Medical care in the workhouses in Birmingham and Wolverhampton, 1834-1914

This study of the medical role of the urban workhouses of Birmingham and Wolverhampton after the New Poor Law addresses the following questions: what were the standards of medical and nursing practice and what treatments were used to alleviate inmates’ suffering? It considers the nature of illnesses encountered covering acute non-infective illnesses, infectious disease and chronic disability, and highlights the important role the workhouse played in providing institutional care, especially in the isolation of epidemic diseases. Birmingham workhouse had a well-developed medical service prior to the New Poor Law and this continued until the mid-nineteenth century. By comparison, Wolverhampton workhouse did not meet satisfactory levels of medical and nurse staffing until near the end of the century. The study provides a new perspective on medical care in workhouse infirmaries by showing how standards varied over time within the same institution and how medicalisation of the workhouse began in the early years after the New Poor Law. Medical care in workhouses has been viewed as important only in the context of the development of the National Health Service but this study demonstrates that it provided significant, and at times high quality, medical treatment for the poor

'Sick, aged and infirm': adults in the new Birmingham workhouse, 1852-1912

This study has explored the role of a large urban workhouse and its separate infirmary in Birmingham in the provision of indoor medical care for adult paupers between 1852 and 1912. Due to the difficulty in distinguishing between the medical and social care of older people, it has examined the provision for all older inmates. Birmingham guardians were forward thinking in appointing resident medical officers and paid nurses earlier than other unions, but retrograde by continuing to apply the workhouse test to sick patients longer than others. Workhouse medical officers in Birmingham worked long hours, provided care for many more patients than doctors in voluntary hospitals, and stayed in post for an average of four and a half years. Nevertheless, some strove to provide high standards of treatment. Patient narratives have been identified, showing that positive experiences of medical care did occur. Despite being the largest group of adult inmates, older people were relatively neglected compared with able-bodied inmates until the later part of the nineteenth century, when better standards of living were introduced. The development of the infirmary into an acute hospital created conflict between the two institutions and resulted in the workhouse’s role being limited to the care of patients with chronic conditions