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Workhouse Infirmaries in Nightingale’s Day
- Wilfrid Laurier University Press
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Workhouse Infirmaries in Nightingale’s Day ‘‘How gladly would I have become the matron of a workhouse. But, of a visitor’s visits, the only result is to break the visitor’s heart. She sees how much could be done and cannot do it.’’ ‘‘Years ago, when I visited in one of the great London workhouses, I felt that visiting had no other effect but to break the visitor’s heart. To nurse efficiently is what is wanted.’’ I t is difficult for us today to imagine the horrors of the workhouse infirmaries of Nightingale’s time.1 Material conditions were abysmal: overcrowding, poor ventilation, sooty air, shared beds or sleeping on the floor. Toilets and bathing facilities were scarce and poor. Infectious fever cases were mixed in with the rest of the inmates. Medical attendance was occasional. There was no provision for drugs, which the doctor had to pay for out of his stipend. There was no nursing to speak of; untrained ‘‘pauper nurses’’ or women inmates not themselves sick provided what was called nursing. Often these ‘‘nurses’’ were old and could not lift patients; few could read enough to read a prescription. Many drank on the job and indeed they were notorious for stealing their patients’ food and drink. In 1862 Nightingale com1 For good secondary sources on the reform of the workhouse infirmaries see Monica E. Baly, ‘‘Poor Law Nursing,’’ in Florence Nightingale and the Nursing Legacy; Geoffrey Rivett, The Development of the London Hospital System 1823-1982; Gwendoline M. Ayers, England’s First State Hospitals and the Metropolitan Asylums Board 1867-1930; and Herman Asubuel, In Hard Times: Reformers among the Late Victorians. / 223 pared the plight of workhouse paupers with that of the destitute in Calcutta.2 Later, looking back at the horrors, she said that in the ‘‘old workhouses pauper patients could be murdered ad libitum [at will].’’3 The workhouses themselves were still dreadful institutions, housing people who were destitute from a variety of causes: old age, unemployment , mental deficiency or illness, long-term disability, industrial accident . There was then no unemployment insurance, workers’ compensation , maternity leave, old age pension or disability allowance. Nightingale was concerned both with reform of the workhouse system itself (a major subject of Society and Politics) and the care of the sick poor in the workhouse infirmaries (the subject here, but which continues to draw in issues of broader workhouse and Poor Law reform). England’s old Poor Law never provided specifically for the care of the sick poor but only for the ‘‘necessary relief’’ of the ‘‘impotent,’’ which included the sick. Acts of Parliament on poor relief prior to 1834 were silent concerning the provision of medical or nursing care. The Royal Commission on the Poor Law in 1834 expressly included the sick among the impotent. Yet the 1834 act left it to the commissioners to establish care under their general powers of regulation. The Poor Law Amendment Act of 1848 (section 2) provided for medical or other assistance on account of ‘‘accident, bodily casualty or sudden illness.’’ The Poor Law Amendment Act of 1851 (section 4) enabled the guardians to subscribe to ‘‘any public hospital or infirmary for the reception of sick, diseased, disabled or wounded persons, or of persons suffering from any permanent or natural infirmity.’’4 Nightingale herself pointed out in her paper for the cubic space committee that there had never been any express provision for the care of the sick in workhouses, that the reception of the sick in them was ‘‘an accident, an excrescence’’ (see p 378 below). The Elizabethan Poor Law was the means instituted for the care of the destitute after the dissolution of convents and monasteries by Henry VIII in the Protestant Reformation. It gave parishes the duty of providing minimal care for those living within their boundaries. The operative principle was ‘‘less eligibility,’’ that is, that recipients of assistance should not live better (or seem to) than the poorest self2 Letter to William Rathbone 26 September 1864, Liverpool Record Office, Rathbone Collection 610 1/1. 3 Letter to Douglas Galton 29 March 1882, Add Mss 45765 f72. 4 Report of the Royal Commission on the Poor Laws and Relief of Distress (London: HMSO 1909) Cd. 4499:235-36. 224 / Florence Nightingale on Public Health Care [54.85.255.74] Project MUSE (2024-03-19 10:00 GMT) supporting member of the community. The intention was to dissuade people from seeking relief unless truly desperate. The concerted amendments...