Report from the Select Committee of the House of Lords on Metropolitan Hospitals, &c. : together with the Proceedings of the Committee, minutes of evidence, and appendix. / Ordered, by the House of Commons, to be printed, 15 August 1890.
- Date:
- 1890
Licence: Public Domain Mark
Credit: Report from the Select Committee of the House of Lords on Metropolitan Hospitals, &c. : together with the Proceedings of the Committee, minutes of evidence, and appendix. / Ordered, by the House of Commons, to be printed, 15 August 1890. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
23/632 (page 11)
![5 May 1890.] Lieut. Colonel E. Montefioke, r.a. [_Continued. Lord Zouche of Jlari/ngworth — continued. provident dispensaries, but they have a very low scale of fees ; they do not try and make them self-supporting. 1 think the aim and object of the provident dispensary is that the working mens’ contributions should make them self-supporting. 70. Then who may belong to the provident dispensary ; does it depend upon residence in the locality ?—Well-conducted provident dispen- saries would distinctly have a wage limit; some have not, and therefore they have in their turn created as much abuse in that way as the hos- pitals have, as we consider, in theirs. Due discrimination not having been used, they take away from the general practitioner the patients that should go to him, in exactty the same way as we consider the hospitals do. We hope that you will have evidence placed before you on the subject from people more conversant with pro- vident dispensaries than I am ; though I have known something of them for many years. Lord Monhswell. 71. You put it forward as unfair that a man who gets sick-pay should go to a hospital and be treated for nothing though he gets pay from his club or society ; but may you not look at it in one point of view as more loss of work-pay than money to pay for the doctor?—I said, it in answer to a question of the Chairman ; I think I did not give it in evidence. In answer to the Chairman, I said that I thought it might act unfairly, and I think that there again is another reason why discrimination should be exercised in all these cases. There might be a case of a man who has nobody whatsoever dependent on him, and in that case I should think that, the money coming in to him should go to the hospital or to the people who were treating him : but if he has people dependent on him, I should think it should be for somebody who received and studied his particular case to say, if any, what amount should go to the hospital, or to the person treating him, and what amount should be still kept for the family to support them and keep them off the rates during the man’s illness. 72. Y'ou said that at Guy’s they charged 3 d. a week for out-patients; do they exact that payment in all cases, however destitute the person may be ?—No; they refer the cases to the committees in the different districts of our society, who if a man is found unable to pay, have his ticket or paper stamped “free.” 73. And is that the case at other places where they pay, such as the Victoria Hospital?—Not that 1 am aware of now ; I think it is entirely conducted by inquiry in the hospital alone. Lord Clifford of Chudleigh. 74. And if a patient pays the 3 d., I presume they make no further inquiry ?—None. Earl Sptnccr. 75. These charges made by various hospitals I suppose were made in order to overcome some of the evils of the out-patient system ?—Yes. 76. Were they successful in diminishing the number of improper cases coming to the hospital ? —At so many of the hospitals the charges are below the low prices of the medical men in their (69.; Earl Spencer—continued, district, that I think they do not very much lower the number of out-patients. 77. But taking that particular hospital do they not lower the number there?—At Guy’s I think they have decidedly diminished it. 78. They have fewer in proportion than at those hospitals that are quite free ?—I should imagine that they have, but not to any very great extent. But I think evidence will be coming forward from the hospital itself on that particular point. 79. I thought that you, as an observer, might have noticed whether any hospital had been suc- cessful in that way in diminishing the number? —I think that it certainly at first lowered the numbers very materially, but I rather fancy they are rising ac;ain in number. C5 O Chairman. 80. On that point while the payment might reduce the number of out-patients, was it mt also demanded from a desire to provide the hos- pital with funds ?—It was at Guy’s. They required funds very badly indeed, their land hav- ing depreciated very much in value. 81. Then I understand from you that going to the parish doctor whether it does actually make a person a pauper or not is avoided by the people because they consider that it casts the slur of pauperism on them?—Exactly. 82. What occurs in the workhouse infirmary if a man goes there who has sick-pay ?—They have a full system of inquiry through their re- lieving officers and that money at once goes on to the rates to pay for his maintenance if he has nobody to support; but if any of this money can keep his family off the rates it goes at once to that purpose, and he is treated free. 83. What is the next heading ?—The next heading that I have amongst the defects is this : “ The provision of gratuitous medical relief to large numbers of persons both as in and out- patients, without inquiry or any sufficient regula- tion, is, as investigation shows, a serious obstacle to the promotion of provident institutions, at which medical treatment can be secured by small peri- odical payments.” Inquiry in regard to the social status of those Avho are members of provi- dent dispensaries shows that they are of the same class as that which attends the hospitals ; and vice versa, inquiries at hospitals show that there are many patients attending hospitals who might belong to provident dispensaries. The following is a note of an inquiry made by Dr. Ford Ander- son in 1874 ; it is quite applicable at the present time: — The statistics quoted by Dr. Ford Anderson may be thus summarised ; he took 100 cases of provident dispensary patients, as they happened to come, and found the total wages in the 100 families which they represented, 120 l. 2 s. 8 d. per week, giving an average per family of 1 l. 4 s. 0^ d. Of these 100 heads of families, 50 were small tradesmen, mechanics, or skilled workmen, earning- on the average 1 Z. 9 s. a week ; 27 were labourers, earning 1 Z. 1 s. 10 d. a week ; and the remaining 23 were widows, laundresses, or domestic servants, earning on an average 15 s. 6 d. a week. Again, he took 100 instances of free dispensary cases B 2 furnished](https://iiif.wellcomecollection.org/image/b28040193_0025.jp2/full/800%2C/0/default.jpg)
