Report of the Departmental Committee appointed by the Local Government Board for Scotland to inquire into the system of poor law medical relief and into the rules and regulations for the management of poorhouses...

  • Great Britain. Local Government Board for Scotland.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Report of the Departmental Committee appointed by the Local Government Board for Scotland to inquire into the system of poor law medical relief and into the rules and regulations for the management of poorhouses... Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    are sometimes received and treated. It destroys the line that has hitherto been lield to divide a voluntary from a rate-supported hospital. On the one hand, the general hospitals, voluntarily supported, are obviously incapable of meeting the demands made upon them, and are compelled to hand over certain cases to be treated in the Poor Law hospitals, or to refuse admission to other, cases that may ultimately drift into the poorhouse hospitals. On the other hand; the poorhouses receive certain sick patients who are not destitute, but who, under force of circumstances, have to enter a poorhouse for curative treatment. The result is that, although in some cases the whole cost is repaid to the parish authorities, these patients become paupers, and are subject to the disabilities implied in that term. While, however, the inadequacy of the accommodation in the general hospitals and infirmaries of the country tends, as has been shown, to augment the recorded pauperism, it must be remembered that many persons relieved by these institutions are destitute, or would become paupers, did charitable organisations not exist for the treatment of the sick poor. 3. WHAT IMPROVEMENTS MAY BE EFFECTED IN HOSPITALS AND SICK WARDS OF POORHOUSES. 5L Before expressing our views regarding the improvement of poorhouses and poor- house hospitals, it may be well to state generally the difficulties that lie in the way of improvement and how they have arisen. (a) The Existing Poorhouse Buildings. 52. We find that, until of recent years, the plans of poorhouses submitted to the Board for their approval under section 63 of the Poor Law Act have not been critically examined. It is not clear that the Board have power to disapprove a site for a poorhouse on the grounds of inaccessibility ; and we find that poorhouses have been erected in places remote from centres of population, to which it is difficult to remove a sick person, and where there is no resident medical man in the vicinity. The accommodation for which the Board's approval must be given has been sanctioned on a gross capacity over the entire house. In some cases this sanction has been given apparently on the basis of the number of shares taken by the combining parishes and not on an estimate of the number of inmates for whom provision had to be made. Indeed, in some cases it has been given for a number of inmates greatly in excess of what the house will hold. In some instances this initial error has been rectified as the house became fully occupied, or overcrowded, or special attention was otherwise called to the matter. For instance, the sanctioned number in ■ Wigtownshire poorhouse has been reduced from 352 to 134 ; in Kirkcudbright from 250 to 136 ; and in Skye from 75' to 40. But in other houses, which have never been more than partially filled, the question has not been raised, and the numbers remain as originally sanctioned. Henderson, 3770 Appendix L. The accommodation was further sanctioned without reference to any classification of the inmates, even to the extent of distinguishing between men, women, boys, and girls. It was not ascertained that facilities existed for the separation of sick, infirm, and ordinary inmates, or of respectable persons from those who had formerly led dissolute lives, or for the isolation of contagious and offensive cases, or for the treatment of midwifery cases. Accommodation for a nurse convenient to the sick wards was rarely provided. It was not seen that sufficient day-room accommodation was provided. It was understood that the dormitories should provide 400 cubic feet of space for ordmary adults and 600 for sick inmates—an allowance which was too small under the best conditions ; but the plans were not measured to see that this condition was fulfilled. No mquiry was made as to the system of ventilation, and the cubic space provided was and IS often wholly inadequate. Most of the poorhouses are built on what is termed the corridor system {i.e., a central corridor with wards on each side), and apertures or open spaces for the purpose of cross ventilation were not insisted on. The means of heating, which was