Mr. J. Netten Radcliffe on the proposed site of a fever hospital at Maidstone.

  • Radcliffe, John Netten, 1826-1884.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Mr. J. Netten Radcliffe on the proposed site of a fever hospital at Maidstone. Source: Wellcome Collection.

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    consideration, between two blocks of cottages, would, it is obvious, be inadmissable as an approach to the proposed detached wards of the General Hospital; and access is to be made to them from the thoroughfare, open to the country, which runs north of the plot. In the event of the detached wards being erected, it would in my opinion be necessary to clear away the two blocks of cottages referred to and the walls which shut in the back premises of the main building. The entire space between the latter and the detached wards might then be converted into a garden, only such barriers intervening as would serve to prevent needless intercourse between the attendants of the two buildings. The designs for the proposed detached wards came only incidentally under my observation ; but I think it proper to note that the cubic space allowed for each bed did not exceed 1,700 feet, with a superficial area of 125 feet. Eot less that 2,000 feet cubic space should be given, with the amount of superficial space proposed. I think also that the arrangement for the offices should be reconsidered. hTo facts were forthcoming at the time of the inspection which would enable me to judge exactly what amount of accommodation for cases of infectious disease would be sufficient for the needs of the town. i7o doubt there will be periods when, as held by the medical staff of the General Hospital, so little infectious disease will have to be provided for by the Local Authority and in a public institution, that the detached wards will be empty. But, on the other hand, when infectious disease is prevalent, as during outbreaks of scarlet- fever and measles, it seems to me certain that a provision of nine beds would not at all times meet the immediate exigencies of the outbreaks and enable the Local Authority to use isolation in such a way as to limit the extension of the epidemics among the popula¬ tion. Unless the provision for isolation is such as to permit of the earliest cases of an outbreak, when requisite, being weeded out at once, the prime object of the measure is unattained. It must be remembered, moreover, that two infectious diseases, e.g., scarlet fever and small-pox, may happen to be epidemic in the town at one time; and that the two classes of patients cannot rightly be placed together in one ward. I am aware that the Board of Management of the General Hospital proposes to spend in the erection of detached wards the sum of 1,000/., given to it by a generous benefactor for that purpose. The Board is exercising a very manifest duty in expending the money so as to obtain the greatest benefit from it. But as the Local Board of Health is desirous of co-operating with the Board of the General Hospital in carrying out the benefactor’s designs, a wider question arises which particularly concerns the Local Board. It is for the latter to consider how far the proposed accommodation of nine beds for infectious diseases would enable it properly to carry out the duties relating to the isolation of such diseases imposed upon it by the Legislature in the Sanitary Act, 1S66. I am of opinion that in a town of 25,000 population there should always be means at the command of the Local Authority for isolating at least eighteen or twenty cases of infectious disease. I would urge, therefore, upon the Local Board of Health the the importance of securing this amount of accommodation for cases of infectious disease, if practicable, in conjunction with the Board of Management of the General Hospital. The Local Board must remember, however, that it has authority to provide such accom¬ modation independently. It may be .'remarked, in connection with this question, that small wards of the kind contemplated for the detached wards of the General Hospital are wasteful of nursing staff, and involve a very disproportionate cost of construction to wards of somewhat larger size. The nursing staff, nurses’ living accommodation, kitchen requirements, and ward offices, needed for two wards containing four beds each, would equally meet the wants of the same number of wards with eight or ten beds each. If a plan should be adopted of making larger provision ‘for cases of infectious disease than that now' contemplated by the Board of the General Hospital, it might then become a question whether this larger accommodation should be fixed upon the site proposed for the detached wards of the General Hospital. Although no danger to neighbouring dwelling-houses is to be apprehended from a hospital, of from eighteen to twenty beds, for infectious diseases, being erected on the site contemplated for the detached wards of the General Hospital, as a rule, a hospital for such maladies should stand well isolated in its own grounds, unless there are cogent reasons of cost and convenience to the contrary. I may add that in large and increasing tow ns the most jealous care ought to be exercised not to deprive General Hospitals of open spaces attached to them Summary. To summarize the conclusions to which I have come as the results of this inspection:—