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32
MEMORANDUM
on the
PROVISION OF HOSPITAL ACCOMMODATION FOR SMALL-POX,
by the
MEDICAL OFFICER OF HEALTH.
The resolution passed by the Council on the 24th day of October, referring back to the Public
Health Committee the question of the provision of hospital accommodation for small-pox, with instructions
to prepare a statement of the comparison as regards cost between a land hospital and a ship hospital,
suggests to me the advisability of putting into writing some facts which may appear to be pertinent to the
question or calculated to assist the Committee.
This course is rendered the more necessary, owing to the fact that the provision of hospital accommodation
is interwoven with the larger question of the provision of hospital accommodation for other
infectious diseases, to the lengthened period over which the discussion has unavoidably been spread, and
consequently to the somewhat altered "personnel" of the Council since the earlier stages of this most
debateable question.
It would render this memorandum very tedious and scarcely entertaining to give a history of the
discussions, deputations, resolutions, &c., which have been forced upon the Council in this matter during the
past four years, but it is only fair to myself to state that until the Council Meeting of October 24th I had
never been asked the question whether I preferred a land hospital or a ship hospital for small-pox, or I
should, as I did then, unhesitatingly have advised a land hospital. Four years ago, when the scheme
for fever hospital provision, contained in my report dated October, 1890, was adopted by the Council, I was
asked what could be done with small-pox cases if the Small-pox Cottage Hospital were closed, and I
replied, "Take them down the river, or any where, provided they are removed from the crowded district of
West Ham." It is possible that some members of the Council may have been led into the belief that I
was in favour of West Ham having a hospital ship of its own, which is a very different thing. At this
time, 1890, I felt that an arrangement could be made between the Council and the Metropolitan Asylums
Board, whereby the Board's steamers could call at the Council's Wharf, and take the Borough cases to the
hospital ship of the Metropolitan Asylums Board in Long Reach. This was no unreasonable belief, for
local authorities outside the metropolis are empowered by section 131, Public Health Act, to combine for
the purpose of providing hospitals, and I was aware of no legal disability on the part of the Metropolitan
Asylums Board should they see fit to enter into such an arrangement; indeed, many things appear to suggest
it. Small-pox in West Ham is almost as great a danger to the metropolis as small-pox in the metropolis
-itself. The Metropolitan Asylums Board hospitals contain accommodation sufficient to take West Ham
cases, and owing to the extent of their land at Darenth, can be quickly enlarged if necessary. Moreover,
during the 1884-5 epidemic the Metropolitan Asylums Board entered into an arrangement for the hire of
a hospital, situate in West Ham, and filled it with small-pox cases. On the other hand, on the part of