On legislation and provision for the care of the insane / by Alexander Watson Wemyss.

Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: On legislation and provision for the care of the insane / by Alexander Watson Wemyss. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the Continent, and in America, to be such as will contain from 200 to 300 patients. But where a large proportion of chronic incurable cases has to be accommodated, the number may be greater. For these, however, although in connection with the asylum, separate and less expensive buildings are recommended. The above number, in a curative asylum (although the number may be greater in a mixed asylum), is found sufficient for the proper medical care and superintendence of a resident physician, while fewer would not be economical in a financial view. If, therefore, asylum accommodation for pauper lunatics is re- quired for a smaller number only than 300, it would be much better to combine with one or more counties to erect a larger one than to erect and maintain a smaller one—as for 150—because the cost of officials and attendants (being nearly the same for 150 as for 300) would be much greater in proportion for each patient; and, there- fore, would add very considerably to the charge for the board of each. This may readily be seen by the printed reports showing the cost of pauper lunatics in large asylums* Suppose the rate of board to be £24: per annum for each, £12 of this pays for their food, while the other half is required to cover the expenses of medical and other attendants, heating, lighting, and other necessary charges. Now, the greater part of these charges being the same for an asylum containing 150 patients as for another containing 300, it follows that that part of the charge for board, applicable to officials and management, would have to be doubled for each patient, to make up the necessary cost. Hence in place of, say £24: per annum for each patient, £36 would be required to meet the ex- penditure. It must, therefore, be obvious that the erection of an asylum for pauper lunatics to contain only 150, would be very far from economical, and Parochial Boards would have to pay a much higher sum for each patient sent to the asylum than at present. The result of this would be either a greatly increased expense to Parochial Boards, or the asylum would remain empty by their sending their pauper lunatics elsewhere.-f The above remarks refer to what is imperatively required of the county by the Statute, lately enacted ; but it also contains per- * See Report of Commissioners, p. 78, also Appendix, p. 231. First Report of Lunacy Board, p. 53. 2d Report, Appendix C. t The buildings and other accommodation for the resident physician and other officials and attendants, as also the infirmary wards, being the same for 150 as for 300, would greatly add to the cost for a small asylum, in pro- portion to its extent. E
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