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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    Sick Children was established on the free principle ; and the ex¬ perience of its first ten years’ working is given in a supplementary report of the Managing Committee for 1871, with such detailed fulness and unreserved candour as to make the document one of exceptional value.* It contains a very full admission that from its first introduction at the Children’s Hospital, the free system tended to become unworkable, and a source of embarrassment to the Charity, in consequence of the rapidly increasing numbers attending the out-patient rooms. One expedient after another had failed to check that increase, and as a last resort the Committee required 6d. to be paid for each child on admis¬ sion. For a short time the check was effectual. From 1867 to 1870 inclusive, the number of out-patients at the Children’s Hospital each year was 9,500, 11,423, 12,967, 14,059. In 1871, with the institution of the 6d. registration fee, the numbers fell at once to 10,989, and to 9,573 in the following year (1872). The respite was brief. The numbers rose again to 10,973 ; and so soon as the 13th of October, 1873, the Committee instituted a further fee of 6d. each child, to be paid from time to time as a renewal of the note. In spite of this repeated check the numbers * On the establishment of the Hospital it was determined that the patients should be admitted free, i. e., without the recommendation of a subscriber being- necessary. It was thought needful that sick children should have advice and medicine as soon as possible—that those who were without friends among the subscribers should not be debarred from the benefits of the Charity—and that those who could obtain a subscriber’s ticket should not be necessarily admitted to relief, unless in other respects they were fit recipients of it. It was, however, thought proper to insist on a note being brought by the applicant from a householder, subscriber or otherwise, in order that a guarantee should be obtained that the applicant was a fit object of hospital relief. This guarantee broke-down immediately, for persons of every class in the immediate neighbourhood of the Hospital signed the notes for any one who presented them. It was then determined that the Secretary should give out the notes daily, after instituting certain inquiries, with the view to determine whether the parents of the sick child were fairly to be considered fit objects of public charity, in the two-fold aspect of their earnings and their relations to parochial relief. This plan has been in operation for more than seven years. The great increase of the Out-patients, even near the first formation of the Institution, was attempted to be met by the appointment of a Dispenser ; then of a Porter ; then by the limitation of the tickets issued to thirty per diem ; then by an extension of the staff from four to six members ; then by the building of a great department exclusively allotted to Out-patients. But the result of all has been that the Out-patient department is growing beyond the power of the staff to prescribe for, beyond the capacity of the waiting-hall to hold with safety, beyond the strength of the Dispenser to deal with, or of the Porter to keep in order ; finally, beyond the revenue of the Charity. The limitation of the tickets to thirty was soon given up, for the natural result was that they fell to the lot of the strongest and rudest, and to those who lived close to the doors of the Hospital. A patient coming from a distance of twenty miles, the fittest of all the applicants to receive aid on a
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