Our medical charities : an address delivered at the annual meeting of the Birmingham and Midland Counties Branch of the British Medical Association, June 26th, 1877 / by Sampson Gamgee.

  • Sampson Gamgee
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: Our medical charities : an address delivered at the annual meeting of the Birmingham and Midland Counties Branch of the British Medical Association, June 26th, 1877 / by Sampson Gamgee. Source: Wellcome Collection.

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    the expenditure, without sacrificing efficiency and comfort to economical considerations ? An attempt has been made in one of our Free Hospitals to solve the difficulty by taking beds out of the wards ; but to reduce beds when out-patients are increasing, is to commit a double error, lstly, on the score of humanity ; 2ndly, of economy in its true sense. When a hospital is advertised as free, the masses of the people accept the title as literally true, and flock to the institution in the hope of gaining admission. Their likelihood of success diminishes, in proportion as beds are reduced for the purpose of balancing expenditure and income. The practical effect is, that an increasing number of out-patients go backwards and forwards for one or two minutes interview with the doctor, to return at the end of a week, probably with a fatal malady in process of development. The pressure is so great that sometimes patients, who are only convalescent, are sent out to make room for very urgent cases, and this rapid passage of patients through a small number of beds is vaunted by some statisticians as an administrative triumph. But no record is kept of relapses, and of cases relieved but not cured. If urgent cases could be drafted off to a convalescent hospital so soon as ready for it, a comparatively small number of beds might safely be used for a larger number of severe cases, but if these are to be sent home when barely convalescent, to make room for others urgently needing admission, a great deal of hardship is inflicted. When the bread-winner is at home disabled, the scanty resources of the home cupboard are hardly sufficient for the wife and children. By pinching and pawning, to eke out small savings and the contribution from the club or provident society, life is kept in the crippled man ; but his muscles go on wasting, and he often returns to work only partially recovered, to struggle against difficulties which he never surmounts, and which bring him to a premature grave, or to the workhouse. Once a working man’s health has been damaged, and his home broken up, perfect restoration of either is very difficult. When such a man is so seriously injured, or so ill, as to require admission into a Hospital, the true economy is to cure him thoroughly if possible. This is often impossible, if no effective measures are taken to regulate the number crowding into the casualty and out-patients’ rooms, while beds are being withdrawn from the wards to save money. As a question of administration, the reduction of beds for motives of economy is a mistake ; for the establishment expenses remain very nearly the same, and they bear a higher proportion per bed as the number of beds is lessened. Conceding that the free system may be easy to manage in a compara¬ tively small community, and that in a large town it may possibly afford the simplest plan of administration in a hospital sufficiently large, and well endowed, to meet the calls upon its resources, that does not affect the truth of the proposition so tersely and cogently expressed
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