VICTORIAN WORKHOUSES: THE MEDICAL OFFICER

I really enjoyed the first episode of the BBC’s new series of A House Through Time, presented by historian David Olusoga. Ravensworth Terrace in Newcastle is a beautiful Georgian house and the researchers and producers have done an amazing job in uncovering the stories of the people who lived there. I was particularly interested in the surgeon/doctor Nicholas Hardcastle, who was also the medical officer at Newcastle Union Workhouse. His competence was called into question several times; the first complaint about the non-treatment of children with ‘the itch’ (scabies) was made not long after his appointment in 1854. A more serious charge was made against him in 1887 when his treatment of scarlet fever patients was criticised; this led to Nicholas’s resignation as the workhouse medical officer but did not adversely affect his career in private practice or his other role as gaol surgeon.

When I researched Life in the Victorian and Edwardian Workhouse and Tracing Your Medical Ancestors: A Guide for Family Historians, I discovered that complaints about workhouse medical officers and those who looked after the poor in the various districts were fairly common. These men were publicly accountable and whenever there was an alleged case of neglect or incompetence, the guardians of the relevant poor law union undertook an investigation to uncover the truth. As it was a matter of interest to the ratepayers, local newspapers reported on the inquiries. You can read about cases in your area by searching The British Newspaper Archive.

Applicants for the post of workhouse medical officer and district medical officer needed a diploma or degree as a surgeon from a Royal College or University in England, Scotland or Ireland. In addition, they needed a degree in medicine or a diploma or licence of the Royal Physicians of London or a certificate to practice as an apothecary from the Society of Apothecaries of London. They could also apply if they had been in practice as an apothecary on 1 August 1815 or if they had a warrant or commission as surgeon or assistant-surgeon in Her Majesty’s Navy, Her Majesty’s Army or the Honourable East India Company prior to 1 August 1826.

People Queuing at St Marylebone Workhouse, circa 190. (Credit: Wellcome Collection)

The main duty of the workhouse medical officer was to medically examine the paupers as they were admitted to the receiving ward. If any paupers were found to be ill, he had to direct the master to send them to the sick ward; the medical officer would then oversee their treatment. He also had to decide if those of unsound mind were fit to stay in the workhouse, or whether they were too dangerous to themselves and others, and therefore should be sent to a lunatic asylum. In addition to these duties, workhouse medical officers had to issue medical certificates for every sick pauper, record the death of anyone who died in the institution and keep meticulous records regarding the dietary of sick paupers

The district medical officer also had very specific duties. He was to ‘attend duly and punctually upon all poor persons requiring medical attendance within the District of the Union assigned to him, and according to his agreement to supply the requisite medicines to such persons…’ It was important that he only attended paupers ‘with a written or printed order of the Guardians, or of a Relieving Officer of the Union, or of an Overseer.’ Like the workhouse medical officer, he also had to keep meticulous records for the guardians of the medical relief he had provided and make sure he informed the relieving officer of ‘any poor person whom he may attend without an order’.

Throughout the nineteenth century and into the twentieth, the guardians of poor law unions relied on the workhouse medical officers to supply drugs for the inmates from their own salaries. This was an extremely contentious issue and medical officers often recommended extras like food and beer to provide nourishment for the sick paupers under their care. As these extras were part of the workhouse diet, they did not have to be funded from the medical officers’ own pockets.

Old Men’s Ward in a Workhouse (Credit: Wellcome Collection)

The main problem faced by medical officers for poor law unions was that they undertook their roles alongside their private practice and other posts in public service. Yet their duties were seemingly never-ending, leading to many cases of alleged neglect. For my books, I looked at the career of John McNab Ballenden who was born in Stromness, Orkney in 1813. The Medical Register records that he became a Licentiate of the Faculty of Physicians and Surgeons of Glasgow in 1847. He obtained his MD from the University of St Andrews in 1850 and became a Licentiate of the Society of Apothecaries in London in the same year.

It’s not known why John chose to settle in Staffordshire but he commenced general practice in Sedgley and raised a family there. The Medical Directory states that he had a number of additional appointments. He was a member of the Hunterian Society, a Poor Law Medical Officer, a Police Surgeon, a Certifying Factory Surgeon and a Medical Referee for the London & Liverpool Assurance Society. As a police surgeon, John was regularly called upon to offer his professional opinion about suspicious deaths and to carry out post-mortems, the results of which were reported in local newspapers.

John’s long association with the Dudley Poor Law Union began in November 1859 when he was appointed Medical Officer for the Upper Sedgley District (also known as No. 1 District). He had the difficult task of visiting paupers in their homes to administer medical relief across a wide, geographical area, at the same time as attending to patients from his own practice.

In April 1877, it was alleged that John had neglected his duties by ‘not having given proper Medical Attention to…Mary Edwards during her confinement’ and that she died as a result. The guardians suspended him while investigations were carried out. An inquest into Mary Edwards’ death confirmed she ‘died from exhaustion, consequent upon the weak state of the Heart, the laceration of the peritoneum and Vagina consequent on the cross-birth and protracted Labour’. 

John McNab Ballenden wrote to the guardians explaining his actions:

‘I prescribed some opium Pills, and gave a Saline mixture with Tartrate of Antimony, and left the case in charge of a midwife, to whom I gave the necessary directions, and told her if any alteration took place, to send for me again. Having had a very extensive midwifery practice extending over many years and amounting to about 9000 Patients, the case presented no difficulty to me, it was one requiring time, and medicine to allay irritation and help natural relaxation… During my evening Surgery hours I had been told that another Doctor was attending Mrs Edwards…’

If he had returned to attend to Mary Edwards, John had intended to carry out a craniotomy procedure, something he termed ‘breaking up the child’. He explained: ‘I would not when it is necessary hesitate to sacrifice the child to save the Mother…Any man of experience with common sense would say in such a case, use every means to increase the natural dilation and diminish the bulk of the object to be passed through’.

The guardians were satisfied with his explanation for not attending Mary Edwards a second time and his suspension was removed. He continued as the district medical officer for the First Sedgley District until 1894 when he resigned due to ill-health and infirmity, dying the following year. In his obituary, the guardians of the Dudley Union Workhouse described him as the ‘oldest officer of the union who discharged his duties very satisfactorily’.

Obituary for John McNab Ballenden, 1895 (Dudley Herald)

This will be my last post for a few weeks as I take a break over Easter. I will return to Victorian England in early May – see you then!

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VICTORIAN BOARD SCHOOLS: EDUCATING THE MASSES

Like most things in Victorian society, the type of education children received depended very much upon the social class they belonged to. While sons of the wealthy were educated at public schools, their daughters were taught at home for a limited period by a governess. For parents who could afford it, there were ‘dame’ schools usually run by a mistress in her own home who took in a number of children. This service was similar to child-minding and children attending often learned very little, in many cases being left to their own devices.

Working-class children probably learned more at Sunday schools which were first introduced in the 1780s. For children who worked during the week, these schools provided the only education they received in literacy, numeracy and instruction in the Bible. 

There were also ‘ragged’ schools providing free education specifically for the poorest children and orphans. First introduced in 1818, these developed quickly after the Ragged School Union was formed in 1844. From 1833, children working in factories were to be provided with two hours of schooling each day, although this was not always adhered to. This was extended to three hours a day from 1844.

The Lambeth Ragged School, 1846 (Source: Library of Congress)

Education was also provided in industrial schools for vulnerable children, who were at risk of becoming criminal offenders, especially after 1857. In addition, child inmates in workhouses were given schooling to help them escape from the cycle of poverty.

Before the landmark Elementary Education Act of 1870, most schools for ordinary children were provided by religious organisations. The largest was the National Society for Promoting the Education of the Poor set up by the Anglican Church in 1811. It founded National Schools to teach poor children reading, writing, arithmetic and religion. By 1860, it owned around 90 per cent of all public elementary schools in Britain, catering for about three-quarters of pupils.

Another organisation – the British and Foreign Schools Society – was founded in 1814 and established British Schools on behalf of the Non-conformist churches. There were also other denominations running schools such as the Catholic Poor School Committee and the Wesleyan Methodist Education Committee. All these schools were established through public subscriptions, not through rates. They usually charged a few pence per week per child.

From 1833, the government started providing supplementary grants for schools; it was a condition of receiving a grant that annual inspections were undertaken. The standard of education varied enormously across the country, partly because the National and British Schools used variations of the monitorial system. Under this method, there was just one teacher in charge with ‘monitors’ drawn from the older pupils, who taught groups of between eight and twenty younger ones. This meant that very few children were taught by a qualified teacher. Huge numbers were not being educated at all because there was an insufficient number of places, especially in the cities. In Leeds, Birmingham, Manchester and Liverpool, less than a fifth of children were receiving an adequate education. It was impossible for the religious organisations to open sufficient schools because of the ever increasing population.

Waiting for Free Meals (from Living London, 1901)

In 1870, the Elementary Education Act was passed to address the issue. Under the new legislation, school places were to be provided for all children aged between five and 12 in a school run by a qualified headteacher. To achieve this, the voluntary religious organisations were given six months to increase their provision. After that time, in districts where they were unable or unwilling to fill the gaps, ‘School Boards’ made up of elected members were set up. They had the power to build and control board schools in their district which were to be non-sectarian and paid for by rates.

Education provided in these schools was not free and the fees varied between one and four pence a week. However, school boards could waive fees for parents who were genuinely too poor to pay. For many parents, sending their child to school meant the loss of an income for the family, so attendance continued to be sporadic especially at certain times of the year such as harvest or the hop-picking season.

In the new board schools, the use of pupil-teachers was the preferred teaching method. Under this system, older boys and girls over the age of 13 were apprenticed as pupil-teachers to assist in class and after five years, they could become teachers themselves following further training.

What was it like for a child to attend a board school? The day usually ran from 9am to 12 noon, followed by a break for two hours when most children went home for a meal. The afternoon session started at 2pm and finished between 4 and 5pm, depending on the season. In addition to reading, writing, arithmetic and some religious instruction, other activities might include singing, physical training in the form of drill exercises or the ‘object lesson’, which was especially useful for teaching science. Classes were large and more than 100 children could be taught in one room.

Paper and ink were expensive so most work was done on slates. Daisy Cowper attended school in Liverpool in the 1890s. She recalled: “One horrid thing about those days was the use of slates…it was disgusting to see them being cleaned by spitting and rubbing with a slate-rag; if no slate-rag was to hand, the bare wrist would serve!” *

Afternoon Assembly (from Living London, 1901)

Between 1862 and 1897, children were subjected to the ‘payment by results’ system. This was brought in to raise standards and schools could lose part of their grants if insufficient children attained the expected grades in the three Rs. They also needed to show a satisfactory level of attendance. Schools were tested annually by a government inspector, which was stressful for both teachers and pupils.

Originally introduced under the Revised Code of Regulations in 1862 and revised again in 1872, there were six Standards of Education relating to reading, writing and arithmetic through which children were meant to progress. For example, in Standard III, pupils were expected to read a short paragraph from a more advanced reading book, write a sentence slowly dictated once by a few words at a time from the same book, and to carry out long division and compound rules relating to money.

Children could not, for instance, be promoted to Standard IV if they failed to pass the criteria for Standard III. Many children left school without having attained Standard VI, which is unsurprising given the problems associated with sporadic attendance. The Standards roughly corresponded to ages between seven and 12.

Charles Cooper attended Walton School in the West Riding of Yorkshire in the 1870s and 1880s:

“It was a cruel system…Children were not regarded as mentally deficient. The idea was that every child could do the work if he tried hard enough. And he was made to try by threat of punishment. For reading, the same books were used year after year until they were ready to fall to pieces…For writing, Copy Books were used and the correct holding of the pen was insisted upon…Blots and finger marks were punishable by cane…In arithmetic the addition and subtraction of simple figures came first and more difficult examples were gradually introduced…this type of work included boys and girls, but in the afternoons when the girls were sewing, the boys would work from cards.” *

‘Payment by results’ placed undue emphasis on the three Rs at the expense of everything else. It was watered down slightly from 1871 when grants could be awarded for passes in ‘specific’ subjects in higher Standards including history, geography and geometry. From 1875, these grants were extended to passes in ‘class’ subjects across the Standards such as history, geography, grammar and needlework for girls.

Charles Cooper’s school “consisted of one large room, with no partition or classrooms, in which upwards of a hundred boys and girls were taught in Standards 2, 3, 4, 5, 6 and 7 by the Head Master and two Pupil Teachers, in mixed classes…Opposite the school, across the road, was a laundry used for training poor and needy girls…A part of the laundry was used by the Infants. Here the Infants and Standard 1 were taught by a Mistress, assisted by a girl from the Orphanage.”

Discipline was harsh in Victorian schools and the cane was regularly used to punish even slight misdemeanours. Daisy Cowper remembered a headmistress who “would bring her beastly cane on the palms, one on each hand, with such a full-arm action and sickening thwack that I was terrified that the hand would drop off at the wrist, and lie there, cut off, on the floor! I could easily have been sick!” *

Playtime (from Living London, 1901)

The Elementary Education Act was particularly successful in London where between 1870 and 1902, over 400 new board schools were opened. However, nationally, by the end of the nineteenth century, more children still attended denominational schools than board schools. In 1895, there were 2.4 million at voluntary schools and 1.9 million at board schools.

Education was still not compulsory so sporadic attendance remained an issue. Nor was it free, so it was difficult for poor families to send their children to school. It was not until 1880 that education was made compulsory for children up to the age of 10; the school leaving age was raised to 11 in 1893 and to 12 in 1899. The ‘school penny’ was finally abolished in 1891, making education free for all who attended public elementary schools.

*Extracts from the memoirs of Daisy Cowper and Charles Cooper can be found in John Burnett’s Destiny Obscure (see the Books & Resources page).