HOSPITAL ACCOMMODATION. 13 



At St. Vincent's tlie cost is mucli less than this, but this case 

 is exceptional, and much to the credit of the benevolent lady at 

 the head of it. 



A hospital for chronic and incurable patients, &c., ought 

 certainly to be managed at an annual cost per bed of from £16 

 to £18. 



The last figures given are somewhat higher than some of mj 

 most experienced friends consider necessary ; but I am anxious 

 not to understate the probable cost, and feel also it will be true 

 economy to render such an institution capable of receiving the 

 largest possible proportion of cases, if only to relieve the central 

 general hospitals. 



A consideration of these statistics and general experience 

 naturally leads to the conclusion that the character of our present 

 and probable future requirements in respect to hospital accom- 

 modation may be described as follows : — 



1. To provide accommodation of a suitable character for the 



reception, as in-patients, of all cases of serious disease and 

 accident, and to afford clinical instruction to the pupils-, 

 of a University School of Medicine. 



2. To provide suitable accommodation for the reception, as 



in-patients, of all cases of confirmed chronic and incurable 

 disease, and for a certain number of convalescing patients. 



Humanity and reason equally demand that the accommodation 

 for the first class should be provided in a hospital possessing all 

 the appliances suggested by modern science, and therefore com- 

 paratively expensive ; and that for the second class, in one, simple 

 and economical both in its construction and current expenditure — - 

 calculated also to prepare its inmates to resume, without detri- 

 ment, the habits of their home life. The more perfect the first^, 

 the more rapid will be the recovery of the patients, and the 

 smaller the mortality ; the more simple the latter in structure 

 and management, the more will the habits and health of its 

 inmates approximate to what is required to fit them for a life of 

 industry, &c. 



The first or general hospital should, when possible, be placed 

 in a suburban position, but easy of access. The site should be 

 healthy, and free from all possible encroachments of neighbouring, 

 buildings, and adapted to the purposes of a medical school. 



It should, further, possess a branch, in the form of a small 

 receiving hospital, situated in the centre of population, for the 

 reception of bad accidents and other serious cases such as could 

 not safely be removed at once to the general hospital. This 

 branch establishment should be limited in accommodation to the 

 smallest number of beds required for the purpose. 



The arguments in favour of these have been so often put fo.r-» 

 ward that I need not refer to them further now. 



