Of the unoccupied beds, 701 were in wards for sick and convalescent children, and represented more than half the accommodation in those wards. Deducting these and all other vacant beds in special wards, there remained in the wards assigned to healthy school children 4,319 unoccupied beds-more than sufficient to absorb all the healthy children beyond 3 years of age included among the 5,656 sleeping in the children's wards of Poor Law Institutions on the night of February 11. Development of Poor Law Infirmaries. During the year the development of the poor law provision for the sick and infirm has made steady progress. Loans amounting in the whole to the sum of £268,750 have been sanctioned in this connexion, and special mention may be made of the completion of the new Infirmary in the Barton on Irwell Union, containing 500 beds, and the commencement of a new Infirmary which is eventually to contain about 950 beds for the Cardiff Union. The provision of separate institutions under medical control for the exclusive benefit of the sick and infirm dates roughly from 1867 and the passing of the Metropolitan Poor Act of that year. In 1874 only six of the London Poor Law Unions had failed to provide such an institution either jointly or in combination. In 1885 all the London Poor Law Unions and four provincial Unions had provided such institutions, and there were in addition many cases in which the sick, though not technically in separate institutions, were housed in entirely separate buildings within an extensive workhouse curtilage. In all, 73 separate buildings for the sick, providing nearly 10,000 beds, were sanctioned by the Local Government Board between 1885 and 1904. To-day, apart from buildings administered as one with the workhouses to which they are attached, there are 60 poor law infirmaries under separate regulations, i.e., under regulations separate from those applicable to general institutions providing for all classes of indoor poor, including the able-bodied. In a hospital the chief control is vested in the medical superintendent with a steward and matron as his chief assistants. In addition there are 33 infirmaries separately administered but not under separate regulations, which include 19 used solely for mental cases. On the night of the 11th February, 1928, these 93 hospitals had 35,864 inmates and there were 5,125 vacant beds. When all allowance is made for changes in prices, the change in the character of an Infirmary is shown by the fact that in 1875 the cost of the necessary provision per bed was not over £123 while at the present time the cost of providing a new infirmary with its provision for operations and other special services may be as much. as £650 per bed. The accommodation so provided will in many cases bear comparison with that in the large voluntary hospitals. 1970 F 3 The class of patient for whom poor law authorities are required to provide differs from that with which the general hospitals deal in that it includes the chronic and especially the aged sick. The extent to which this class is actually treated in separate infirmaries varies from Union to Union. In London in 1927 the average period of stay of patients varied in the several infirmaries from 24 to 60 days and in the whole body of London infirmaries, with an average number of patients of 13,795, no less than 1,701 had, on the 1st January, 1928, been in the infirmary for more than 12 months. In the London hospitals maintaining a Resident Medical Staff the average duration of stay of patients in 1926 varied from 13 to 32 days. It is an obvious question whether the new infirmaries, built and equipped on a standard which compares favourably with that of the general hospitals, ought to be used for patients of this class, and whether the further hospital accommodation which will be required in the near future should not, in part at any rate, be met by providing other accommodation for these chronic patients. The difficulty of provision in this direction is clearly greater while the needs of London have to be considered not as a whole but in twenty-five separate poor law Unions. The staff of many infirmaries now includes consultants of the first rank in their respective branches of medicine and surgery, and the Guardians employ in separate and other infirmaries 10,000 persons as nurses and probationer nurses, nearly 4,000 of whom are fully trained. In the year 1927 there were 1,717 candidates from poor law training schools for nurses who passed the preliminary examination of the General Nursing Council and 1,300 who passed the final examination. Sixty-six poor law infirmaries undertake the training of nurses in midwifery under the rules of the Central Midwives Board, and 502 nurses trained in these infirmaries received the certificate of the Board during the year 1927. CHILDREN. On January 1, 1928, 8,697 children were boarded-out by Guardians in England and Wales. Of this number 7,138 were boarded-out in the Union to which they belonged and 1,559 beyond the Union. The total number boarded-out shows a reduction of 556 from the corresponding figure for January 1, 1927, which is doubtless attributable to the operation of the Widows', Orphans', and Old Age Contributory Pensions Act, 1925. The total number of children in receipt of relief at January 1, 1928, was 480,773, which is less by 88,808 than the number of children relieved at January 1, 1927. The greater part of this reduction was due to a diminution in the number of children receiving domiciliary relief on account of the unemployment of their parents. The number of children receiving domiciliary relief on account of causes other than unemployment fell from 201,358 at January 1, 1927, to 196,997 at January 1, 1928, notwithstanding an increase of 7,275 in the number of such children residing with their fathers. The total number of children receiving institutional relief at the same dates was respectively 61,218 and 58,412. The number of children dependent on widows who were in receipt of relief dropped from 64,490 at January 1, 1927, to 53,871 at January 1, 1928, and this reduction must be largely due to the operation of the Pensions Act above-mentioned. It has not yet been found possible to secure complete compliance with Article 4 of the Poor Law Institutions Order, 1913, which requires that healthy children between the ages of 3 and 16 years shall not be maintained in the Institution for more than six weeks. When the figures were examined in the early part of 1928 in the light of available returns from 601 Unions out of the 635 in England and Wales, it was found that 174 Unions had on January 1 between them 833 children whose presence in the Institution apparently contravened the regulation in question. Particulars of such of these cases as indicated any serious departure from the Order were referred to the General Inspectors for special investigation; as a result of these investigations it was found that the position was much more satisfactory than the figures indicated. For example, in one Union where there were four children over the age of three in the Institution it was found to be the Guardians' practice to keep children up to four years of age in their excellent nursery, the four children in question were under four years of age, and the Inspector was satisfied that no harm would result from their maintenance in the Institution even though the letter of the regulations was violated. In other cases it was found that there had merely been temporary delay in finding homes for difficult children, that the children's homes were in quarantine, that the admission of one large family to the Institution had temporarily caused the difficulty, or that the children in the Institution belonged to parents of the "in and out" class with whom it is difficult to deal without a separate Children's Home, the provision of which could not always be justified on the numbers available to use it. Co-operation between neighbouring Unions might however solve the problem and enable one Home to be kept fully, and therefore economically, occupied. There remains however a residuum of Boards of Guardians who, having in their Institutions accommodation which is not in itself unsuitable for children of school age, are averse from incurring the expense of acquiring separate children's homes or of sending their children to schools or homes outside the Union and at some 1970 F4 distance from their friends and relatives. Where the condition of the children is in all other respects satisfactory and the means of separating the children from adult inmates are adequate the Minister has so far refrained from taking drastic action to secure compliance with the letter of the Order. In view, however of the reduction of pressure upon the accommodation in the schools and separate homes provided by Boards of Guardians in consequence of the Pensions Act, and the increased number of schools and charitable homes certified under Section 84 of the Poor Law Act, 1927, such justification as has existed for non-compliance is steadily diminishing and every Board of Guardians should realize that the removal of children of school age from the influence of the Poor Law Institution is not a task of any great difficulty. MIGRATION. The number of persons assisted by Poor Law Authorities to migrate in the year 1927 was 726 including 156 orphan and deserted children, substantially less than the total number for 1926, which was 985, and less than half the number recorded for either of the years 1923 and 1924. Of the 635 Boards of Guardians in England and Wales only 142 made use of their powers to incur expenditure on migration in 1927 and here again there is a drop in the number as compared with 1926, which was 165. Of the 726 emigrants 370 went to Canada, 290 to Australia and 38 to New Zealand. The corresponding figures for 1926 were 401, 381, and 127. The total amount of the Guardians' contributions towards the cost of migration was £10,172 2s. 8d., approximately £14 per head. The average cost per head in 1926 was £13 15s. VAGRANCY. On the last Friday of March, 1928, the number of casuals in receipt of relief was 12,077 and there was throughout the year under review an increase in those numbers over those for 1926-1927 and the highest figure of 12,558 was reached in May, 1927. Whilst it is impossible to view without concern this increase in the number of casuals, it is important to bear in mind that, despite the increase of population and the difficulties of industry, and especially of the coal industry, during the year under review, the figures are substantially lower than those for certain pre-war years. In 1909 the highest number relieved was 14,825 and even in 1912, which was not a period of great depression, a figure as high as 12,878 was reached in April. Some light is thrown upon the constituent elements of the casual ward population by a census carried out in London and in certain provincial Unions on the night of the 10th February, 1928. The investigation covered 2,582 persons, or nearly one quarter of the total number relieved on that night, and its results may therefore be taken as fairly representing the position throughout England and Wales. The results correspond very closely with the results of the census carried out in 1905 for the Departmental Committee on Vagrancy, and, so far as they cover the same ground, with those of a return of the whole number of casuals relieved in a large provincial Union during the six months from October, 1927, to March, 1928. The results must, as in all such cases, be regarded with some caution since they depend either upon the uncorroborated statements of the casuals themselves or upon the personal bias of the officers making the return in the different institutions. Subject to these reservations it appears that some three per cent. of the casuals are below the age of 21, 15 per cent. between 21 and 30, 21 per cent. between 30 and 40, 46 per cent. between 40 and 60, and 15 per cent. over 60 years of age. These proportions are substantially the same in the London wards and in the provincial ones. 22 per cent. of the men were described as being persons undoubtedly seeking work and 28 per cent. as being undoubtedly habitual vagrants. Of the remainder 29 per cent. were described as temporarily unemployed persons possibly seeking work and 21 per cent. as being probably habitual vagrants. In London the respective percentages were, undoubtedly seeking work 123; undoubtedly habitual vagrants 33; possibly seeking work 314; and probably habitual vagrants 23. The difference in the figures may be due to the special circumstances of the Metropolis and the apparent existence of a class who, seldom or never leaving London, habitually resort to the London wards, or possibly to the wider experience of the superintendents of the London wards, who are in much closer relation to the vagrants under their charge than the masters of many of the provincial institutions can be. In the Union return already mentioned, detailed information is given as to the trades to which the casuals claimed to belong. It will be understood that their claims have not been verified in any way. A total number of 8,876 persons passed through the ward. Of these no less than 7,559 described themselves as labourers. The remaining 1,317 were distributed over no less than 74 occupations, there being 37 bootmakers, 25 bricklayers, 22 carpenters, 57 cooks, 65 clerks, 75 fitters, 59 firemen, 79 grooms, 78 porters, 150 painters, 77 stokers, 295 seamen and sailors, and 40 tailors. Nine declared themselves to have no occupation. It must be admitted that there is still a lack of uniformity in compliance with the law and regulations governing the relief of the casual poor. Steady progress has, however, been made toward |