With regard to the important subject of maintenance of patients in the hospital, the following extract from the annual report of the president of the board of directors for the year 1891 may be of interest: It is the common impression that the expense for maintaining a hospital for adults is much greater than one for children, when in point of fact, in several important particulars, the reverse is true, and in nearly all the others the cost is substantially the same. From a comparison of our reports with several of the hospitals in other cities, and among them one for women and infants, another for general service, and another largely for men and women, I find that the percentage of expense for food, compared with the total cost of maintenance, varies but little, being about one-third, whether for children or for general service. The nursing and care, always a large item of expense, is greatest with children. The reason is obvious. Beyond the actual nursing, which averaged the same whether child or adult, the helplessness of the child patient not being relieved upon convalescence, as with the adult, makes the required attention twofold, and such service must be paid for at the same rate in each case. Besides, in free hospitals men and women are required, when able, to assist in light work, saving quite largely in expenditure for such service. In the child's hospital this factor can never be counted. In the laundry department for sick children provision must be made for from one-third to one-half more labor than for the same number of adults. The following statement from the treasurer of our hospital shows the per-capita expense during the past year: The cost per capita for 66 inmates in the hospital during the year 1896 was— For subsistence.. For professional and domestic services.. For medicines For clothing. Total The rate of mortality for the past ten years has been as follows: Percentage of deaths.. 6.96 In 1896, as seen, the deaths from all sources were 30; of these 18 were from tubercular disease, making the percentage of deaths from all sources 6.90, but excluding tuberculosis, only 2.78, showing a remarkable preponderance of cases of this diseased condition. Dr. LOVEJOY. When we asked permission to come before this committee it was with the purpose of discussing and of repudiating certain things that have been said before this committee and that have been published in the papers with regard to our rule, a rule enforced by all hospitals, as to the reception of contagious diseases. But on receiving your programme covering this hearing, indicating what was expected from us, we struck out the portion of our statement upon this subject. We are, however, ready to answer questions or to make another report and send it in to the committee with regard to that matter at any time. We have regarded this matter as entirely misunderstood by the public and I think, possibly, by the committee, and for that reason that matter I think ought to be ventilated by the committee. As the accusation in this respect has appeared in the newspapers and has been repeated before this committee I think it is hardly more than fair that we should have an opportunity to repudiate it. Senator MCMILLAN. Where is this hospital located? Dr. LOVEJOY. On W street, between Twelfth and Thirteenth streets, and occupies a whole square. Senator MCMILLAN. You have the whole square? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. How many children can you accommodate? Dr. LOVEJOY. A year or two ago, on account of the scarcity of funds, the board of directors limited the number to 80, but it was afterwards increased to 92. Senator MCMILLAN. But you have accommodations for more than that, have you? Dr. LOVEJOY. We might accommodate a few more at present. Senator MCMILLAN. You say a report has been circulated that you do not receive children suffering from contagious diseases? Dr. LOVEJOY. Yes, sir; we do not receive children that are suffering from those diseases, and on account of one or two children having been refused--children brought there affected with diphtheria-we have been, as well as other hospitals, considerably blamed. Senator MCMILLAN. You have no isolated wards in the hospital where you could place these children? Dr. LOVEJOY. We have a ward of that kind, but it is one that is intended for our use when children who are in the hospital and happen to be taken with contagious diseases after they are brought there. It consists of two small rooms, accommodating five children-five bedsand it is the fact that we have this which has probably given the idea that the Children's Hospital is the one which should receive these cases of contagious diseases. The last one that was sent there was sent from another charitable institution here and was put in our hospital, in the working room of the dispensary, without any of the authorities knowing anything about it. The child was left there from a police ambulance; and after some trouble and some hours' exertion to find some place for it to be taken-we felt obliged to take it-we gave it for the night a comfortable place, a comfortable cot in a very excellent, dry, pleasant room, thoroughly warm and pleasant. We had a trained nurse attend to it during the entire night, and our superintendent of nurses herself remained with it almost the entire night. The following morning the isolated ward was got ready for it and the child was placed in that ward and kept there until the health department considered it proper to let it out. Now, sir, we have come in for considerable blame for that particular case. I do not see where the blame lies. We did refuse to receive it because it had come from another charitable institution, which ought to have by all means-every charitable institution should have-provision of a few beds for these cases which happen to be taken with a disease of a contagious nature while in the institution. In speaking of that I might go a little further and say why we have that rule. It is a rule, I think, that is universal with hospitals. I have a memorandum here of some hospitals in different parts of the country in which that rule exists, and it is a rule in all of them, so far as I know. Senator MCMILLAN. I understand, then, that when these cases of diphtheria or scarlet fever develop after children have been brought to the hospital that you take care of them? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. But if a child should be brought to you suffering from scarlet fever or diphtheria that you would refuse it admission? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. On the ground that you would endanger the lives of the other children? Dr. LOVEJOY. Yes, sir; we consider that by no principle of honor or dictates of conscience can we admit into the hospital, containing, as it does, 70, 80, or possibly 90 children, an infectious case from the outside that might spread the disease. For instance, a child was brought to the hospital suffering from what they called croup, and at the time it was almost expiring from suffocation, owing to the filling of the larynx with membrane. They had it carried into the hospital and the surgeon was telephoned for. When he arrived a more careful examination was made and it was found that the child had diphtheria. He operated upon the patient and saved it. Of course such a case under our rule, or under no rule, could not be turned out into the city or into the streets; we had to keep it. We put it into the isolated ward, but in spite of all the precaution we used five other children contracted the disease and two died, but this child got well and three of the five who contracted the disease. Senator MCMILLAN. I think the committee understands that your rule is the same as in all the hospitals. Dr. LOVEJOY. They understand that it is a just rule, do they not? Senator MCMILLAN. Yes, sir. What would be the objection to your building an isolated hospital for children on your grounds? Dr. LOVEJOY. There are several reasons why that could not be done; one of the reasons is that the hospital is too near inhabited houses and it is too near a public school. Some years ago a society of young ladies, called the Daisy Chain, raised a very considerable sum of money which they proposed to give to our hospital for the purpose of erecting on its grounds a hospital for the reception of contagious diseases, but the board of directors decidedly refused to accept it, because they knew that putting such a hospital on our grounds would raise a loud complaint among the people around, particularly on account of the large public school immediately opposite. Senator MCMILLAN. We understand that. Let me ask you how you are organized? Dr. LOVEJOY. The body is incorporated by 100 incorporators, and these incorporators, under the law, elect 20 directors. Those directors are the governing body of the hospital, and they appoint all the subordinate officers, all the committees, superintendents, and officers. Senator MCMILLAN. Do you make any reports to the Commissioners of the District? Dr. LOVEJOY. There is a report handed in four times a year to the superintendent of charities. Senator MCMILLAN. To the superintendent of charities? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. Has any one officially any supervision over your institution? Dr. LOVEJOY. No, sir; not further than the supervision exercised by the superintendent of charities. Representative NORTHWAY. You have said, I believe, that you decidedly object to the Government taking charge of the hospitals. In what sense do you make use of the word "government?" Dr. LOVEJOY. The Government of the United States, or of the District of Columbia. Representative NORTHWAY. Either one? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. You have spoken about $10,000 being appropriated by the United States for the benefit of the Children's Hospital. That has been an annual appropriation? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. Who has had charge of the expenditure of that fund? Dr. LOVEJOY. The board of directors. Representative NORTHWAY. Do you make any returns or account of that money to the Government? Dr. LOVEJOY. Every bill with regard to that goes to the Auditor of the Treasury. Representative NORTHWAY. Has the Government of the United States anything to say as to the application of the funds it appropriates; that is, as to how it shall be applied or for whose benefit? Dr. LOVEJOY. No, sir; it is applied according to the judgment of the board of directors. Representative NORTHWAY. Why should the Government give any thing? Dr. LOVEJOY. For the reason that it is not the business of the citizens individually to take care of the sick poor of the District. Now, there are a great many of the patients who are natives of the different States. We have there represented the natives of almost all of the States, but not in large number, of course. The large majority are natives of the District of Columbia, and we think that the General Government, as well as private individuals, ladies and gentlemen engaged in the work of the hospitals, should bear a portion of the expense of taking care of these children. Representative NORTHWAY. Is your hospital a charitable institution? Dr. LOVEJOY. Yes, sir; there has never been any fee charged for the admission of any patient. Representative NORTHWAY. If the Government should give part, why not pay the whole expense. Dr. LOVEJOY. If the Government chooses to take charge of it, it is hardly probable that the ladies and gentlemen working for it would be as enthusiastic in that work as they would otherwise be. I am pretty sure that every individual employed under the Government, no matter who he is, expects to be paid for his time and services. Representative NORTHWAY. Now, this $10,000 is taken from the Treasury of the United States, and how is it disbursed? Dr. LOVEJOY. It is in the care of the Treasurer of the United States. The bills are gone over regularly every month by the executive committee of the hospital and sent to the Treasurer, who sends them to the Auditor of the Treasury. Representative NORTHWAY. What bills do you allude to? Dr. LOVEJOY. The bills for the money expended out of the appropriation. Representative NORTHWAY. Those expenditures are made entirely at the direction of the board of directors, are they? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. And the Government has nothing to say about the matter? Dr. LOVEJOY. No, sir. Representative NORTHWAY. Then it is a mere gratuity on the part of the Government? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. The Government does not give the money to take care of this or that particular child? Dr. LOVEJOY. No, sir; it does not. Representative NORTHWAY. And the hospital renders account to the Government when it uses up the $10,000 which it receives? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. And then it goes on to its own private funds? Dr. LOVEJOY. Yes, sir; and pays a great deal more than the Government does; far more. Representative NORTHWAY. Far more? Dr. LOVEJOY. Yes, sir; far more. Representative NORTHWAY. But the Government has no contract with the institution? Dr. LOVEJOY. No, sir. Representative NORTHWAY. It is simply a gratuitous appropriation which the Government makes? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. Your report would show that the Government pays toward the support of your hospital $10,000 and that you get from private sources about $4,000. Dr. LOVEJOY. The expenses of the hospital are over $20,000. Those sums represent only the actual expenses, but you must consider the value of the property and Senator MCMILLAN. It is owned by this corporation, is it not? Senator MCMILLAN. Well, is there any debt on it? Dr. LOVEJOY. Yes, sir; about $20,000. Senator MCMILLAN. There is a mortgage, then? Dr. LOVEJOY. Yes, sir; for money borrowed to make an addition to the hospital. Senator MCMILLAN. What do you do with these children after they are well? Dr. LOVEJOY. Some are returned to their families. We have very little trouble in getting rid of them. Some of the charitable institutions take them after they are cured. We have always some one to be responsible for taking the child when it is well. The Children's Hospital, you understand, is not an asylum at all; it is only for the care of sick children. Senator MCMILLAN. You take care of them when they are sick, but get rid of them when they get well? Dr. LOVEJOY. Yes, sir. Senator MCMILLAN. Do you keep any charge of them after they are given out? Dr. LOVEJOY. No, sir. Senator MCMILLAN. What institutions take them off of your hands? Dr. LOVEJOY. Some of the orphan asylums. The great mass of these children have homes of their own. Senator MCMILLAN. But the parents are not able to take care of them properly when the children become sick and they are sent to your hospital? Dr. LOVEJOY. Yes, sir. Representative NORTHWAY. Do you know of any other institution in the city where the same work is being performed as at yours? Dr. LOVEJOY. No, sir; I do not know of any other. |