AND PAYING WARDS THROUGHOUT THE WORLD. FACTS IN SUPPORT OF A RE-ARRANGEMENT OF THE ENGLISH SYSTEM OF MEDICAL RELIEF. BY HENRY C. BURDETT, HONORARY SECRETARY, HOME HOSPITALS ASSOCIATION FOR PAYING PATIENTS; FELLOW AND MEMBER OF COUNCIL, SANITARY INSTITUTE OF GREAT BRITAIN; GOVERNMENT BUILDINGS;" "THE SANITARY CONDITION OF DUBLIN;" “THE UNHEALTHINESS OF PUBLIC INSTITUTIONS," AND NUMEROUS PAPERS ON HYGIENE AND BIBLIOTHER APR 80 BODLEIANA LONDON: J. & A. CHURCHILL, NEW BURLINGTON STREET, W PREFACE. "There are two kinds of charity one beneficent, the other injurious; the former raises its objects, develops their resources, trains them to habits of self-help, and calls forth in them a spirit of independence; but blind, foolish, and injurious charity, even while temporarily benefiting its recipients, permanently degrades them. it discourages thrift and prudence; it induces habits of carelessness, improvidence, and helplessness; and it both generates and fosters that spirit of dependence, which is the chief cause of pauperism in this country."-Westminster Review. "Under present circumstances the administration of charity requires, as Sir Arthur Helps has said, the sternest labour and the most anxious thought. It must not be forgotten that there is a limit to the liberality of the most liberal profession in the world. As now constituted, the Hospital not only does the work which belongs to the Parochial Authorities, but usurps and intercepts much of that which rightly appertains to an expensively educated professional class."-The Quarterly Review. It has been his aim to systems of management, only of the hospitals of FOR many years the author of this book has devoted his energies to the study of hospital administration and management. familiarise himself with the and of medical relief, not Great Britain and Ireland, but of those throughout the world. Gradually he has been enabled to master the details of this great subject, but the difficulty in obtaining exact and reliable information from foreign lands, and the number of languages to be dealt with, have not lightened the task the author set himself to do. However, if it prove the means of re-arranging the present pauperising system of English medical relief, the labour will not have been in vain. The object of the present work, and the plan upon which it is written, may be briefly referred to. The object of the author is to give facts, and facts only, and to form no conclusion, to urge no scheme of reform, which has not had the merit to command success, after a fair trial. It is highly necessary to bear this in mind, because so many people start theories of hospital reform, that the stern teaching of facts is too often in danger of being swamped by the unworkable fallacies that are put forward. It has been well said, that the urgent need of the moment is an accurate knowledge of facts, in relation to particular medical institutions, in different localities and countries. Experience and co-operation are the two guides which hospital managers at the present sorely need. Experience, to point to the only feasible method by which they can hope to finally remove the present abuses, and to relieve existing financial embarrassments: co-operation, without which it will be impossible to ensure success, because simultaneous action will alone command it. Many years' hard work at this great question, hospital administration, has taught the writer that without experience and co-operation all hope of adequate reform must be given up. With these views he has devoted the last three years to the collection of the dry facts to be found in this book. Brevity has been his aim throughout. Every fact has been carefully weighed and condensed, its accuracy rigidly tested, and its force conserved. Encouraged by the success of the new methods now brought to light, it is hoped that hospital managers throughout the country will combine for the common good. Then, and then only, will the present unsystematic, unsatisfactory, and unjust system of medical relief be successfully and wisely remodelled. The author cannot adequately express his gratitude for the great assistance he has received from many unknown friends. Where so many have aided, it is almost invidious to mention names. The special information supplied by the following gentlemen was, however, so valuable as to claim distinct acknowment:—Mr. F. L. Coster, Dr. James F. Duncan, Dr. Elisha Harris, Mr. Robert Heath, Mr. G. H. Makins, F.R.C.S., Mr. Thomas Moore, F.R.C.S., Mr. Joshua Nunn, and Dr. Whittemore. The author therefore ventures to offer to one and all of these gentlemen his most cordial acknowledgments. Any additions, corrections, or suggestions will be gratefully received by the author. THE HOSPITAL, GREENWICH, Nov. 29th, 1879. |