Conference on 12 Dec 1871:
The situation to be considered was well presented by Mr.Fairlie Clarke of the Charing Cross Hospital. He estimated the total number of out patients in London at 1,257,016; and point out that even if it were placed as low as 820,000 to allow for possible duplications it would form a quarter of the 3 and 1/4 milion inhabitants of London. The rate of increase was also very serious. During thirty-nine years the population of the Metropolice had little more than doubled, while the attendance at eight hospitals had increased more than five-fold.
Trevelyan on the evil of medical service:
It is a misake to suppose that the class of malades imaginaires is only to be found among the rich. For one fine day who pays her two or three guineas a week for the luxury of frequent conferences with her physician, hundreds of poor women are tempted by our medical charities to live upon drugs, tonics, and cordials, to the neglect of the real sources of health---regular employment, good food, cleanliness and roomy well-ventilated dwellings ... What we propose os that the medical officials of the provident and poor law dispensaries, should, on the one hand, send up to the general hospitals of their respective districts cases of more than usual difficulty and those requiring clinical treatment, while, on the other hand, the large class of trifling or imarginary ailments with which the out-patients departments of the general hospitals are at present over-burdened, should be referred to the dispensaries.