«MEDICAL CARE IN THE WORKHOUSES IN BIRMINGHAM AND WOLVERHAMPTON, 1834-1914 by ALISTAIR EDWARD SUTHERLAND RITCH A thesis submitted to the University of ...»
majority of workers suffered breathing difficulties by middle age.40 The majority of manufacturing took place in workers’ homes, workshops and small industrial units and the majority of workers were skilled or semi-skilled.41 Birmingham was unique among the large centres of industry in the country in the number of small, independent
diversity of trades offered a degree of protection from economic cycles and many workers were able to switch trades within the metal industry. During the seventeenth and eighteenth centuries, Birmingham had few commercial restrictions and gained the reputation as a town of liberal principles, in regard to both trade and politics.43 Wolverhampton Poor Law Union was established at a meeting organised by the PLCs in September 1836 as an amalgamation of the townships of Wolverhampton, Bilston, Willenhall and Wednesfield. The guardians elected to the board were of a similar social background to those in Birmingham, namely manufacturers, shopkeepers and merchants, with occasional clergymen and medical practitioners. The union inherited a workhouse at Wolverhampton, which had been erected in the 1700s, a smaller one at Bilston to accommodate up to 50 inmates, and one in Wood Street in Willenhall, which at that time was in a very dilapidated state.44 In March 1838, there were 163 inmates in the first workhouse and 91 in the second. All were moved to a new workhouse erected in Bilston Road, Wolverhampton, on 7 October 1839 (Appendix W. C. Aitken, ‘Brass and Brass Manufactures’, in Timmins (ed.), Birmingham and the Midland Hardware District, p.363.
Hopkins, pp.10, 17, 144; Woods, p.178; A. Briggs, History of Birmingham, Vol. II, Borough and City, 1865-1938, London, 1952, pp.1, 5-6.
J. S. Wright, ‘The Jewellery and Gilt Toy Trades’, in Timmins (ed.), Birmingham and the Midland Hardware District, p.454.
Timmins, ‘The Industrial History’, p.211; Aitken, p.255.
www.wolverhamptonhistory.org.uk/work/the_workhouse, accessed 10 May 2011; The National Archives (hereafter TNA), MH12/11674, 2 April 1836, 27 August 1838.
I).45 It was designed as a hexagonal building in keeping with one of the model plans published in the second Annual Report of the PLCs and could accommodate up to 450 paupers.46 An auxiliary workhouse was opened in Wednesfield in August 1841, but closed after about 15 months.47 Wolverhampton was incorporated as a borough council in 1848, the largest in Staffordshire, and as a county borough in 1889. The town’s population in 1831 stood at 18,380, but it had doubled by 1851 and almost quadrupled by the beginning of the twentieth century.48 By comparison, Bilston, which had been designated a market town in 1824, saw an increase of only 66% from a base of 14,492. The much smaller towns of Willenhall and Wednesfield, with populations of 5,834 and 1,837 respectively in 1831, experienced huge population increases, in the latter due to the expansion of housing in the area of Heath Town in
1866.49 The erection of additional buildings at the workhouse could not keep pace with the increasing number of inmates towards the end of the century and a new workhouse was opened in Heath Town in September 1903 with accommodation for 1,301 paupers (Appendix J).50 There was no voluntary hospital in Wolverhampton until the South Staffordshire General Hospital opened in 1849 with 80 beds. After 1948, the new workhouse became the major general hospital for the area and was renamed New Cross Hospital.
As in Birmingham, the towns that made up Wolverhampton Poor Law Union relied on metal manufacturing as their industrial base. All except Bilston specialised in lock WALS, WC, 14 March 1838; Wolverhampton Board of Guardians’ Minute Book (hereafter WBG), PU/WOL/A/2, 27 September 1839.
The National Archives (hereafter TNA), MH12/11674, 30 November 1837.
WALS, WBG, PU/WOL/A/3, 22 July 1842; TNA, MH12/11675, 9 November 1842.
G. Barnsby, Social Conditions in the Black Country, 1800-1900, Wolverhampton, 1980, pp.3-4; T.
Cockin, The Staffordshire Encyclopaedia, Stoke-on-Trent, 2006, p.567.
WALS, Wolverhampton Journal (hereafter WJ), LS/L07/79, p.liv.
making, although many other small metal items, such as screws, bolts and guns were also produced. Wednesfield also specialised in vermin traps and Bilston in shoe buckles and enamelled trinkets. By way of contrast, Bilston saw the rapid growth of coal and iron mining in the first half of the nineteenth century. The best-known manufacturer of locks in Wolverhampton was Chubb, which developed a tamperproof lock.51 The staple trades of the town included tin-plate working and japanning, with the production of such articles as trays, coal vases and tea caddies.52 Bicycle production began in the mid-nineteenth century and the Sunbeam Company turned to car production in addition in the 1890s.53 The substantial diversification of trades within the metal industry, typically produced by small family firms, allowed workers to continue in employment when the popularity of particular items declined.
However, not all were so fortunate; for instance, J. P. Taylor of 10 Horsely Fields in Wolverhampton had been employed in the locksmith industry for a short period in 1835, but was unable to find another situation in the trade and applied to the LGB for support in obtaining a loan to set up as a tobacco dealer.54 In the next two decades, the Black Country towns experienced industrial unrest, with strikes by iron miners, puddlers and tinplate workers.55 Sanitary conditions in the towns were severely criticised, due to the lack of facilities for sewage disposal. They were worst in Bilston, where Bilston Brook was the only source of water, but was also used for dumping waste.56 The town experienced a severe outbreak of cholera in 1832 and ten years later, much of it remained undrained, with pools of green stagnant water J. C. Tildesley, ‘Locks and Lock-making’, in S. Timmins (ed.), Birmingham and the Midland Hardware District, pp.83-84.
H. Loveridge, ‘Wolverhampton Trades’, in S. Timmins (ed.), Birmingham and the Midland Hardware District, pp.117, 122.
TNA, MH12/11674, 21 March 1837.
C. Upton, A History of Wolverhampton, Chichester, 1998, pp.87-88; Cockin, p.597.
throughout.57 The Lancet described Wolverhampton in 1867 as a ‘dirty town’ where the roads were black with coal dust and ‘soot begrimes the houses and the people’.58 According to the historian George Barnsby, social conditions throughout the Black Country remained appalling throughout the nineteenth century.59 Birmingham poor law authorities played a major part in the provision of medical care within the town. By 1766, an infirmary wing had been added to the workhouse at a cost of £400.60 Its capacity is uncertain, but only 37 adult patients were being cared for in May 1785.61 Four years later, the accommodation for sick paupers was felt to be so inadequate that a detached building was approved and erected adjacent to the workhouse in 1793, as the ‘Town Infirmary’ at a cost of £1,475.62 By August 1818, 94 patients were being treated in the infirmary, the number increasing steadily to about 233 in 1847.63 New buildings were also erected in 1835 as the ‘Lunatic Branch of the Town Infirmary’. In April that year, the new buildings accommodated 36 ‘idiotic cases’ and patients suffering ‘mental aberration’, who would otherwise have been transferred to a lunatic asylum, but 25 insane women remained in their old apartments. As the workhouse’s role in the treatment of mental illness became more important, the number of patients had increased to 78 by 1847.64 This contrasts with another huge provincial urban workhouse in Manchester, which in 1841 housed 1,261 paupers with 268 in sick wards, but only ten lunatics.65 The first voluntary hospital, BPP, 1842 (006), p.15.
Anonymous, ‘The Lancet Sanitary Commission for Investigating the State of the Infirmaries of Workhouses. Country Workhouse Infirmaries. No. IV. Wolverhampton Workhouse, Staffordshire’, The Lancet, ii (1867), p.555.
BCL, BBG, GP/B/2/1/1, 6 June 1785.
BCL, BBG, GP/B/2/1/1, 23 March 1879, 3 June 1793.
BCL, BBG, GP/B/2/1/2, 11 August 1818; GP/B/2/1/5, 12 October 1847.
BCL, BBG, GP/B/2/1/3, 7 April 1835, 15 November 1837; GP/B/2/1/5, 20 April 1847.
the General Hospital, opened in Birmingham in 1779 (Appendix F) and the second non-specialist one, the Queen’s Hospital, in 1841, both providing care for the sick poor throughout the borough. Access to the former hospital was restricted for older residents of the parish as only six patients over the age of 60 years, out of a total of 127, were admitted in the first three months after it opened. Regarded as chronic cases, older patients would have been admitted to the workhouse infirmary.66 By the mid-nineteenth century, it contained 240 beds and the Queens’ Hospital 180.67 The infirmary for 310 inmates at the new workhouse in 1852 was described as ‘one of the finest in the country’.68 Medical cases were divided among a number of separate wards including those for common cases, convalescent patients, ‘idiots’ and epileptics. Detached buildings were similarly provided for fever, infectious and maternity cases (Appendix H).69 In keeping with most workhouses at that time, the erection of extra accommodation was necessitated by overcrowding, as a result of Birmingham parish’s population increasing by over one-fifth throughout the 1850s.
Illness was also an important factor, giving rise to the need for extended facilities.70 Cape Hill School was opened with 200 places for boys in 1864, alleviating some pressure on the institution and allowing the old school to be converted into an epileptic ward the following year. A more elaborate extension that same year added a further 340 places to the infirmary.71 In 1867, isolation wards were augmented when a shed was converted into a smallpox ward, and new wards for 200 old women J. Reinarz, The Birth of a Provincial Hospital: The Early Years of the General Hospital, Birmingham, 1765-1790, Stratford-upon-Avon, 2003, p.24.
G. Griffiths, History of the Free-schools, Colleges, Hospitals and Asylums of Birmingham, London, 1861, pp.165, 233.
BCL, Visiting and General Purposes Committee (hereafter VGPC), GP/B/2/8/1/4, 1 January, 16 December 1864; GP/B/2/8/1/5, 10 November 1865.
opened the following year.72 In 1868, The Lancet pronounced it ‘one of the best managed of all provincial workhouses’.73 The wards were not overcrowded at that time, with the exception of one ward holding 25 insane patients. However, in later years, overcrowding became so persistent that the guardians decided in 1885 to erect a new separate infirmary building adjacent to the workhouse. It opened four years later with a capacity of 1,511 beds, only 990 of which were in the new pavilion-style building, while the remainder were in some of the old infirmary wards. The new building consisted of nine three-storey blocks set on alternate sides of the main corridor, which was almost a quarter of a mile long (Appendix G).74 The surgical wards and operating room were on the ground floor, while those for patients with chronic conditions were located on the third floor. Separate blocks were constructed to give four wards for 24 patients with infectious disease. By March the following year, the new infirmary was almost fully utilised, with 1,286 patients accommodated.75 The development of the infirmary into an acute general hospital has been described by one of its former consultant physicians, George Hearn, although this is a traditional, progressive account written to celebrate the institution’s centenary.76 By comparison, Wolverhampton’s medical service for the poor developed after the setting up of the union. According to Barnsby, no Black Country workhouses had separate infirmaries when they were built and sick paupers were scattered throughout Ibid., GP/B/2/8/1/5, 27 July, 10 August 1866.
Anonymous, ‘Dr. Edward Smith’s Reports on the Treatment of the Sick in Selected Provincial Workhouses’, The Lancet, i (1868), p.166.
H. Richardson, English Hospitals, Swindon, 1998, p.72.
BCL, BBG, GP/B/2/1/59, 7 May 1890.
G. Hearn, Dudley Road Hospital, 1887-1987, Birmingham, 1987.
the buildings.77 Although the new union workhouse in Wolverhampton did not have a separate infirmary, there were infirmary wards and ‘infectious wards’ (Appendix I).
In 1842, the former could hold 28 men and 25 women and the latter six of each sex, accounting for 23% of total beds.78 Thirteen years later, the male sick wards had been enlarged to accommodate 45 patients, but those for women remained unchanged.79 By 1867, additional sick wards had been built, so that the infirmary consisted of a series of buildings of various ages and ‘degrees of fitness’.80 When pressure for additional space occurred in the late 1880s, Wolverhampton guardians, following a visit to the cottage homes in Birmingham, decided to erect a similar provision. As a result, 240 children were moved out of the workhouse in November 1890.81 By this time, the number of beds in the wards for the sick had increased to 273.82 The equivalent wards in the new workhouse, erected at New Cross in Wednesfield in 1903, could accommodate 196 men and 150 women (Appendix J). Little further information is available in the literature regarding these workhouses or the evolution of the last one to become a general hospital, New Cross Hospital.83 Despite being similar industrial towns, there were differences in the structure of their populations that would influence poor law services. For instance, the overall pauperism rate for Wolverhampton was around double that for Birmingham from 1881 for three decades, although Wolverhampton’s rate did not follow the reduction Barnsby, p.115.
WALS, Master’s Journal (hereafter MJ), PU/WOL/U/2, 16 April 1842.
TNA, MH12/11682, 27 October 1855.
Anonymous, ‘The Lancet Sanitary Commission for Investigating the State of the Infirmaries of Workhouses. Country Workhouse Infirmaries. No. IV. Wolverhampton Workhouse, Staffordshire’, The Lancet, ii (1867), pp.555-56.
WALS, WBG, PU/WOL/A/22, 13 January 1888; PU/WOL/A/23, 7 November 1888, 4 November 1890.
BPP, 1890-91, (365), p.11.
One of the few studies available is D. E. Wood, ‘The Poor Law in Wolverhampton 1870-1900’ (unpublished BA dissertation, The Polytechnic: Wolverhampton, 1986).