[from the Medical Aid and Poor Relief Commission Report - 1879]

APPENDIX VIII. - Report of Tynwald Court Hospital Committee.

The Committee appointed by the Tynwald Court on the 22nd November last, for the purpose of inquiring into the subject of Hospital accommodation for the Island, beg to report as follows :—

1. They have obtained an extension of time for one month, from 27th November last, for the acceptance of the offer for sale of Falcon Cliff property, at the price of £4,750.

2. They are of opinion that the plot of the Hills Estate, which was purchased several years ago as a site for public buildings, will realize upwards of £2,500, and that the best mode of disposing of it would be to lay it out in building plots for sale, fixing a reserve price on each lot.

3. The amount of funds belonging to the present Hospital in Douglas, available for hospital purposes is reported by Mr. E. L. Watts, one of the Committee of that institution, to be about £1,900, after paying for the outlay on the new buildings in the Hospital Gardens, in Fort-street. To this may be added about £500 likely to be raised by the sale of the Fort-street Hospital.

4. The income of the present Hospital for the year ending 30th June, 1875, amounted to £482, which includes £67 interest on securities ; its expenditure for the same year being £523. For the year ending 30th June, 1876, the income, including £41 interest on securities, amounted to £593, the expenditure being £577. For the year ending 30th June, 1877, the income amounted to £523, including £47 interest on securities, the expenditure being £584.

In order to show the various sources of its income, the Committee annex to this report a copy of the Hospital balance-sheet for the year ending 30th June, 1876.

5. The Committee appointed a sub-committee of two of their members (the Receiver-General and Mr. Sherwood) to meet several members of the Douglas Hospital Committee and the medical men connected with it upon the Falcon Cliff estate. The sub-committee report that they there met by arrangement Messrs Harris, Watts, Killey, Shaw, Gell, and Hodgson, and Doctors Fleming, Nelson, Wise, and Gray. Robert Cain, a builder and Mr. Kelly, a mason, who had been instructed to examine and survey the property, and who attended there on the same occasion, reported to the sub-committee that the building was of that character that the annualcost of keeping it needful repair would be about £50, and that to make certain repairs which they consided necessary, and to remove partitions and raise several ceilings requisite to give better ventilation and proper accommodation, and generally to make the main buildings suitable for a general hospital, an outlay of about £450 would be required.

The examination of Falcon Cliff buildings showed that there would be sufficient accommodation in the main building and the wing attached, for 70 patients, and for servants and nurses, besides a residence for a medical man, and a Committee-room. The lodges were not included in this estimate. The opinion of the medical men there was that if this property was purchased, a contagious ward should be provided in a separate building, to be erected on the property. The Committee has obtained an estimate of the cost of a suitable separate building for 14 patients, containing two wards each, 35 by 18, a nurse's room, two water closets and lavatories. It amounts to £455.

The members of the Hospital Committee who were present at Falcon Cliff, and the majority of the medical men disapproved of the site of the present Fort-street Hospital, as unhealthy and unsuitable, but they suggested the retention of the Hospital garden premises for the purpose of a Dispensary and Accident Ward. They explained that new shed buildings have recently been erected in their garden, affording considerate accommodation for patients. These new buildings consist of two large wards - 26 by 19-6 and 23-9 by 19-.6 a nurse's room, disinfecting room, dead house, and two water closets.

In discussing the amount of accommodation likely to be required for a General Hospital for the Island, the members of the Hospital Committee, and the majority ot the medical men present at Falcon Cliff, stated to the sub-committee, that they wore of opinion that, assuming the necessity for accommodation should hereafter considerably increase by a greater number of patients seeking the benefit of a General Insular Hospital, in consequence of the increased facilities of access provided by the present and probable Railways, and for other reasons, accommodation for the reception of at least 40 patients should be provided, this to be exclusive of accommodation for contagious Cases, which was recommended by the medical men to be provided for in a separate building, and to the extent of about 14 beds. A separate building as a Lock Hospital, to accommodate six was alao recommended. The estimate of the cost of converting Falcon Cliff lower lodge into a Lock Hospital, containing two wards and nurses' room, and including new water-closets and lavatories, is £120. The site of the Falcon Clif property (irrespective of the questions of its distance and the state and extent of the buildings) generally approved of as a fresh and healthy situation suitable for the required purpose.

They also ascertained from the members of the Hospital Committee that the Douglas Hospital, whilst receiving patients not only from Douglas, but from the neighbouring parishes, and occasionally from Port St. Mary, Laxey, and other places in the Island, had hitherto not been called on to supply beds and accommodation for more than the average number of seven or eight patients during the year, and that the highest amount of accommodation which had been required over an average of several years did not exceed twelve beds.

Whilst on their visit to Falcon Cliff the deputation ascertained that the members of the Hospital Committee present were opposed to the purchase of that property. They expressed their desire to have premises nearer the town and the outlay of so large asum as £5,000 in providing a building and site, seemed to weigh considerably in their opposition. As the deputation considered the opinion of these gentlemen entitled to very great weight they requested them to call a Committee Meeting at the Hospital, and after discussing the matter among themselves, to communicate the result to this Committee. A meeting was accordingly held on the 7th December. instant, which Mr. Hodgson reports as follows —

Douglas, 8th December 1877

" Dear Sir,— At a meeting of the Committee of the Isle of Man General Hospital and Dispensary held yesterday, (December 7, 1877), there being present-Samuel Harris, Esq., High-Bailiff, in the chair, Dr. Nelson, Dr. Fleming, Dr. Ring, Dr. Adair, Dr. Okell, Rev. M. Washington, Rev. W.T. Hobson, Capt. Skottowe, Capt. MacGregor, Messrs P. Killey, Wm. Gell, Wm. Kelly, C. W. Shaw, and J. Hodgson, the following resolutions were passed— ,

"1. That in the opinion of this Committee, any General Hospital for this Island should contain accommodation for from forty to fifty patients suffering from diseases of a non-infectious or non-contagious character.

"2, That in the opinion of this Committee, it would be undesirable to purchase Falcon Cliff for the purposes of a General Hospital, the Committee believing that a building designed and erected specially for hospital purposes could be much more economically managed.

"3. That in the opinion of this Committee the field known as the 'Gooseneck' is more desirablo as a site which to erect a General Hospital than any other site which has yet been offered."

6. For reasons connected with the conditions on which the Baume Trust money can be applied, the Committee consider that the sum proposed to be devoted from that fund for Hospital purposes should be invested towards providing a maintenance fund, unless absolutely required for defraying the cost of a building.

7. The best mode of approaching the public would, in the opinion of this Committee, be through committees formed in each town and parish, having the respective High-Bailiffs and Captains as chairmen. Meetings could be called by them occasionally as required, but standing committees should be maintained in each town and parish to superintend the collection of subscriptions.

8. The Committee agree with the Hospital Committee in recommending that the Fort-street Hospital garden should be retained as a Dispensary and Accident Ward.

9. They recommend that Dispensaries should be established in the towns of Peel and Castletown, and the villages of Laxey, Kirk Michael, Foxdale, Ballasalla, and Port St. Mary. Arrangements could be made with the Public Vaccinator of each district to visit the Dispensaries within his district on certain fixed days in each week, and medical aid should be given gratuitously to those unable to pay for it for themselves or their families, their inability to be certified by the Hiub-Bailiff of the town, or the Captain or Vicar and Wardens of the parish, or some members of the local committee. Arrangements should also be made that cases requiring treatment other than that which can be given at the local Dispensary should, on the certificate of the medical man, be transferred to the General Hospital, or, if proper treatment can be given at the patient's own house, the medical officer to attend there, and to be allowed a certain fee for such attendance. Without going further into detail, the Committee approve of the general features of the scheme contained in the Lieutenant-Governor's Memorandum upon providing dispensaries, laid before them by the Receiver-General, care being taken that the aid from the Insular Revenue, proposed by the Memorandum, should be afforded in such a manner as not to dispense with the necessity of voluntary contributions from each district. They suggest that a copy of the Memorandum above referred to be forwarded to the members of the Tynwald Court along with this report.

10. To suggest a scheme for the government and management of a general hospital connected with dispensaries throughout the Island would require more information than this Committee could possibly procure within the period allowed for making their report.

The Committee further report that they agree with the recommendation of the Hospital Committee with respect to the Gooseneck Field as an Hospital site. A plot of an acre or more can be purchased at the price of £1,000 per acre, and they recommend the purchase of an acre of it at that price.

The Committee further suggest that if there is any reasonable apprehension that the present visitation of smallpox will not cease very shortly a contagious diseases hospital should be at once provided and set up on the field referred to, which they have ascertained is available at any time. A suitable iron hospital, lined with felt, containing wards for 20 patients, two rooms for nurses, two other small rooms, and one large room - 20 by 20 - can be procured for £355. A building of this kind, after bein used whilst required, can be taken down and laid aside for future use.

Ridgeway Harrison
G.W. Dumbell
Richd Sherwood.

Douglas 15th December 1877.

Isle of Man General Hospital and Dispensary

The Account for the Year ending 30th June, 1876,

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