Blackwood's Edinburgh Magazine, Vol. 60, No. 373, November 1846

by Various

The number of medical officers in a Union varies. In some cases, where there are two relieving-officers, there are four medical officers. The medical officer resides within the limits of the Union. He is not prevented from attending to his private practice, and he does not therefore reside in a central position, or at the nearest point to his pauper patients; he is supplied with a list of persons who are in receipt of relief, and he is bound to attend these without an order; he must also attend to cases upon the receipt of a written order from the relieving-officer or the overseer; he regulates the diet of his patients, and he is paid by a salary, and by fees in certain cases.

There are contradictory opinions respecting the efficiency of this system. Some say that the amount of remuneration is inadequate to insure qualified persons, and others that the qualifications are secured by the requisition of recognised diplomas.

If we inquire of those among the peasantry who have never received parochial relief, or even of the yeomanry, we find that in many districts, and especially those of which we are now speaking, it is a difficult matter to obtain immediate medical aid; and if this consideration have any weight, the system would appear satisfactory, providing always the overseers perform their duty when applied to. It would be desirable to ascertain whether there are any restrictions in the issue of medical orders. As regards relieving the poor with food, there are many who say, that, in so doing, the very evil is created which we are endeavouring to destroy. But this is not said with respect to medical relief. The labouring man with his family may earn an average wage of from 7s. to 12s. per week. The most prudent cannot save much, and those savings are invested in the purchase of a stack of wood, a sack of meal, a crop of potatoes, a stye of pigs, or a cow. His savings might enable him to provide food for his family during illness, but they would be totally insufficient to pay for medicine and medical aid. It would be desirable to ascertain where and to what extent medical clubs and dispensaries exist, and what means the agricultural labourer, in thinly populated districts, possesses for obtaining gratuitous medical aid.

It would be well, too, if Boards of Guardians would remember that their duties have not ended when they have disposed of the cases on each board-day. They have to do with pauperism, not only as it exists to-day, but as it may exist next month or next year; and therefore they have to do with its causes, as well as its existing results. This truth is just now occupying the minds of statesmen, and it is to be hoped that it may receive the attention of Boards of Guardians. Sanatory regulations will decrease pauperism. Many men have been destroyed, and their families pauperised, by uncovered sewers in thickly populated lanes and alleys; and much disease has been engendered by the want of facilities for cleanliness. And so also has much pauperism been engendered by the drain upon the resources of the poor man during a long illness. Could not this be remedied, and that without weakening the feeling of independence? And why might not a Board of Guardians be allowed, or compelled, to contribute a given sum to any dispensary or medical club which may be governed by certain rules duly certified?

We must now refer to the churchwardens and overseers of the several parishes of this rural Union. The question with respect to them is, do they receive the applications of the poor in their respective parishes, and deal with them in the same way as the relieving-officer? It would not be a sufficient answer to quote acts of parliament, or lists of duties. It is doubtless of importance to know that, according to law, the duty of relieving in cases of sudden and urgent necessity is still reserved to the overseer. But it is of equal importance to ascertain whether, in those extensive or thinly populated parishes where the relieving-officer may reside many a weary mile distant from the cottage of the destitute, any check, or hinderance, or heavy discouragement has been offered to the overseer in his attempt to perform his duty. We can easily conceive the farmer overseer, before 1834, riding over the fields of his parish, and meeting one of the poor cottagers, at once relieving him with a piece of money, and taking no further note of the circumstance than was necessary to prevent his forgetting to repay himself. And we can understand how the same overseer, under the new system, when men to whom he has been accustomed to look up with deference are united with him in the administration of relief, may not trouble himself to inquire into, or care to exercise, the rights reserved to him. Or he may find that he has something more to do than merely to enter the amount in his pocket-book. He may have to report the case to the relieving-officer, or to defend it at the Board—neither of which acts his literary habits, his opportunities, his patience, or his ability to speak before the magnates of his district in Board assembled, may dispose him to perform. In other cases, where these considerations may have no weight, the overseer may be of opinion, since paid officers have been appointed to do the duty, and are paid to do it, that they are the proper persons to perform it.

In thus referring to the duties of overseers, it must not be supposed that a recurrence to the old system is aimed at. It is a common opinion that the Union system is diametrically opposed to the old parochial system. And it seems to be too generally thought that relief should be given through paid agency. But this is not so. The power to relieve, in cases of sudden and urgent necessity, still rests with the overseers. But the law has deprived the overseer of the power to give permanent relief. It will not allow him to give a regular weekly allowance. The question the overseer has to do with is not whether labourer Miles shall receive, for a number of consecutive weeks or months, a certain sum, but whether he should not receive relief at this moment, his necessities being sudden and urgent. The question of permanent relief is no longer a subject of personal controversy and irritation between the labourer and the farmer. It is now a question between the labourer and the Board. What he shall receive no longer depends upon the will of a single person, but upon the collective will of a number so great, that personal partialities and prejudices can scarcely have place. The system, in this respect, assures justice alike to the rate-payer and the indigent poor. It stands between the poor man and the overseer; and also between the overseer and the sturdy threatening vagrant.

But it is desirable to know whether the dereliction of duty by overseers has been of frequent occurrence, and whether there has been any want of care or disposition on the part of the authorities to facilitate its exercise. That the relief given must be duly recorded and accounted for, is quite clear. Now, do the means for doing this equal those given to the relieving-officer, who requires them less? Then, again, have arrangements been duly made to enable overseers to relieve in food? Is the loaf or the meat at hand? Can it be had from the nearest shop? Or must it be brought from the store of the contractor, who cannot always reside in the next village? In fact, must the destitute person wait for the periodical visit of the relieving-officer, and is the duty of the overseer thus made a superfluity?

It is likely that the dweller in cities may not sufficiently estimate the importance of this topic. In a populous city, however sudden the casualty may be to which a fellow-creature may fall a victim, the means of relief are within a stone's-throw from the spot. But the case is different in that wide expanse of level country which opens to the view of the pedestrian as he gains the summit of the hill. The plain is dotted with solitary cottages, hamlets, and villages. The town is just perceptible in the distance. But its hum and its chimes are unheard. The Union-house loses its barrack-like appearance by its remoteness. He descends, and its "goes on his way." He hears the voices of children, the song of birds; and he sees cottages "embosomed" in trees, and those pictures which pastoral poets have so loved to paint, pass in panoramic order before him. He enters the cottage door; he sees the dampness of the walls; he feels the clayey coldness of the floors, and observes the signs of poverty. While pondering upon these things, sensation vacates its office, and imagination rules in the ascendant; material images fade away. Now the fields, the trees, and the entire air become covered and filled with drifting snow. Or,

"The stillness of these frosty plains,
Their utter stillness, and the silent grace
Of yon ethereal summits, white with snow,
(Whose tranquil pomp and spotless purity
Report of storms gone by
To those who tread below.")

Or the winds howl, the biting sharpness of the frosty air nips the joints and shrivels the flesh, and the smoking smouldering fire has no power to control the winds which rush across the room. The scene changes. The lowlands are flooded, and the waters reach to, and stagnate at the cottage door. The rains descend; the air is saturated with water; it chills the frame; the heart beats languidly, and the soul of man stoops to the deadening influence of the elements. Agues, rheumatism, and fevers prevail. The hardships of the season bear down old and young; for the want of sufficient or nutritious food has shorn them of their strength.