HH62/2/LANARK/50

Transcription

[Page] 49

ward part of the district given as 91. After a full discussion,
the Committee requested me to lay before them alternative
schemes of small and large hospitals, and to leave out all
consideration of the present hospitals so as to have the
way clear for a scheme which would, untrammelled, best
suit the wants of the Middle Ward as a whole. Accord-
ingly, in my second report, while dealing more definitely
with the number of beds required, and showing that, as
suggested by Mr. Dobson, the basis of one bed per thousand
of population was too low an estimate for a population
where a large proportion lived in one and two roomed
houses, two schemes were considered, viz., (1) that of erecting
seven small hospitals throughout the district; and (2) that
of providing two or, at most, three large central hospitals.
The advantages and disadvantages of these schemes were
discussed in the report; and a third scheme was recom-
mended which embodied the best features of the other two.
This scheme was unanimously adopted by the Committee,
and accepted at their next meeting by the District Com-
mittee. By it, when carried out, practically the whole of
the inhabitants of the Middle Ward will be within four
miles of a fever hospital.
The following is the report which, in view of the import-
ance of the decision arrived at, I give in full:-

TO THE CHAIRMAN AND MEMBERS OF THE DISTRICT
COMMITTEE OF THE MIDDLE WARD.

GENTLEMEN,
In my previous report on this subject I described the
hospital accommodation at present available in the Middle
Ward, and indicated in what respects it fell short of our
requirements for the proper isolation of infectious cases.
After careful consideration and discussion, the Hospitals
Committee were of opinion that, in preparing a scheme
or schemes for the provision of hospitals on an adequate
and comprehensive scale, the present joint-hospitals for
several reasons might be left out of the question.
The population of the Middle Ward, exclusive of the
Burghs, was, according to the available returns of last

[Page] 50

census, 143,000 in round numbers, and for this number, on
the usual basis of one bed per 1,000 of the population,
practically 140 beds are necessary.
In a report placed in my hands by Mr. Dobson, whom,
at an early stage of this inquiry, I asked to assist me with
his complete local knowledge and experience of existing
difficulties, he points out that an unusually large pro-
portion of the inhabitants of the Middle Ward live in one
and two-roomed houses, where attempts at isolation are
consequently futile. He also takes into account the
number of cases notified for some months back, and
argues that no fewer than 263 beds are necessary to fully
meet the requirements of the Middle Ward.
There is, however, what appears to me a fallacy in
estimating the number of beds required from the average
of cases lately notified.
Our present hospital accommodation is obviously de-
ficient, and we have not therefore had a fair opportunity
of combating the spread of the various infectious diseases.
With better accommodation and a more thorough system
of disinfection, we ought to be able to diminish the number
of cases, otherwise the building of hospitals and consequent
isolation of patients fail in their main object.
The first argument is one, however, which must not be
lost sight of, viz., the large proportionate number of small
houses; and, after due consideration, I am of opinion that
it would be safer to provide a total of 180 beds for present
necessities.
The question then arises of how these are to be dis-
tributed.
Two schemes at least suggest themselves - (A) one by
which small hospitals are placed in situations so chosen
as to be within easy distance of the population they are
intended to serve; the other (B), by which larger hospitals
are more centrally situated so as to command a larger area.
A. - By the first scheme I am of opinion that seven
hospitals would be necessary, viz.:- One near Glasford
Station, with 14 beds, for a population of 10,000; a second
at Larkhall, with 26 beds, for 20,000; a third at Blantyre
or Cambuslang, with 36 beds, for 30,000; a fourth at
Bellshill, with 38 beds, for 32,000; a fifth at Airdrie,
with 36 beds, for 28,000; a sixth at Shotts, with 16 beds,
for 12,000; and the last near Cambusnethan, with 14 beds,
for 11,000.