Guardians may subscribe to hospitals. Poor Law outdoor medical relief. medical relief is given too indiscriminately. The sharper the line is drawn between the Poor Law and charity in these matters, the greater is the possibility of making charity tend to, instead of seduce from, self-help. Many papers regarding medical relief can be obtained at the Offices of the Council of the Charity Organisation Society, 15 Buckingham Street, London, W.C. The workhouse and the infirmary are both under the care of a medical officer. In the Metropolis, under the Metropolitan Poor Act 1867, the Local Government Board have formed two districts. The Central London Sick Asylum District comprises Strand, Westminster, and St. Giles, and has an asylum at Cleveland Street, Fitzroy Square. They have also an asylum at Highgate, which is to be sold very shortly to the St. Pancras Union. The Poplar and Stepney Sick Asylum District, which includes these two Unions, has an asylum at Devons Road, Bromley. The managers of these asylums are partly elected by the Boards of Guardians concerned, partly nominated by the Local Government Board. They may contract for the reception in the asylums of paupers chargeable to other Unions; and if, under circumstances of urgency, they relieve at the asylums persons who are not paupers, all reasonable charges are, subject to restrictions of the Local Government Board, recoverable, and the relief given is deemed to be given by way of loan. The asylums may be used for training nurses. * Guardians may,‡ with the consent of the Local Government Board, pay annual subscriptions towards the support and maintenance of any public hospital or infirmary for the reception of sick, diseased, disabled, or wounded persons, or of persons suffering from any permanent or natural infirmity. They may with similar consent also subscribe towards any association for providing nurses. § . Next with regard to the out-patient accommodation provided by the Poor Law (see local lists). The general medical Poor Law relief of a union is under the supervision of one or more medical officers. Unions are, if necessary, subdivided for medical purposes. In that case district medical officers are appointed to the several districts. But no district is to contain more than fifteen thousand statute acres, or a population exceeding fifteen thousand persons. The medical officer has to attend and supply with medicine all the *39 & 40 Vict., c. 61, s. 22. † 39 & 40 Vict., c. 61, s. 42. 14 & 15 Vict., c. 105, s. 4. 42 & 43 Vict., c. 54, s. 10. The Guardians may, with the consent of the Local Government Board, subscribe towards any other asylum or institution,' besides those specified, which appears to the Guardians to be calculated to render useful aid in the administration of the relief of the poor. This would appear to include convalescent homes, &c. For the wording of this section of the Act see p. lxxxi. poor requiring medical attendance in his district, on an order from the Guardians or the relieving officer. If he attends a sick person without an order, he has to inform the relieving-officer. Metropolis. In the Metropolis, under the Metropolitan Poor Act, 1867, Poor Law special provision is made for the establishment of Poor Law in the Dispensaries in the several parishes and unions. The dispensaries are, if the Guardians so desire, placed under the management of dispensary visiting committees, of not less than five or more than nine, elected by the Guardians from their own body. Medical relief, as may be required, at the dispensary or at the patient's home, is given on an order to the district medical officer, signed by the relieving officer or the clerk to the Guardians. 'Urgent' is written on the order if the case is so considered. Drugs, medicines, and medical appliances are supplied. A dispenser and medical officer are in daily attendance, Sundays excepted. The cost of medicines, &c., and the salary of medical officers are charged to the Metropolitan Common Poor Fund, and if, on the requisition of the Local Government Board, they refuse or neglect to provide a dispensary, they forfeit the repayment from the fund. They may, with the consent of the Board, make arrangements for the treatment of paupers at some general hospital or dispensary.* LV.-VACCINATION. The influence of the almoner may be of lasting benefit in urging the poor to be vaccinated, especially at times when there is apprehension of small-pox. as to vacci Stations. Unions or parishes are divided into Vaccination Districts. Regulation These are in charge of Vaccination Officers, 'appointed to see to nation. the execution of the Vaccination Acts, with a view of securing the vaccination of every child who is not unfit for it, or is susceptible of it.' In each District is a Public Vaccinator, appointed and paid by the Guardians; and there are Vaccination Stations, for the Vaccination performance of vaccination. The Registrar of Births has on or within seven days after the registration with him of the birth of a child, not already vaccinated, to give notice to its parent or custodian, requiring the child to be vaccinated within three months ; and he has to inform the parent of the place and hour at which the Public Vaccinator may be found. When the vaccination has taken place, and has after seven days been examined, a certificate, if the vaccination has been successful, is sent by the Public Vaccinator to the Vaccination Officer, and a duplicate is given to the parent. There are provisions for cases in which the child is unfit for vaccination, or where the operation is unsuccessful. If a medical practitioner, * 32 & 33 Vict., c. 6, s. 59. See Glen's Archbold, p. 357; and Metropolitan Dispensaries Order, April 22, 1871. Glen, p. 394. † Local Government Board Orders. Knight & Co. 1883. p. 800. Constitution not the public vaccinator, performs the operation, the parent has to send to the Vaccination Officer, within 21 days of the operation, a signed certificate of successful vaccination, in accordance with a prescribed form. Neglect to vaccinate is punishable by a penalty of 20s.; and for neglect to transmit the certificate there is the same penalty. The vaccination is free and not to be considered parochial relief. The vaccination officer has to supply on demand a copy of the vaccination certificate at the cost of 6d. and 3d. for search. The Registrar receives 1d. in respect of every child whose birth he registers. The Guardians may incur reasonable expenditure ir circulating notices, making inquiries, or taking measures to prevent the spread of small-pox, and to promote vaccination upon any actual or expected outbreak of that disease in their Union. If the vaccination officer informs a justice of the peace in writing that he has reason to believe that any child under 14 within the Union has not been successfully vaccinated, the parent may be summoned and required, unless the child is found to be unfit for or insusceptible to vaccination, on penalty of 20s. to have the operation performed. LVI. THE VESTRIES AND DISTRICT BOARDS. The Vestries and District Boards are the local sanitary authorities, and the rate collectors for the Metropolis. Their duties, their officers, and their constitution are interesting to the almoner chiefly owing to the fact of their being the sanitary authority. Questions are continually arising in which the intervention of the sanitary officers is desirable. And as with the Board of Guardians, any person who has leisure and experience in executive work cannot do a greater service to the people at large than by becoming a member of the Vestry. (1) The constitution of the Vestries and District Boards.— The Vestries and District Boards, together with the Metropolitan Board of Works, which has now been superseded by the London County Council (see p. cxxiii.), were constituted on their present basis by the Metropolis Management Act, 1855, and amending Acts. There are twenty-seven Vestries and thirteen District Boards. At the head of the lists of local endowed charities in the Register will be found the number of the members of each Vestry and District Board and the qualification required of candidates for election.* The number of vestrymen to the parish is regulated by the number of ratepayers. If there are a thousand ratepayers, there *See, generally, Woolrych's Metropolis Management Acts, edited by Goodrich. Shaw & Sons. 1888. In English local government so much turns on questions of rates and rating that it is hoped to insert sections on this subject in subsequent editions of this Introduction. A short statement in regard to it will be found in Greater London,' by Geo. Whale. are eighteen vestrymen; if there are more than a thousand and less than two thousand, there are twenty-four. Over two thousand, twelve vestrymen are added for every thousand additional ratepayers; but the number of the Vestry cannot exceed one hundred and twenty. The incumbent and churchwardens are members of the Vestry in addition to the elected vestrymen. Parishes of more than 2,000 rated householders may be divided into wards. The London County Council has now the power of making this division. If there are wards, the election is by wards; if not, it is by the parish. The qualification of members of the Vestry is (1) a rate or assessment to the relief of the poor upon a rateable value of not less than £40 a year,* and (2) occupation of the house thus rated; but if not more than a sixth of the assessments exceed £40 or upwards, the rateable value necessary for qualification need not exceed £25. Joint occupiers jointly rated have each a qualification if their total rating, when divided amongst them, gives for each a sum not less than the £40 or £25. The qualification of a voter is--to have been rated in the parish to the relief of the poor for one year next before the election, and have paid all parochial rates, taxes, and assessments due from him at the time of so voting or acting, except such as have been made or become due within six months immediately preceding such voting or acting.† Even when the owner pays the rate, the occupier is held to be rated and to have made a 'constructive payment' of the rates, and he retains the privilege of voting as a ratepayer, and, if his qualification be sufficient, of standing for the Vestry.‡ The elections are in May. A third of the members of the Vestry resign annually. By notices affixed in some public and conspicuous situation, such as church and chapel doors, the churchwardens have to give at least twenty-one days' notice of the election of vestrymen to vacancies due to resignation or other causes, and of the election of auditors. On the day named the parishioners qualified to vote are required to meet and to nominate two ratepayers as inspectors of votes, and the churchwardens nominate two. In the case of a ward election, the chairman nominated by the churchwardens to preside nominates these two inspectors. 'Such persons, duly qualified, as may be there proposed for the offices of vestrymen and auditors,' are then elected. Any five ratepayers may then and there demand a poll, which must be taken by ballot the next day. Each voter has as many votes as there are vacancies, and can give only one vote to each candidate. The inspectors of votes examine the votes and settle any disputed matter by majority * 18 & 19 Vict., c. 120, s. 6 (1856); 19 & 20 Vict., c. 112, s. 8 (1856). † 18 & 19 Vict., c. 120, s. 16 (1855). 19 & 20 Vict., c. 112, s. 6 (1856); 32 & 33 Vict., c. 41 (1869). Annual reports of District Boards. or by umpire; they report to the churchwardens, who publish the list of vestrymen and auditors in the same manner as the notices of election. To ensure that only qualified ratepayers vote, the rate collectors attend the meeting. District Boards are appointed for districts consisting of two or more parishes. Each such Board consists of representatives of the Vestries of the several parishes in the district. The number of representatives to be elected to the District Board by each such Vestry is fixed by the Metropolis Local Management Act, 1885, and amending Acts. Every Vestry and District Board has in June of every year to Vestries and cause to be printed (1) an audited account in abstract and summary statement for the preceding year, (2) a report of their proceedings under the Metropolis Management Act, of works commenced, completed, or in progress, of proceedings in pursuance of any regulations of the general board of health for the time being in force, or otherwise for the removal of nuisances or the improvement of the sanitary condition of the parish or district; and (3) it has to append to its report a copy of every report of its medical officer. Copies of this 'account in abstract, statement and report,' together with a list of the names and addresses of officers, 'shall be delivered to any person applying for the same' for a sum not exceeding 2d. Sanitary duties of District Boards. The full statement and account' is to include the amount of all contracts entered into, and of all moneys received and expended' by the Vestry during the preceding year, all arrears of rates and other moneys then owing, all mortgages and other debts and liabilities.'* (2) General Duties of the Vestries and District Boards.-To Vestries and the Vestries and District Boards are entrusted the repair and cleansing of sewers, the paving, watering, cleansing, or improving of any parish or district, and all other duties, powers, and authorities in any wise relating to the regulation, government, or concerns of such parish.'+ 'The affairs of the church,' and the legal relief of the poor are excepted. They are the authorities for establishing out of the poor rates public baths and washhouses,‡ and for providing burial grounds. They are the 'local authority' under the Metropolis Gas Act, 1860, and the Public Libraries Act, 1855. They appoint analysts under the Sale of Food and Drugs Act, 1875. They are the rate collectors of the Metropolis. If the Guardians do not appoint a collector or assistant overseer to collect the poor rates,§ the overseers on behalf of the Vestry collect them. Out of *Metropolis Management Act, 18 & 19 Vict., c. 130, ss. 192, 198. +18 & 19 Vict., c. 120, s. 90 (Metropolis Management Act, 1855). 9 & 10 Vict., c. 74. Collectors of Poor Rates Order. Glen, p. 492. |