Joseph Rogers, M.D.: Reminiscences of a Workhouse Medical Officer

by Joseph Rogers

Immediately subsequent to this our Workhouse Association engaged itself in drawing up a scheme for a general dietary for all London workhouses, which differed in every establishment; in some being, as at the Strand, when I first went there, niggardly in the extreme, while in others it was absurdly liberal. This question had engaged my attention many years before, and when I introduced an amended dietary at the Strand I was often twitted by the economical element of the Board to the effect that my liberality in the way of dietary was the reason why the House had filled so much, paupers being attracted to the Union by the prospect of being better fed by the liberality I had evinced. This allegation was absurdly unjust. Years before, in 1863, I had, at the time I amended the dietary at the Strand, addressed a letter to the Department urging that they should issue a general order to the London Boards of Guardians enclosing a copy of a uniform dietary to be used in all Metropolitan workhouses (acute cases of sickness alone excepted). Although this suggestion had the approval of Mr. Farnall, who invited me down to the Board to talk the matter over with him, it was set aside. Mr. Fleming, the secretary, objected to everything of a controversial character. About this time, understanding that Mr. Hardy was engaged in drafting his Metropolitan Poor Bill, I wrote to him on several occasions; one of the subjects I urged on him was the advisability of turning the vast field for clinical observations which our Workhouse infirmaries afforded to some practical purpose by throwing the wards open to medical students, pointing out what had been done at the Marylebone Workhouse Infirmary some thirty years before; I also urged that the hospitals he was about to establish should be officered by a resident medical man or resident medical men, but that in no instance should they be left alone in their control, but that their work should be superintended by an extern physician. I understood that my view was overruled through the opposition of certain physicians who thought that the educational opportunities thereby proposed would interfere with the voluntary hospitals they were connected with and the students attached to them.

I also pointed out how desirable it was that pauper schools should be consolidated, and that permanent young pauper children should be separated from those who were constantly going in and out of workhouses. Mr. Hardy always replied personally and with marked courtesy to the letters I sent him. In the session of 1867 Mr. Hardy brought in his Metropolitan Poor Bill. In his speech introducing it he referred to my evidence before the Select Committee, and said that he had resolved to adopt the views I had advocated, namely, the provision of all medicines and appliances at the cost of the rates; but although the Bill passed with great facility and amidst general approval it was a very long time, in some cases four, five, and six years, before the dispensary clauses were carried out. The Bill had hardly become law before Mr. Hardy was transferred to the War Office and Earl Devon became President. This nobleman when Lord Courtenay, Poor Law Inspector, or Lord Courtenay, Parliamentary Secretary, had entirely supported the worst parts of the old system of administration and control. He always yielded to Boards of Guardians, and, when President, entirely deferred to the permanent staff. During the short time that he held office—for the election of 1868 shortly afterwards occurred and with it a strong reaction—he instituted a new order of officials at Gwydyr House—to wit, Assistant Inspectors.

Of course it was not to be expected that the evidence given by me at the official inquiry would fail to intensify the bitter hostility of a section of the Board towards me, especially as the clerk to the Guardians never lost an opportunity of putting my conduct before them in the worst light. Consequently, shortly after my evidence had been given an attempt was made to displace me. The Guardian who moved my resignation was a lodging-house keeper in St. Clement's Danes. Having been told that this Guardian contemplated this procedure, I forwarded a letter to the Board in which I gave an outline of all I had done and had attempted to do during the ten years I had been the medical officer, the amount of antagonism I had provoked, and the various resolutions which had been adopted as the result of my endeavours. It was not very pleasant reading for some of them to hear, as there were several still there who had taken an active part in thwarting me at all times, and this letter thoroughly answered them. In spite of all that was alleged, when the resolution was submitted to the vote it was found that I had just as many friends as enemies, and therefore the motion was not carried. I do not know whether at that time the intrigue between the clerk and certain permanent officials of the Poor Law Board had commenced, but it took place not a very long time afterwards, as I found out some twenty months after.

One result of the evidence I had given as regards the over-crowding was this: I was empowered to send some of the acutely sick to the voluntary hospitals, and I did so to a limited degree, but my action here was again met by the hostility of a section of this Board. It was suggested that I had sent them away to get rid of the trouble of attending to them, and it was gravely proposed that I should have the cost of the cabs in which they were removed deducted from my salary.

As an illustration of the mode adopted by some Boards to annoy their medical officers I subjoin the following: In June, 1867, a person was sent into the Strand Workhouse by the district medical officer, insane. In conjunction with a Justice of the Peace, I examined him, and we certified as to his mental condition, whereupon he was sent to Hanwell. Three weeks after, he was discharged from the asylum, not because he had recovered, but through an informality in the certificate given by the justice. As this latter gentleman was out of town, I took the lunatic before Mr. Vaughan, at Bow Street, who, after examining him for a minute or so, threw up the certificate, and said he would not sign it, the man was not mad. I again implored him to fill up the certificate, as the man had been only sent back to the House through an informality in the certificate. As he again refused, I said, "Then I have to request that Sir Thomas Henry be apprised of the case." This was done, and Sir Thomas advised that he should go back to the House for another week. That afternoon the lunatic was interviewed by three of the Board, who pronounced the opinion that he was of sound mind. Hearing of this irregularity, I wrote to the Commissioners in Lunacy, and asked them to see the man. They attended at the House and examined him, and directed his removal to Hanwell without delay. That night he escaped by scaling a high wall, and was not captured for three days, when the police caught him. In the following September he was discharged cured, when I received a letter from the clerk, informing me thereof, and stating that the Board was of opinion that I had been too hasty in sending the man away, and that too by an unusual course. I immediately wrote to the Commissioners in Lunacy, enclosing the clerk's letter, and asked their opinion, when the secretary, Mr. C. P. Phillips, wrote to me stating that at the time the Commissioners saw him he was clearly insane, and that the Commissioners approved of my action under the exceptional circumstances of the case. I sent their reply to the Board. The evening the clerk read my letter to the Board, the man's wife made an application for his re-admission to the House, as he had a relapse of his insanity. This man went into and out of the asylum on several occasions subsequently. Whenever he was at liberty he made me aware of it by coming to my house between 1 and 2 a.m., and ringing my night-bell violently. Of course I had to put up with the infliction, as the man was not in his right mind. This annoyance went on for years, and only ceased when I left Soho.

The Guardians also authorized my sending some of the infirm women to Edmonton, where the school for the pauper children was situated. This school was a favourite place of resort for the worst members of the Board, and very comfortable parties were kept up there at the expense of the ratepayers. A certain portion of the Guardians went down fortnightly in carriages to inspect the schools, and every scheme was adopted by those not on the School Committee to be asked to go out of their turn by those who were entitled to go. It meant an outing in the country, and a splendid dinner with wine, &c., and tea, free of cost, to all who went there.

Of course the resident officers were always in high favour with the majority of the Board, and to arraign them or their conduct was a hopeless affair, as the least competent element immediately stood forward to shield them.

In the September of 1867 a young girl was admitted, suffering with rheumatic fever; she remained ill some time, but towards the end of the month she recovered sufficiently to be sent to a Convalescent Home, but as the autumn was a cold one I decided that she should be sent to Edmonton, and to secure her considerate treatment I wrote a special certificate, which was addressed to the matron, in which I stated what had been the matter with her, and begged that she should be kept warm and not employed in scrubbing or any damp occupation.