HH62/2/STIRLI/23

Transcription

[Page] 22

define areas for lighting, cleansing, and paving roads or streets (in
populous places) and to assess therefor ; and (b) to exercise the
functions of a Dean of Guild Court in controlling the erection of new
buildings as far as the site and sanitary arrangements are concerned.
Hospital Accommodation. - This subject has occupied much
time during the year. It may be accepted as one of the essen-
tials of sanitary administration that there should be within
reach of every village within the District of a Local Authority
some place in which a person suffering from infectious disease can
be isolated and treated. Unfortunately, county Districts are not
always suitable as hospital districts, and very often the rural
population in a District is not large enough to require a hospital
of such size as can be wrought with economy and efficiency.
In the Eastern District the problem has been comparatively
simple. The District is small, compact, thickly populated, and
the Burgh of Falkirk is situated almost in the centre. The
burgh possesses a small fever hospital well placed on a rising
ground to the south of the town. It contains fourteen beds.
The water supply is at present defective, and the administrative
arrangements insufficient as to laundry, disinfector, ambulance
waggon, &c., but it is understood that the deficiences are about to
be remedied. The natural arrangement appeared to be that the
use of this hospital should be obtained for District cases. At the
same time the District Committee, as successors to the former
Local Authorities for the Parishes of Falkirk, Polmont, and Both-
kennar, had a right to send patients to the Grangemouth Hospital.
It is a modern brick building, of one storey, and able to take about
ten patients. It admits medical and surgical as well as infectious
cases, but the total admissions are very few. The population of
the Eastern District being over 36,000, the amount of accommoda-
tion which ought to be provided should ultimately be about thirty-
six beds. These two hospitals combined do not give anything like
this, but it will probably take some years to get the people to
appreciate fully the value of hospitals for infectious cases, and at
first there will be much reluctance in sending patients. As I men-
tioned at some of the District meetings, in the five years, 1880 to
1885, only eighty patients were sent to the new fever hospital in
Kilmarnock, while in the five years, 1885 to 1890, over 400 were
admitted. In the light of such facts, and in view also of the length

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of time that it would take to arrange for purchase of site, prepara-
tion of plans, and erection of buildings, it seemed advisable to take
advantage of the existing accommodation. Another factor in the
case was the desirability, in the interests both of economy and
efficiency, of establishing a working arrangement between the
burgh of Falkirk and the District. Their public health interests
are very much in common, and the expenses of management are
proportionally much less in a large hospital than in a small
one. As a result of lengthened negotiation an agreement with
Falkirk burgh has been arrived at, of which the main condition
is the following:- That for the use of one-half of the beds in
the Hospital a "bed rent" of twenty-five guineas per annum
(amounting to £183.15s for seven beds) be paid by the
District Committee to the burgh authorities; and that in addi-
tion four guineas be paid for each case sent in, this sum to
include all charges for maintenance, nursing, medical attend-
ance, &c., and to be independent of the length of duration of
the case. The agreement also includes a stipulation that if at
any time the District Committee requires more than seven beds,
and other beds are available, the District patients may have the
use of them. The whole arrangement is to last for five years, by
which time greater experience will have been obtained regarding
the necessities both of the burghal and rural population. As
Grangemouth hospital receives very few patients it may be taken
that the total number of beds at the disposal of the District
Committee is about fifteen.
In the other two Districts, owing to their large and irregular
area and the sparseness of population, the difficulties as to hospital
accommodation are much greater. In the Central District the
natural course would have been for the burgh of Stirling and the
District to take joint action. This, however, the burgh has
declined to do, preferring to continue, for its own population, the
use of the building which it already possesses for isolation
purposes. The most populous place in the District, and also
the most central in situation, is Bannockburn, and this neigh-
bourhood therefore suggests itself as suitable for the erection of a
small hospital. But a hospital here would not be convenient for
outlying places like Kippen and Gargunnock in the extreme north-
west and the parish of Kilsyth in the extreme south-west. The