[685] Annual Reports of the Metropolitan Asylums Board, 1889-1906. In 1888, in anticipation of the necessary amendment of the law, the Central Authority authorised the admission of diphtheria cases (Local Government Board to Metropolitan Asylums Board, October 1888; _Local Government Chronicle_, 27th October 1888, p. 986; Poor Law Act 1889 (52 & 53 Vic. c. 56, sec. 3); Order of 21st October 1889, in Nineteenth Annual Report, 1889-90, p. 96). The boards of guardians outside the Metropolis failed, we believe everywhere, to respond to the invitations of the Central Authority to provide similar accommodation for infectious diseases. In 1876 the inspector was doing his utmost, by special Order of the Central Authority, to induce the Manchester, Salford, Chorlton, and Prestwich Boards of Guardians to unite in establishing out of the poor rates a hospital for infectious diseases, which should admit non-paupers on payment (MS. Minutes, Manchester Board of Guardians, 17th February 1876). A similar enlargement of the sphere of the Poor Law institution has, of late years, been going on in other than infectious cases. "The poorer classes generally," to use Mr. Goschen's words, "as distinguished from actual paupers," came more and more to appreciate the practical distinction between the workhouse and the Poor Law infirmary; and, especially in the Metropolis and the large towns, the latter became more and more freely used as a general hospital.[686] This tendency was facilitated in London by the operation of the Metropolitan Common Poor Fund established by the Central Authority itself, which, from 1870 onward, bore the bulk of the cost of maintenance of the Poor Law infirmaries, as of the hospitals of the Metropolitan Asylums Board.[687] The Central Authority saw with approval the increasing attractiveness of these institutions, not only in London but throughout the country. In an official memorandum communicated to all boards of guardians in 1892, it observed that: "The sick poor can usually be better tended and nursed by skilled nurses in well-equipped sick wards than in their own homes; and the regularity, neatness, and order of the wards _tend to diminish the repugnance to entering the workhouse_, which is often evinced by the sick poor of the better class when reduced to want by failing health."[688] It did not refuse to permit them to be made use of by paying patients, where--as is usually the case in rural districts--no "non-pauper institution" was available. "If," writes the Central Authority in 1902, there is "a sick person who is in receipt of an allowance from a benefit club or similar society," and who "is unable to obtain in a non-pauper institution such treatment as the illness from which he suffers requires," the Central Authority will "offer no objection to his admission to the workhouse infirmary."[689]