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POOR-LAW MEDICAL OFFICERS' ASSOCIATION OF ENGLAND AND WALES.
1292 Council,
on
the advice of the Finance Committee,2 to seek
powers for the establishment of one instead of two receiving houses as originally recommended. The committee urged the In the Council to give this point further consideration.
report submitted last July the committee expressed the opinion that two receiving houses, one on the north and one the south side of the Thames, each to accommodate 250 patients, would be sufficient for the needs of London, and that the total cost should not exceed .B150,000 to 180,000. This suggestion was put forward as the result of long experience of the numbers and classes of patients received at the asylums and of some knowledge of the conditions under which alleged lunatics were dealt with at present in the London workhouses and Poor-law infirmaries. The proposal to establish receiving houses should not be regarded as altogether tentative, especially in view of the recommendations of the Royal Commission on the Feebleminded. The only question was as to the total accommodation required. One receiving house could not cope with the whole of the 7000 or 8000 cases of alleged lunacy dealt with annually in London-some 150 cases a week. It would be necessary, therefore, to schedule a district more or less extensive which a receiving house was to serve. In the area where the Receiving House Act operated there would be a vital alteration in the method of dealing with alleged lunacy ; for instance, it would be unlawful for an alleged lunatic to be received in a workhouse (except under the conditions set out in Clause 21 of the Bill) and the method of certification would be new. No doubt the Council would wish to provide, in due course, sufficient accommodation to allow of the whole county having the advantage of the receiving house system and its attendant benefits ; otherwise there would exist the anomaly of one law operating in one part of the county and another in the remainder. The committee thought, therefore, that the Council should not limit its application for powers to one receiving house, but should put itself in a position to provide whatever accommodation might be found necessary. The advantage of the receiving house principle had been recognised so long, and the urgent need for giving practical effect to it had been so strongly emphasised by the Royal Commission that the committee believed the Council, on further consideration, would agree there was no need to treat the proposal to apply for powers as though the application were directed to some end entirely on
in a direction altogether unknown. The committee asked the Council to rescind the resolution of Oct. 12th, 1909, limiting the application to one receiving house, and to resolve instead :
experimental, leading
That application be made to Parliament in the session of 1910 for powers to enable the Council to establish and maintain receiving houses tor alleged lunatics in the County of London.
POOR-LAW MEDICAL OFFICERS’ ASSOCIATION OF ENGLAND AND WALES. of this association was held at 34, April 28th. The chief business before the meeting was the annual meeting of the association at Halifax. Dr. MAJOR GREENWOOD, the honorary secretary, said that Dr. A. Drury had arranged for this to take place on June 29th. The Mayor of Halifax would open the conference at the Town-hall, and later the Mayor and Mayoress would entertain the members at afternoon tea. The Mayor and Mayoress had also accepted the invitation of the association to the annual dinner in the A COUNCIL meeting Copthall-avenue, E.C.,
on
evening. Dr. DRURY said he had that week called a meeting of the medical officers of the Halifax Union, who had pledged themselves to give all the assistance in their power to promote the success of the conference, and he could assure the council that no effort would be spared to make the gathering at Halifax a thorough success. The council decided that invitations should be sent to all members of the Poor-law Medical Service in England and Wales. The HONORARY SECRETARY reported that the answers to the questions submitted to the outdoor Poor-law Medical Service had been analysed by himself and Mr. A. Withers Green, with the following results :1. Are you in favour of the abolition of boards of guardians throughout England and Wales ?-To this question 37 per cent. of the answers were in the affirmative and 59 per cent. in the negative. 2. What authority would you propose to set up ?-To this question 12 per cent. of the answers were in favour of an 14 ad hoc authority,"22 per cent. for the statutory committee of the county council, and only 3 per cent. in favour of the abolition of any special Poor-law authority. N. B.-Only the answers of those who wished for the abolition of the guardians were counted with regard to this question. 3. Should any difference be made between medical and other public relief beyond the disfranchisement in the case of the former ?-77 per cent. of the answers were in the negative, 8 per cent. in the affirmative. 4. Should there be any "test," or deterrent"such as the present medical order, to regulate the granting of medical relief to poor applicants ?7 Or should the latter be permitted to claim public assistance subject to no other liability than having to pay the cost of the same, if proved to be in a position to ?-83 per cent. were in favour of a test, 11 per cent. opposed to it. 5. Are you in favour of a public assistance medical scheme based on provident dispensaries, subsidised by the State, and contract practice generally?-83 per cent. of the answers were opposed to this and 12 per cent. in favour. 6. Are you in favour of a public medical service based on an amalgamation of the present Poor-law Medical Service with the sanitary medical service ?-60 per cent. were opposed to this and 33 per cent. in favour. 7. Do you approve of the district medical officer being made relieving officer so far as medical relief is concerned ?— 76 per cent. opposed to it; 22 per cent. in favour. 8. Are you in favour of "whole-time"or "part-time" appointments in any reformed public assistance medical service ?-17 per cent. were in favour of "whole-time" appointments; 71 per cent. were in favour of part-time"
The Finance Committee, reporting on the proposal, recapitulated its reasons for opposing the larger scheme (reported in THE LANCET of July 24th, 1909), and pointed out further that the Asylums Committee had introduced new matter, particularly the proposal making it compulsory that every alleged lunatic should go in the first place to a receiving house. The Finance Committee was still without information which would enable it to advise the Council as to the financial effect of the present proposals. It certainly was not present to its mind at the time of the earlier report that an essential part of the scheme was that every person alleged to be a lunatic should pass through the receiving house, and such a scheme formed no part of previous Lunacy Bills. If the Bill was approved in the form desired by the Asylums Committee the Council would be definitely committed to a new policy as appointments. 9. Are you in favour of a reform of the present Poor-law regards the early treatment and certification of lunatics, and, however desirable the changes might be, thev would involve system, or would you prefer a "break-up " ?-ll per cent. in considerable expenditure, on both capital and maintenance favour of a "break-up " ; 82 per cent. in favour of "reform." In the opinion of the ’ 10. Do you think that a"unified medical service," that accounts, of unknown amount. Finance Committee the Council would be ill-advised to attended to all poor applicants with no other test or agree to the present proposal of the Asylums Committee, deterrent than the liability to be compelled later to pay the or to any extension of its previous decision until it was in cost, would, or would not, be dangerous to the interests of possession of full information as to cost. On general all general practitioners in poor districts?-Answers in the and financial grounds the Finance Committee opposed the affirmative were 90 per cent. ; in the negative, 6 per cent. recommendation. This analysis was approved by the council, and it was The report was not reached until 1.30 A.M., when the decided that resolutions framed on these answers should be Council had been sitting for 13 hours, so the consideration of submitted to the general meeting in Halifax in June, and, if carried there, should again be brought forward for confirthe matter was adjourned. I at the meeting in London during the British Medical 2 THE LANCET, vol. ii., 1909, p. 1161. Association week in July-August next.
mation
on
the advice of the Finance Committee,2 to seek
powers for the establishment of one instead of two receiving houses as originally recommended. The committee urged the In the Council to give this point further consideration.
report submitted last July the committee expressed the opinion that two receiving houses, one on the north and one the south side of the Thames, each to accommodate 250 patients, would be sufficient for the needs of London, and that the total cost should not exceed .B150,000 to 180,000. This suggestion was put forward as the result of long experience of the numbers and classes of patients received at the asylums and of some knowledge of the conditions under which alleged lunatics were dealt with at present in the London workhouses and Poor-law infirmaries. The proposal to establish receiving houses should not be regarded as altogether tentative, especially in view of the recommendations of the Royal Commission on the Feebleminded. The only question was as to the total accommodation required. One receiving house could not cope with the whole of the 7000 or 8000 cases of alleged lunacy dealt with annually in London-some 150 cases a week. It would be necessary, therefore, to schedule a district more or less extensive which a receiving house was to serve. In the area where the Receiving House Act operated there would be a vital alteration in the method of dealing with alleged lunacy ; for instance, it would be unlawful for an alleged lunatic to be received in a workhouse (except under the conditions set out in Clause 21 of the Bill) and the method of certification would be new. No doubt the Council would wish to provide, in due course, sufficient accommodation to allow of the whole county having the advantage of the receiving house system and its attendant benefits ; otherwise there would exist the anomaly of one law operating in one part of the county and another in the remainder. The committee thought, therefore, that the Council should not limit its application for powers to one receiving house, but should put itself in a position to provide whatever accommodation might be found necessary. The advantage of the receiving house principle had been recognised so long, and the urgent need for giving practical effect to it had been so strongly emphasised by the Royal Commission that the committee believed the Council, on further consideration, would agree there was no need to treat the proposal to apply for powers as though the application were directed to some end entirely on
in a direction altogether unknown. The committee asked the Council to rescind the resolution of Oct. 12th, 1909, limiting the application to one receiving house, and to resolve instead :
experimental, leading
That application be made to Parliament in the session of 1910 for powers to enable the Council to establish and maintain receiving houses tor alleged lunatics in the County of London.
POOR-LAW MEDICAL OFFICERS’ ASSOCIATION OF ENGLAND AND WALES. of this association was held at 34, April 28th. The chief business before the meeting was the annual meeting of the association at Halifax. Dr. MAJOR GREENWOOD, the honorary secretary, said that Dr. A. Drury had arranged for this to take place on June 29th. The Mayor of Halifax would open the conference at the Town-hall, and later the Mayor and Mayoress would entertain the members at afternoon tea. The Mayor and Mayoress had also accepted the invitation of the association to the annual dinner in the A COUNCIL meeting Copthall-avenue, E.C.,
on
evening. Dr. DRURY said he had that week called a meeting of the medical officers of the Halifax Union, who had pledged themselves to give all the assistance in their power to promote the success of the conference, and he could assure the council that no effort would be spared to make the gathering at Halifax a thorough success. The council decided that invitations should be sent to all members of the Poor-law Medical Service in England and Wales. The HONORARY SECRETARY reported that the answers to the questions submitted to the outdoor Poor-law Medical Service had been analysed by himself and Mr. A. Withers Green, with the following results :1. Are you in favour of the abolition of boards of guardians throughout England and Wales ?-To this question 37 per cent. of the answers were in the affirmative and 59 per cent. in the negative. 2. What authority would you propose to set up ?-To this question 12 per cent. of the answers were in favour of an 14 ad hoc authority,"22 per cent. for the statutory committee of the county council, and only 3 per cent. in favour of the abolition of any special Poor-law authority. N. B.-Only the answers of those who wished for the abolition of the guardians were counted with regard to this question. 3. Should any difference be made between medical and other public relief beyond the disfranchisement in the case of the former ?-77 per cent. of the answers were in the negative, 8 per cent. in the affirmative. 4. Should there be any "test," or deterrent"such as the present medical order, to regulate the granting of medical relief to poor applicants ?7 Or should the latter be permitted to claim public assistance subject to no other liability than having to pay the cost of the same, if proved to be in a position to ?-83 per cent. were in favour of a test, 11 per cent. opposed to it. 5. Are you in favour of a public assistance medical scheme based on provident dispensaries, subsidised by the State, and contract practice generally?-83 per cent. of the answers were opposed to this and 12 per cent. in favour. 6. Are you in favour of a public medical service based on an amalgamation of the present Poor-law Medical Service with the sanitary medical service ?-60 per cent. were opposed to this and 33 per cent. in favour. 7. Do you approve of the district medical officer being made relieving officer so far as medical relief is concerned ?— 76 per cent. opposed to it; 22 per cent. in favour. 8. Are you in favour of "whole-time"or "part-time" appointments in any reformed public assistance medical service ?-17 per cent. were in favour of "whole-time" appointments; 71 per cent. were in favour of part-time"
The Finance Committee, reporting on the proposal, recapitulated its reasons for opposing the larger scheme (reported in THE LANCET of July 24th, 1909), and pointed out further that the Asylums Committee had introduced new matter, particularly the proposal making it compulsory that every alleged lunatic should go in the first place to a receiving house. The Finance Committee was still without information which would enable it to advise the Council as to the financial effect of the present proposals. It certainly was not present to its mind at the time of the earlier report that an essential part of the scheme was that every person alleged to be a lunatic should pass through the receiving house, and such a scheme formed no part of previous Lunacy Bills. If the Bill was approved in the form desired by the Asylums Committee the Council would be definitely committed to a new policy as appointments. 9. Are you in favour of a reform of the present Poor-law regards the early treatment and certification of lunatics, and, however desirable the changes might be, thev would involve system, or would you prefer a "break-up " ?-ll per cent. in considerable expenditure, on both capital and maintenance favour of a "break-up " ; 82 per cent. in favour of "reform." In the opinion of the ’ 10. Do you think that a"unified medical service," that accounts, of unknown amount. Finance Committee the Council would be ill-advised to attended to all poor applicants with no other test or agree to the present proposal of the Asylums Committee, deterrent than the liability to be compelled later to pay the or to any extension of its previous decision until it was in cost, would, or would not, be dangerous to the interests of possession of full information as to cost. On general all general practitioners in poor districts?-Answers in the and financial grounds the Finance Committee opposed the affirmative were 90 per cent. ; in the negative, 6 per cent. recommendation. This analysis was approved by the council, and it was The report was not reached until 1.30 A.M., when the decided that resolutions framed on these answers should be Council had been sitting for 13 hours, so the consideration of submitted to the general meeting in Halifax in June, and, if carried there, should again be brought forward for confirthe matter was adjourned. I at the meeting in London during the British Medical 2 THE LANCET, vol. ii., 1909, p. 1161. Association week in July-August next.
mation