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7
present year it has not been enforced; the charge for
patients from outside the district remains the same,
three guineas a week.
In my report for last year I drew attention to the
needs of increased accommodation, and said, from the
experience of the two previous years we might expect
there would be 390 requiring admission during 1897.
My estimate proved to be far too little, the actual
admissions being nearly one hundred more. It is not
to be wondered at, therefore, that there was a breakdown
in the autumn, and extra temporary accommodation
had to be provided. If the patients were restricted
to one disease there would be far less difficulty in
arranging for their accommodation, but with three
diseases imperatively requiring admission, the accommodation
may soon be overstrained. Separate
buildings have to be kept for each disease, and it
would be quite possible for the accommodation to be
too little, for instance, for diphtheria, while the scarlet
fever wards were half empty, it being of course out of
the question to place the diphtheria patients in the
scarlet fever wards; or the scarlet fever wards may be
overflowing while the others are comparatively empty.
There is another point also which occasioned a great
deal of difficulty owing to the number of patients
under treatment. There is one permanent block
designed expressly for the purpose of isolating doubtful
cases; this building I had been compelled to use
permanently for diphtheria and typhoid fever cases,
and consequently was unable to isolate doubtful cases