HOSPITALS AND DISPENSARIES—AN URGENT QUESTION.
[TO THE EDITOR OF THE " SPECTATOR."] SI11,—Efforts have recently been made on behalf of St. George's, London, and King's College Hospitals to obtain an extraordinary levy from the philanthropic public for these institutions. How- ever energetic and laudable such efforts may be, it goes without saying that they can hardly, year by year, be maintained. The obvious conclusion follows that the constantly-increasing popula- tion of London taxes the resources of the London Hospitals beyond their strength. The causes of this and the evils engen- dered by such a state of things, though familiar to most of us, are not necessary to enumerate here. A remedy must, of course, be found. It seems, therefore, worth while, with this object, to draw public attention for a few moments to an attempt which has been made for the last two years in London to cope with the difficulty, and to do something to lessen the strain upon the hospital out-patient system. In April, 1880, an Association was formed, at a meeting of representatives of the Friendly Societies, the Hospital SatLrday Fund, the Charity Organisation Society, and members of the Medical profession, and others, for the extension and consolidation of the Provident-dispensary system throughout London. This Association is in active work, and with your permission I will describe, as shortly as I can, the results up to the present time. Nine dispensaries have been established in different parts of London. Already about 23,000 a year is being paid in small sums by members of these institutions. In each of three neigh- bourhoods there are over 3,000 persons thus absolutely insured against medical risk, although one of these centres is within a mile of three large hospitals. That even with the present few branches, about 150 additional persons join in each week. That assistance is given by unpaid voluntary committees of members numbering more than 150 persons, and that several letters are constantly being received, inviting the formation of such dis- pensaries in working-class neighbourhoods in and about London. That in a comparatively short time, it is estimated, if the neces- sary branches were established, the system would embrace a membership of between 150,000 and 200,000 persons. This would in a great degree mitigate the strain upon the Hospital out-patient system, relieve the Hospitals from over- work and pecuniary pressure, and give the people prac- tically more available and effective medical attendance, while preserving their independence, save the time, often of money value, now occupied in waiting at the out-patient department of the Hospitals. As I have stated, the scheme has generally received the support of the Friendly Societies, but it is obvious that until a further extension of it becomes practicable, many such men might live beyond the radius which is touched, and would thus be out of benefit until the system is sufficiently developed to include them. I have now briefly described this work ; the principle is not new, and it is only the general and systematic application of it that gives it a claim to public atten- tion. Although it has none of the sensational characteristics which attend the efforts now made on behalf of the Temperance movement, nor those which have for their effect the improvement of the dwellings of the poor, the scheme is simple, but it is in full swing, the working-classes in Dalston, Bow, Rotherhithe, Deptford, Kensal Green, and other outlying districts of London are eager for its extension ; and it is a work which, one would think, would recommend itself to that large number of persons who have the amelioration of the condition of their less fortunate countrymen at heart.
A meeting will be held on Wednesday, June 6th, at Sir Charles Trevelyan's, 8 Grosvenor Crescent, at which the Right Hen. W. H. Smith, M.P., will preside, to consider the progress of this work, and the desirability of its further extension in London.
—I am, Sir, &c., H. N. HAMILTON HOARE. Offices of the Metropolitan Provident Medical Association, 24 Bedford Street, Strand.
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