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BMJ Reports on the Nursing and Administration of Provincial Workhouses and Infirmaries, 1894-5.

In 1894-5, the British Medical Journal — as part of a campaign to improve the nursing and medical facilities in workhouse infirmaries — conducted site visits to around fifty workhouses in England and Wales. Below are extracts from their report on the East and West Flegg union workhouse.


On the edge of Ormsby Broad, among the water ways of Norfolk, stands the quaint old workhouse of the East and West Flegg Union. It dates from 1777, a relic of the past left high and dry above the receding tide of population, which has swept away from its walls to distant towns and cities. The house is in Rollesby parish, and serves a union of twenty parishes. It was built to accommodate 400 inmates, but on the day of our visit there were but 40, including the sick.

The house, with its rough-cast walls and generous overhanging eaves, beneath which the windows look out over the expanse of the Broad, has a somewhat foreign aspect from a distance. Its arrangements are in keeping with the structure, and it lacks all modern conveniences; no water is laid on to any part of the house; all hot water is conveyed from a copper in the laundry. The drainage is carried by pipes into a field at some little distance. The wooden staircases are steep, and, in most instances, lead directly from the lower room to the upper.

The old and infirm are in the house; none of them were in bed. The old women were in their day room on the ground floor; the sun was flooding the room, and with the open fire, round which they were seated on benches or in armchairs, there was an air of home-like comfort. A flight of stairs from the room led to the dormitory above. There is the same arrangement for the old men, but there was only one inmate, and he was gardening. Commodes are in use in the dormitories.

The lying-in ward is in the house, on the first floor, close to the matron's apartments. There were five beds in the room, one of which was occupied by a mother with a fortnight-old baby. The women are kept here a month, until they are quite strong. There is an earth closet in a recess for the use of this ward; it appeared to us to be too close to the ward from a sanitary point of view, but in justice to the management we must say that there has only been one death in twenty-three years. The matron is responsible for the after-care of the women; there is a midwife (not certified) in the village„of Rollesby, and the medical officer attends all confinements.

The infants are in the able-bodied women's room. There were two of them in the care of an imbecile; their mothers feed them, and have them to sleep with them at night. We asked the matron if she were not afraid of trusting these mites to the uncertain temper of an idiot, but she said that she had never found her unkind to them, and that there was really no choice, as able-bodied labour was very scarce in the house; there were only three women available for the work, including that of kitchen and laundry, and all the men are old. Still the arrangement is not one to be commended. The elder children are in the charge of the schoolmistress.

The sick house is at some distance from the workhouse, on the other side of a field. It holds sixteen beds, nine male and seven female; these are all occupied in the winter, but there were only six patients when we visited. One man was placed in a separate ward because he was slightly deranged; this ward, holding two beds, opened out of the day-room. The other male patient, an infirm old man, was amusing himself with a little gardening in a nice small garden attached to the sick house. The four female patients were in their day room. The men's rooms are on the ground floor, and the women's upstairs. A nurse (not trained) is placed in charge of this department. We found her at work in her own apartment, which is in the sick house in the women's side, and a little apart from the "slightly deranged" male patient. The bedding is straw in all parts of the house, and the beds appeared well filled.

The cheerless appearance of these rooms, especially those of the women, with the washed walls and meagre furniture, was very marked, as contrasted with the old peoples quarters in the house. The women were gathered round a cold fireplace, the nurse having neglected to light the fire, as she had been instructed to do. Little sun seems to come into this room, and the poor creatures had little to divert them.

On the ground floor, opposite the nurse's room, was a scullery, in which, as the door was opened, we perceived a bad smell coming from a sink pipe, in which, as the matron pointed out, there should have been the wooden stopper. This pipe went into the drain which carried off the waste to the field. A few shillings would be well spent in cutting that pipe, and discharging it over a gully, when the wooden stopper may be forgotten with impunity. At present the sink is quite insanitary. There are no fixed baths, but the long movable baths are in use, for which the hot water is carried from the laundry copper. There is a pump outside the sick house, and we were informed by the matron that the water supply is good.

The medical officer lives in an adjoining village, scarcely a mile away; he visits the patients twice a week. The sick diets are arranged by him in conjunction with the matron. The food is sent over to the sick-house in portions, in a covered tin, from the house kitchen. We met the tin on its way; it contained boiled meat and potatoes. The cooking is done by an inmate.


The sick house was quite suitable for its purpose; but there appeared to be a lack of consideration on the part of the nurse, and we thought that more might be done to make the rooms, especially for the women, more cheerful and comfortable. The sink pipe should be disconnected and made sanitary. and we should advise a supply of earth closets for the house and sick house. We would also suggest that some other method of caring for the infants be found than employing the services of an idiot. Again we would urge on the authorities the possibility of making a country union infirmary the centre of the medical relief for the poor of the district.

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