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95
It will be seen, by the block plan, that to the South of each of
these two pavilions I propose airing-courts for patients freed from all
obstruction.
Before proceeding to a description of the new buildings, a few
important observations are necessary. I understand it is suggested
by the Medical Officers that accommodation for over 200 patients
should be provided for the Borough. I may say, at once, this site is
totally inadequate for any such normal number. It is considered by
many authorities that no hospital should contain more than a maximum
of 50 patients per acre, while others hold that 20 per acre should be
taken as the standard. Four of the large hospitals of the Metropolitan
Asylums Board range from 40 to 47 beds per acre, while the four
most recent ones give a much smaller number per acre, but on these,
there is a zone of from 80 to 100 between the buildings and the
boundaries of the site.
Your present ratio is about 70 per acre, but it must be borne in
mind that the surrounding district is not yet fully built on, and,
therefore, the surrounding atmosphere is, in a quiescent state, purer
than it will ultimately be.
In my judgment, no hard-and-fast rule should be followed. The
factor for any particular site should be determined by (a) the isolation
of the site, (b) its elevation; in short, by the facilities afforded for the
free access of air-currents, to rapidly change the atmosphere of the
site. I think that a wide distance between the pavilions is of great
moment. This not only insures that no vitiated air from one building
should be drawn direct to another, but it lets in sunlight, even when,
as in the Winter, the sun is at a low angle.
I have made enquiries, as to the results, in a London hospital
having 47 patients per acre, and cannot find that less favourable
results obtain there than with hospitals having a lower ratio.
I should also report that the administrative buildings for a larger
or smaller hospital are practically the same in number, though not in
size. The result would be in your case that the cost per bed for a
hospital, say for 120 patients, would be about 10 per cent, in excess
of that for 179 patients.