Report from The Lancet


"This workhouse is admirably situated, and occupies a part of a large plot of land belonging to the guardians. The main body of the building occupies three sides of a parallelogram, and contains all the adult inmates, whether sick or otherwise. Part of it has been built many years, and additions have been made from time to time, and so injudiciously, that one part has nearly blocked up the windows of another part.
There are also large schools which, with the chapel, constitute a detached building ; and there is also a recently constructed iron house consisting of two rooms, in which the sick children are placed.

Cases of fever and small-pox are, for the most part, sent to the hospitals, but occasionally it becomes requisite to admit them, and a separate ward must be extemporized for their use. A few cases of venereal disease are admitted; and, on the men's side, they are placed in the itch ward, or in an adjoining ward, whilst the females are placed in a separate room. Violent and dangerous lunatics are not admitted except for the purpose of being forwarded to an asylum at the earliest moment. The inoffensive ones are retained, and occupy separate rooms.

There is no attempt to classify the sick into medical and surgical, or acute and chronic cases.

There are not any day rooms for the use of the sick, but there are some for the imbeciles. The lying-in ward is so small as to hold the labour bed only, and the cases are removed as soon possible to the convalescent lying-in ward. The latter, however, is not a day room, but a day and night room.

There is a kitchen in the sick ward where food is warmed, and chops and beef cooked, but the food must be carried, on the plates, more than 150 yards from the general kitchen. There are also three rooms where the washing-up is done.

The buildings are well drained. There is an abundant supply of good cold water, but hot water is not found upstairs except in the small boilers of the grates. There is only one fixed, and one portable bath.

There are 613 inmates, of whom 13 are able-bodied, 35 are imbeciles, and 119 are upon the books of the medical officer.

In the body of the workhouse, the usual height and width of the wards are 9 to 10 feet, and 16 to 17 feet. Hence the usual floor space and cubical space, are 41 to 59 superficial, and 395 to 590 cubic feet; and 13 of 21 wards do not offer 500 cubic feet, as required by the Poor Law Board. The itch ward is of very small capacity.
Nearly all the rooms throughout the workhouse are both low and narrow; but as there are windows on two or three sides, they are all light, and if properly coloured and furnished would be cheerful. The staircases and corridors are also very small and narrow, and give a very confined air to the whole building. Certain rooms in the basement and even on the ground floor, as the male and female foul wards, are dark and cheerless. The rooms in the iron house are not satisfactory.

The bedding throughout the workhouse is fairly good. It consists of flock placed upon iron bedsteads, with iron laths or sacking. The rugs are of wool, and of red colour ; and the bed coverings are good. There is in general, a great deficiency of furniture, and an aspect of bareness and want of comfort. There are rooms without a dresser on which to place the crockery. There are no lockers for the inmates, and scarcely any chairs ; and such as are there, are for the most part old and repulsive. The tables are very small; the benches are similarly small, and without cushions; there are no looking glasses on the men's side, and no prints. We did not see any illustrated periodicals. There are games, as dominoes and draughts. There are also screens in some of the wards, and there also chest and foot warmers in all the wards.

The plates used are of tin, and are old and repulsive. Tin pannikins are also used instead of pottery mugs. The buckets and other large utensils, and even the swill tub (emptied and cleansed daily) are placed in the lavatories. There is not one room which has been coloured, but all are whitened. The windows on the sunny side have green blinds.
Three towels are supplied twice a week to a ward; and there are also to each ward a metal washhand basin, two combs and soap ; but no hair brush is supplied to the adults.
The workhouse is generally clean; and with some few exceptions the linen and utensils are clean also.
Much pains have been taken to improve the ventilation of this workhouse. In nearly every room there are three sets of ventilators, viz., an Arnott's ventilator in the chimney; openings in the ceiling, which are covered with perforated zinc, and which communicate directly with the outer air, by air bricks in the walls, or shafts going through the roof ; and openings from the corridors and staircases, defended on the outside by metal, with large meshes, and on the inside by a wooden case which is intended to direct the current upwards.

There was also a system of ventilation by means of an open and perforated panel in the the doors; but it has been abolished by boarding up the perforated zinc. In one or two places pieces have been cut out of the top of the doors; and in a few windows these are perforated panes.

But, notwithstanding all this, the workhouse is very ill ventilated. When we entered a room in which the windows were not open, the air was close; and we were informed that in the early morning the air was very close. This is accounted for in several ways:
1. A majority of the ventilators are closed up; and many of the Arnott ventilators are tied up. The ventilators in the ceiling are covered with paper ; or have been covered by flannel, to prevent too great a current of air. The wooden protectors of the ventilators from the corridors interfere too much with the entrance of air.
2. None of the ventilators open immediately into the outer air. Those in the ceiling have the nearest approach to this ; and when the wind blows in certain directions, the outer air bricks, or the chimneys in the roof, permit too strong a current of air, and thus defeat the object of those who-placed them there.
3. They are not sufficiently numerous.
4. The corridors and staircases are too much enclosed, and are not the great ventilators of the wards, as they should be.
5. The rooms are too full of inmates.
But whatever care may be taken in this matter, the result can scarcely be satisfactory, with rooms so low and narrow, and with corridors and staircases so small and confined. It will be difficult to introduce a sufficient quantity of air by ventilators to keep the wards sweet, without allowing the current to be felt by those who occupy the beds; but with an improved system, an extended plan, and constant ventilation by day and night the temperature would not be raised, as at present; and the inmates would be less sensible of the admission of the outer air. The rooms in the basement, and the two lying-in rooms, were perhaps the most close of any perceived by us. The windows are, for the most part, made to open by swinging on a central pin, and there are open fire-places. There are only two paid nurses in the workhouse, one of whom has only, just been appointed. And it is intended that one shall have charge of the men, and the other of the women. The present superintendent nurse is also practically the midwife ; for although the medical officer is presumed to attend these cases, it frequently occurs that the labour is terminated in his absence. These receive 35l. and 25l. per year.

There is also a pauper nurse, and a helper, to each ward. Two men of this class receive 1s. and one 1s. 6d. each, weekly; and the woman who has charge of the receiving ward, with the itch cases, receives 1s. 6d. per week, besides extra food and stimulants. No special night nurses are appointed, except when any case is very ill. The matron distributes and administers all the wine and spirits, and the paid nurses are expected to give all the medicine.

The master is not dissatisfied with the present arrangement, and whilst the assistant to the medical officer does not think the pauper nurses truthful, he considers their conduct to be good, on the whole. He does nor think that any additional paid nurses are really necessary. There are, however, many important sick cases in the workhouse, which require attention during the night. The medical officer usually attends twice or thrice a week; and when an epidemic occurs he attends daily, or twice a day. His assistant attends at least twice a day ; and altogether about 1 to 2 hours per day are devoted to the duties. There are usually about 150 cases upon his books; and of them about 100 are sick ; but nearly half of them are placed upon his books, that they may obtain meat or beer, or both daily.
The salary is 130l. per year; and the medical officer finds his own assistant, and all drugs, except cod-liver oil, and quinine. There is no extra fee for midwifery, or vaccination; but 10s. 6d. is paid for each lunacy certificate. We were informed that, in his opinion, the guardians should provide drugs, pay extra fees for midwifery, and vaccinations, and give 150l. per year as salary. Subsequently we met the medical officer, and were informed by him that his salary should be 200l.

Photo:Hackney Union Infirmary, 1905

Hackney Union Infirmary, 1905

© The Builder Magazine

This page was added by Lisa Rigg on 06/10/2009.

If you're already a registered user of this site, please login using the form on the left-hand side of this page.