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37
and (2) by calculating what proportion of the expenditure on the land hospitals and land ambulance service
should be charged to this disease.
£
1.—a. The floating hospital total cost during 1884-5 was £ 68,631, from which may be
deducted £24,000, being the average nominal cost of maintaining the ships when
without patients for two years 44,631
b. The camp for 1,000 convalescent patients at Darenth, maintenance and administrative
charges 81,112
c. Plaistow Hospital, rent for one and a half years, with maintenance, &c., &c. 8,882
d. River ambulance service 16,860
2.—e. At the beginning of the epidemic three-fourths of all the patients admitted into the
land hospitals in London were suffering from small-pox, but as has been explained,
convalescents were at an early period transferred to the ships, mild cases were soon
afterwards removed from their homes to the wharves, and at last all cases, with
few exceptions, were so treated, and the land hospitals admitted fever cases only.
Under these circumstances the total expense may be fairly divided between the two
diseases. The total expense of the land hospitals during the period was £171,759.
Deducting one-half, it leaves £85,880 to be added to the cost of the epidemic 85,880
f. A similar deduction can be made from the total expenditure on the land ambulance
service, but in this case one-quarter only should be deducted, as three-quarters of
all the patients were suffering from small-pox, and were carried either to the
hospitals or the wharves, and the expense must be debited in either case to small-pox 19,800
Total £257,165
As 11,060 cases were admitted during the period, it follows that each case cost £23 5s.
This is exclusive of the capital expenditure on the sites and buildings of the hospitals, wharves, and
ambulance stations and steamboats. The sums thus expended are raised on loan from the London County
Council, at 3½ per cent. interest, and are repayable in an average of fifty years. The cost of the epidemic
was defrayed from the current account of the managers, and was a charge on the rates of the several
parishes of the district.
For the purpose of estimating the comparative cost of ship and land hospitals, the question may be
considered under three heads—(a) cost of buildings and site, (b) ambulance service or apparatus for
conveying patients, (c) annual cost of maintenance; and in doing so I shall quote the figures given by
Mr. Hudson to the Council as the estimated cost in providing a ship hospital, and figures suggested by
consideration of Dr. Thorne Thorne's report to the Local Government Board, together with the experience
gained in West Ham itself. Many items may be left without consideration, as they would entail the same
expense in both ship and land hospital, such as furnishing, cost of nursing, and medical attendance.