Charity Hospital

“ Unfortunately, at present the governors are themselves untrained, and to finance the hospital and to make it a good institution is their sole object. Hospitals, however, are, after all, only a part of the general administration of charity, though as they are now managed they have seldom any systematic connexion with that administration. Nor is there any co-ordination between the several hospitals and dispensaries. If one rightly refuses further treatment to certain applicants, they have only to wander to some other hospital, there to be admitted with little or no scrutiny. ”

“ When the centenary of the Hospital was celebrated in 1879, a suggestion was made that an event so interesting in the history of the charity would be most fittingly commemorated by the establishment or a Suburban Hospital, where patients whose diseases are of a chronic character could be treated with advantage to themselves, and with relief to the parent institution, which is always so pressed for room that many patients have to be sent out earlier than the medical officers like. ”

“ It has been taken for granted that a hospital cannot both serve and be self-supporting—that it has to be either an institution kept going by private contributions or pass into the class of private sanitariums managed for profit. This hospital is designed to be self-supporting—to give a maximum of service at a minimum of cost and without the slightest colouring of charity. ”

“ Our plan, we reasoned, was analogous to the custom of “private” hospitals, which give free treatment or charge according to the resources of the ward patients. Both private hospitals and visiting nursing are thereby lifted out of “charity” as comprehended by the people.
We felt that for economic reasons valuable and expensive hospital space should be saved for those for whom the hospital treatment is necessary; and an obvious social consideration was that many people, particularly women, cannot leave their homes without imperiling, or sometimes destroying, the home itself. ”

“ This hospital at present contains 220 poor helpless men and women, 146 of whom are upon the foundation, and are plentifully supplied with all the necessaries of life, at the expence of the hospital; but the other seventy-four are paid for by their friends, at the rate of 9l. a year each. This charity also extends to lunatics, for whose accommodation a large infirmary is provided.
To this foundation belong a Chaplain, Physician, Surgeon, and other proper officers, who carefully attend the pensioners, and administer to their several necessities. ”

“ Every voluntary hospital, while admitting all accidents and urgent cases needing immediate attention, should institute a system whereby each applicant would be asked to prove that he or she was a fit object of charity. The only real attempt at reform, up to 1909, was the appointment by many of the larger hospitals of almoners to ascertain whether certain selected patients were in a position to pay or not. By putting the burden of proof of eligibility to receive free medical relief upon the patients and their friends, all abuse of every kind must speedily cease. ”

“ Middlesex Hospital, for the reception of the sick and the lame, and for lying-in married women, in Marybon Fields near Oxford road. This is a neat, plain, and not inelegant brick building: it has the decent appearance and all the accommodations one would wish in a house devoted to charity, without that ostentatious magnificence which too often in a great measure defeats the humane and noble end of such pious and charitable institutions, where those sums are squandered away in useless decorations, that ought to be employed in administering health to the sick, and giving feet to the lame. ”

“ Patients’ cottages have electric call bells to summon the nurse, and electric lights are supplied from the City Hospital plant. A bath house is now being erected, providing separate bath rooms for male and female patients.
Adjoining the City Hospital grounds the Flower Mission—a private charity partially supported by public funds—maintains a hospital for incurables. It is the only place in the State where hopeless cases are received. The Flower Mission nurses also minister to the relief of tuberculosis patients at their homes. ”

“ Private families do not wish to take the burden of the sick. Consequently, in self-defence, hospitals are built so that any wanderer coming to a house, dying, or suffering from any disease, may immediately be packed off to a hospital and not become a burden upon private charity. The fact that many diseases are contagious rendered hospitals necessary for the preservation of the lives of the citizens. ”

“ George’s Hospital, near Hyde Park Corner. This undertaking was set on foot soon after Michaelmas 1733, by some gentlemen who were before concerned in a charity of the like kind in the lower 13part of Westminster. This house they judged convenient for their purpose, on account of its air, situation, and nearness to town; they therefore procured a lease of it, and opened a subscription for carrying on the charity here, which increased so fast, that on the 19th of October they were formed into a regular society, and actually began to receive patients on the first of January following. ”

“ The hospital now has about five hundred thousand dollars worth of property, from which it receives twenty thousand dollars in rents, all of which it expends upon its patients, and through a commission of citizens it is most admirably administered.
The Sisters of charity attend upon the patients, but do not control the management of the institution. The number of patients now in the hospital is three hundred, and this is about the average in seasons of peace, but at times during the last war, it was nearly trebled. ”

“ A distinct, and most important, branch of the Hospital is the Cancer Charity with its Research Laboratory. The history of this department is certainly worth a little notice. It was established in 1792, mainly through the munificence of an anonymous donor, who turned out to be Mr. Whitbread, father of the famous Whig member of Parliament. It began with the allocation of one ward in the hospital to the care of patients who were to be kept in “until{10} relieved by art or released by death”—a phrase retained to the present day. The disease was described by Mr. ”

“ Thomas' Hospitals, now in process of construction at the Surrey Side of the Thames, in Lambeth, opposite the Houses of Parliament, will combine a number of hospitals for Special Diseases, and will accommodate about 2,000 patients, with as many beds, and will have an income of £50,000 a year, or more.
It is impossible to think of any disease, complaint, deformity, or injury to any member or organ of the body, which has not its special hospital or institution for relief or cure, in the English metropolis. ”

“ I should be glad to hear that some other charitable donor had sent in like manner an offer of funds to fill those two great vacant wards which, waiting for patients, are among the saddest sights in this hospital.
{261} HEALING THE SICK.
Amidst the numerous great charities which distinguish this vast metropolis, hospitals must always hold a prominent if not preeminent place. Helpless infancy, the weakness and infirmity of old age, and prostration by sudden accident, or the ravages of disease, are the conditions that necessarily appeal to humanity. ”

“ Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves. The old prejudice against hospital treatment has disappeared, for the least intelligent members of the population now understand that, when a citizen is sick, there is no place so good as the wards of a well-administered hospital. ”

“ These principles, as civilization grew, education improved, and the tastes and requirements of the common people were developed, made men and women of many races realize that the treatment of disease in buildings set apart exclusively for the care of the sick was, in fact, a necessity in urban districts. The establishment of a hospital freed the streets of the abuses attendant upon beggars and other poor creatures, who made their ailments the chief ground of appeal for alms. ”

“ This institution at first met with great opposition; but in 1832 its value became widely recognised, owing to the fact that it alone, of all the London hospitals, received cholera patients. In 1843 the hospital was moved into Gray's Inn Road, to a site previously occupied by the light horse volunteers of the city of London, a site which was afterwards purchased by the beneficence of wealthy friends, and upon it was built the Royal Free Hospital, Dr. Marsden becoming its senior surgeon. ”

“ The glorious halls and corridors, the massive marble pillars, the splendid marble staircases, indicate wealth, but the perfection of the sanitary and scientific arrangements tells of long years of anxious thought and study and research. So perfectly is this marvellous hospital built that, in the event of plague or cholera breaking out to such an extent as to infect the building, the whole of the inside of the hospital can be removed and another hospital will still be left standing as complete as the other. ”

“ Often, too, these diseases rose to the height of epidemic pestilences, so that patients, however extreme their need, dreaded the very name of hospital, and the most skilful surgeons distrusted their own craft. New hospitals or new wards were built, yet after a very short time the new became as pestiferous as the old; and even scrupulous care in ventilation and housemaids’ cleanliness failed to prevent the devastation. Surgery had enlarged its freedom, but only to find the weight of its new responsibilities more than it could bear. ”

“ Nay, even at the least, the alleviation of suffering to those on whom death had already laid his hand has been no small thing; and when we know that of 240,000 out-patients who have received advice and medicines, and 10,400 in-patients whose cases have warranted their admission to the wards, a large number of actual cures have been effected since the establishment of this hospital, we are entitled to regard the institution as one of the most useful that we have ever visited together. ”

“ Another problem is the question of creating, in connection with General hospitals, wards where patients of this sort may receive at the beginning of their treatment, their preliminary examination, where they may be evacuated home with compensation or without compensation, or evacuated to a prolonged treatment hospital for further care.
It has sometimes been difficult to get enough men, trained personnel, to man these wards. ”

“ An echo of the old difficulties can be noted in this document, as the royal licence states clearly that the said Priory is “outside our allegiance, and the licence is to continue so long as there is no war between us and the King of Navarre.”
The fortunes of the Hospital in the middle fifteenth century can only be judged by inference, but there can be little doubt that it continued to be useful, and that gradually its functions as a place for the cure of the needy sick became more developed. ”

“ That has been one of the complaints on the part of T.B. workers not only in government but in civil institutions as well.
We still find relapses occurring after the patient has been discharged from the sanitarium or T.B. hospital. Men go into training, and in a short time undergo another course of treatment, and so on. The reason for that is that they have not been given the necessary physical rehabilitation while still in the sanitarium, while under institutional protection and medical supervision. ”

“ The current system of large hospitals is abandoned, as being equivalent to 'warehousing diseases on the largest possible scale;' while special hospitals are deemed unnecessary—'as if the different organs could walk out of the body and present themselves for separate treatment.' Each hospital has an ambulance ready to be sent out to bring any injured persons to the institution; the ambulance drives straight into the hospital, where a bed of the same height on silent wheels receives the patient, and conveys him or her to a ward. ”

“ If we close the ward to visitors ... we have never in all the years the hospital has been in existence done ... that! Public confidence is our greatest asset. Has been. What shall we do? The newspapers, the police, the reputation of the hospital, d’y’see?”
“Too well, sir.”
But the tension was wearing itself out in speech and Dr. MacArthur went on:
“The hysteria among the nursing and medical staffs was bad enough, God knows, but before today is over, we must face the hysteria manifesting itself among the menial staff. How can a hospital run without orderlies, electricians, cooks? ”

“ Besides this tendency in hospitals as charitable institutions to increase pauperism, another serious objection to the use of public hospitals for the purpose of treating the sick beyond the extent absolutely demanded by necessity is, that every time an individual is removed from his home—let that home be ever so humble—and taken to a hospital, the family as an institution receives a blow. ”

“ Our hospitals in London are always crowded, the waiting-lists mount up till it seems hopeless to attack them, and all the time it is because we have no base hospital down in the country to which our patients might be sent to recover. I wonder how long it will be before each of the great London hospitals has its own base down in the country, with its own motor ambulances and its own ambulance coaches to carry its patients in comfort by rail to surroundings where they could recover as can never be possible in the middle of the London slums? ”