SECOND READING. (Hansard, 19 March 1867)

§ THE EARL OF DEVON

, in moving the second reading of this Bill, said, that the objects of the measure were three-fold—first, to provide for the sick poor, both outdoor and indoor, within the metropolitan area, for the insane and other classes of the inmates of workhouses, better accommodation than they at present enjoyed; 103 secondly, to assimilate the powers and duties of guardians in certain parishes under local Acts to those of guardians acting under the general law; and thirdly, to provide for the equalization of certain charges over the whole metropolis; and for other purposes relating to the relief of the poor within the metropolis. The evils which the Bill was intended to remedy might be classed under two heads—first, the inadequate, inefficient, and ill-managed accommodation for the sick in the metropolitan workhouses; and secondly, the want in many of those workhouses of a sufficient and well-trained staff of nurses. That the accommodation for the sick in workhouses should be exceedingly bad was hardly to be wondered at when they recollected that at the first introduction of the Poor Law Amendment Act it was hardly at all contemplated that the sick and infirm should be received within the walls of the workhouses, which were mainly intended as places for able-bodied paupers. But as years passed on the law was so administered that the workhouses became, to a great extent, hospitals for the sick and infirm. A paper which he held in his hand showed that in 1865 no less than 25 per cent of the inmates of all the metropolitan workhouses were sick and infirm, and that this was considerably above the average throughout the country; and when they considered the great number of cases of this kind which were continually received into the metropolitan workhouses, it was easy to understand how the amount of accommodation was inadequate. From the Return with which the Poor Law Board had been supplied, it appeared that whereas indoor relief in England and Wales amounted to only 14 per cent upon all cases, in the metropolis it rose as high as 27 per cent. He was happy to be able to acknowledge that in many cases within the metropolis well-considered, judicious, and philanthropic provision had been made by Boards of Guardians for the accommodation of the sick and infirm, and had thus met to some degree the want of sufficient hospital accommodation. But that was not the case throughout. There were many cases in which it would be impossible to provide proper accommodation for want of space, and he feared he must say there were a few in which when motives had been scrutinized the guardians did not show an inclination to provide a remedy for wants which in other districts had been more liberally supplied. Another cause 104 which prevented the improvement of the accommodation for the sick was the limitation which applied to the Poor Law Board, as to the amount of money which they could compel the guardians to expend. It was well known to their Lordships that until last year the Poor Law Board could not compel a Board of Guardians in any parish to carry out any alterations, the cost of which would be more than £50. It was thus obviously impossible for the Poor Law Board to provide that any great alterations should take place. Another consideration which pressed upon the Poor Law Board was this. Until a late period the Poor Law Board were advised by competent medical authorities that a space of 500 cubic feet was sufficient for each sick person. Doubts, however, had been thrown upon the correctness of that belief, and in order to solve them, a Committee was appointed to inquire into the matter. That Committee, at the head of which was Sir Thomas Watson, the distinguished President of the College of Physicians, was composed of physicians and surgeons and other gentlemen whose studies and duties had familiarized them with the subject. The Committee reported that not less than 850 cubic feet on an average ought to be allowed to each sick inmate, and in certain offensive cases not less than 1,200; but that in chronic infirm cases, in wards occupied by day as well as by night, 500 cubic feet would be enough; and 300 cubic feet for healthy classes of children. It had been determined, therefore, by the Poor law Board that 850 cubic feet was the minimum which the guardians would be authorized to provide for the sick. But in addition to these general grounds for this measure, there were some special and individual cases which had strongly impressed the Poor Law Board with the necessity of amending the present system. He referred to the cases of Timothy Daley, who died in the Holborn Workhouse on the 23rd of December, 1864, and that of Richard Gibson, who died in the workhouse of St. Giles and St. George. In consequence of the complaints which had been made with respect to these cases, inquiries were held by Poor Law Inspectors, and the result proved not only the allegations of personal neglect in these particular cases, but that also the sick wards in these hospitals were insufficient and ill-arranged; and inquiries that subsequently took place into the management 105 of the Paddington Workhouse showed in that case also that the staff of nurses was Insufficient, and the provision for the sick and the medical arrangements generally unsatisfactory. In speaking of the investigations carried on by paid officers of the Poor Law Board, he would not be doing his duty if he passed over without acknowledgment the services rendered by professional and scientific gentlemen connected with The Lancet, who, at the cost of much valuable time and money, visited the workhouses of the metropolis, and supplied the Poor Law Board from time to time with most material facts in reference to their condition. The result of the information thus collected was the appointment of Mr. Farnall and Dr. Smith to make a special investigation into the state of the wards in the workhouses, and their Report, though differing in other respects, agreed in this—that the wards were overcrowded, and that the general arrangements for the sick were very unsatisfactory. Shortly after his right hon. Friend Mr. Gathorne Hardy) came into office, two other Inspectors were appointed to make inquiry, not merely into the state of the sick wards, but, into the general accommodation in the metropolitan workhouses. These gentlemen were instructed to take as the basis of their judgment the opinion given with respect to the amount of cubic feet. Having made a careful inquiry, the Inspectors came to this conclusion—that in twenty-four unions and parishes the existing workhouses were such that by partial re-construction they might be made adequate to the necessities of the case; but with respect to the remaining fifteen, the greater number of them were not capable of being made suitable to the purposes for which they were required. Sufficient proof had therefore been brought forward to show that the Poor Law Board had ample grounds for adopting some comprehensive measures for the improvement of the workhouse infirmaries. With regard to the provision of an efficient and proper nursing staff, the evidence was not less strong. The subject had often engaged the attention of the Poor Law Board, and had been pressed by their Inspectors on the Poor Law Guardians, to whom a circular had been issued and re-issued. It would be improper on such an occasion to omit reference to the improved feeling on the subject which had resulted from the admiration the country must feel for the exertions of that excellent and gifted 106 woman, Miss Nightingale, whose name would always be received with that respect which was due to her Christian activity and self-devotion. Contemporaneously with her labours, the ill-arrangement of the sick wards of the workhouses, and the want of a proper nursing staff, had pressed themselves on the Poor Law Board as matters requiring attention; and the available remedies seemed to be additional buildings; increase of staff, and greater means of classification. The first consideration that presented itself to the Poor Law Board, on reviewing the question, was that there were no fewer than thirty-nine different areas of taxation within the metropolis, fifteen of these being unions under Boards of Guardians, and fourteen parishes under the general law; while no less than ten were governed by guardians elected in different ways by vestrymen. The obvious conclusion that pressed itself on the Board was that it was absolutely necessary to create new and larger districts in order to carry out the remedies that were proposed. Having thus adverted to the evils which it, was sought to remedy, and the reasons of introducing Poor Law Board for introducing the measure, he would proceed to call attention to some of the provisions of the Bill. Three Committees which had inquired into the subject had stated in their Reports that the extension of the power of the Poor Law Board over local guardians was necessary. The Bill therefore gave power to the Poor Law Board to provide asylums for the reception and relief of the sick, insane, or infirm poor; to combine unions or parishes, or unions and parishes into districts, to constitute bodies of managers partly elected and partly nominated, with powers to erect new buildings, purchase lands, and borrow money. It was further provided that the appointment and duties of the officers were to be determined by the managers; but their salaries were to be determined by the Board. Auditors were to be appointed, and might be removed at the pleasure of the Board. In the provision for the application of the asylums, the words were very general, and included fever, small pox, and lunatics. There was also a provision for the establishment of dispensaries to afford outdoor medical relief, with a committee of management and the necessary officers. The medicines were to be provided by the Board of Guardians, in order to secure that they should be of the best description. The next clause to which he would call attention way, that very 107 important one which provided for the establishment of a general metropolitan fund, to which all unions and parishes were to contribute, and out of which would be made the disbursements required by the purposes of this Act. The question of the equalization of all the metropolitan rates had for years been under consideration both in and out of the House. The equalization of metropolitan rates involved grave and serious considerations; but, stopping short of that, there remained a middle course, which he thought the Poor Law Board had properly decided to adopt—namely, to take certain charges, and make them payable equally over the whole of the metropolis. The charges proposed to be thrown on this common fund were—first, the maintenance of lunatics in the asylums, and licensed houses for the insane poor; secondly, the maintenance of the patients in the asylums for patients suffering from fever or small pox; thirdly, for the medicine and attendance supplied for the relief of the poor; fourthly, salaries of all officers employed in the relief of the poor and the management of schools, asylums, and dispensaries; fifthly, for compensation in cases arising under this Act; sixthly, for payment of fees for registration of births and deaths; seventhly, the payment of fees for vaccination; eighthly, the maintenance of pauper children in district or licensed schools; and lastly, for relief of destitute persons under peculiar circumstances. He trusted that when the measure passed into law the effect would be to extend to pauper children an education which would fit them for the duties of their after life. He had thus endeavoured to explain what appeared to him to be the material provisions of this Bill, which came up to their Lordships with the almost unanimous approval of the other House. The measure had been generally approved by his right hon. Friend the late President of the Poor Law Board, and he believed it had commended itself to most of those who were aware of the evils which it sought to remove. He was anxious to say that the Bill was brought forward in no spirit of distrust or jealousy of the local authorities. It was intended to extend the authority of the Poor Law Board no further than was absolutely necessary for the purpose of carrying out the provisions of the Bill. That harmonious co-operation between the central authority and the local Boards of Guardians, which he was happy to say had hitherto prevailed, would, he trusted, continue to prevail, and would 108 show itself in the ready assistance which the Poor Law Board hoped to receive from the guardians in carrying out the provisions of this measure. In the full confidence that the Bill would be beneficial, alike to the poor and to the ratepayers, he now moved that it be read a second time.