Report of the Royal Commission on the Poor Laws and Relief of Distress.
- Royal Commission on the Poor Laws and Relief of Distress 1905-09
- Date:
- 1909
Licence: Public Domain Mark
Credit: Report of the Royal Commission on the Poor Laws and Relief of Distress. Source: Wellcome Collection.
264/1272 page 238
![938 DEVELOPMENT OF THE SYSTEM OF MEDICAL ASSISTANCE TO THE POOR. because, from the Commissioners’ graphic description of the deplorable state of the workhouses in the small pauperised parishes, it is clear that the condition of the sick therein must have left much to be desired. The sick were housed with prostitutes, ex: gaolbirds, tramps, and other characters of the worst description, and their sufferings were not infrequently aggravated by “ the incessant ravings of some neglected lunatic.” ‘In such receptacles,” said the Royal Commissioners, “the sick poor are often immured.” The explanation of the apparent omission 1s perhaps to be found in the fact that the Commissioners proposed to set up a system of “ well-regulated workhouses ” with improved classification of the inmates, in the benefits of which the sick would be sure to participate.2 On the other hand, we must point out that the report did not specify the sick among the classes for whom it was deemed necessary to provide separate accommodation. There is, however, specific mention of sick wards in the work- house rules published in the first Report of the Poor Law Commissioners,’ and, in their model plans for some of the larger workhouses, the midwifery cases were accommodated separately. Two classes of lying-in wards, “ first” and “second ” class,*,. were provided, thus anticipating apparently what has often been urged, viz.. the separation of the more respectable from the vicious. 15. For thirty years subsequent to 1834, attention was chiefly directed to the question of outdoor medical relief, and little progress was made in the arrangements for the treat- ment of the sick in workhouses. Indeed, although a relieving officer was empowered to send an outdoor pauper to the workhouse for treatment, it seems clear that the sick wards } ‘“ were originally provided for the cases of paupers in the Workhouse who might be li attacked by illness,’’® and that, even as regards such cases, the equipment was not always sufficient for their treatment. For example, in 1842, we find the Commissioners dis- couraging the performance of important surgical operations in Workhouses, and recom- I mending that cases which require surgical treatment, or which have “long been the i subject of medical treatment in the workhouse,” should, if possible, be removed to an ‘Ae ae infirmary or hospital where they would enjoy “ the practised skill and combined judgment i of the medical men usually connected with such establishments.’ 16. From time to time Select Committees’ enquired into the subject of medical relief, and evidence was occasionally submitted showing ill-treatment of patients in the sick | wards of the workhouse. The cases had, it appears, usually been investigated by the | Poor Law Commissioners, and the delinquent officials dismissed or reprimanded prior to the cases being brought under the notice of the Committees. The Committees may also have regarded them as isolated instances rather than as. typical of the prevailing conditions. But, at all events, their reports contain no recommendation for i the improvement of the lot of the sick pauper in the workhouse. The Select Committee Hl of 1864, after an inquiry extending over three or four sessions of Parliament, reported fl that “the poor were never so promptly attended to, or so effectually relieved’ during | sickness, as they are at the. present time,” and that there were “no sufficient grounds for materially interfering with the present system of medical relief” which “ appears to be administered with general advantage.”® The tone of the Committee’s Report, it will be observed, is extremely reassuring, and, in the light of the events which were so soon to follow, is significant of the general ignorance or indifference as to the condition of the sick poor in workhouses, which had generally prevailed up to this time. i 17. The Report is dated May 31st, 1864; in the beginning of 1865, however, the cir- . cumstances attending the deaths of two paupers in London workhouses led to official inquiries into the treatment which they had received during their illness. . “* These inquiries disclosed serious defects in the state and management of the sick wards, i and the publicity given to them led to further complaints, and attracted general notice.” ° a The matter was taken up and investigated by the Lancet; and deputations were sent to the Poor Law Board, who finally ordered “a full and searching inquiry into the state 1] of the infirmaries and sick wards of every workhouse ” in the Metropolis. | 1 Report of Royal Commission of 1832 Report, p. 303. 2Tbid., p. 306. 3 First Report of Poor Law Commissioners, 1835, p. 59. 4 Ibid., App. A., No. 10. 5 Twentieth Annual Report, Poor Law Board, i 1867-8, p. 28. 6 Explanatory Circular accompanying General Medical Order, 1842, Vide App. to Eighth i Annual Report, Poor Law Commissioners, 1842, p. 82. 7Select Committees on Medical Relief, 1844 and fl 1854, and Select Committee on Poor Relief, 1864. 8 Report of Select Committee on Poor Relief, 1864, | p- 16. The only recommendation for the improvement of medical relief made by the Committee was that rf certain expensive medicines should be provided at the expense of the guardians instead of by the medical +i officer out of his salary. 9 Nineteenth Annual Report of Poor Law Board, 1866-7, pp. 15-16. 10 Jbid. ‘](https://iiif.wellcomecollection.org/image/b32170555_0264.jp2/full/800%2C/0/default.jpg)
