[686] In 1889, for instance, the Central Authority provided that, in cases of sudden or urgent necessity, the medical superintendent or his assistant should admit patients on his own responsibility, without order from the relieving officer (Special Order to Mile End Old Town, 10th October 1889). [687] Under the Metropolitan Poor Amendment Act 1870, the cost of the maintenance of adult paupers in workhouses and sick asylums, to the extent of 5d. per head per day, was thrown on the Metropolitan Common Poor Fund. To two-thirds of the Metropolitan unions, including all the poorer ones, this operated as a bribe in favour of indoor (or infirmary) treatment as against domiciliary or dispensary treatment. Mr. Longley wished to go much further. In order practically to compel all the Metropolitan boards of guardians to provide these elaborate and expensive hospitals, he recommended that the whole cost of indoor maintenance of the sick, when in infirmaries separated in position and administration from the ordinary workhouses, should be made a charge on the Metropolitan Common Poor Fund (Mr. Longley's Report on Indoor Relief in the Metropolis, in Fourth Annual Report, 1874-5, p. 54). [688] Memorandum on Nursing in Workhouse Sick Wards, April 1892; in Twenty-fifth Annual Report, 1895-6, p. 114. [689] Decision of Local Government Board in _Local Government Chronicle_, 18th October 1902, p. 1051.