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As an introduction to this report it is proper to say that all the public hospiials and alushouses in the First Judicial District have been visited iluring the year by the President of the State Board of Charities, Hon. William R. Stewart, as Commissioner of the First Judicial District; and, further, that he directed the inspection of these institutions by Dr. Robert W. Hill, Inspector of Almshouses, and requested the Inspector to write the report upon these public hospitals and almshouses which follows, and that the same has been submitted to him. read and approved.

466

REPORT

IN GENERAL.

The public hospitals and almshouses of the First Judicial Dis. trict, which comprises the boroughs of Manhattan and the Bronx, may be said to have remained in statu quo since the last report. The several hospitals and almshouses, the Depart. ment of Outdoor Poor, the pavilions for the insane and idiots, and the schools for feeble-minded children have been inspected at frequent intervals so that their operations might be thoroughly studied before the preparation of this report.

With one or two exceptions little except minor repair has been done in the way of extension or improvement during the past year. The exceptions are the Metropolitan Hospital and the Asylums and Schools for Feeble-Minded Children on Randall's Island. To both of these institutions additions in the way of buildings have been made, so that accommodations are increased and preparations made for even better work than in

the past.

The great struggle for political supremacy which has occupied the attention of the people of the city of New York has been felt to a greater or less degree in provision for the maintenance of the public institutions. The desire to go before the people with a record for economical management has prevented the appropriation of sufficient funds to carry out the betterments absolutely necessary for the welfare of the public dependents.

At the time of last inspection, in the closing days of December, 1901, in most of the institutions the shelves were found swept bare of supplies. Many things which should have been done long before election time had been postponed awaiting the result of the ballot at the polls. As a consequence of this desire to make an appeal to the people on the ground of an economical administration, the institutions have been crippled where they most needed assistance.

The total amount available for supplies was $825,623.97, which was only reached by a transfer of a large sum from the fund appropriated for alterations, additions and repairs. This transfer stopped much necessary work and reduced an already de pleted fund to a point where nothing of importance could be undertaken. Of the net decrease of $64,206.76 in the appropriation for the Department of Charities, as compared with the preceding year, $63,500 were taken from the estimate for alterations, additions and repairs, which, as before stated, was further reduced by a necessary transfer to eke out the supply fund.

With an average population in the institutions of about 7,500 to be provided for, the appropriation made the annual per capita cost for supplies about $107.

In spite of this apparent desire for economy, where economies could have been well made (that is, in the employment of assistants), none were practised. Heretofore in these institutions election times have witnessed large additions to the roll of employes. The last campaign was an exception to this rule, and although no additions were made to the roster of attendants, many incompetents and inefficients were retained in the city service, to the detriment of the institutions which thus were compelled to carry an unnecessary burden.

The total amount appropriated for the support of the Depart. ment was $1,413,033.21, and, with the estimated average population of 7,500 to be maintained. the annual per capita cost was $188. As $159,316 was paid for salaries and wages, the annual per capita cost for this purpose alone was $61.24. On the first of October, 1901, the total number of employes was 1,928, and it can easily be believed that many of this number were worse than useless to the Department service, and will have to be dismissed by the new administration as soon as possible.

The outgoing administration accomplished one good thing in its last months of service. It made the necessary appropriation for the building of the Harlem Hospital, and during the coming

year, doubtless, that structure will be erected and new conditions prevail where they have been so sadly needed for many years.

This affords an opportunity to secure a properly planned hos pital for the city. Heretofore public buildings of this character have not represented the best ideas in the arrangement of wards, work and service rooms, quarters for help, ventilation and sanitary equipment. The new administration can have, if it will, the benefit of special study of hospital problems, and in these buildings introduce an arrangement of the several departments of service which will make the new Harlem Hospital a model institution. This may be done within the appropriation of $275,000.

The general approval which the public has accorded to the proposal for a new Bellevue Hospital, an approval voiced unanimously by the press of New York city, gives assurance that in time the city of New York will add to its general receiving hospitals an edifice in every way worthy of the greatest city of the western continent, an institution equipped with all that modern science can provide for the alleviation of sickness, and so managed as to reflect credit upon the business ability and humane spirit of the administration.

The more frequent the inspection of this institution the more forcibly is it borne in upon the mind that nothing other than a new hospital can meet the demands of the city. Although the basements have been largely cleared of occupants, the cellars remain damp and wet, the walls are in a state of dilapidation, the floors are more or less worn, and the various dark rooms, diet kitchens, air shafts and closets continue breeding places for the germs of disease. A new hospital on a larger area, preferably to the north so as to abate the nuisance now maintained by the electric light and power company, whose smokestacks belch torrents of smoke and gas which pour into the windows of the hospital wards, will give opportunity for a properly planned hospital of the most modern type.

In his annual estimate of necessary appropriations to the Board of Estimate and Apportionment, Commissioner Keller presented an item of $2,000,000 for a new hospital, but, probably owing to the fact that in a short time there was to be a change in the administration of city affairs, this item was not embodied in the final appropriation. It therefore remains for the new administration to do what the old failed to do, and make provision for Bellevue commensurate with the importance of the work to be done therein.

The new board of trustees which is to be vested with the management of Bellevue and its allied hospitals is composed of the Commissioner of Charities (ex officio) Homer Folks and the following appointees of the mayor:

Dr. John W. Brannan, James K. Paulding, Howard Townsend, Theodore E. Teck, Martin Stine, Samuel Sachs, Myles Tierney.

Of these Dr. Brannan has been chosen president and Mr. Paulding secretary of the board.

In making the appointment the mayor addressed these gentle. men as follows:

“ Under the revised charter, on February 1, 1902, the jurisdiction of the Department of Public Charities ceases over Bellevue Hospital and over the Fordham, Harlem, Gouverneur and Emergency hospitals. These five hospitals thereafter are to be committed to your care as the Board of Trustees of Bellevue and allied hospitals.

“ The charter made it my duty to call upon the United Hebrew Charities of the City of New York, the Particular Council in New York of the Society of St. Vincent de Paul and the New York Association for Improving the Condition of the Poor 10 present to me a list of not less than twice the number of persons to be appointed. I have not been constrained by the charter to make these appointments from this list, but I have been glad to do so, first, because I believe you are all well equipped for the sacred trust to be committed to your care, and, second, because in making my selections from this list I hope to secure for you, in the management of the hospitals, the potent support of the great and strong societies that have placed you in nomination.

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