1313

paralytica) and agranulocytosis (1000 leucocytes per c.mm.,no polymorphs) with pyrexia, necrotising tonsillitis, and

aplastic bone-marrow. Despite blood-transfusions andtherapy with penicillin, streptomycin, and corticotrophinthe patient died four days later. Necropsy confirmed thediagnosis. In our opinion, the chronic syphilitic infectioncould be considered as an agranulocytosis-promotingcondition.

H. WENDEROTH.Department of Medicine,

Städtische Krankenanstalten,Dortmund, Germany.

Parliament

Hospital Building ProgrammeMr. R. H. TURTON, the Minister of Health, on Dec. 12

announced that the Government proposed to spendB20 million on capital developments in the hospitalservice in England and Wales in 1958-59, compared withjE13 million this financial year and 218 million proposedfor next year.Hospital boards had already been informed of their

allocations within this total for the modernisation ofmental hospitals, the replacement of obsolete plant, andordinary capital expenditure. In addition, the pro-gramme of major building projects already announced,which included the first phases of a number of largeschemes, would be extended. He hoped to authorise afurther phase of the new Greaves Hall Mental DeficiencyHospital to be begun next year, and further phases ofother projects in 1958-59, including Balderton MentalDeficiency Hospital, and the West Wales GeneralHospital, Glangwili.In that year also some big schemes already announced

but not ready to begin earlier were expected to makea start. He was also inviting the boards concerned tocomplete the planning of a number of additional majorprojects on the assumption that they could be startedin 1958-59. These included :

The first phase of a new hospital at Slough ; a new dental

hospital at Birmingham ; the reconstruction of HillingdonHospital ; extensions to the St. Helen Hospital, Barnsley,the Orsett branch of the Tilbury and Riverside General

Hospital, Poole General Hospital, Bridgend General Hospital,and Lea Castle Mental Deficiency Hospital, near Kidderminster;additional hospital facilities at Kettering, extensions to theLuton and Dunstable Hospital, and new outpatient depart-ments at the Royal Northern Hospital, Oldchurch Hospital,Romford, and Selly Oak Hospital, Birmingham.

These major projects were additional to the buildingwhich would be undertaken by boards from their ownshare of the funds available for capital expenditure.They were a further stage in our plans to meet the needfor major developments in the hospital service, and withthe projects already announced constituted a programmeof substantial improvements in each hospital region inEngland and Wales.Mr. JAMES STUART, giving the figures for Scotland,

said that the total provision for capital expenditure onhospital building would be increased from its presentlevel of .82-2 million this year to £2.5 million in 1957—58,and to £2.7 million in 1958-59. From these sums

approximately £1.3 million would be available to regionalhospital boards for their ordinary building programmes.Allotments of £350,000 and £300,000 were being made inthe year 1957-58, and 1958-59 respectively for plantrenewal. The balance of the money would be allocatedto further major building schemes at present underconstruction and to begin six new major schemes.At present work was being carried out on the following

eight schemes, at a total estimated cost of £3.25 million :Radiotherapy institute at the Western General Hospital,

Edinburgh ; neurosurgical unit at the Western GeneralHospital, Edinburgh ; reconstruction and modernisation ofWestgreen Mental Hospital, Dundee (stage i) ; extension ofVictoria Hospital, Kirkcaldy ; new maternity hospital at

Bellshill, Lanarkshire ; extension of Ladysbridge Hospital forMental Defectives at Banff (stage I); extension of BaldovanInstitution for Mental Defectives, Dundee (stage i) ; extension

of the Royal Scottish National Institution (for mentaldefectives), Larbert.

In 1957-58 it was proposed to start the following threeprojects with a total estimated cost of £1.01 million :

Extension of the Royal Edinburgh Mental Hospital ; newhospital in Shetland ; reconstruction of the Glasgow VictoriaInfirmary.

In 1958-59 it was proposed to start the followingthree further schemes with a total estimated cost of £0.92million :

Radiotherapy institute in Glasgow ; reconstruction andmodernisation of Westgreen Mental Hospital, Dundee (stageII); new maternity hospital in Glasgow.

QUESTION TIME

Hospital Capital SchemesMr. KENNETH ROBINSON asked the Chancellor of the

Exchequer if he had now reached a decision on the recom-mendation of the Guillebaud Committee that hospital capitalschemes of less than £100,000 should no longer requireindividual approval by the Treasury ?-Mr. HENRY BROOKEreplied : Yes, Sir. Hospital capital schemes costing lessthan £60,000 no longer require individual approval by theTreasury. Mr. ROBINSON : Is the Minister aware that the

regional hospital boards will tender to the Chancellor theirhalf-hearted thanks for his having gone half-way to meetingthis recommendation ? Can he tell the House why it has notbeen possible to go the whole way to meeting this very modestrecommendation in the report ?—Mr. BROOKE: I had

hoped that the hon. Member, as a member of a regionalhospital board, would have been wholehearted on thisoccasion. The fact is that £60,000 is double the previouslimit of £30,000, and it is also the limit that already appliesto most other civil and defence building paid for by theExchequer.

1. Kentish Mercury, Nov. 30, 1956.

Medicine and the Law

A Death at Home

A WOMAN, aged 73, whose tibia and fibula were

fractured in a road accident, was examined by a casualtyofficer, after which a nurse treated the cuts on her headand she was told to return next day for further treatment. 1She died next morning, and at necropsy the pathologistfound congestion of the brain and of both lungs, one ofwhich was collapsed. Eight ribs were broken and thespleen was ruptured. The pathologist said that the

collapsed lung and ruptured spleen could have been

treated, if they had been recognised. The casualtyofficer said that he was trying to cope with six otherpatients at the same time, and that to his mind therehad been no indication that the woman should havebeen admitted. The house-surgeon had agreed with him.The coroner, instructing the jury, reminded them thatthe job of the casualty officer required great clinical

experience, which might here be lacking.

Appointments

BUTLER, N. H., M.D. Lond., M.R.O.P., D.C.H. : consultant pædia-trician, Oxford and South West Metropolitan Regional HospitalBoards.

DONNELLY, JAMES, M.B. Glasg. : senior casualty officer, RoyalInfirmary, Doncaster.

HARRIS, WALDRON, M.R.C.S., D.o.M.s. : assistant ophthalmologist,Leicester Royal Infirmary.

HUTCHINSON, W. J., M.B. Belf., D.P.H. : M.o.Bf., Huoknall.ORR, JOYCE, M. B., M.B. Edin. : assistant M.O., Hertfordshire.ROBERTSON, J. S., M.B. Leeds, D.P.H. : assistant M.o. and m.o.H.,

Barton-on-Humber and Brigg.WHITEHEAD, T. B., M.B. Mane., D.P.H. : assistant M.O., Surrey.WOODGER, B. A., A-r.iB. Glasg., A.R.I.C., DIP. PATH. ’ * consultant

pathologist based at Hairmyres Hospital, East Kilbride.