. GARLAND COLLINS.
26th Tanuarv, 1931.
170