The Four-Shilling Grant
We observe that the important question of the Government Grant has been again before the Lancashire Asylums Board. It would appear that the resolutions of the County Councils' Association were in favour of extending the four-shilling grant to chronic pauper lunatics maintained in workhouse wards under special regulations, and to idiots maintained in public institutions. It was pointed out, however, that there was a material departure from the resolution adopted by the Lancashire Board, which prescribed that, before the grant was to be extended in that manner, the patients must have been treated in an asylum—a period of two years having been mentioned, thereupon a deputation to the Local Government Board was appointed, and the Lancashire Asylum authorities are to be congratulated upon having made a stand for their own opinion. The treatment of acute insanity cannot be effective under workhouse regulations. An asylum is a hospital, and should receive the mentally-afflicted in the first instance. A workhouse may, under proper authority, be fitted to accommodate harmless dements; and, in the interest of the ratepayers as well as of the insane, such a rearrangement is highly desirable. It is, however, of essential importance that the cases selected for the cheaper, simpler, and less specialised care of workhouse officials should have passed through the local asylum and under the review of the Commissioners. We are not inclined to fix any term of residence in asylums, preferring to leave their physicians unfettered by such a regulation as the two-year limit spoken of at Lancaster. It is quite probable that a very much shorter period of observation would suffice to determine the propriety of passing a hopeless, easily-managed case from an overcrowded asylum to the lunatic ward of the neighbouring workhouse. We need not support these views by lengthy reference to the results obtained in Scotland under such a system as is now recommended, but must congratulate Dr. J. A. Campbell on the eminent success attending the proposal which he brought forward at our Annual Meeting of 1893.