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'"T '■^r;TF„i 
 
 
 FOR PRIVATE CIRCULATION. 
 
 I. K 1^ r K H 
 
 ON 
 
 HOSPITAL EXPENDITURE 
 
 ADURKSSKD TU 
 
 PETER RKDPAPH, ESQ. 
 
 ^fi;i'*ii<lciil (Moiittical (Penetial .Ijiospital. 
 
 UY 
 
 MR. ANDREW ROBERTSON, 
 
 ^tieasuiie^. 
 
 Monfrcdl : 
 
 PRINTED AT THE "UAZETTE" PRINTING HOUSE 
 
FOR PRIVATE CIRCULATION. 
 
 LET T E R 
 
 I ' 
 
 V-vfrV 
 
 ON 
 
 HOSPITAL EXPENDITURE 
 
 ADDRESSED TO 
 
 PETER REDPATH, ESQ., 
 
 I^t;e$ident ^ontt]ea) (|lenei;a) l^oapita]. 
 
 BY 
 
 MR. ANDREW ROBERTSON, 
 
 ^tteasuiteir. 
 
 PRINTED AT THE "GAZETTE" PRINTTNO HOUSE. 
 
 1877. 
 

 'bC 
 
PETER UKDPATJI, Esq, 
 
 1 Resident 
 
 MONTHEAI, (rENEHAL Ho.SPITAL. 
 
 My Dear Sir,— I deeply regret that iinavoidable 
 absence from town prevented my being at the Annual 
 Meeting of the Governors in May, and also that, from 
 the same cause, I could not attend the last Quarterly 
 Meeting, nor the Special Meeting of the Governors, 
 held in September. 
 
 At the Annual Meeting of the Governors in May, a 
 resolution was passed directing the Committee of 
 Management to inquire into Hospital Expenditure. 
 This report was discussed at the special meeting 
 of the Governors, and was by them referred back 
 to the Committee of Management for further action. 
 This Report, as presented to the Governors, has 
 been printed, but, so far as I am aw \ has 
 not been circulated. My object in thus aO Iress- 
 ing you is to say that, perhaps through my 
 fault, I may have been the means, in consequence of 
 th</way the Yearly Statements have been presented, 
 especially in the item of " General Charges," of perhaps 
 misleading the sub-committee in arriving at a proper, 
 conclusion, and that the deductions drawn from these 
 figures will have to be modified accordingly. 
 
 You will no .doubt rememb.'r that our mutual 
 friend (and who, while in Montreal, took such an 
 active part on the Committee of Management), Robert 
 Muir. Esq. finding tht» finan<-ial accounts very 
 incomplete, prepared the Financial Statement of 1872, 
 modelled upon that of the Glasgow Infirmary Keports. ' 
 No *' General Charges " appear in that Report, but we 
 
 '^C^^t) 
 
h 
 
 find them in 1873, the year previouH lo rny nccepting^ 
 office, and they h:\vo been since continued, It was my 
 intention this year to have had the Report Ibr 1877 as 
 compk'te in this respect as that of 1872, hut because of 
 my absence, as already mentioned, I did not hco the 
 report till it was printed and circulated. 
 
 In justice to myself I must here romark that seeing 
 "General Expenses" had so much increased, being 
 nearly one-seventh of the total expenditure, and this 
 account having b^en introduced into the annual state- 
 ments by one of themselves, I regret lliat the sub-com- 
 mittee did not call my attention to it, be<'rtu«e, although 
 absent from the meetings already referred to, I was 
 repeatedly at the meetings of the Committee of Manage- 
 ment, besides being in Montreal for a considerable 
 period during the time the inquiry wa» being made. 
 I may further say that on applying to the Accountant 
 for an explanation why he used the term '• General 
 Charges," he replied that he had been ordered to do so 
 by the Committee of Management at the time. 
 
 Having said this much, let me draw your attentioiit 
 to the following remarks on pages 6 and 7 of aaid 
 Report — the comparison being made betNveen the years 
 1870 and 1877 : — " It will be seen that the cost of food, 
 " milk, &c.,— from $8417.12 to 114,944,98— has very 
 " nearly doubled, and appears to your Committee to be 
 " excessive. 
 
 "The items of 'Servants' Wages* and 'General 
 " Expenses ' have very greatly increased — servants' 
 " wages by no less than $5491, or upwards of 800 per 
 " cent., and the cost of general expenses by $6408, or 
 " upwards of 1000 per cent." 
 
 This statement seemed so very alarming, that it in- 
 duced me at once to look into what was included under 
 the head of "General Charges." An eiamination 
 
shelved me that ovorythin- which had not Immm. dotuilod 
 under its proper headinjr was included here. 
 
 This examination also showed mo how easy it wtw 
 jo give sensational ligurcs, and as an exampl,, IVom th(» 
 Income side of the account, take the ordinary DonationH, 
 —that IS, the free-will and unsolicited oiieriny-s. of the 
 public, which were in 1870, $l,247,and in 1877, 15,277 
 or 36t per cent of increase. From the E.nployoN." 
 mSxn 1870, to $l,218in 1877, or 291 per cent. increa«o. 
 Irivate patients, $52 in 1870, to $1,574 in 1877, or up. 
 wards of 302G per cent. I would not call your atten- 
 tion to such figures were it not that I desin^ to show 
 how unfair it is to draw such arguments, or as 1 nm 
 It to encourage a feeling against the Hospital, that, if 
 allowed to go on or remain uncontradicted, would 
 imperil the best interests of our noble Institution. 
 
 I have, therefore, prei)ared Statement (See Appendix 
 A) shewing the amounts expended during the yeurM 
 I have been Treasurer, as Ihey appeared in the Annual 
 Ualance-sheets, and another statement with fuller details 
 (See Appendix B) which will show, by reference' 
 one to the other, where the "General Charges" 
 should have been . :tributed. Thus, for example 
 the cost of food, milk, &e., which in the llrst 
 statement is $14,944.98, is in the second increased to 
 $17,0.:>4.88, the dilferenco being included under the 
 heading, "General Charges" in the first statement. 
 This will illustrate the principle upon which I have 
 attempted to apportion to their proper accounts thin 
 Item of General Charges. What is not so apportioned 
 IS included in the second statement under the head of 
 " Other Expenditure." 
 
 In servants' wages, the Statement divides them into 
 four divisions, instead of three as formerly ; thus, take 
 the year 1877, and the wages of workmen employed 
 
6 
 
 
 was $8G0..''>2, and should luon* i)iopi'rly have hcoii 
 chai^'(MHo "Repairs" account. 
 
 For ]iurpos('s of comparison, it stMMns to mo that to 
 compare thiM'xpcnditurc of 1S70 with that of 1H77 is 
 apt to mish>ad. I think comparison should lit- nuulo at 
 Home later i)crio(l. If you will refer to the Kcport lor 
 1870, you will lind it there stated — 
 
 The expenditure of the v<'ar is ^<2;{01.7H less than 
 
 that of th( 
 
 preceetlin 
 
 ar 
 
 the 15oard of Mi 
 
 irement 
 "havinn^ thouj^ht it necessary, owinu' to the limited 
 "resources of the iSociety, to restrict the daily number 
 " of in-door patients to oiu' hundred." 
 
 "The expenditure of the year has neen §10,727 42, 
 " the details of which may he seen in tin- book for 
 " that purpose placed on the table. 
 
 "The undertakini? to raise $10,000 from the citizens 
 " by special subscription has not been proeeedinl with 
 " this year, as, owing to the depressed state of the mer- 
 "cantile interest, it was held not to be a favorable 
 " time." 
 
 It is, therefore, my intention to deal with this <|uestion 
 mainly as it existed during the last four years, and for 
 purposes of comparison, chielly with 1875 and 1877 
 (say the financial years ending April 30th). 
 
 In 1874 it will be seen that the Total Expenditure 
 was $33,797.10. 
 
 When I assumed office I found that the usual 
 practice was to pay the balance of the lust quarter's 
 account of the previous year in the first quarter of the 
 following one. The amount remaining unpaid of 1873 
 was $3910.75, and believing that it would be better 
 that each year should stand complete in itself, I 
 included the whole expenditure in 1874, so that 
 deducting the sum $3910.75, would leave the actual 
 expenditure for 
 
 1^74 at $29,880 34 
 
 1875 " 34.073 35 
 
 1870 " 38,206 24 
 
I^y tills It will be seen thut duriiiu- thu hwt lour vears 
 our ordinary working oxponses have yratlually oone up 
 about i„ur thousand dolhirs per annum. The increase 
 betwe.Mi 1874 and 1875 may b.» rou-hlv stated - 
 provisions. #1.500: .oul. «1,000 ; medic'al salaries. 
 »l,000 ; men and women's waives, $775. For the sak.' 
 ot argument I th.-relorr inf-.-r. th.t 1875, with an 
 expenditure of $.'U.073, was ior that vear considered to 
 be a reasonabl,. expenditure, and siiall now endeavor 
 to point out, HO far as I can, some of the points of 
 ditteren... b.-tween 1H75 and 1877. so a.s if possible to 
 produce a better understanding- of the subject, and 
 lead to *,uch con.lusions as may seem likely to result 
 I'l H reduction of tlie expenditur.', whi.h is no doubt 
 much to b(! desired. 
 
 h\ the year 1875, as you will remember, th.- Hos- 
 pital proper .ontaiued Ki wards with 110 beds, giving- 
 a cubic space to each bed of about 8!)8 feet We had 
 also the small-pox Hospital, conta" ^- 17 beds and 3 
 private wards, thus givino- e<iual ti ^39 beds as the 
 total in the Hospital. 
 
 In June of the year 1875 (but which comes under 
 the financial year of 1S7.J), the Morland wino- was 
 opened, and in October of (hat year the svstem of trained 
 nurses was introduced, .so that tlic vear 1870 was prac- 
 tically half of the old, and half of the new system. 
 
 In the year 1877, the Hospital j)roper was almost en- 
 tirely gutted, and the wards .M.larn-ed as much as pos- 
 sible, and wheiv there were Id wards with 111) beds 
 their are now 10 wards with lOtJ beds, and with other 
 arrangem<Mits the Hospital has to-day IGV beds in the 
 public ward.s, with 1,035 leet of cubic space per bed. 
 besides 5 private wards or 172 beds in all. If the 
 same space only were allowed as we gave in 1875 we 
 oould put ii. 107 beds, beinu- about 21 per cent, more 
 
8 
 
 beds with 15 per cent, moro space, or about 42 per cent 
 more beds with the same cubic space. 
 
 This increased room necessarily requires more ser- 
 ^ants, on the same principle that a man necessarily 
 spends more in a larger (han a smaller house even if 
 ^m other things are equal. But besides the element of 
 increased space and number of beds, there is also an- 
 other element which must not be overlooked viz • The 
 increased cost of labor. 
 
 was .8 and their wages $2,796; the same num- 
 ber in 1875, $4,562, and in 1877. $5,632; that is to 
 say the same number of servants in each of these years 
 performing the same, or nearly the same, services, cost 
 so much more in 1875, and so much more again in 1877 
 but comparing these two latter years we find that 
 the number of servants in 1875 was 36, and the 
 wages per annum $5,186; the same 36 costing in 1877. 
 ^6 .90. an increase of $1,404. The increase of wage. 
 
 lat"'"V. Ji "^' '''' '^"^^ ^^^^"y <!- t« -e^in 
 
 r , , n '^''^'''' ^^''^ ''^^^^ 1^77, chiefly due to in- 
 creased skill. 
 
 The number of servants added since 1875 seems to 
 have been 1 day nurse, 3 night nurses, 2 asssistant 
 
 n Z'' \''r"T'' ^ ^""'"'''^'y maid, 5 ward scrubbers, 
 inak ng 13 female servants in all. Two servants, anight 
 doorkeei>er, and a messenger, have been added to the 
 male stati. 
 
 t n° t'o.^' '^'"''' ^^ '''''^'''' "^ 1877, the wages 
 >eiiig $8,222; increase, $3,036, which increase may 
 be apportioned as aln^ady mentioned. $1,404, to in- 
 creased ski 1, the balinrp \l MO t • V / 
 
 ,, ' "' '^"^lance, !S1,632, to increased number 
 
 oi servanfy. 
 
 In connection with the increase of servants, it na- 
 tuially follows that there should be an increased 
 
The ,1 ..;!h ', ? ""°"T "' '••5«' "• »">°nt 2J per cent 
 
 mM .not^.s^T \r;-' -f-«' fro".^.2-. in 
 
 o«csHl 1 , seeing tlierelbre there was only ISO beds m. 
 
 that number t he re ' I„ Ts^T^M ' "."k""'" "''"" 
 ■n any „„e day „,. :CT. and !h: Vw^t';?'"' """"^^ 
 
 venue and e^^e.uUtl'elS:;; ^ . UH 7 "o" -^Ha: 
 ^"^77 T'""" ""■ ^>-^'™ ™- introdL'ed by 
 «pe.fi ^'"""' "^"'""-^ -'■ extraordinary' 
 
 . £f • "iSjvr^- °|™----'- 
 
 1874.... ;;•• si'nj; ^^ 24,423 74 
 
 . 1870 30 100 Ik '^'^'^ -^ 
 
 1877.. 35'740r5 38,200 2 [ 
 
 ^ $i97,72b^ $^nn; 
 
 .•.xces.s ot ordimny income $1,951 54 
 
 allt' wlr'' ""'7^' ''" ^'"^^ ^^^^ -- -» -option- 
 ally hard year, bat in 1872 it will b. s.on that 
 
 bein ^8,007 deficiency m 187(> and $7,112 in 1877- no 
 aonbt cau.n. much anxiety, because if the .ane^^ o 
 
10 
 
 were to continue it would be a verv serious blow to the 
 Hospital. It is true that, as far as the six years are 
 concerned, there is a balance of revenue over expendi- 
 ture of $1,951. But the experience ol the last two 
 years shows that we must either reduce expenditure or 
 nicrease revenue, and upon the methods to be adopted 
 to this end, I shall have somethino- to say further on 
 in the meantime let me call your attention to the extra- 
 ordinary revenue and expenditure. 
 
 ^''•''"- Uevenue. 
 
 ]^'J 6,214 26 
 
 ^^^'4 ,-),930 00 
 
 ]^'^ 3,586 66 
 
 J^'^^ 8,987 12 
 
 ^P^ 5,97150 
 
 Morland Wing 7,500 00 
 
 Expenditure. 
 
 $ 484 55 
 6,847 05 
 11,216 17 
 25,151 18 
 7,410 35 
 9,222 32 
 7,500 00 
 
 Total $43,80148 $67,83162 
 
 Making- an excess of expenditure of $24,030 14 
 This sum has been expended, first of all— 
 
 For extraordinary repairs to Hospital $21,959 00 
 
 ;or MoHand Wing- 20,656 00 
 
 Ana lor landed property , 25 266 00 
 
 The actual property used by and in connection with 
 the Hospital has been thereby increased by $42,615. 
 
 At tho b.'Kinninu: of tlio financial yuar of 1872 
 
 the Hos[)ital property was valuorl at ' $100,200 00 
 
 Ar 1 the t.wniture at ,0,000 00 
 
 ]ii .Mlditio.i, the amount of .securities, niort- 
 p^'' R, Ac., itRJuding ra.sli on hand, wore 
 in all ' 
 
 I'eductin.ir tlie Nixon Tuoii^-ajv,. . • ' " ...... 
 
 And unpaid Quart. ri.y aecounts'.'. ...'. 
 
 •t,800 00 
 3.513 !)3 
 
 Which left the Endowment Fimd at. 
 
 S 83,GG5 13 
 
 8.343 98 
 ST5,321 15 
 
11 
 
 On the I«t May, 1877, the securities an.uuuted 
 
 Lots 240, 24l', 242" and'245 "cost $80,258 42 
 
 32,200 00 
 
 The liabilities duo on lots 240 and 2U $. n^.o -> ^^ ^^'"^'^ ^'^ 
 
 „. " lot 242 *",''JJ .- 
 
 Nixon mortf,'ng(> G 1 2 Oo 
 
 Quarterly accounts -^'^^'^ 00 
 
 iJorrowed money '?."S9 38 
 
 7,809 4D 
 
 2C,5G0 55 
 
 Leaving the Endowment Fund at ' T 
 
 $85,897 87 
 
 with this differeucc-that §24,000 of the land is not 
 
 ^b Is aI:^ ;'■' "°^';;';'' ^'^ »' ^'-y ■-'. -ul rrom the 
 think a saving can bo ..ffected, and to gnWo you as to 
 how fav the recommendations of the Sub-commit ee can 
 b carried into effect. The increase in provision oe 
 187,,. considering the number of servants additional 
 
 Jeast $1,000 or more will be saved in the present year. 
 Ihe next very important item is the Uru- account 
 
 Hos^M : k" V"'^ "'^ *"' "- ^'°™"'<' Genera 
 
 ii'owing the exact circumstances, no proper comnari 
 son can be mad. int vvasdeemed advlal,:\;:. mi: ; 
 g»e at the Out-door Kelief aU,ice Kmtis and 
 charge a minimum sum of 10,:. per prescrii'tio, T n 
 aure this would bring into the'nosXl v S, oo 
 year; while, at the same time, it wodd Largely p 'e^n 
 
 le« hunu, cd dollars more. Jiven if nothing is charged. 
 
-i~^ 
 
 ir-.i 
 
 12 
 
 a saving should b. tried to be effected of, at least, S500 
 or more. Tiiere will b. a savin- in coal this year of 
 about $1,000; on the other hand, from the consumption 
 by the gas stoves, there will be at least $250 to add 
 irmting should be reduced. Six hundred and ninety- 
 six dollars will be saved by insurance being paid last 
 year for three years. Salaries will be increased by about 
 
 „ . -^- — ..o. ^aw, Nurses' 
 
 Jixpenses aiul Washing- were all abnormal charges last 
 year, and should not be required to any great amount. 
 1 venture therefore to submit that, to carry on the Hos- 
 pital lor the present year on the same scale as last year 
 the sum of $37,500 to $38,000 will be sufficient, estimated 
 as loilows : — 
 
 Provisions, etc $16,000 
 
 Drugs, etc 3 .^qo 
 
 Bedding and Clothing i'oqo 
 
 ]^^T« 1,000 
 
 J<°^^ 2,000 
 
 '^IS »7QQ 
 
 ^ Water "" oqq 
 
 ]^"'i^!»s- '.'''''''''. Joo 
 
 j?^P''^»'« 1.500 
 
 l^urniture qqq 
 
 Medical Salaries qqq 
 
 ^l^''^'' ^o ."'.'.".".' 3,000 
 
 ^^''"^'^'^ <^o 5,400 
 
 $36,000 
 
 Leaving for unenumerated $1,500 to $2,000 
 
 In this calculation, I assume the Medical Staff to be 
 as at present, consisting of House Surgeon, Assistant 
 House Surgeon, and Apothecary. 
 
 The Steward, Assistant Steward, Clerk, Messenger, 
 two Orderlies, Doorkeeper (day), Surgery-man, Cook 
 (man). Carpenter, and two Firemen for six months 
 
st, $500, 
 i year of 
 Liraption 
 
 to add. 
 
 ninety- 
 aid last 
 )y about 
 
 trained 
 ould be 
 Nurses' 
 ges last 
 amount. 
 fie Hos- 
 st year, 
 timated 
 
 3G.000 
 12,000 
 
 to be 
 istant 
 
 niger, 
 Cook 
 onths 
 
 18 
 
 fount '"''"-"^ "^""""^° -- P--n all the year 
 
 t^O- THE FEMALE STAFF 
 
 fk„ ""-"^'"ff-womcn, one—making foitv in .>ll v^i 
 tho numbufnif of Word. .,,,,1 tT ,.'. ""' ''°^ 
 fwenty.fiv,. NMr.„. ","■"''' ,*'"- division lof the 
 dizC.) ' "'"* W''^<l-''le=iiere, (see Appen- 
 
 This givoN Mfdical Stofi; three ■ Male <iMtr .i 
 Female Stall; forty. Total, Hfty fouf ' °™" ' 
 
 your wiXr^^r f " *''•"'''■ "'''«''• fr»'» 
 
 J «.«uwitagO 01 this work, VOU will arlmif +^ u 
 
 very low rate Nr««, w "'^ , &ainit to be a 
 
 patients n.. 1 ^^ """ ^''''"'*' *^«t "^«tead of 140 
 
 patients per day we could get twenty mor.^ of „ \ n 
 average, I caleuktn iU.. i1-.- .^ ^^'^^- ^^ a daily 
 M^Ai ■ ^"*<'"^ate the additional cost of Food ani 
 Medicines, even at our rate in 1877 ih.i ,1 
 would not exccad US 9nnZ J' ^^'^ expenses 
 
 dav for ifln!! * 'f ^ "'°'*'' *"^ ^°^'<1 cost 64c per 
 duce ou n r^t ®"P^"^^' «" *^« «*l^er hand, we re- 
 
 AdministratTon Id Hon I • *''"^ department, the 
 
 one Nicrht NuTr « 7 ^^"' P'''°°«' ^^^ °^« I>ay and 
 clea„ert!:;4^^^^^^^^^^^^^ one l^ard- 
 
 and PatientT a' ful ^^'^'^' ^^«&«. &<^-. for Servants 
 
 per day for 120 c^l^^^ "^''"^^^ ^"^"^^ -«* ^^^ 79c. 
 
 JcsVsT'l;'*' ^°' i''' ^^ '^*^- P- ^-y ; 80c. gives 
 Insurance, and the abnormal Washing account To 
 
14 
 
 more than make up the differenco of the $42,861 98 
 expended. 
 
 In this connection it rni^ht he as well to quote some 
 other hospitals :— ' 
 
 The Pennsylvania Hospital in 1875. (s.o 125th An- 
 nual Report) : Total number treated, 1,974; total num- 
 ber of days, 59,053; total cost, $64,951.99; number of 
 out-door patients, 9,750; costing equal to one dollar 
 and ten cents per day. The Presbyterian Hospital in 
 1«76 cost one dollar and eleven cents per day. 
 
 The Leeds Hospital, in England, treated 3,192 pa- 
 i-ents in 1873, average daily 201, average time 23i 
 days, total number of days 73,365, at a cost of i;i5,18o 
 ov lour shillings and two pence sterling, equal to one 
 dollar and four cents per day. In examining this report. 
 I was struck with the enormous waste of linen there 
 reported. In the years, 1872-73, they used up 42 
 bolster cases, 42 counterpanes, 43 dustors, 1,127 pillovr 
 cases 1.272 sheets. 61 pairs of slipper.. 37 table cloths. 
 523 towels, and 34 toilets. 
 
 I will now call attention to the report of the sub- 
 committee appointed on the 24th day of September 
 and their proposals for reducing the expenses of the 
 Hospital, (see Appendix B;. 
 
 I have numbered the paragraphs for convenience of 
 referei.ce, and would say that with Nos. 1, 2. 3, 4. and 
 19, I entirely agree. No. 4, the words "simply enor- 
 mous seem very strong. The amount should have 
 been given so as to form an estimate. I may say that 
 tlV '""^'l^ ^^'^ thonsar^d dollars per annum. 
 5. While It may be possible to dispense with the night 
 door-k.eper-a messenger can hardly be dispensed 
 with. Nos. 6, 7, 8, are, I think, practically the same as 
 m Appendix, (see C). 
 
 No. 9. Is to my mind simply impossible unless to 
 
15 
 
 i" a proper „.an„„r "„ oue ;"u b tn 7'"'' "' '" 
 myself. ^'" ''" '"*"'■'• pleased (han 
 
 i... »d 'h: "Tzt:"'- ""'z ""■"""""- »- i"<i«'god 
 
 admit in ™e;: cas r.M ""' tT""" '' '" ™P°-ible to 
 
 «0, or 83 bed, md ,h " °"'' "''"•<'■'' "'"" »» 28, 
 
 attached ft tl; m rts'T''" '°"-»-™«- »<! ™m„ 
 
 four nurses con d do fl; k "'""'« '" "<''»" ">«' 
 to 7 7i „7s . . "*""'" """'''" «'y one nurse 
 
 amoult ™r":r d' ^P'^™"''— ■ "'hen . i:^: 
 amonnt of lypS ,et?'"^ " "'"'"'"''• "^ " '"^S" 
 
 iuformed tat ThifZ ':•■'" """""^ O'^^^-' ' »» 
 Hospital hardly comls'^i"'" u "'*"'■='"■ !>»* ""r 
 
 nu.es d , ward .U.n.^:.^Zs'Ztn' wIm! 
 21, 23, bemg on 2d flat with nothino- else nL th 
 
 20, 22, 24, withT bed * r;',» :-;"-« f OS 
 
 beds, which requirerurhirrr !Lf a]::'' 
 1 assmg up-stairs to third floor, Nos 30 3 ' 34 1 ' 
 
 ito^tVdTd^VeV" ?''■■■ ''• '^' -'«^-^c! 
 
 1 day assisCf .!, ti't':: Vwrf" rf '■^"'■''^" 
 
 "iffht, when no one is aboiU T In """""S ""« 
 
 tween, although this can h»rdl f '""' '" S" •>«• 
 For the privaie wards ^ J considered correct. 
 
 nursetok.de^ro:^t Sk^r/rr'' * "*="''' 
 Which itself requires 1 ,?,.• 1 i , ^^^ '^'"^ A^t. 
 
 35 beds i„ it ' "^"^ ^"^^ ^ ^'^'^^^tant' there bein.- 
 
16 
 
 This makos the number of nurses 2.;. and of ward 
 cleaners 5, the kteer having, in addition to their e,ec 
 ttve wards to clean, all the halls, passages, etc., etc 
 
 Exception will no doubt be taken to this statement 
 
 140 average datly pat.ents, and as one i„ C is considered a 
 hberal allowance, 28 is all we should have. As ha2 
 been already stated, we have had 307 patients in Z 
 
 hlled^ We „u.s be prepared for the largest number. 
 
 mt r"?- T"" '■"^ ""-' !'""'» wards, and 
 twt 1 '" r"^'"^ •''='"? "'' near as possible I in G. lu 
 this connec ton rt...ould be as vvell to read the report 
 of the Medical Board, (see E in Appendix) for their 
 
 neetion. It seems to me that as soo.i as patients are 
 convalescent they should not be allowed to" on! 
 
 UuZTul'' "Vrr^- ^'*'> ™«?esti„nsVos 
 in M.. '1 "°."'^ '""■" ^'^'^ ""« satisfactory if 
 
 TJlTiril >f"T *""* """"' "'"»'<'• ""-i '» "-e 
 
 cWk should r ^ ^:f V'*"' ""' P™P<»*'» «'«""<•■'• 
 Clerk should board m the house, and reduce the salary 
 
 l::i:zr '-"^ ''"'■ °- ^"-"^ -^ «•"« •» - 
 
 Nos. 17 and 18. I„ this connection you cati refer to- 
 the op„„on of the Medical Board. For myself I mu t 
 most strongly dissent from No. 17. Mv recollection 
 
 Mta ML^r ''"™ "" '» y°" hands, is that 
 
 Miss Machin camr ,o us as a Matron or Lady Superin- 
 tendent, or whatever the Committee of Manaerment 
 choose to call her, with trained nurses to carrTrthe 
 work of the .Hospital at a stipulated salary of «640 ~r 
 
 crtabhshed her renumeratiou should be increased for 
 
^7 
 
 ^h^' additional wdiL- ..„ i i 
 
 ArmstioMff, on,. ,o, 1 , '7 '"'"^•^'"■y '" ""y that Mm 
 
 .1.0 ai:;r:;r;:';,;;",;; ';'"■•■'>• '- «■-'■'■'". -J till 
 
 byth,. |„o,,,«,,i ,.h,„„ „' ""' f '" »s I eun loam 
 
 "..<! the ward .-loan . t '^ "T" '•"' "■•^'''"'^ '" "'<>■ 
 ;van-e.s saved ^vill be sav $0, t, ^' '^" '^"^^""* «^' 
 be reduce,!, from the .„ , ihl' ' '''''"'' ^^"^ ^^"''^ 
 
 various staffs of "0 00 "^'"""'"^ ^"^^ ^^^^ the 
 
 'h<'Munof.$7.l'20 ' ^ '^""' '" P^^^ .ent., say to 
 
 Sn^n!^' A^^st'.lif H^'^" T"'^^ ^^"^^^^^ ^'^ ^^'^ H«"«e 
 
 which they o,:^^C-:t^^ t]^;>avanta,es 
 reduced one-ha]]; *^^ Hospital, might bo 
 
 1 AKKistant $t;40 
 
 1 f 'lurk . . . ,' .'. 480 
 
 1 Mi'SMeDffor 240 
 
 2 Orderlifs.. 120 
 
 ' IJ«y Duorkor'nVr '*<5S 
 
 1 Night d,. 180 
 
 1 Surgery Man . ^ 80 
 
 1 t!arpen ter 1 80 
 
 1 Fireman ..'*.'.'.'■'■ 180 
 
 ^ ^ Men Servant, ..osting ." ^' 
 
 Tn Kitchen, , (cZ^T''\ '"^"-^"^vr. 
 
 In Launch-;, 4' ^^ "'*' -^^-^'^^'ot and Maid) .... ^.^ 
 
 Houscn^HidV 2' .'.■■■■ *;^n 
 
 seam«tre«s,' ,; :;;:;::;:;;;;; ■■■'. til 
 
 — 120 
 
 2 1« 
 
 2 $'.'J2 
 
18 
 
 NL'rtKi>i(i KKi'AnriiKNr. 
 I Matriiii ^ 
 
 " NiKlit .1.. ''j"! 
 
 n AHsiKlmifs , f": 
 
 .-. Ward 8.1UM..TS .....'''..'■.■,■,';.'.';;,'; ',,„;, 
 
 This makes th. tolal staff 5o in iMimlMT. a.ul total 
 wago« SO.OGH. I rnay her. stat. that Ih. a.tnal w„t 
 paid under these separate stallk han bee,, (or ,ho half- 
 year endin- the 81h( October has been «4,837.0(i. 
 
 The report of the «t,b-Connnittee, as I u,.d.,rsta,ul it 
 means a redmt.on in the male stall' IV.u. Jl ,o !. vi/ 
 the Night Doorkeeper and Messenger. ' ' 
 
 The Housokeepino stall' is now arranged aecordinir 
 o report at ]0 pc-rnons, costin,. same an ha« U.-n al- 
 ready mentioned. 
 
 The Nursing D.-pariment is proj>osed to b,. reduced 
 from 31 persons to 21 ; and as , of then, are wa 
 deaners, and the trained nurses are not to be dinpensed 
 with the calculated saving would be $(mo. To nnm 
 up 8 Medical Staff; U .Stewards. &c.. ,0 honHekee™: 
 and .1 nurses, will give a total of 4ii per^onH ;~and 
 as 1 IS i)roposed that the Assistant Wteward or Clerk 
 shall board out, it will save the food of 14 persons 
 wfuch will amount to a further saving of $1 200 —' 
 thus making a total saving of $2,840, to be further in- 
 creased by such amount us they may agree on an the re- 
 duction by the proposed new Matron's Balary, In order 
 to accomplish these savings, we are to part with our 
 present I.ady Superintendent. I am ntrongly opposed 
 to this^ I do not oelieve that theno Havi«g« .an be 
 effected, having regard to the efficiency of the Hospital. 
 But even if they were possible, I cannot thmk that the 
 friends of the Hospital would consent for «tich an 
 amount, to relapse into the system of untrained Huper- 
 
19 
 
 I would her«» coll +^ 
 «no«,lo.s,a„d oubot/r 'T"'''™'"" ">- '■"- 
 
 Pected,that,„ecossarilv r " "■"' '" '"' •'«• 
 
 *>« carried on with n « enaoio the opcratioiiM to 
 
 I cannot, a. p:^:^ , i^Z^h " ''?"" "' ■•"""■""• 
 half-year endi,.. .^'^^^ Zntr''"" '"' '"•' 
 w«y, that our ordinarvincL, I ■'""'f"""-"' 
 
 ♦I.OOO, and our exld Z" '"" '"";■"■"'' "'"'" 
 ♦2,500-as compared ithL: v 'T'' ''^ ■"'"'" 
 «h«t this will be the Ir!t ^ ' """""" '" '"- 
 
 with the Ho»pi al h . ' tiirh ""t ."'^ ■■»•"-'■'". 
 of p.operco.pari.n.':hl.tlnX;;„:r '■'''"'- 
 
 rthi°rd?to:tr'»F- 
 
 always disclaimed LL-TrrthL:' t T' "■""■"" 
 ■nternal management of th,.wf , ''" "'"'' "'" 
 took care of th% r„me a, d" Z' h at f"'"" """ "' ' 
 vouched for, before it .vis expe, ded i did Z7'T'' 
 of the work. But on my return t,',* '"/I'""''"'" 
 many Governors p„n-„, u ""'" ' f""'"! "o 
 
 system of iZ dX--"'' '"^' >''™'"" """ "■ "'" 
 1 have to include theL ; T" ''"''"''""'' ""'1 '» 'hi, 
 withdraw their s„ltrfr''>""f "''■"'• ">ey woul,, 
 'hatX felt a ^eL;?;:: o^t^J ^/^^ H-Pital, 
 prevent such a resnlt t 4u T^ ^ "P°" "'e lo 
 
 imposed task,rd intended'";:'°"-"'f-'' ™ >»y -1-^ 
 before — 
 
 you in a much less formal 
 
 mr/i\ 
 
 8Ubj( 
 
 »fr, but fmdin^^ 
 
20 
 
 ^o..u).i|y eri,i,.i„„, ,„ ,1,., p„hlio,„c». on the action 
 
 > "l'i»u>t(i 10 ijio < hau'res |>roi)os»'d in ihn, 
 
 "r"-";'" "-..,, I hav,. ,h„.,:h, !, hl.r ",1° 
 
 K„ ■ '^^'' ^' "HI '>»' proj)orly earned ouf anrl 
 
 «»;?'::",:'[;'""""■' "• ""■ •'"'""'''- ■»-""' ^ 
 
 iM art, ,e„ Tl"' '7I"'^«' "'-'^"- in 'h" NurMnR 
 
 ™ et, 'Tb'" """";■'"' '"" '""^ '"'■ ''■' """ »^'ke 
 ...adeo ,,,■''''•'':•■'■";" "'" «»'■"■"•'■"'» already 
 lojh, Ilosp,,,,! „, ,„„,, ,h„„<,o,„,i„ ,he suving pro. 
 
 I am. 
 My Dear Sir. 
 
 Youvs veiy Jaifhl'ully, 
 
 ANDHEW KOBERTSON. 
 
 3Iontreiil. Nov. 2, 1877. 
 
iction 
 well 
 
 most 
 I the 
 
 take 
 ly as 
 atter 
 
 nch- 
 
 aiul 
 
 bincT 
 
 ake, 
 ady 
 
 loss 
 pro- 
 
 t. ,1 
 
22 
 
 "''IS'^oj^If •^"''•^ "' "=^''»"-'""™ - »'»"- 
 
 m 
 
 1877. 
 
 Provisions 
 
 Drugs, Medicines. 
 
 1876. 
 
 Instruments 
 
 jL^widing, Clothing...,. 
 
 3483 62 
 
 393 07 
 
 1687 03 
 
 Medical salaries 606 no 
 
 Steward, &c 1952 00 
 
 Servants' wages | V 237 48 
 
 Wines 
 
 Fuel, Gag, Water 
 
 Insurance 
 
 Printing, be 
 
 Ordinary Repairs 
 
 Furniture 
 
 General charges 
 
 $14944 98 j$13159 81 
 
 3253 98 
 
 273 13 
 
 1775 87 
 
 913 84 
 
 834 00 
 2054 70 
 5702 38 
 
 948 68 
 
 3698 73 3194 04 
 
 Total . 
 
 796 93 
 
 426 57 
 
 754 59 
 
 560 90 
 
 145 48 
 
 743 44 
 
 279 05 
 
 738 44 
 
 5079 17 
 
 4540 30 
 
 $42871 ')7 
 
 $38306 24 
 
 $12225 80 
 2629 69 
 664 75 
 1391 31 
 1712 00 
 1250 00 
 4107 70 
 807 15 
 3506 73 
 350 40 
 343 29 
 172 20 
 613 14 
 
 4299 19 
 
 $34073 35 
 
 1874, 
 
 $12874 4r 
 2616 95 
 616 03 
 1470 16 
 725 00 
 1395 00 
 3879 06 
 1085 41 
 2862 68 
 250 72 
 381 93 
 176 35 
 1203 10 
 4260 34 
 
 $33797 19 
 
 For fuller details see opposite page-the total result being the 
 
 same. 
 
23 
 
 ^^^S-T^'^"^^^ of Expenditure absorbing (leneral Charge, 
 under Iheir respective heads. "^ 
 
 Total provisions 
 
 Drugs, Medicines 
 
 Instruments 
 
 Bedding and Clothing . 
 
 Wines, ic . . 
 
 Coal 
 
 Gas 
 
 Water '.......'.. 
 
 Printing 
 
 Insurance ][ 
 
 Repairs 
 
 Furniture . . . 
 
 Hardware ' ' 
 
 Soap, Oil, &c ..... ..[[[ 
 
 Salaries — Medical . . 
 
 '' —Men .' 
 
 " — Women 
 
 " — Workmen .... 
 T^w 
 
 Nurse's Expenses .. . 
 
 Washing 
 
 Other Expenditure 
 
 1877. 
 
 Meat Poultry, Ac, $ c.52!) 80 
 
 Vegetables 
 
 Bread and Flour .... 
 Butter and Cheese . 
 
 Milk ■;;■ 
 
 Groceries 
 
 Fruit 
 
 187«. 
 
 520 !)8 
 1829 83 
 1943 07 
 3787 78 
 21!)0 06 
 
 253 36 
 
 $ 6129 93 
 495 38 
 1800 14 
 1448 41 
 3107 32 
 1852 46 
 228 70 
 
 * 17054 88 $15062 34 
 
 1875. 
 
 '§ 5517 46 
 477 17 
 1901 02 
 1528 41 
 2801 72 
 1365 45 
 234 79 
 
 $13826 02 
 
 3483 62 
 393 07 
 1687 03 
 913 84 
 2870 26 
 521 28 
 211 85 
 754 59 
 696 93 
 1459 36 
 640 12 
 305 23 
 327 15 
 696 00 
 3204 00 
 5018 96 
 866 52 
 100 00 
 179 62 
 947 81 
 427 95 
 
 3253 98 
 273 13 
 1775 87 
 948 68 
 2443 23 
 452 52 
 211 85 
 560 90 
 3o5 51 
 1697 36 
 1103 70 
 326 80 
 276 97 
 834 00 
 2844 00 
 4056 12 
 852 96 
 61 06 
 564 22 
 
 1874. 
 
 $ 5006 29 
 407 22 
 19U 72 
 1"36 88 
 2197 21 
 1495 43 
 249 90 
 
 12304 65 
 
 '''"*"' $42861 97 
 
 241 04 
 
 $38206 24 
 
 2629 69 
 
 2715 97 
 
 664 75 
 
 341 75 
 
 1391 31 
 
 1082 04 
 
 807 15 
 
 983 61 
 
 3023 08 
 
 2068 83 
 
 380 97 
 
 376 8!) 
 
 212 80 
 
 200 10 
 
 343 29 
 
 303 43 
 
 350 40 250 72 
 
 1249 54 ]572 58 
 
 019 80 1.375 50 
 
 163 21 118 00 
 
 254 96 269 82 
 
 1712 00 
 
 725 00 
 
 2134 00 
 
 1982 00 
 
 3052 00 
 
 2429 00 
 
 371 70 
 
 408 28 
 
 686 68 
 
 4288 91 
 
 $34073 35 $33797 10 
 
 • $391«.75 Bhould be deducted from this item, being the balance of Iwt 
 ^::Z:::T'' ""' ^^-^ '---^ *^^ --• expenditure^-^ 
 
2i 
 
 ^V; 
 
 No. of NurscH, 
 ctv., required. 
 
 Brick Building 
 
 ■omen's wards. Ncs. 
 
 :i6 and H6 are infectioifi wards """ "' '"'' "'°'"""'« «' 
 
 The wasos paid to Uw ab..v.. a 
 «nnum:- ''^"''' ^' P'''' October sheet, will cost per 
 
 7 diiy Nurses 
 
 " ni.ylit do 
 
 11 day AsHistiint.s.. 
 T) ward cleaiiors 
 
 $1200 
 
 840 
 
 lO.JG 
 
 480 
 
 ••'0 inaiI,eo8ti„,., per ,„„„„,.._ 
 inis Mini will incn.as,. in ti, S'd:u6 
 
26 
 
 <i ^ 
 
 a 
 
 CI 
 
 o 
 
 At the regular meeting of th^ n ^^'^ September, 1877 
 
 ^th day of SeptembSTnstent : Commhtr' ^^'"»*^««««t held on the 
 ^e following gentlemen, viz MeZ?^i '''^*PP°'"'«^ composed of 
 •BiysonandClendinnena i«„i^' .^®?^"- Alexander, Brydees Piimoiii 
 "trying out tL rep'oTt' of TeTuV^*" ''^ t'^"^^ 
 Hospital expenditure: which reS,rth;ST"'^ *^" *''« reduction of the 
 the Committee of Management on th!^,mK'' ^'^^'""^'y Mly adopted by 
 "ijet.ngofQoyernorsonttTsth '^^ 10th mstant, and by an a(yourned 
 
 ^f^^^:ir^oz;::sj^jr^/'^r^^- -t this day, ^eth 
 
 when were present, Messrs Ail! f ^^ ^''^ Institution, at 9-3o am 
 Clendinneng'^ Afte^ TJZ ancUe^t"'^ ^'ft«' ^''™««". Bryson aSd 
 the report, also an interviW of 'nf ^i^^°?*? discussion of the object of 
 which howcyer in its rSuTts failed ^oS'f 1 '*'"«*'» ^'"^ Miss Mad in 
 Jie,olved,~That the adoption ofll, '^^ ""^ t'ommitloe, it was ' 
 
 J^ent, by the meeting "rtraoVs ''f f '''. .1'^' Committee of Manage- 
 *y upon the Committee to\"ter at on '" ^"''""♦' ''^"^*^'-« '* «Sa- 
 
 xnp« J^*" request made to thrLadv «^ ' -^t 'T'' *^'''*'" ^'an^ruptcy 
 means of economy having fail J „ft ^«"y ^"Permtendent to suggest anV 
 any response which promises anymlt^ ^" ' '"i"'"^''''^ ^'"^ >>«••, tf p oduce 
 pursuance of the respons bility now r f- '■«^"'^t'«"- The Committee [n 
 the whole question in the mannr^^" V"f "''^^ *^^'» m"«t S wit 
 judgment. The cost of conSictfni The H ^^f .''^"""ends itself to treir 
 That tl ^T '^' '""'^^ ayaflable^ ^^ "°'P'*^' "°^ ^^^^^eds by at lea^t 
 «ome ti„^: be'slcTin^Teilt^'STir ^*^"""* '^^'^^ "^^ '^'^^ f- 
 
 Sr ^~ -- -^- -'^;tin^-;i:,-'-ons>:; 
 
 imperious 
 
 thepreseiU ^n^-^^'artir' ^"^^ P-^^i- "oH 
 necessity. "^ '^''"''*^'^ ^^ery economy a matter of 
 
 J'^'TVtiizrzi'r^ ''■ "' -- p"* ^" ^-e .- 
 
 Wards be advanced to'fif,??eStf;erdi;r "^'^'""'^ ^"'^" "«' '" ^"-te 
 
 f 7sS::^:;ti^^s?-^eirr^' -^-^^ ^« -^« ^-o their 
 
 ^^r r^Th' ''"""^ enforced. '' *^'" *° ^« «°. ^^^e charge of 50 cents 
 
 admission tru"fS^;i^ \otV? *'" '^^^'^^' ^^-d on the subject of 
 With the object Of pu^^^l^rany Ifte ?f T ^^^^^ n.les l^cSr ced 
 and the poi^sibiliiv of its usHnhL ^ *''^ rfsourscs of the Hosnital 
 
 m.crfcred with in-fut„,;" ""'"'"^«''' ^'""^ ««"* "f funds, being ferSly 
 
 -rio^^ly ^s£r"'^S:S"r onln^""''"' ^^-■t-'^-- relief be yerv 
 branch of the Ho.spi.al is gSiy '4, ^ "'"" "* *''". Committee tha S 
 
 '".^ T]«t ti,„ li,, s.rvrtV™,';,i """, '1'™""!!'" te di.peo.d »ltl, 
 «.W. te r,,l„.„l .„ ,C '""'"'^'' '» '"« "■■'» foom and I, H„,„o. 
 
 'til. Hint the five Scivnnf 
 '^"*^-;!/"-lfbly after a td^.TtS'"^'^^ ''" "" ^^^""^'•V ^^^ -''"ced to 
 
 otU. 1 lint Mk. niivil ,. ,. . '-'"^>- 
 
 it b 
 
 le cor sidered if tliMt 
 yth. Tliat the nurn 
 
 tl.cnumlerof Cook.sbe 
 
 ■ ......mi lu III, 
 
 niiuibcr may not be reduced 
 
 ni!:'!l':^'"'>^^'^^^^terirM 
 
 exceeding twenty. " - ''" reduced from^ imnty-: 
 
 ■five to not 
 
26 
 
 buUdingf t * ™l,e%r''H "*'^ "'" ''"^" "^''^° Permanently in tho 
 coiftro of kn th M *'"'" ^'''^ '*J^e'-«>^'«*« i« not exceded ; who 8 hall haw 
 
 the itl!.t '"" "•""•"'I'" »"»»«1 one j„„l„, Cierk to .Ml.t him .UK 
 
 vams^Je'f thrj 1?'^"* ^■*"°"*' !!f "'"P^'^y^^ *" »"> tho Regular Ser- 
 bolS'inJ'I'c^X*""'' ■" "'° '""""' """ '"""" "' *— "-'■■ -'«■ 
 
 h/fcilre'""'"'' """""S,-"- hi. d«,e?S he'lellS^'i'S 
 must therefore wthre^rpf.! ^-^f ^ bupenntendent, and the Committee 
 
 19^%.?;'^'^'^''"'^ "P°" ""* •"-* P-P-- and liberal basis *' 
 
 niSl ^*-!." ^■°"f'"-«»^-« ^ith the Medical Board, the whoroucstion of 
 
 ttn?p:rr:»r;LS""*'' ""* ^"'^ ''- ''''^'^'' ^^ "- ^'^^^^'^ ^•* 
 
 toSfh?fo'^"'''•™T'"r^'■^^°™'"•'"^*'''• Committee of Mauaffemen* 
 to paj,s the foregoing Resolutions as calculated to save tho HosDitfS 
 
 f CHAS. ALEXANDER, 
 I C. J. BRYDGES, 
 (Signed) J JOHN PLIMSOLL, 
 I T. 51 BRYSON, 
 [ WILLIAM CLENDINNBN* 
 
John Plimsoll, Knq , 
 
 27 
 
 iSt'pti mlier lOtli, 187'; 
 
 Seiretury ComfnlHoc of Miinagement. 
 Dear Sin,— I lu'^ to iMUnowItdKo tlic rocoipt of your letter ot the 17th 
 September, encIo«liiK Mi)iy i,f n resolution of tlie (Jomniittec of Manage- 
 ment referring tlw r.!|)oit of the Huli-Coramittecon the Hospital expendi- 
 ture tothe M.diciil lioitril for their conHideration ; this Board consequently 
 heldaKpecial meetii.g oil llio 18th instant, and adjourned until this dav, 
 
 when the following icdojiiUonK were passed ; 
 
 l8t. That with re»(|wt to the item of increased expenditure for food, 
 milk, &c , this IJoard itn- of opinion that as far as the item of milk is con- 
 cerned, it can reiulily bi' mwjf\mU'.(i for, by the increased prevalence of 
 typhoid fever anil Um ^mti consumption of milk in that disease, also 
 owing to the opening ol tli« (Jhlldren's Ward which did not exist in 1870, 
 further that it into hn rnnarki^d that while the item of milk is much 
 greater per patient now tlmn In 1H70, the charge per patient for stimulants 
 IS considerably leu* tlmn at that time, the former having largely sup- 
 planted the latter. With ntgard to other articles of food we are not in a 
 position to offer any tfxplftiwilon. 
 
 2nd. That with ntfciciMii to the suggestion of the Sub-Committee that 
 considerable reduction ih l\w number of Servants might be made, this 
 Board would do.-ire U) Psprni4H its decided opinion (founded mainly upon 
 the statements of the pn-ncnt attending Physicians) that the staff of 
 fvctual Nurses, i.e., Uu)m lit Immediate attendance upon the patients, is by 
 no means in excuHW of what is really required to insure a degree of 
 thoroughness and caro In tfilN all important work. On enquiry the Board 
 are informed that tU« nuniliitr of Nurses employed at the present time, is 
 as follows :—Heml Pny Niimm, (i ; Assistants, 9; Night Nurses, 6. 
 Making 15 Nurses fictimlly on duty in the daytime, or an average of 
 about 9| i)atjen«,s to oimjIi Nnrso. In addition to the Nurses 7 women are 
 employed in the Witrdu for the purpose of keeping them clean, and in 
 other ways assisting tho Nlirm s, and were not such assistance given, we 
 are of opinion that thuwo Jfi NnrsHs would not be sufficient, for the proper 
 nursing of the patientu, 
 
 3rd. In explanation of iho following expression in the report of the 
 Committee, " Your tJonjnilltcd also consider it advisable to remind the 
 attending Physician* thftt tho Hospittil is not a Convalescent Home," 
 the Medical Board would ting to refer to Schedule B. appended to said 
 report, where it will lu. Nimn that the average number of days of each 
 patient in 1870=2807 ; In IH77*2(;.92, besides which must be taken into 
 account, the greater j)r«Vrtloiico of typhoid fever in later years. The 
 attention of the M.-dlciU Hoard has more than ever been directed to this 
 point during the lust twtilva months. 
 
 4th. The Sub-comniitt«fo recommend the appointment of a Matron to 
 replace the present Uuiy Hiipcrintendent. The Medical Board desires 
 respectfully to dinsent from that view. In the treatment of all diseases 
 good nursing is of th-i utmost importance, and without this medical advice 
 would be pow'irloSM f..r good, In oider to have nursing properly per- 
 formed, it is highly advlitttblB that the Nurses should be under the control 
 of a lady capable of Inxtnatlng them in their duties, and consequently 
 commanding their ro»\mi, The Board, therefore, would strongly depre- 
 cate any action which would have the effect of substituting a non-trained 
 Matron for a skilled r,«dy Hiipcdntendent. 
 
 6th. The Medical Boiird heaitily concurs with the Committee of Man- 
 agement in the great nBUfHnHy thst exists for reducing the expenditure of 
 the Hospital, and pl«dgB« lUtdf to co-operat« with them in their effort* to 
 <*<> «>. I remain, Dear Sir, 
 
 Your obedient servant; 
 <1F0, H088, M.D., Secretary to Medical B<mt4. 
 
28 
 
 PETER REDPATH, Esq., 
 
 President 
 Montreal Genkrai, Hospital. 
 
 T w" ^"'■-S;>"=e I addressed you ou the 2,id inst 
 
 LmT/T""'' "•" ^'""-'™™* ft' the quarter end nt 
 31st Oetober, 1877. I am thereby enabled to rive you 
 a statement of the income and expenditure (ordinarv 
 
 k hert r- '"^- '''O'" "■« statement whieh 
 
 noomelTr'ffr ^'°" "'" '"'-n. that the ordinarv 
 
 ZT ri ! '"'"^•'"''"' <'"^"= Sist October, 1877 has 
 ncreased by $910.57, and the extraordinary meome h^ 
 
 diurcT." T'^'l- "" '*■'''■ TheordLryTxpe" 
 dure,., the working; and maintenance of the Hos- 
 
 r288 M T:^ •'^^ ^''■"'' ^'"^ "-» decreasedby 
 by m58 eT TK- ""T'""'^ expenditure decreased 
 fv^l; *"' ■■*'"" ™»'"' I "™ ""■«. be as grati. 
 
 decre" e but r" 'u'T ' "«eipated a considerable 
 been.;. •^^.T'''' S^'^'ifyi-S. "'asmuch aL it ha.s 
 
 pa ents m the Hospital, there having been dnrmg- the 
 
 im IrT' '"■''' '""'' "=»"'-'^' 23,771 day's t 
 fo! r^" ."'"■" ™' *'' ■'"'"^^ I expressed i,, my 
 
 t would be found when we wer„ fairly in settled order 
 
 Th ner'd?'™'? '™"''' ""' ™''-'l™bly decreased! 
 
 hope, d.em rnte you will note shows a much laroer 
 
 fceebe.ng 96 cents in 1870, as against 71.0 eel 
 
 the present hall-year; this arises from the laro-er 
 
 number being treated, an,l at the small 
 
 or p-i 
 
 xpense 
 
lllSt., 
 
 29 
 
 am not yot able togivo particular.s of where the savings 
 have been effected, if able before this goes to press, I will 
 add it to th(> statement, if otherwise I hope to be able to 
 give it at the next quarterly meeting of the Governors. 
 In the meantim(\ 
 I am, 
 My dear Sir. 
 
 Yours very faithfully, 
 
 ANDKEW TiOBERTSON. 
 
 MoNTnEAL, 9th Nvvcmhcr. 1877. 
 
 COMPARATIVE STATEMENT lo.- (ho half-yoars, i.uoino and cxpen- 
 diture m the Hospital, cudiiis lil.st October, 187t; find 1877 
 tively ; — 
 
 respof. 
 
 
 1876-77. 
 
 1877-78. 
 
 Increase. 
 Increase. 
 
 
 Ordinary Intonie 
 
 Extraordinary Iiiconio. 
 
 10.,577 8G 
 640 00 
 
 11,488 43 
 r-i.UO 00 
 
 910 ,'57 
 4,800 00 
 
 Totals 
 
 811,217 86 
 
 i 6,928 43 
 
 Increase. 
 
 
 
 5,710 57 
 
 Ordinary Expenditure . 
 Extraordinary do 
 
 22,219 .S3 
 2,476 66 
 
 18,936 19 
 622 07 
 
 Decrease. 
 Decrease. 
 
 3,283 14 
 1,853 69 
 
 Totals 
 
 $24,695 99 
 
 19,569 16 
 
 Decrease. 
 
 
 
 5,126 83 
 
 Average Nos. of days of patients in 1876, 23,771, cost 96c per diem. 
 
 Do 
 
 do 
 
 do 
 
 in 1877, 26,432, cost 71 6-lOc per diem. 
 
80 
 
 Number and Salaries of the various Staffs iu the 
 Hospital, as they existed during, the investigation of 
 the Sub-Committee :— 
 
 No. of Persons. 
 ;.t 
 
 MEDICAL BTAPK. 
 
 ■ Medical Stiiff. 
 
 Wages. 
 
 STEWAIiD A.ND MEn'S STAFF. 
 
 I Steward j Q^^^ 
 
 ' AKsi.stnnt ,g,) 
 
 ' Office Clerk 240 
 
 /, Messenger [[[][[ jgo 
 
 - Orderlies ^gg 
 
 ' I>ay Doorkeeper jgo 
 
 Night Doorkeeper j so 
 
 ; Stirgeryman jgo 
 
 ' < 'arpenter j g^ 
 
 ' - Firemen, day and night, six 
 
 months — e(iiialling one 
 
 (ill the year roimd jijo 
 
 i' la all, 
 
 STAFF. 
 
 HOfSKHOLU 
 
 ^ Kitchen $456 
 
 ; Laundry ggf, 
 
 _ Seamstress 2 20 
 
 "•' Housemaids 2I6 
 
 II 
 
 11 
 
 In all. 
 
 NUKSINO DEPARTMENT. 
 
 • Lady Superintendent $ G40 
 
 . Day Nur-scK 1 200 
 
 Night Nurses g52 
 
 Assistant Nurses ... 1104 
 
 Ward Scrubbers 480 
 
 •^' In all 
 
 Total Staff, r,0; total (.'ost. 
 
 Totals. 
 $ 600 
 
 $2860 
 
 $1452 
 
 $4276 
 $9178 
 
81 
 
 The Sub-Committee propose the following Stalf by 
 tbeir report (Appendix D) :— 
 
 No. of Persons. 
 3 
 
 USDIOAL 8TAFP. 
 
 .Medical Staff 
 
 Wngt.H. 
 
 STEWARD AND MENS HTATr. 
 
 ^ Steward r,QQ 
 
 ^ Assistant ' . ^qq 
 
 ^ CKrk Conunitteedf Maiiage- 
 
 ::' Orderlies 4^8 
 
 l><i.v Doorkeeper j «(, 
 
 SiJrgeryman jpy 
 
 Carpenter j yy 
 
 2 Firemen, day and niglit, six 
 
 months— equalling one 
 
 all the year round i;i2 
 
 9 In all 
 
 HOI'SEnOLD STAFl.-. 
 
 3 Kitelien 
 
 '' Laundry 
 
 ^ Se.tmstresK 
 
 ^ Housemaids 
 
 45B 
 540 
 120 
 210 
 
 10. 
 
 In all. 
 
 ^ Assistant 
 
 21 In all 
 
 Total Stall; 43 ; total Cost 
 
 NUriSI.NO STAFP. 
 
 Matron ^^q 
 
 D.iy Nur.<es 1 200 
 
 Night Nurses §52 
 
 C24 
 
 Total K. 
 $600 
 
 2,740 
 
 1.332 
 
 3,076 
 f7748