The expenses (direct) of treating the out-door sick are:— Salaries of Medical Officers, &c. £1,800 Medicines, &c. 1,378 £3,178 The cost of maintaining the Workhouse Hospital may be estimated as follows:— Maintenance of Patients £9,700 Salaries of Medical Officers 485 Medicines, &c. 1,050 £11,235 The Hospital contains accommodation for over 1,000 patients, and has often 1,000 in it. The cases at present are:— Medical 485 Surgical 345 Fever 120 Smallpox 20 The weekly discharges are from twenty to thirty per cent. of the whole number in the hospital.[3] The present workhouse staff consists of fourteen paid officers (who are superintendents, but not trained nurses), and about 150 paupers acting as nurses, but not paid. It has been proposed to add a trained hospital matron and trained nurses, such as those trained in the Nightingale School, and assistant nurses, so as to give one trained day-nurse and one paid assistant to about every three pauper nurses, and a trained night-nurse on every flat; it is further proposed to pay the paupers who act as nurses, wages. The cost of this would be about 2,000_l_. per annum. Does your experience of hospitals lead you to believe that the cost of this improved system would be “in part,” “wholly,” or “more than” repaid to the ratepayers by curing people more quickly, by curing those who otherwise might have become chronic cases, and by enabling those to resume their work who must otherwise have remained or died, and by thus diminishing the duration or amount of that part of pauperism which is the result of sickness? REPLIES OF PHYSICIANS, &c. OF ST. THOMAS’S HOSPITAL. 1. _Reply of_ R. H. Goolden, Esq., M.D. “I have no doubt but that the plan suggested, if properly carried out, would be in the end a saving to the ratepayers, the restoration to health relieving the parish of constant burdens.” 2. _Reply of_ John Simon, Esq. “I do not feel myself competent to measure at all exactly what might be the pecuniary result of the proposed system. But in my opinion the substitution of skilled for unskilled attendance would be of great advantage to the sick, and would of course tend to diminish that part of the pauperism which results from sickness.” 3. _Reply of_ Sydney Jones, Esq., M.B. “In my opinion the improved system of nursing recommended would amply repay the expense incurred.” 4. _Reply of_ J. S. Bristowe, Esq., M.D.