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60
APPENDIX TO REPORT OF THE POOR LAW COMMISSIONERS
Appendix (B.)
Reports of Assistant
Commissioners,
No. 8.
Report of Mr. Haw-
ley, Mr. Phelan,
and Dr. Corr,
on Unions in the
Counties of
Limerick, Tipperary,
Clare, Kerry, &c.
Nenagh Union.
Dispensaries.
Portroe Dispensary.
Fever Hospitals.
eluding a portion of a contiguous County in the District of the Institution. That Town
is divided from the County Tipperary by the River Shannon; the near p^t of Tippe¬
rary is connected with the Birdhall Dispensary, the Medical Officer of which resides at
Castleconnel, about six miles from this part of his District. Were it included in that of
the Killaloe Dispensary, the convenience of all parties would be much consulted.
There is no Fever Hospital in the Scariff Union. The Subscribers and Medical Offi¬
cers of the Scariff and Killaloe Dispensaries state, that though Fever prevails much amongst
the poor, such Patients rarely go to the Ennis Fever Hospital. They advocate the
establishment of a similar Institution in the Union, but on a small scale.
Infirmary Relief is obtained at Ennis only by a small portion of the lighter cases, the
distance being too considerable for those of a more serious nature to admit of removal
thereto. But, except for a portion of the Tulla Dispensary District, the Ennis Infirmary
and Fever Hospital are considered to be of little value to the Sick Poor of the other
Districts, being too distant from them. The greater part of one large parish (Feacle), is
so remote from any Dispensary as to be altogether deprived of the benefits of such Insti¬
tutions.
A considerable portion of the wealthier classes do not subscribe to these Dispensaries, the
Funds for which are chiefly obtained from the relatives and friends of the Medical Officers.
From these and the other circumstances here enumerated the general feeling at the Dispen¬
sary Meetings was, that the necessary Fimds for the support of Dispensaries, and also of
local Fever Hospitals, should be raised on the principle of the Poor Rate, due provision
being made to ensure a good local administration, and the appointment of competent Medical
Officers.
On the expected appointment of a Surgeon to the Scariff Dispensary lately, several rela¬
tives, and other personal friends of the Gentleman who was elected, became Subscribers;
but having secured the situation for him, and not possessing much property in the District,
many of them have this year ceased to be Subscribers.
The Nenagh Union contains eight Dispensaries, and three Fever Hospitals.
The Dispensaries are fairly distributed, and the duty in some appears to be well per¬
formed. But the population and area of others are so great, that it is impossible for
one Medical Officer to attend and visit the Sick, and we believe much of the more necessai-y
part of the domiciliary attendance is omitted, a fact which the Medical Men themselves
acknowledge. To this want of efficiency other circumstances greatly contribute. It is
a Rule of the Burrisokane Dispensary, for instance, that the Tenants of those who
subscribe 2/. or upwards annually shall be visited when necessary by the Medical Officers.
But as there are only nine Subscriptions to that amount in an extensive District,
containing a population of 16,576, and as this Rule is pretty fully carried out, a large
majority of the Sick Poor must be unattended when unable to go to the Dispensary.
The Medical Attendant of another, that at Toomavara, is old and apparently so inert,
that it is evident \he is physically inadequate to the discharge of the active duties of his
District. We saw enough there to induce us to believe, that this Dispensary is of very
little value to the Public, and in this opinion we are confirmed by local parties, who stated
that the duty is not satisfactorily performed.
The Portroe Dispensary affords perhaps the most perfect evidence to be met with of
the want of Infirmary or Fever Hospital accommodation for the Sick Poor, and of
judicious arrangement for Dispensary Attendance, This Institution is intended for a
population of about 16 to 17,000. It includes an extensive Mining District, where sei-ious
accidents frequently occur. The Medical Attendant resides in the Town of Nenagh, 8
miles from the Dispensary, and more than 12 miles from those Mines and other parts of his
District. He is only required to attend the Dispensary upon two days in each week, and
it is not part of his duty to make domiciliary visits, except upon these days.
The Nenagh Fever Hospital is capable of accommodating 86 Patients, and is provided
with that number of Beds. It admits all cases of Fever that offer, no matter from
whence they come. There is at present no want of Funds, but the Committee state,
that a lage majority of the Proprietors and other wealthy Persons, whose Tenantry and
Domestics obtain Rehef, do not subscribe at all, whilst others contribute but very
moderately relatively with their respective properties. A considerable portion of the
Funds are obtained in a manner which appears to be very objectionable.
The Institution is attended by four Medical Officers. They are elected annually, and as
the appointments are thrown open to all qualified persons, and the competition is con¬
siderable—^the relations and friends of each Candidate subscribe, in order to ensure his
election or re-election.
This is not a legitimate mode of raising Funds for such an Institution, as it taxes parties
who have no direct interest in its prosperity. But even though it were, it is here attended
with serious disadvantages, which we know to occur under similar circumstances elsewhere.
It causes considerable excitement and angry feelings amongst the friends of the different
Medical Men, who themselves are but too apt to participate in them, whilst persons so sub¬
scribing, and in such relation with the Medical Officers, cannot be expected to become useful
local Governors. These are the views of the Rector (who presided at the Meeting which
we attended), and of those who were present, and who requested that we should record it as
their opinion that, under the circumstances, in the event of Subscriptions for the support of
this and other Institutions faihng, the necessary Funds should be raised as a portion of th
