26 The Hospital Requirements of Sydney. 



2nd. We have to classify those to whom we have agreed to 

 afford assistance, for the purpose of efficiency and economy. 



This will most effectually be carried out by separating them 

 into three classes. 



1st. Those who, meeting with accidents, or being afflicted with 

 acute disease, cannot be safely removed to a distance, or who, if 

 removed, could not receive that amouut of medical attendance 

 and careful nursing which the urgency of their disease demands ; 

 with these I would place such sub-acute cases as require the 

 highest class of medical treatment, diet, &c. 



2nd. Those who, having battled through acute disease, remain 

 weak, requiring continued rest, with change of air and scene, and 

 good diet, to restore them to such vigour of body and mind as 

 will enable them to resume the laborious duties of their station. 

 We may also class with these all chronic cases of disease requiring 

 for their relief a passive treatment of considerable duration. 



In the third division we find the infirm and incurable separated 

 perhaps, in many instances, but little from the pauper, but still 

 as a class possessing a distinct claim for the consideration of those 

 who undertake to deal especially with the illness and infirmity of 

 mankind. 



"We have next to consider the character of the buildings re- 

 quired — and first we will deal with those for the reception of cases 

 of accident and acute disease. For these it must be allowed that 

 a central hospital is essential, and experience has proved it to be 

 necessary ; the only point upon which issue has been raised being 

 as to the amount of accommodation, in proportion to the extent 

 and character of the population. 



The Centra] Hospital should afford such accommodation only 

 as will suffice for the reception of all severe accidents, and acute 

 cases of disease. I consider that no such establishment should 

 be larger than will be necessary to meet this requirement, and 

 that most cases of protracted disease should be drafted off to a. 

 convalescent hospital placed at a distance from the metropolis. 



The proper proportion of hospital accommodation to population 

 is calculated in England to be about 300 beds to 120,000 persons, 

 but this must be regarded only as a proximate estimate ; local 

 circumstances will have to be taken into consideration, as well as 

 the nature of the hospitals to be provided. 



As it will be impossible to calculate the accommodation which 

 will be required in a central hospital, separately from that which 

 has to be provided for in the hospital for the reception of con- 

 valescing and chronic cases, I will at once endeavour to attain a 

 proximate idea of each — the infirmary requirements being left 

 for the consideration of the Government. 



Considering the imperfectly developed condition of the country 

 districts, and the large number of patients which therefore come 



