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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 St George Hanover Square workhouse.

ST. GEORGE HANOVER SQUARE.

Though it retains its old name, this workhouse now serves the parishes of Westminster and Chelsea as well as that of Hanover Square, and has incorporated into itself the old Chelsea house called "Little Chelsea." It has accommodation for about 2,000 inmates; the infirmary is adjacent, and communicates by a covered corridor with the chapel which thus serves the two buildings.

Classification is almost impossible, as the quarters are crowded; on the female side smaller day rooms and better airing courts enable the authorities to keep the older and better-class women from consorting in the daytime with the worthless and ill-conditioned, but the crowded state of the dormitories must go far to nullify the good effect of better classification by day; the master seemed to feel the hopelessness of his task under present conditions.

The building is another instance of the style known as "patched," and still there is a cry for more room. The house is built in blocks, of which the upper floors are connected by bridges; the old part consists of four blocks, and the newer part is in the same style. There are single bedrooms for the married couples, with a cheerful day room common to all; here we saw the men playing games, and the women were mostly occupied with needlework. Near the entrance is the probationers' ward, where the new comer is detained until classified by the medical officer.

The old and infirm are located in separate blocks; there were 60 in the male wards and 153 in the female. For these there are two nurses, with pauper help, and there is one nurse at night, also assisted by paupers. We were glad to learn from the master that the guardians contemplate increasing the staff, for, though the inmates are not sick, they require in many cases as much assistance as children, and it is useless to expect attendance from the pauper helps. There is no doubt that the cunning old hands levy contributions from the helpless before rendering service. The system is hopelessly wrong; it is not the fault of the officers, who have far more work on their hands than they can properly execute, and adequate supervision is impossible with the present proportion of administrators to administrated. And in the meantime those who know the conditions are aware that the practice of setting one pauper to tend and control another is responsible for much petty tyranny, and even absolute cruelty, which can never be exposed and punished.

On visiting the dormitories we found them in possession of the cleaners, who were endeavouring to eradicate the vermin by burning out the nests and eggs in the interstices of the bedsteads. The old frame of the bedsteads must be favourable to the propagation of these pests, and it seemed to us that until they were discarded for others of a more modern make, which will take to pieces and wash in chloride of lime, the wards will still be infested, especially as the old building is also likely to harbour vermin in the joints of the floors and woodwork.

The wall surface is of painted brick. Some of the ventilators consist of a square piece cut out of the ceiling, hanging from cords, which are presumably attached to some framework in the roof. They looked somewhat dangerous, as there was no means of ascertaining the state of the cords. In other wards the ventilation was supplied by the upper sash of the window.

The nursery is a cheerful and pleasant room, but it is badly situated, since the children must mix with the able-bodied in the airing court on to which it opens. Girls of 12 or 14 years of age are detained here when from any cause they are in the workhouse, and this arrangement ought not to be tolerated for a moment. Two trained nurses are in charge of this department, and the mothers come to suckle their infants; otherwise they only visit the nursery on visiting days. We were sorry to see the tube feeding bottle in use, and would recommend that the old-fashioned boat-shaped bottle should be substituted for it. Another desirable improvement is the provision of a metal-lined receptacle for the soiled napkins which are waiting removal to the laundry.

The lunatics have a small self-contained department of 8 beds for each sex, under the charge of an attendant. The padded room is very good. Here are detained the patients waiting removal, and also those whose noisy habits render them unfit to be with the sane. We were surprised to notice that neither here nor in the epileptic wards were any special beds provided; the narrow beds with unprotected sides seemed hardly safe for such patients.

The sanitary and lavatory arrangements were undergoing alterations. On the female side there are fixed basins outside the dormitories with hot and cold supply; on the male side the fixed basins are out of doors, with the result, as the master said, that the old men do not wash in cold weather, or they make use of the chamber utensil in the dormitory. The old women, as we were informed by an inmate, preferred to make this use of the chamber vessel instead of that for which it is intended; we can understand that among this large number of paupers, many coming from the very lowest class, there will be some who, if left to themselves, will show every trace of the state of savagery out of which they have come, but we do not see the necessity of the workhouse lowering itself to their level.

The sanitary arrangements are weak, baths few and not well placed; that for the infants and children appeared to us to be too deep, but already the engineers were at work turning the place upside down, so that it was not easy to gain a clear idea of details.

The laundry is of ancient construction, small and ill-found; when we consider that from 16,000 to 17,000 pieces pass through the laundry in a week we wonder that the task can be accomplished at all. The mangles are turned by hand, the washing machine is small, there is only one wringer, the drying closets are small, there is no callender, indeed no machinery to speak of. The small room for counting the soiled linen is dark and ill-ventilated; the folding and ironing are carried on in a recessed room off the drying room. For all these defects there is but one remedy — to build a new laundry; and we trust that the guardians will put that matter in hand without loss of time.

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