Hospitals and the state : with an account of the nursing at London hospitals, and statistical tables showing the actual and comparative cost of management and maintenance, and of work done by the principal hospitals, convalescent institutions, and dispensaries throughout Great Britain and Ireland / by Henry C. Burdett.

  • Burdett, Henry C., Sir, 1847-1920
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Hospitals and the state : with an account of the nursing at London hospitals, and statistical tables showing the actual and comparative cost of management and maintenance, and of work done by the principal hospitals, convalescent institutions, and dispensaries throughout Great Britain and Ireland / by Henry C. Burdett. Source: Wellcome Collection.

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    of 1871 for a basis, and include all who by position or occupation are not above this class, cannot be estimated at more than 1,400,000—whatever deductions may reasonably be made for a certain number of patients appearing more than once on the lists in the same year—there is enough remaining to warrant an independent inquiry into the whole question by a Eoyal Commission. This feeling is rapidly spreading, and is making itself felt in the diminished incomes which the hospitals are now receiving from voluntary sources. This difficulty will certainly increase as the public become impressed with the knowledge that it is not the sick poor at all who are being benefited, but nearly the whole wage-receiving and industrial classes, a large proportion of whom are well-paid artisans. It cannot be too forcibly impressed upon the managers of these institutions that, though for the most part under private management, the hospitals, if they are to fulfil any useful purpose, must be public, or they will cease to be indispensable. Each large hospital should be the centre of a district, and the dispensaries in that district should be affiliated with it. At the present time there are no means of extending medical relief in proportion to the demands of a growing population, and every year the poor are being moved further and further away from the larger Metropolitan hospitals. Finally, it should be distinctly understood that the views set forth in this Paper are not merely those of the writer, but have gradually become the convictions of the majority of the more intelligent and better informed of hospital managers. In proof of this it may be well to conclude with an extract from a letter* written by Sir T. Fowell Buxton, late treasurer of the London Hospital, in response to a suggestion of the writer to hold an annual conference of hospital managers, which was published in the Times of April 23, 1878. Prom a long acquaintance with hospital management I am convinced that its principal defects, both in London and the country, arise from want of organisation and co-operation, and from the absence of all central control and of Government inspection. If the hospital system were complete, each central hospital would be surrounded by its satellites of dispen- saries, cottage hospitals, special hospitals, convalescent homes, &c., which would intercept numberless cases which otherwise burden the wards of the hospital, and would furnish advanced education for the pupils of its school. Without some such authority as is possessed by School Boards, it is impossible to organise such a system as this, or to apply the theory, which all acknowledge to be the right one, of provident medical charities, or to make our medical colleges worthy of the name, or to promote the scientific training of nurses. I entirely concur in the proposal of a conference, not that of itself it would effect much, but it would pave the way to the appointment of a Royal Commission and ultimately to Parlia- mentary action. I do not believe that hospitals upon which the demands increase year by year can much longer keep pace with the requirements of modern medical practice on the precarious support of voluntary contributions, and I earnestly hope that Parliament will take the matter in hand before it is forced upon its notice by the collapse of some important institution. * The Times, May 2, 1878.