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THE MIDDLESEX HOSPITAL ANNEXE.

FORMAL OPENING.

ON Feb. 23rd Mr. Neville Chamberlain, the Ministerof Health, formally opened the temporary premisesof the hospital in Cleveland-street. The building wasonce a Metropolitan Asylums Board infirmary and hasbeen fully equipped from top to bottom accordingto modern standards of hospital design. There aresix wards, two operating theatres, and an X raydepartment, and as the annexe is likely to be occupiedfor several years, during the reconstruction of theMiddlesex Hospital, no pains have been spared tomake it a self-containedunit of real efliciency. Thetransference of 98 patients over the distance of 250yards from the condemnedwards into the Cleveland- street annexe was success-fully accomplished on

Feb. 19th in less thanthree hours. The BritishRed Cross Society lentnine motor ambulances andthe work was done by36 students and the avail-able staff of nurses. Theaid of the police was neededto keep back the curiouscrowds that gathered inthe neighbouring streets.The first patient was placedin an ambulance at8.15 A.M. and the move wascomplete by 10.50-in tenminutes less than the timeallowed. At the same time14 patients were moved toanother part of the mainhospital.

Prince Arthur of Con-naught, chairman of the

hospital, formally wel-comed Mr. Chamberlain,who, in a short address,touched lightly on manysubjects of topical interest.He pointed out that the simplest, the easiest, and certainly the cheapest way of carrying on during the Inecessary reconstruction of the hospital would havebeen to refuse to accept any new patients until thenumbers in the hospital had been so reduced that the Iold wards could be cleared for reconstruction. Hehad no doubt the Board must have considered such Ia course. But they regarded themselves as a unit Iin the great voluntary hospital system of Londonand they realised a responsibility towards the public. And so with great courage, but also with great wisdom, ithey took the opportunity to acquire an old buildingin close proximity to the hospital itself, and trusted Ito the public to see that the means were providedto carry out their plan. Moreover, they had not beencontent merely to provide a sort of clearing-house fortheir patients, but had visualised the ultimate con-version of the annexe into a new out-patient depart-ment which should be worthy of their importance inthe hospital world. An out-patient department mightnot always seem as interesting or as important asan in-patient department, but it stood to the institu-tional work of the hospital in somewhat the samerelation as prevention does to cure. It was in the out-patient department that the surgeon or the physiciansaw the first premonitory symptoms of disease, andit was there that often he was able to take suchmeasures as might make it unnecessary for the patienteven to visit the wards of the hospital.The recent history of this hospital was a rather

striking testimony to the vitality of that longthreatened, but apparently unconquerable voluntary

system. The three great functions of any generalhospital were the provision of treatment for accidentand for disease, the training of future practitioners,and the pursuit of research. It was a significantfact that every teaching hospital in this countrywas on the voluntary principle and that the voluntaryhospitals were not only the pioneers of medicalresearch, but are still actively developing the researchside of their activities. The voluntary system hadadmitted defects and gaps and it was not altogetherunnatural that some people should protest againstthe uncertainties of a scheme which depended entirelyupon the voluntary offerings of a generous public,and plead that it should be turned over to the State,and to the boundlessness and unfailing resources of

View from the air showing the part of the Middlesex Hospital that is to be rebuilt(encircled by a white line) and the position of the Annexe. ’

the Chancellor of the Exchequer. Were we certain,however, that they are unfailing ? P It would not bevery long before we were all made aware of the stateof the national purse, and then we should know whetherwe could afford to despise these voluntary sacrifices,which, to the givers, formed a source of satisfaction,in that they were giving of their own free-will whatthey would only yield to compulsion with reluctanceand perhaps even with resentment.

In Mr. Chamberlain’s opinion, destruction of thevoluntary system would be a national disaster of thefirst magnitude. It might be that some day the healthservices would be so developed as to come nearerto the ideal plan under which there should be nounnecessary duplication, no waste, no overlapping,and yet which should offer to every citizen not merelythe highest professional skill, but the use of all thatwonderful apparatus and equipment which modernscience had put at our disposal. Even to get anapproximation to such an ideal meant that everyagency now working for the prevention or the cureI of disease would have to be coordinated. It mightbe that, if an adequate place was to be found insuch a scheme for voluntary hospitals, it would benecessary to bring about some changes in their

relations with other institutions, to ask them to yieldup something of the complete independence theyenjoyed to-day. But if such a change should evercome about he expressed conviction that the changemust be so contrived that they should not in any wayimpair or injure those great qualities which had madeour voluntary hospitals the pride of this country.