HL Deb 28 November 1867 vol 190 cc315-27
THE EARL OF DEVON

rose to move that there be laid before this House Copy of a Letter dated 16th August, 1866, and addressed by the Poor Law Board to their Medical Officer, Dr. Edward Smith, instructing him to visit Five or Six Workhouses in each of the Poor Law Inspectors' Districts (not including the Metropolis), and to report upon the Sufficiency of the existing Arrangements for the Care and Treatment of the Sick Poor in such Workhouses; and also, Copy of the Report, with the Appendix, of Dr. Edward Smith, dated 15th of April, 1867. In moving for these Returns he had two objects to serve—the one to place the Special Reports upon forty-eight workhouses in various parts of England and Wales before their Lordships and the public; and the second, to give himself an opportunity of explaining—as he thought it was very necessary to do at this time—the duties and powers which belong to various parties who are connected in different ways with the management of workhouses and infirmaries. It was, of course, known to their Lordships that public attention had been of late very much directed to the condition of workhouses and infirmaries. Various gentlemen had paid voluntary visits to these institutions, and had published reports of their visits in the leading medical journals of the metropolis. He desired, in the first instance, to say that he did not for a moment intend to throw doubt upon the motives which actuated those gentlemen; and still less was he inclined to doubt the real benefit which would result to the workhouses from the inquiries which they had voluntarily and laboriously carried on. No Department ought to be superior to receiving useful information, from whatever quarter it might come; and he, for one, believed that a Department was under an obligation to those who brought before it a real grievance candidly, fairly, and temperately. It was with that view he looked upon the reports in the medical journals, from which, supplemented as it would be by the action of the Poor Law Board, he believed good would result. He could not forget that in the year 1865, gentlemen connected, he believed, with those journals, or perhaps with an Association working for a similar object, made very important investigations into the metropo- litan workhouses, and in that respect acted, so to say, as pioneers to those measures of reform which subsequently, when based upon the recommendations of the Poor Law Inspectors, were matured and adopted in the Bill which received the sanction of the House in the last Session of Parliament. He thought it was important that their Lordships should have before them a statement of the organization which existed in the country for the general management of the workhouses and infirmaries. There are no less, in England and Wales, than 663 unions, including the metropolitan unions. Those unions, setting aside those in the metropolitan districts, were divided into eleven inspectorial districts, each placed under the management of one Inspector connected with the Poor Law Board. He was anxious to bear testimony to the ability, efficiency, and conscienciousness of the gentlemen who acted in the office of Inspectors. It was an office requiring a combination of qualities which was not easy to be met with. It required a knowledge of detail combined with a power and ability of taking and acting upon general views of public policy. It required a union of firmness and vigour, with temper and tact, which he again said could not always be met with. Speaking now, as he was justified in doing by considerable experience in the Department over which he had the honour to preside, he said conscientiously that the Department and the public were under great obligations to the gentlemen who so efficiently performed the duties of their situation. In each of the workhouses of the districts to which he had alluded there was an infirmary which was more or less adequate. It was right their Lordships should be aware that those infirmaries were originally intended for the accommodation of only those cases which arose within the workhouse; but they had now—certainly in the metropolis, and partly in some large towns—become rather places for the reception of those who would otherwise have been attended at their own houses, and they had ceased to have the character of infirmaries for indoor sick only. Thus it came to pass that many of our workhouses, which were originally intended by the framers of the Poor Law Amendment Act and the Legislature mainly to meet the claims of the able-bodied destitute for relief, had become, in many cases, little more than hospitals or infirmaries. It would be obvious at once to their Lordships that the buildings intended for the one purpose could only at considerable expense and some delay be adequately fitted to and adapted for the altered purposes which the changed circumstances required. The workhouses, with those infirmaries, were placed by the rules and regulations of the Poor Law Commissioners under the management of a Visiting Committee, who were appointed by the Guardians. The duty of the Visiting Committee was thus prescribed— The Guardians shall appoint one or more Visiting Committees from their own body; and each of such Committees shall carefully examine the workhouse or workhouses of the Union once in every week at the least, inspect the last reports of the chaplain and medical officer, examine the stores, afford, so far as is practicable, to the inmates an opportunity of making any complaints, and investigate any complaints that may be made to them. Having done all these things the instructions required that they should embody in writing for the information of the guardians, in answer to certain questions, such information as they had acquired. Again, it was the duty of the guardians to see that all cleanliness was observed, to remedy deficiencies in the building, to repair defects in drainage and ventilation, and to attend to other matters necessary for the health of the inmates. In addition to that security for the good management of the house, it was also required that the Inspector of the district should once in every half-year visit the workhouse, and on each occasion go into a detailed investigation of every point connected with the health of the inmates, and the cleanliness of the place, especially of the sick wards, and report the result to the Poor Law Board, besides entering the results of his inquiry in the Visitors' Book. Thus it was clear that if each performed his duty it would not be easy for any abuse to escape detection. But this organization he was bound to admit had in many instances broken down. It appeared that in many unions in the country in which the visits to be made by the Committee ought to have been weekly, were very scantily and carelessly performed, if performed at all. He knew himself instances in which the Visiting Committees allowed one or two months to pass over without discharging their duties; thus one very important security failed, and he therefore thought it almost imperative that increased power should be given to the Poor Law Board in this respect, and other measures taken for regular and periodical visits of the houses in case of the Visiting Com- mittees neglecting their duties. At present the Poor Law Board had only the power of appointing a paid visitor if the Visiting Committee neglected their duty for a period of three months. He believed that the Poor Law Board ought to be enabled to exercise that power within a shorter period. The next point he wished to bring under their Lordships' notice was that respecting the power which the Poor Law Board possessed in the event of the guardians declining to remedy the defects thus brought under their notice. He bore willing testimony to the cordial and zealous co-operation of the guardians, in the great majority of cases, with the Poor Law Board in the administration of the law. The mere fact that though the Poor Law Board had no power to order the erection of workhouses, no less than £6,000,000 had been spent by the voluntary act of the guardians in endeavouring to carry out the law by the erection of workhouses since the Act had passed showed the willingness and readiness of the guardians to co-operate with the Board. But there were, unfortunately, remarkable instances of the contrary. He would not on this occasion mention any particular union; but he held in his hand a paper which showed that during no less a period than five years the Poor Law Board had been continually urging upon the guardians of a particular union the necessity of erecting a new workhouse, in place of one obviously inadequate to the wants of even the able-bodied, to say nothing of the sick. He had yesterday under his consideration papers which showed that in the case of another union a very reasonable and proper proposal had repeatedly been pressed upon the consideration of the guardians by the Inspector for the erection of new infirmary and new infection wards, but the subject was invariably adjourned by the guardians. Facts, indeed, continually arose showing how necessary it was that the Board should have more power over the guardians. It was quite true that under the old Poor Law the Board had power to order a certain expenditure for enlarging or improving workhouses; but the expenditure was not to exceed £50 for each parish—an amount which was obviously insufficient for the alterations which circumstances might occasionally demand. It was also true that a very beneficial Act was passed in 1866 under which the Board acquired power to expend, without the consent of the guardians, a sum equal to one-tenth of the average amount expended for the three years preceding. The Board, however, had only power to act in this way for the enlargement of the workhouse, and they could not order a single article of furniture—not even a wash-hand basin or a towel—or to compel the guardians to supply such, or even any medical appliances whatever. He thought that they must apply to the Legislature for further powers in this particular. With regard to the orders of the Board generally, it was right that their Lordships should be aware that the only mode in which these orders could be enforced was by a writ of mandamus issued by the Queen's Bench—a cumbrous operation, and one requiring time, and not at all applicable to cases where prompt and active interference was required. The fact, also, that, until a year or two ago, the Poor Law Board, unlike any other Department, occupied a position of comparative uncertainty—its existence being only renewed from time to time instead of being permanently secured—greatly militated against its utility and authority. It would, from these circumstances, be obvious that the chief power of the Board depended upon the exercise of its influence, its advice, and its moral suasion. Having thus stated the power, or rather the want of power, of the Poor Law Board, he would take the opportunity of showing what had been the course pursued during the last few years. Taking, for instance, the question which was now deservedly attracting great attention, that of nurses in workhouses—he found that as long ago as 1856, Mr. Bouverie, being then the head of the Poor Law Board, communications—in which he (the Earl of Devon) had some share—took place with various benevolent gentlemen, physicians, and others, on the subject of improvements in the nursing system in workhouses; and this ultimately led to a communication from the Board to their Inspectors, instructing them to urge upon the guardians the necessity of employing paid nurses, and of generally improving the system. This was followed in 1865 by a communication with a similar object, addressed to all the Boards of Guardians throughout the country. He now came to the time when, principally from the efforts of voluntary visitors, the state of workhouse infirmaries engaged the careful attention of the Poor Law Board. In consequence of that, his right hon. Friend (Mr. G. Hardy), in April, 1866, instructed Mr. Farnall and Dr. Edward Smith to make a careful inspection of the infirmary wards of the metropolitan workhouses, and to inquire into the existing arrangements for the care of the sick. Their attention was specially directed to the adequacy of the accommodation provided, and other matters affecting the treatment and care of the sick poor in those workhouses. A very valuable Report was made, and in the month of August it was followed up by another on Metropolitan Workhouses, containing additional particulars. About the same time Mr. Hardy appointed a Committee, composed of very eminent physicians, military and civil engineers, and other persons, with the special object of ascertaining what was the amount of cubic space that should be allowed to each patient. The Report of that Committee had been laid upon the table of their Lordships' House, and it contained very valuable information. The facts brought out by these inquiries led to the introduction of that very valuable Bill which had received the sanction of Parliament—the Metropolitan Poor Act of 1867—which gave to the Poor Law Board largely increased powers in securing improvement in the condition of sick inmates of the metropolitan workhouses. It would be a matter of satisfaction to learn that arrangements under that Bill were progressing very satisfactorily, and he rejoiced to say that, in the very great majority of instances, the suggestions made by the Board had met with the ready concurrence of the guardians. Now as to the country districts. The Board in January, 1867, ordered their Inspectors to report as to the country districts; those Reports, necessarily very voluminous, contained very valuable information, and it became the duty of the Board to act upon them. There was also the Report for which he moved, made by Dr. Smith, as to certain selected workhouses; and this was made in consequence of instructions given to him in August, 1866. Such had been the sources of information possessed by the Poor Law Board in consequence of recent inquiries upon the subject. The course taken by the Board was this. Ordinarily, when the existence of any abuse had been reported, they communicated directly to the guardians, and requested that they would send any observations which they chose to submit; and they also directed an Inspector to make a personal inspection, and make a Report on anything complained of, and to try to get the guardians to remedy it. There had also been cases, such as that of Farnham, to which it seemed to the Poor Law Board that the ends of morality and humanity would not be satisfied without a more public inquiry—an inquiry conducted not by the Inspector for the district, but by an Inspector specially sent by the Board for that purpose, and accompanied by the Medical Officer of the Board. He had now placed before their Lordships, as clearly as he could, the powers, duties, and responsibilities of the different parties connected with the management of workhouses, and he had done so in the belief that if defects were brought forward, or abuses discovered, it was most important that their Lordships and the public should have an opportunity of knowing who, under certain circumstances, should justly be held responsible for their continuance. The Poor Law Board frankly accepted the responsibility and duty of making such administrative arrangements for the treatment of the sick poor under their charge as might be consistent with the best sanitary knowledge of the day, and most conducive to the proper curative treatment of the patients. The Board did not shrink in any way from any public remarks and comments that might be made on them—comments which, when temperately, calmly, judiciously and candidly made, were often very important auxiliaries in the performance of public duty. Having explained the powers of the Board, he would say that it might become necessary to apply in the next Session for increased powers in some respects; and if that were done, he felt confident that the Legislature would not refuse justly and reasonably to strengthen the hands of the Board.

Moved, That there be laid before this House, Copy of a Letter, dated 16th August 1866, and addressed by the Poor Law Board to their Medical Officer, Dr. Edward Smith, instructing him to visit Five or Six Workhouses in each of the Poor Law Inspectors' Districts (not including the Metropolis), and to report upon the Sufficiency of the existing Arrangements for the Care and Treatment of the Sick Poor in such Workhouses: And also, Copy of the Report of Dr. Edward Smith, dated 15th April 1867, and made in pursuance of the above-mentioned instructions, after visiting Forty-eight Workhouses situate in various Parts of England and Wales; together with the Appendix to such Report containing the Observations of Dr. Smith upon each of the Workhouses in question.—(The Marl of Devon.)

THE ARCHBISHOP OF YORK

thanked the noble Earl (the Earl of Devon) for the statement he had made, and said that he thought that the Reports which he had moved for would no doubt prove very important documents. In the interesting remarks he had made, the noble Earl had not, however, informed their Lordships upon what principle the forty-eight unions had been selected, but no doubt he would kindly give them that information. Another point of great importance was that these Reports would be much more valuable if they had been submitted to the respective Boards of Guardians, and their opinion obtained as to any action to be taken thereon. As to the investigation that had taken place at Bedminster, it appeared that the official Report was not submitted to the Board of Guardians, and as soon as they obtained it through some other channel, Sir Arthur Elton, the chairman, pronounced the Report to be most meagre and unsatisfactory. It was no doubt desirable that the different Boards of Guardians should have seen the Reports so that Parliament might be made acquainted with their opinions, and might know whether they meant to take any action. He believed that a good deal of the dissension between the guardians and the Poor Law Board had arisen from the character of modern workhouses not being appreciated; these workhouses were really hospitals, but they had not been conducted according to the known principles of hospital management. The greater part of the inmates were necessarily persons requiring constant medical care, and the guardians were not accustomed to the management of patients who wanted such treatment. And, again, without desiring to cast any reflection upon the Inspectors appointed by the Poor Law Board, he must say that these gentlemen were not always qualified to appreciate the wants of hospital patients, and the principles which should govern a well-regulated hospital. Thus, according to the practice in the best hospitals, at least 1,000 cubic feet of air should be allowed for every sick person, and paid day and night nurses should be employed when required. What they were now about to receive was not a Report of Inspectors, but a Report of an Inspector of Inspectors; and therefore it would be interesting to compare the ordinary Reports of the Inspectors of these workhouses with the extraordinary Report now asked for by the noble Earl at the head of the Poor Law Board. It gave him great gratification to hear that a measure on this subject would be introduced during the present Session—and he had no doubt that every one who took an interest in the subject would look forward to that measure with the greatest interest and anxiety.

THE EARL OF CARNARVON

said, that their Lordships had doubtless listened, as certainly he had, with great interest and satisfaction to the statement which had been made by the noble Earl at the head of the Poor Law Board. He agreed with the right rev. Prelate that it was worth the attention of the noble Earl to consider whether it would not be advisable to extend his Motion so that it should embrace the Reports of the Inspectors, to the production of which he could not see any possible objection. The noble Earl had gone into the question of the powers and authority with which the Poor Law Board was invested; and it was impossible to doubt, from what had fallen from him, that it was his deliberate conviction that those powers and that authority were not sufficient. If that opinion of the noble Earl were correct, and these powers were insufficient to carry out the ordinary requirements of decency and humanity, Parliament would not hesitate to grant such additional powers to the Board as would enable them to perform their duty to the satisfaction of the country. If the responsibility of supervising the workhouses was cast upon the Poor Law Board, it was only just that they should have sufficient power conferred upon them to enable them to discharge themselves of that responsibility. It would, of course, be premature to enter into a discussion of the reforms to which the noble Earl had referred, until after the production of the Report for which his noble Friend moved; but he could not help expressing his gratification at hearing the noble Earl's promise to give his full attention to this most important subject; and he hoped that the observations of the noble Earl were an earnest of really well-considered legislative action on the part of Her Majesty's Government. He used the phrase "well-considered," for no one could doubt for a moment that the work was one involving serious difficulties. Many, indeed, of the difficulties which last year had beset the reform of the metropolitan workhouses would have to be encountered in endeavouring to introduce reform into those of the provinces. It was absolutely necessary that there should be some classification of the inmates, for he believed it was the practice in many parts of the country to send persons to the workhouses as a pre- liminary step to sending them to the lunatic asylums, than which nothing could be more injurious, if not more fatal, to those who were mentally afflicted. It appeared from the last Report of the Poor Law Board that out of the 40,000 sick persons now maintained in various workhouses throughout the country, no less than 10,000 were said to belong to the insane, or partially insane classes. So, too, it would be necessary to inquire into the alleged inadequacy of the salaries and of the general powers of the medical officers of the workhouses. These were questions which had been taken into consideration in effecting a reform in the metropolitan workhouses, and they would be sure to arise in any attempt to reform the provincial institutions. On the other hand, some difficulties which existed with regard to the metropolitan workhouses, would not be felt in dealing with those in the provinces. Thus, in the provinces, land being often cheaper than in the metropolis, it would in many places be easy to secure large space and ventilation; and he also hoped that vested interests would prove less formidable in the provinces than they had done in the metropolis. Still, it must not be forgotten that the number of provincial workhouses was vastly greater than those which had been dealt with in the metropolis, and that therefore not only must the operations in dealing with the former be upon a much wider scale, but the expense involved would be far beyond that which had been incurred in improving the latter institutions. It had been stated that it would be impossible to find fit persons to undertake the supervision of the provincial workhouses; but if the right measures were adopted it would not be difficult to discover a sufficient number of well-qualified men in our country gentlemen, among whom there was an almost inexhaustible fund of experience and knowledge of local matters, and though it might be a task of greater difficulty, he did not despair of finding a sufficient supply of similar men in our provincial towns. In any steps that might be taken for the reform of these institutions he should also be glad to see the co-operation of private benevolence secured as far as possible—a co-operation which there was no real difficulty in regulating by, and subordinating to the necessary discipline of every hospital, and which experience had shown to be of the utmost service in those institutions. There was one point upon which the noble Earl had not touched, but which deserved the most careful consideration on his part. It had been clearly proved in the recent inquiries into the metropolitan workhouses that a certain combination of professional, technical, or, if they pleased, scientific knowledge was absolutely necessary in those who were intrusted with the inspecting and controlling of these institutions; and it was a matter for the serious consideration of the noble Earl how far he could extend to the provincial workhouses that scientific inspection which was already extended to the metropolitan district. No doubt, the inevitable result of such reforms upon the large scale now asked for must entail a considerable expense. The rates had been carried down almost as low as they could go—many of the payers of poor rates were, it was well known, but very little superior in condition to the recipients of parochial relief; and therefore it required great consideration and care lest while imposing fresh burdens on the rates upon the one hand they increased pauperism on the other. He must further confess he looked with great jealousy on any tendency to create large official establishments, apt to become unwieldy and unmanageable. He did not intend to criticize his noble Friend's administration at the Poor Law Board. A great deal of what his noble Friend had told them was urged in excuse of the course they had taken; but he must say that for many years past the conduct of that Board had been such as to appear, at all events to a general observer, dilatory, uncertain, irregular, and perhaps contradictory. They had recently witnessed a paralysis of all administrative action; they had seen in some of the most serious cases the spectacle of the central Board waiting for the action of the local Board, and the local Board waiting for the impulse which the central Board ought to have given; the result being that nothing was done. The Committee of the House of Commons which sat so long and published so many volumes upon this subject had reported in favour of strengthening the hands of the Poor Law Board. It was quite possible that that body should be strengthened; but he hoped when his noble Friend brought forward his Bill he would be able to show that they had made good use of all the power which Parliament had placed in their hands. Anxiously as he desired to see a great improvement, he was hardly so sanguine as to the result anticipated by the most rev. Prelate as to expect to see the work- houses throughout the country converted into first-rate model hospitals; but he did think it incumbent on Parliament, no matter at what expense or sacrifice, to save them at all events from the scandal of such cases as had recently come to light in two or three parts of the country, and to provide that, while an ample pressure or, even if they pleased, coercion was placed on the able-bodied paupers who would not work, a decent retreat should be afforded to the aged sick and infirm.

LORD HOUGHTON

was very glad that the noble Earl had shown that this question of workhouse hospitals had engaged his attention, and was likely to form the subject of future legislation. It was entirely a new question, and altogether separate from the ordinary conditions under which the Poor Law had hitherto been conducted and the poor rates collected. Great care must be taken, for if changes were rashly and inconsiderately made the effect might be to produce something not unlike a demoralization which existed in the old time, when the poorhouse was a place of resort for all kinds of idleness and improvidence. He hoped the noble Earl in any new legislation would guard against this danger. But, besides the question of danger, there was also the question of justice to the ratepayers. The poor rate, as now collected, bore so hard and descended so low that in many cases there was very little difference between those who paid the rate and the recipients of relief. It appeared to him that when they introduced the question of large hospital accommodation in connection with these institutions, it might also be a question for consideration whether it might be advisable to place a portion of the charge on the county rate or the Consolidated Fund. He ventured to suggest to the noble Earl that it was a very serious question whether this question should not assume a totally different character. That involved a very serious question of public justice. He would ask those who brought prominently forward particular cases of harshness, whether it was not very probable that the condition of the paupers if left at home would have been at least as bad as it had been found in the workhouses. It was an extremely difficult question, for there were two parties to be considered, the pauper and the ratepayer, and he hoped the noble Earl who was so worthily intrusted with the administration of the Poor Law Department, would be enabled to assure them that the measure he contemplated would be at once just to the ratepayer and humane to the poor.

THE EARL OF DEVON

said, in reply to the most rev. Prelate, that the Inspector of the district had visited the union more than once, and had brought the facts before the guardians previous to their being placed before the Poor Law Board. With respect to the Reports under Mr. Hardy's circular, he must consider whether it was desirable to lay them upon the table of the House, but his impression was that it might be advisable to do so. Perhaps his noble Friend would allow him a day or two to consider the matter. His noble Friend had referred to the question of the insane at present in workhouses, and to the practice of sending dangerous lunatics to workhouses for a short time previous to their being sent to the asylum. This was, of course, a very injurious practice, and wherever that system prevailed it was desirable that it should be checked. There was also another class of insane persons—those whom it was legal to detain in workhouses—who were not injurious to themselves or others. He believed it would be most desirable that that class should be withdrawn from the workhouses. His noble Friend had stated, and this was no doubt the fact in many cases, that the ratepayers themselves were little, if at all, raised, as to their pecuniary means, above the class whom they were called on to aid in supporting. He could only say that it would be the object of the Poor Law Board, in carrying out such improvements as may be necessary, to bear this in mind, and, as far as possible, to prevent or mitigate the pressure of unusual demands for rates, unless public considerations interfere.

Motion agreed to.

House adjourned at a quarter past Six o'clock, to Monday next, a quarter before Five o'clock.