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

by Joseph Rogers

My brother commenced his practice in London in 1844. In 1855 there was a serious visitation of cholera in St. Anne's, Soho, and he became a supernumerary medical officer in the district. Cholera had a very serious effect on his private practice, as he states himself, and nearly twelve years after he had taken up his abode in London, he concluded to become a candidate for the function of medical officer to the Strand Workhouse. He was to receive a stipend of £50 a year, and find all medicines for the sick. It may be doubted whether he knew what he was undertaking: certainly they who appointed him and the officials who confirmed his appointment at the Poor Law Board had no conception of what they were doing. The character of his duties, and a description of the place in which he had to perform these duties is to be found at the commencement of his narrative. For its condition it is hard to decide whether the Guardians of the time, or the central authority were most to blame.

The Strand appointment was the beginning of those systematic labours on behalf of the sick poor and the medical profession which thenceforward became the principal business of his life, to which he sacrificed such leisure as he had, health, and money which he could ill spare. He gave also what was more important—undaunted courage, and accurate information. Thus in 1861 he gave evidence before a Select Committee of the House of Commons, on the subject of the supply of drugs in Workhouse infirmaries, such a supply being as essentially part of the Guardians' duty as the purchase of food and clothing are. His views were adopted by the Committee and pressed on the Department. What he advocated was the germ of the Workhouse infirmary.

During the last few months of his life he lived at Hampstead, in the hope that the air might help him. At the back of his new home there was built one of those great hospitals for the sick poor which it was the principal aim of his labours to render general, and to see constructed in such a way as would give the fairest prospect of recovery for the patients who were treated in them.

The practice of the Poor Law Board at this time was to assert on paper the supremacy of the medical officer in his own department, to give him no personal support when he did his duty, to visit on his head all the consequences of their own negligence or dilatoriness, and, right or wrong, to support the Guardians when they took offence at conscientiousness and zeal. Now, in 1865, a scandalous case of neglect led to an inquest, to an exposure of the facts, and to very severe comments by the Press. Shortly afterwards the proprietors of The Lancet newspaper—a medical journal which has, during a very long career, been distinguished alike for its zeal in maintaining the honour of the medical profession and for its advocacy of humanity in dealing with the sick and destitute poor—resolved on investigating the condition of the London workhouses and their hospitals. Among other places, Dr. Anstie visited the Strand Workhouse, in Cleveland Street, and made his own report on what he saw in the columns of the paper which he represented. The report was candid, graphic, and by no means flattering to the Guardians, to their management, and to their officials. But it was entirely accurate, for the Strand Union and its Guardians at that time were probably the worst examples of a thoroughly bad and vicious system. Of course the Guardians were as angry as they could have been if they had been known for the best of characters and motives and had been grossly defamed.

The time was plainly come for concerted action, and one of the Strand Guardians, a Mr. Storr, a gentleman of very different character from most of his colleagues, convened a meeting at his own offices, in order to discuss the situation. It was at first suggested to call a public meeting; but my brother pointed out that even if the meeting were a success its effect would be ephemeral. It was determined, therefore, to create an association under the title of the Workhouse Infirmaries' Association, Mr. Storr offering to find £100 towards its preliminary expenses. But his generous offer was not needed. As soon as it was known that the Association was in process of formation, names and money poured in upon the scheme. New evidence about the Strand Union came out, and was forwarded to Mr. Charles Villiers, then President of the Board. An inquiry was held, and, as usual, the permanent officials strove to throw the blame on the medical officers, and to exonerate the Guardians. Now, to counteract this, my brother called a meeting of all the Workhouse medical officers in London. The object of this meeting was the formation of an Association for the protection of the character and interests of these officials, and for supplying information to the public as to the manner in which their best efforts were hampered and thwarted. This was the nucleus of the Poor Law Medical Officers' Association, an organization which has extended itself to the three kingdoms. Of this my brother was, as long as his health allowed, the president and principal administrator.

In 1867 Mr. Gathorne Hardy, now Lord Cranbrook, was President of the Poor Law Board, and in this capacity introduced the Metropolitan Poor Bill, some of the provisions of which were the establishment of Workhouse hospitals and dispensaries, and the supply of all medicines and medical appliances at the charge of the Guardians. The President frankly acknowledged that he owed much of the information which he had acquired from my brother. It was unfortunate that the provisions of the Act were not made general, throughout England at least. But London at last got an instalment of Poor Law Reform, and on rational lines. The administration of the Poor Law is far from perfect; but the best part of it is that of the sick poor. Even here officials for a long time obstructed the will of the legislature and the objects of the law, but, on paper at least, the ancient abominations described in the earlier part of my brother's reminiscences were swept away.

In the eyes of the Strand Guardians, or rather of a majority among them, his offences on behalf of justice and humanity were unpardonable. He had to be got rid of. In this the officials of the Poor Law Board, then under Lord Devon, agreed with the Guardians. The Guardians picked a quarrel with him, the Poor Law Board instituted an inquiry, and apparently instructed their Inspector as to what he should report, and the President gave solemnity to the farce by removing him from his office. The ground on which he was dismissed was that "he could not get on with the Board of Guardians." Of course he could not. No man of sense, honour, humanity, decency, and conscientiousness, could get on with them, or, in those evil days, with the Poor Law Board either; for the President and his officials, perhaps unconsciously, leagued with the Guardians in the maltreatment and oppression of the poor.

It is a common trait in mean and malignant natures to think, if they can injure in fortune or character an advocate of justice and right dealing, that they can arrest his efforts and discourage those of others. Many experiences will occur to those who have any knowledge of public affairs which will illustrate this policy and its failure. It always fails with such men as have any character at all. They disregard the loss or the insult, and redouble their efforts after the object which they have put before them. I do not remember that my brother ever dwelt with any peculiar acerbity on the circumstances of his dismissal; but he gave himself more than ever to the self-imposed task which became the business, and eventually the success, of his life. He spoke, indeed, with bitterness, and wrote with bitterness of the crew who had sought to injure him, but for the reason that they were prolonging the miseries of the poor, and for that reason only.

Of course my brother had the sympathy of his profession and the support of the medical papers. But he resolved to perfect and extend the organization which he had founded. The result was the formation of the Poor Law Medical Officers' Association. In order to give strength and stability to this agency he visited most of the principal towns in England. He made several journeys to Ireland, the infirmary system of which he highly commended, and went once at least to Scotland, where indeed reform was greatly needed. And in these places he inculcated the important truth, that where medical relief was abundantly and generously accorded by the Guardians, pauperism decreased and rates were lessened. In my frequent communications with him, I urged him to insist on this as a matter of principle and a matter of fact. Generous relief to the poor, if it be discriminating and founded on a few intelligible rules, is the truest economy in the end. Owing to his efforts, many towns voluntarily adopted the principle of the Metropolitan Act, and with the best results. In the earlier years of his campaign he obtained great assistance in Parliament from the late Dr. Brady, Member for Leitrim, and from Dr. Lush, Member for Salisbury.