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The Metropolitan Asylums Board was established by an Order of the Poor Law Board, 15 May 1867. This Order combined the London unions and parishes in to one 'Metropolitan Asylum District' to comply with the stipulations of the Metropolitan Poor Act of 29 March 1867 (30 and 31 Vict c 6). This Act provided for "the Establishment in the Metropolis of Asylums for the Sick, Insane, and other Classes of the Poor and of Dispensaries; and for the Distribution over the Metropolis of Portions of the Charge for Poor Relief; and for other Purposes relating to Poor Relief". The Metropolitan Asylum District was responsible for "the reception and relief of poor persons infected with or suffering from fever or the disease of smallpox or who may be insane".
Under the Local Government Act, 1929 the powers and duties of the Board were transferred to the London County Council.