Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    cause, making it desirable tliat the attention of a consultee should be given to the case. (2.) The Sub-committee in the next place directed their atten- tion to the social position of the patients, and they are of opinion that the probable income of half the number of out-patients may be estimated at from IZ. to If. 10s. per week ; one-fourth more than this, and the remainder less. The Sub-committee are of opinion that persons in the receipt of upwards of IZ. per week should, as a rule, be expected, at least in ordinary illnesses, to pay something out of their own earnings towards medical advice, either by joining sick clubs, to which medical practitioners are usually attached, or by becoming members of Provident Dispensaries, the payments to which are expressly suited to their means 5 and the Sub-committee are of opinion that persons with an income of more than IZ. 10s. per week should not be considered as proper objects of gratuitous medical advice, but should be referred to Provident Dispen- saries, where, by the payment of a moderate entrance-fee, they would be entitled to advice and medicine. And as regards the rest, who are obviously unable to provide either medical advice or medicine, the Sub-committee are of opinion that such persons should, at least in the first instance, be attended by the Medical Officers of the Poor Law Dispensaries, which should be so organised as to secure a prompt and really effective attendance upon the necessitous poor, and so con- ducted as to remove them as far as possible from the degrading associations of the workhouse. The Sub-committee are of opinion that the great extension of the hospital out-patient system during the last thirty years is largely due to the repres- sive action of the Poor Law, and to the serious imperfections in the system of Poor Law medical relief. It must be observed especially that the statistics recently issued by the Poor Law Board show, that more than 96 per cent, of the whole number of persons relieved out of the poor rates consists of sick and aged adults, and children under sixteen years of age, a fact which proves conclusively that a large proportion of the sick paupers are proper objects of charitable assistance, and are really identical with many who now present themselves at the out-patient department of the public hospitals. (3.) The Sub-committee are of opinion that the system of admission by governors’ and subscribers’ letters is radically wrong as regards out-patients, and ought to be abolished. This practice is one of the chief sources -of hospital abuse. The Sub-committee believe that many masters and employers of labour contribute to hospitals, with the object of providing medical assistance for their servants and workmen at a cheap