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Popular Myths about the Workhouse

Myth 11 - Workhouses were unhealthy places.

Workhouse medical care evolved enormously during the nineteenth century. The union workhouses that were established following the 1834 Poor Law Amendment Act always had an infirmary of some sort, together with a fully qualified medical officer to provide medical care for the inmates. However, workhouse infirmaries at that time were often cramped and badly ventilated. Medical officers were poorly paid — thus attracting less able or experienced practitioners — and any medicines they prescribed had to be paid for out of their own salaries. Nursing was usually carried out by elderly, and often illiterate, female inmates who were frequently drunk through imbibing the daily ration of beer they usually received for performing the work, or by illicitly snaffling some of the alcohol-based drinks or medicines prescribed for the patients. Conditions were particularly bad in London, where many pre-1834 workhouse buildings had been kept in use rather than erecting new ones which was the more common practice in other parts of the country.

Following a campaign to improve medical care in the capital's workhouses, spearheaded by the Lancet medical journal, major improvements were instituted. London's workhouses had to place their infirmaries under separate management and, ideally, on separate sites. Many new workhouse infirmaries were erected and, largely thanks to the efforts of Florence Nightingale, trained nurses were increasingly employed. These changes were gradually taken up by workhouse authorities in the rest of the country. New workhouse infirmaries built from the 1870s onwards were often state-of-the-art establishments and amongst the best facilities in the country. In 1905, Hammersmith's new workhouse and infirmary proved so expensive that it virtually bankrupted the Hammersmith Guardians.

By the 1880s, workhouse infirmaries were increasingly treating non-inmates who were too poor to pay for medical care, effectively becoming local public hospitals for the poor. In 1948, this principle of free care was inherited by the new National Health Service, with a large portion of its real estate comprising former workhouse infirmaries.

Hammersmith new workhouse and infirmary, 1905. The infirmary (at the front) is much bigger than the workhouse accommodation at the rear. © Peter Higginbotham

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