METROPOLITAN WORKHOUSE HOSPITALS.
MHE attention of the public having been directed to the treat- ' ment of the sick paupers in workhouse hospitals, particularly by the case of Daly at the Holborn and that of Gibson at the St. Giles's Workhouse, we are gratified to find that the Poor-Law Board are directing such inquiries to be made as will fully expose the defects of the present management, and suggest remedies for their removal. A Report has just been printed for the House of Commons which shows the condition of these hospitals, particu- larly in respect to the amount and nature of the accommodation, the sanitary arrangements, the character of disorders admitted for treatment, and the kind of nursing provided for their care.
With respect to the amount of accommodation, we find that of the Male Hospitals in the 35 Unions of the Metropolitan district from which correct returns were made, 10 were full, 3 were overflowing, and 13 had spare beds not exceeding 10 in number ; so that in 26 workhouses the hospitals may be said to be quite full. The Female Hospitals are somewhat less crowded ; in 7 cases, however, they were quite full, in 1 overflowing ; and we have heard that it is the practice to make up beds upon the floor in order to supply the extra accommodation thus required. Two workhouses alone appear to be provided with a large number of spare beds, and when we find that there are besides the sick in hospital 6,549 aged and infirm persons who require constant medical care, we cannot help thinking that many of these would be better in hospital, provided there was room for them.
In the next place, we observe that the kind of accommoda- tion is extremely defective. There are 461 wards, of which the cubic contents are given and the number of beds. In more than three-fourths the space allotted to each bed dees not exceed 600 cubic feet, whilst in 33 instances it is leas than 400 cubic feet. The regulation of the Poor-Law Board provides that each sick bed shall be provided with 500 cubic feet of space, but this regu- lation is evaded in 185 instances, showing the great necessity of placing these hospitals under competent medical inspection ; but it may be remarked that the provision of the Poor-Law Board is much too little. In the Army every hospital bed must have 1,200 cubic feet of space ; in the metropolitan charities, from 1,300 to 1,500 cubic feet is the very lowest estimate, whilst the wards of several contain 1,700 cubic feet, and one at least 2,000.
There is no poison so subtle or depressing as the emanations from the sick, and no remedy so cheap or so effectual as a large space and unlimited supply of fresh air. Cure is all but impossible, and convalescence is always retarded in confined sick wards, and it is to be feared that the enormous amount of chronic disease which incumbers the workhouse hospitals must be greatly increased from this cause.
There are at the present time not less than 6,400 sick in the workhouse hospitals, of which not quite one-third are acute cases susceptible of cure. As the ablebodied inmates form a proportion of only 13 per cent., there is scarcely any of this class who can be spared from the household duties which the large proportion of aged, infirm, and children necessarily entails.
What, then, are the means provided for nursing the sick? In 41 workhouses there are 71 paid nurses, but as 30 of them are employed at St. Pancras and Marylebone, there remain 41 nurses for 39 workhouses.
13 hospitals have no paid nurses, and 16 have only one each. In two of these the persons so returned act in the capacity of assistant-matrons, and have but little to do with the management of the sick, who are therefore committed to the care of paupers suffer- ing from old age or infirmity of some kind. There are 859 pauper nurses—of 11 employed at one place 6 are over 70 years of age, and one only is less than 50. Of 7 employed at another the majority are over 60, and they have charge of 83 beds, nearly all full, without any paid assistance whatever. Such a state of things surely cannot last in this civilized country. In Paris we cannot visit any quarter of the city, without being struck with the palaces which have been converted into hospitals for the incurable and aged. We have so neglected a great duty.
We have consigned the sick, aged, and infirm to workhouses, which were intended as a test to prevent imposition upon the poor-rates. They are no longer inhabited by the idle and dissolute, but by those whose age or misfortunes should entitle them to better fare. We hear that the Workhouse Visiting Society, which has for a long time past directed its attention to this important subject, has urged upon the Poor-Law Board the importance of placing those and similar hospitals under the inspection of competent medical men. Such inspectors are found necessary in the Army and Navy hospitals, and in asylums for insane. This department of the public medical service is the only- one not subject to medical control, and we cordially hope that the recommendation of the society will be speedily attended to.
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