The Lancet Reports on Country Workhouse Infirmaries, Farnham.

FARNHAM (NEAR ALDERSHOT.)

THIS report will, we fear, be a "sensational" one. We regret that it should be so, for the task of writing such a paper is unpleasant to a degree that no one can appreciate who has not, like ourselves, had to experience the pain of condemning the conduct of officials who are probably only half-conscious, if conscious at all, of the mischief their own negligence has caused. We can only say, in deprecation of the annoyance which our statement is likely to cause to the guardians of the Farnham Union, that the exposure of the simple facts is all that we intend; and that this, in some shape or other, was as inevitable as, in the public interest, it is certainly desirable.

The Farnham Union Workhouse is a perfect marvel of bad construction for any purpose, whether of simple dwelling, or still more of the housing of sick persons. It consists, firstly, of a main building (an old-fashioned pile, which has apparently been a residence of the better class, and is now occupied by the master's apartments and certain offices, and by dormitories for the "able-bodied"); secondly, of an infirmary (two-storied), at the other extreme of the buildings; thirdly, of a two-storied block, devoted to so-called "fever wards;" fourthly, of a range of miserable one-storied buildings (running parallel to the fever wards, and forming, with them, the third and fourth sides of an incomplete quadrangle), which contain a nursery, a ward for infirm women, a laundry, and other offices; fifthly, of a block of buildings in the centre of the quadrangle, containing the dining-hall and, beneath it, the kitchen. Outside the buildings there is a considerable space of garden-ground, which is very properly applied to the production of vegetables for the consumption of the inmates.

To commence our description with the infirmary — the more immediate object of our inspection, — we may first speak of the female syphilitic wards. These are in a two-storied building, of which the upper room only was occupied at the time of our visit. We ascended to this by an open wooden staircase, which leads straight up from the lower ward, so that the air of the two rooms is mixed. There are seven syphilitic patients here, of whom three or four were the subjects of most severe affections. The room was extremely bare and gloomy; it was a "roof-ward," the dimensions being 36 ft. x 18 x 10 (plus the roof-space); so that the allowance of cubic space to the present number of inmates is as much as 1100 feet per head; but there have been many occasions in which the surgeon has been obliged to place twice as many patients in the ward. The lighting is by a very insufficient number of windows, but these are fortunately opposite each other, and the medical officer has fitted them with glass Venetian ventilating panes, fixed open. It happens not unfrequently, however, in cold or windy weather, that the patients complain, and then the panes are simply boarded up.

It was in this apartment that our attention was called to many features which are common to all the infirmary wards, and may be described once for all. The walls were bare and dirty, the bedsteads were narrow, the beds (except one water-bed, on which an almost moribund patient lay) were single mattresses, filled with chopped straw. There are only two round towels per week allowed for all purposes of ablution to this whole ward, and a proportionately niggardly allowance reigns through the house. The only watercloset is a dark and filthy place outside the lower story. And the only lavatory is a miserable room adjoining the watercloset, with a kind of cellulated slate manger (looking more like a urinal than a washing-place) at one side of it. There are no lockers or cupboards of any kind in this or any other ward; and the natural consequence is that all manner of miscellaneous articles of food, dress, and convenience are hidden under sheets or mattresses. The only drinking vessels are some coarse slop-basins of yellow crockery, which hold by turns the beef-tea, the tea, the porter, and any other drink that may be ordered for the sick. What struck us with most disgust, however, was the fact that in this ward, where two, if not three, patients lay mortally sick, there was no attendant nurse, not even a pauper; so that the patients, in any emergency, must rely on the bell to fetch them assistance. But what assistance? There is but one paid female nurse (a good and skilful woman, but not capable of ubiquity), aided by one broken-down male pauper, who has been five times tapped for dropsy, for all nursing purposes in the house whatever. There are no night nurses at all. Beyond a few pauper "helps" (for merely menial purposes), and a pauper keeper of the nursery, there is no supplement to the above-named staff.

In the body of the infirmary the arrangement both of male and female wards is very bad. The general plan in each case is this:— One larger ward, with from nine to fifteen patients; outside this a gloomy, little, so-called "day-room;" and then two or three little wards, with three beds each. The long ward is lighted by windows only on one side; the little wards by one window each. The connecting passage is narrow and inconvenient. The plan of out-door waterclosets is universal, except that there is one tolerably good in-door closet near the female wards. Nearly all these places are dirty; and as the guardians do not condescend to supply necessary paper, the drains frequently get choked with rags and other rubbish which the unlucky patients are forced to use. The drainage is into cesspools, and stinks abound from time to time.

Of the "fever wards" we shall not say much, because there were no fever cases in the house, although typhoid is at any time a possibility, owing to the state of the drainage of Farnham. The male and female wards are above each other, and communicate by an inside staircase. The only watercloset is one which must be reached through the open air, and by passing through the lower ward. The ventilation of the wards is most insufficient.

Passing across to the opposite side, we came to the nursery, and the ward for infirm women. Two more melancholy apartments we never saw. The former is a gloomy, damp, brick-floored room, with absolutely no furniture, except one low wooden bench, on which seven or eight little children were sitting in front of the fire. Most of these looked healthy enough; but we encountered three of their companions in one of the female infirmary wards (cowering together over a plate of nasty-looking, lukewarm mutton and potatoes), all of whom bad itch, and one of them porrigo. The nursery-woman — an untidy but kind-hearted woman — complained bitterly that the children had no furniture in their room. They, visibly, had no toys, no amusement, and no education. It is true that some twelve months since the guardians subscribed for a sovereign's worth of toys; but only about two shillings' worth ever made their appearance in the nursery, and since these were broken no more are forthcoming.

The infirm women's day-room presented, if anything, a still more pitiable spectacle. Here were seven aged women, toothless and decrepid, crouching over the fire, and making believe to dine. The doctor kindly orders them a meat dinner every day. The actual dinner supplied consisted on the day of our visit of thick lumps of beef or bacon (not mutton, as ordered); and, as if to mock the poor old creatures in their efforts to dispose of these tough morsels, knives were served out to them, but no forks. It may be mentioned that all the meat is cut up in the dining-hall, and by the time the various rations for the sick and infirm arrive at their respective wards, they are in a condition of tepid greasiness which is well calculated to repress inordinate appetites.

Passing to the day-room for infirm old men, we found another gloomy room, barer and more cheerless than any prison cell of modern construction, in which some dozen old men were sitting on hard benches, with no occupation whatever. The only happy-looking persons amongst them were two fidgety imbeciles. One of these had such very dirty hands that we were induced to ask for an explanation of their state. "Oh!" said our informant, "he does all the dirty work of the house." Among the inmates of the room, we found one man, aged eighty, who was a hard-working, respectable fellow till late in life; then broke down, and came to depend upon his wife's exertions; then lost his wife, and was presented by his merciful Board of Guardians with out-door relief to the extent of 2s. 6d. a week and one loaf. Under this genial treatment he found himself rapidly approaching the vanishing-point; so he wisely came into the house, and avoided starvation. Another old man, for sixty-two years a ratepayer, and who has a rich and genteel nephew in Farnham, had come to the end of his working powers, and was allowed out-relief to the amount of 2s. a week and one loaf. He, too, preferred residence in the workhouse to the role of Ugolino. It is a remarkable feature in the character of the late master of the workhouse (of whom more anon), that when the poor old fellows in this room once obtained some newspapers to while away their time with, he immediately took them away.

The dormitories for the so-called able-bodied (of whom about nine-tenths are infirm) are really good and spacious rooms, with nearly sufficient ventilation; but the inmates are locked in at night, without watercloset or any bell to call assistance. In answer to our expressed desire to see the able-bodied men, we were shown into a brick-floored room, in which there were precisely four persons, all of whom were diseased or infirm. In all the house we saw no really healthy people, except a few young women, mostly with babies, and a few young children.

One word more, and we have done with the mere description of what we saw at Farnham Workhouse. In one of the yards we observed what looked like two rabbit-hutches, on a rather large scale certainly, but with the ordinary furniture of frowsy ' straw, and fastened with huge padlocks. These are the male and female tramp-wards. The men are allowed no food at all, however weary or faint they may be. The women are allowed a piece of bread if they have children with them, not otherwise. One night, not long ago, a female tramp, known to be on the verge of confinement, was locked up all night in the female rabbit-hutch. When the porter unlocked the door at seven in the morning, the woman had been already four hours in labour.

We have hurried through the merely descriptive portion of our narrative, because the remainder of our limited space must necessarily be devoted to a historical aperçu of the management of this remarkable, and, we almost hope, unique workhouse. For fourteen years the virtual government of the place has been a despotism on the part of the late master, tempered, however, during the last four years by revolution on the part of the doctor. The master was a large man, with an imposing presence, a confident manner, and a faculty for talking down any mildly remonstrant guardian. Among other notable performances of this official we may cite an outbreak of indignant virtue on his part which led to awkward consequences. He chose to think that an epileptic inmate, who had remained in bed to repose himself after a severe fit, was unduly self-indulgent, and made him get up and go into the garden to ladle out manure from a cesspool. The lazy man perversely went into another fit, fell into the liquid sludge, was pulled out three parts drowned, and a few hours afterwards gave up his fits and his life together. Fortune, however, favoured the master; and he escaped the more serious consequences which might have been expected. On various occasions he threatened the doctor, who was always proposing some tiresome reform or other, with personal violence. He has finally succumbed to the stroke of fate, and resigned his office, in consequence of a Poor-law inquiry which was held because he (a widower with seven children) had seduced one of the female inmates. The present master and matron would seem to be decent and respectable persons, and they are now actively engaged in cleansing the house from top to bottom.

Of the medical officer, Dr. Powell, it is impossible to speak without sincere esteem. This worthy man, with a salary of £55 per annum, with some few extra fees for lunacy and midwifery cases (and the privilege of supplying and dispensing all drugs at his own cost), has fought a good and persistent tight against the evil traditions of the place. He has constantly remonstrated against the condition and management of the house, and at length, we believe, has won not merely the respect but the support of the better members of the board. Bare and cheerless as the wards still are, the patients are possessed of many comforts which they lacked when Dr. Powell first took office. For instance: it is a fact that even the scanty allowance of towels which are now provided were then altogether absent; so that the inmates, after washing or bathing (which they did in the chamber utensils), dried themselves on the sheets of their beds. The medical officer has also procured, by diligent and incessant asking, various articles, such as feet and stomach warmers, night-dresses, &c., which are a great alleviation to the discomforts of sickness. And although he has at present sixty patients (and often a great many more) to attend to, and has to provide and dispense all drugs, there is neither stinginess nor carelessness in the way he does his work; the medicines are good in quality, and properly dispensed in clearly labeled bottles. The one paid nurse, though preposterously overworked, really does appear to keep a general supervision over all the medicine taken. This good and zealous person eagerly assured us that she never allowed anyone to administer the medicines but herself. The wounds and sores which we saw on various patients were dressed with proper care.

Our most painful task is to say what we must say about the guardians. These gentlemen, we are informed, are some of them farmers, some of them clergymen, and some of them squires, and there are not wanting in their number men of genuinely kind hearts and intelligence above the average. And yet the fact is, that for years past they have tolerated a state of things in their workhouse which was like nothing but Pandemonium, simply because they chose to believe implicitly all the master told them, and ignore all complaints from other quarters. We use these strong expressions advisedly; and we assure our readers that, if the evidence we have above adduced be not sufficient to convince them of their justice, there is plenty more behind. The materials for writing a melodramatic story are furnished in abundance by the bare facts of the history of Farnham Workhouse which have come to us from more than one trustworthy source; and if we withhold many of them now, it is because we have no special liking for lurid, even though faithful, colours. And should the guardians answer to our censures that, after all, it was natural for them to trust the master's judgment (since they believed him to be a respectable and faithful servant), we can reply at once with an instance which affords irrefragable proof that this excuse would be empty and insincere. It is a fact that they followed the master's advice not merely in matters as to which they might distrust their own judgment, but in committing the cruelty of locking up faint and weary travellers all night in a mere cage, without one morsel of food; and this although their medical officer repeatedly begged that at least a slice of bread might be given to these wanderers. And although the bareness and discomfort of the wards must have been patent to the most careless eye, the stinking closets obvious to the least sensitive nose, and the inadequacy of the nursing staff unmistakable to anyone above the capacity of an idiot, not one word of complaint about these vitally important matters can be found amongst the numerous records, in the Visitors' Book, of the guardians' visits of inspection. On the contrary, the perpetually recurring statement in those records is that "we found the wards clean, and everything very satisfactory," or something equivalent to this.

If we have had any compunction in speaking as we have done of the guardians, there is at least one person in speaking of whom we need exercise no reserve. This person is he who signs his name in the Visitors' Book as the delegate of the Poor-law Board for workhouse inspection in the district of which Farnham is a part. For the negligence and blunders of the guardians there is at least this partial excuse — that they have grown up, as it were, in a system, and that its defects naturally present themselves with less clearness to their eyes than to those of outsiders. But the inspector is paid by the country a very large salary precisely in order that it may be worth his while to take the greatest pains to detect any faults which may thus arise. He has (or ought to have) no local prejudices; and one would say he has at least senses to which the untidiness and the smells of a place like Farnham workhouse can hardly suggest themselves as right and proper things. Although he is a country inspector, his life, we presume, has not been so exclusively passed in barbarous regions but that he must know it to be savage cruelty to leave persons who are mortally sick, day and night, without any nursing tendance except what they might (or might not) succeed in summoning by ringing a bell for a nurse who might be in any part of a large and straggling building. He might well have suspected that far more was behind than met the eye in a workhouse which has been, within a comparatively short time, the scene of two Poor-law inquiries and a coroner's inquest, at all of which the most disgraceful state of things was more than hinted at as existing in the management of the place. He might have been expected to bestow more respect and credence on the very reasonable complaints of the medical officer than on the contradictions of them by a master who considered emptying cesspools the proper work for a patient still staggering with weakness and dizziness after a fit, or by guardians with so little natural sense of justice that they would have mulcted the doctor of his lunacy fees had not the County Court peremptorily ordered their payment. In short, one would suppose that the very least that could be done by anyone calling himself an inspector would be to remonstrate without ceasing-first to the guardians, and then to the Poor-law Board-against the whole construction, management, and government of the Farnham workhouse, and to insist that an utterly different building, and an utterly different staff of officials and style of management should be as soon as possible provided. Instead of anything of this kind we find this inspector writing placid little reports, month after month and year after year, in the Visitors' Book, which scarcely ever recommend reforms at all, but almost uniformly speak of the general appearance and management of the house as "good" and "satisfactory"! Not one word does he say which would convey the impression that the general condition of things was bad; and the isolated scraps of reform which from time to time he recommends are mere trifles. There is little trace in the inspector's work at Farnham of the seeing eye, the hearing ear, or the smelling nose; his perceptions seem to be all second-hand. It is not improbable that he has a kindly heart; but the practical exercise of such an organ is a dangerous luxury for an inspector from Gwydyr House. When the officials of that highly respectable establishment catch a comrade with a soft spot in him they butt at him with one consent, as deer do at a sick or wounded companion, and drive him into a distant and disagreeable province. Witness the fate of Mr. Farnall.

Nor is the conduct of the Poor-law Board by any means to be excused, although it is true that their inspector, charged with the care of the district in which Farnham stands, is first of all to blame. To a president or a permanent secretary with a head on his shoulders or a heart in his body one would have thought the rumours wafted to the central office in consequence of the inquiries the Board was compelled (by the medical officer of Farnham) to hold, and the inquest on the unfortunate epileptic, must have occasioned acute uneasiness and a determination to see to the bottom of the affair and insist upon a thorough reform. There is no trace of any such action on the part of the Poor-law Board. The President and his satellites have been "lying beside their nectar" like the most careless of heathen gods. If anyone desires a sufficient and final proof of the utter ignorance with which the Poor-law Board administer the law, let him go to Farnham at the present time and observe how nearly full the house is at this moment, when it contains but 90 persons. And then let him reflect on the fact that the Poor-law Board have certified it for 314 inmates! It is time we drew this report to a conclusion. What can we say — what can any reasonable person say — of the Farnham Workhouse but this: that the existence of such places is a reproach to England — a scandal and a curse to a country which calls itself civilised and Christian!