the reach of the independent labourers consulting the "sixpenny doctor," and even beyond the usual resources of the provident dispensaries of the period.[379] Finally, in 1867, the Metropolitan Poor Act authorised the establishment throughout London of Poor Law dispensaries. These institutions were consistently pressed on the Metropolitan boards of guardians by the Central Authority, as having been successful in Ireland in reducing the amount of sickness among the poor, and as ensuring, not only regular and more successful medical attention, but also a sufficient supply of medicines and medical appliances of standard quality.[380] By this elaborate systematisation of outdoor medical relief, the Central Authority not only put within the reach of the sick paupers medical attendance far superior to that accessible to the lowest grade of independent labourers, but even placed the sick pauper in the Metropolis, without loss of liberty, in a position equal to that of the superior artisan subscribing to a good provident dispensary. [375] _See_, for instance, _The Administration of Medical Relief to the Poor--Reports by the Poor Law Committee of the Provincial Medical and Surgical Association_, 1842; _Life and Times of Thomas Wakley_, by S. Squire Sprigge, 1897. [376] Mr. Baines (President of the Poor Law Board), 12th July 1853; _Hansard_, vol. 129, p. 138. [377] Sixteenth Annual Report, 1863-4, p. 108. [378] Circular of 12th April 1865, in Eighteenth Annual Report, 1865-6, pp. 23-24. [379] Some boards of guardians rebelled in this connection against a departure from the principle of "less eligibility" that they did not understand. When the circular of the Central Authority inviting compliance with the recommendation of the House of Commons Committee reached the Manchester Board of Guardians, it was referred to a committee. When the committee, after eighteen months' delay, recommended compliance, its report was rejected (MS. Minutes, Manchester Board of Guardians, 20th April 1865, and 25th October 1866). [380] Twenty-second Annual Report, 1869-70, pp. xliv-lii.