Public Institutions. Inmates of Workhouses, Prisons, Lunatic Asylums, and Hospitals
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We have already adverted to the aggregate number of the people of England and Wales who at the date of the Census were lodged in the workhouses, prisons, hospitals, lunatic asylums, and other establishments, which it has been found convenient to include under the general designation of "Public Institutions." During the last decenniad there has been a considerable increase in the number of these institutions. The great principle of practical benevolence has been actively at work, and, with the increased wealth of the country, there has been remarked a greater disposition on the part of the rich to do good while living, instead of merely bequeathing a portion of what they have amassed to be dispensed in charitable objects after their decease. In the detailed tables in Vol. I. will be found a statement for each of the eleven Divisions of England and Wales, showing the total number of persons, and also of special inmates, (paupers, prisoners, &c.) in each of the principal public institutions.1
Other tables are given in Vol. II. with respect to the sex, age, and former occupations of in-door paupers, of prisoners, and of patients in lunatic asylums and general hospitals.2
The chief aggregate results disclosed by these tabular statements will now be briefly noticed. It is well known that by the law of England all poor and destitute persons have an absolute right to food, shelter, and medical attendance, subject to certain conditions. Our system of relief to the poor consequently entails upon the country a vast expense, and no less a sum than 77,960,000l
. was raised in poor rates in England and Wales in the ten years ended in 1860. Of this amount, however, upwards of 18,000,000l
. England. were disbursed as part of the cost of the police and for other purposes unconnected with the relief of the poor; but Parliament voted during the ten years 1,246,000l
. in part payment of the salaries of schoolmasters and medical officers, and for other expenses not charged upon the rates. The average net expenditure on the poor in England during the period under notice may be taken roughly at 6,000,0007. per annum, equal to ah annual charge of nearly 6s
. per head on the population; while the average number of paupers, in-door and out-door, was 892,670, or 4.7 per cent. of the people. In Scotland during the same period the annual average of paupers was 120,600, or 4.0 per cent. of the population. In Ireland, where out-door relief is almost extinct, the paupers were 95,880, or 1.5 per cent. TABLE XXIV.—OCCUPATIONS OR MEANS OF SUPPORT OF 94 DEAF-AND-DUMB PERSONS IN HEREFORDSHIRE At the date of the Census the severe distress which has unhappily existed during the last two years in the cotton manufacturing districts in consequence of the civil war in the United States of America had not yet commenced, although in Her Majesty's speech on opening Parliament, 5th February 1861, allusion was made to" the serious differences "which have arisen among the States of the North American Union." According to the returns published by the Poor Law Board the average number of persons relieved, exclusive of vagrants and lunatic paupers in the quarter ended 31st March 1861 was 889,942; viz., 131,501 in-door and 758,441 out-door. In the corresponding quarters of 1862 and 1863 the returns of pauperism gave the following numbers, in which the effects of the failure of the cotton supply are too plainly discernible:— The number of paupers in workhouses
(including children in the District schools) on the Census day was 125,722. This number is below the average for the quarter ending on the preceding 31st March, as derived from the returns of the Poor Law Board; probably the explanation may be found in the fact that many paupers are in the workhouses in the months of January and February who leave as soon as the weather becomes less severe and employment is obtainable, so that by the first week in April the number in-doors is greatly diminished. The ratio of paupers in workhouses was 1 in every 160 in the population, or 6.3 in every 1,000. At the Census of 1851 there were 126,488 in-door paupers, that is 1 to every 142 inhabitants, or 7 in 1,000. It should be borne in mind that the partial relief given to out-door paupers is often continued for short periods only, on account of sickness or temporary distress, while the relief given in the workhouses is not only so complete as to supply all the actual necessities of the destitute poor, but is often continued for long periods, and in the case of aged persons generally for the remainder of their days. According to a Return made to the House of Commons in 1861 no less than 14,216 paupers had been inmates of workhouses during 5 years and upwards, of whom 4,940 had been inmates between 10 and 20 years, 1,322 between 20 and 30 years, and 175 upwards of 30 years.3
The highest ratios of in-door paupers to the general population are observed in the counties contiguous to the metropolis, namely, in Middlesex and Surrey ( Extra-metropolitan), Essex, and Kent, the pauper children belonging to several of the large London parishes being placed out in the Central District Schools and other establishments situated in those counties. In Hertfordshire also, and in Cambridgeshire, Suffolk, Norfolk, Wilts, and Leicestershire, the ratios are considerably above the average. In the North-western Division (Cheshire and Lancashire) 1 in-door pauper is returned in every 204 inhabitants; in the four northern counties 1 in 251; in Yorkshire 1 in 282; the lowest proportion is in the Welsh Division, where 1 in-door pauper is returned in every 319 of the population. In a few unions in Yorkshire and Wales, however, there are no workhouses, out-door relief only being given. The relative numbers of the sexes
of in-door paupers are not widely different, 62,320 being males and 63,402 females. From the number of widows who are yearly left destitute, and the comparative helplessness of women, when in distress, a large excess of females in workhouses might perhaps have been expected. To every 10,000 males and 10,000 females in England and Wales there were 64 males and 62 females in workhouses at the time of the Census. It will be seen from the tables showing the ages
of in-door paupers, that a large number of the aged, including some of the oldest people in the country, are sheltered in the workhouses; 20,882, or about one-sixth, were upwards of 70 years of age, including 390 aged 90 and upwards, and 19 said to be aged 100 and upwards; 45,903, or 37 per cent. of the whole number, were children under 15 years of age; 5,729 men and 13,876 women were between 20 and 40.4
The abstract of the previous occupations
of in-door paupers in Summary Table XLIV. (Vol. II. p. ciii.) is derived from the statements of the masters of workhouses, who acted is enumerators for these institutions. It will be seen that almost every class of employment—professional, commercial, trading, manufacturing,. and agricultural—is represented, The largest items are: agricultural and farm labourers, 8,285 men and boys and 1,388 women and girls; labourers undescribed 5,324; domestic servants, 15,108, all but 647 of whom are females; charwomen, 2,699; washerwomen, 1,663; milliners, dressmakers, seamstresses, &c., 2,603; shoemakers (both sexes), 2,133; tailors, 942; cotton manufacture, 2,103; seamen, merchant service, 848; soldiers and Chelsea pensioners, 207. Several important changes have been made in the law and practice relating to criminals since the Census of 1851. By an Act which came into operation in 1853, all sentences of transportation of less than 14 years were abolished prospectively, and sentences of "penal servitude" substituted for them, the terms of penal servitude being considerably shorter than those of transportation. At the same time power was given to grant tickets-of-leave to convicts for good conduct in prison, but revocable during the unexpired term of the sentence. By a subsequent Act (1857) sentences of transportation were abolished altogether, and sentences of penal servitude substituted for them in all cases. The sentences of penal servitude since 1857 have been carried into effect by detaining the. convicts in separate confinement, chiefly at Millbank and Pentonville, for about nine months; while at the end of that period they have been removed to other prisons for associated labour on public works. The prisons used for the latter purpose are Chatham, Portsmouth, Portland, and Gibraltar for able-bodied convicts, Dartmoor for light-labour convicts, and Woking for invalids. Since 1858 no convicts' have been confined in hulks. The convict establishment at Bermuda has been entirely given up, but a limited number of convicts has been selected from among those employed on public works for removal to Western Australia, which is the only colony to which they can now be sent. Juvenile male convicts under 16 years of age sentenced in Great Britain to penal servitude undergo their term of imprisonment in Parkhurst prison, Isle of Wight. Female convicts sentenced in England to penal servitude are mostly confined in Millbank and Brixton prisons. From the criminal tables prepared at the Home Office, and annually presented to Criminal Parliament, it seems clear that the amount of crime in England has decreased in the last 21 years in its ratio to the population, especially during the last seven years (1856-62). During the two years 1861-2, however, a considerable increase of serious crimes was shown by the returns, and this increase was attributed by the Commissioners appointed to inquire into the subject at the close of 1862, partly to the defective system of secondary punishment in force, and partly to the accummulation of discharged convicts at home in consequence of the small number sent to a penal colony since 1853. These various circumstances, and also the fact that imprisonment for debt or bankruptcy has been in a great measure abolished, should be borne in mind in considering the Census tables relating to prisoners. On the 8th April 1661, the number of prisoners detained in England and Wales in the convict establishments, county and borough prisons, gaols, bridewells, houses of correction, and reformatories certified by the Secretary of State for the reception of youthful offenders under the Act of 17 & 18 Vict. c. 36, was 26,096, viz., 21,177 males and 4,919 females. Of these some few were insolvent debtors (bankrupts), and a considerable number were awaiting their trial, but the majority had been convicted and were undergoing sentences. The ratio of prisoners of all classes to the general population was 1 in 769. At the Census of 1851 the aggregate number was 23,768, and the ratio 1 in 754. In every 10,000 males and as many females in England and Wales in 1861, there were in prison about 22 males and 5 females; in 1851 there were 23 males and 4 females. The great excess of prisoners above the average in London, Surrey, Kent, Hampshire, and other localities is attributable to the convict prisons situated within the metropolitan district and the counties named. In London the proportionate number is highest, and in the Welsh Division it is lowest, as in 1851. As regards the ages
of prisoners, the returns for 1851 and 1861 present the following results:— The increase in the absolute number of persons detained in prisons is mainly due to the recent legislation already referred to. The Summary Table XLV. (Vol. II. p. cvi.), showing the Occupations
of prisoners, may be compared with the corresponding table published with the abstracts of 1851. It distinguishes the former employments, real or alleged, of 23,414 prisoners, but does not indicate the number of professional
criminals who are withdrawn for a time from their ordinary pursuits. Amongst the occupations furnishing the largest numbers are: agricultural labourers, 2,240 (both sexes); labourers not otherwise described 2,933; domestic servants 1,054 (viz. 150 males and. 904 females); shoemakers 1,022; tailors 902; hawkers and itinerant vendors 578; engaged in the cotton, manufacture 649; carpenters, bricklayers, masons, slaters, plasterers, plumbers, and painters, together 1,543; seamen 770; soldiers 427; commercial clerks 270; milliners, dressmakers, and seamstresses 448; laundresses and washerwomen 257. There were 1,144 male and 1,538 female prisoners without stated occupations. Several members of the professions are included in the table, and 65 employès of the Post Office. The laws for the protection of the person and property of lunatics in England continue to be carried out with vigour and success. By a system of inspection and control both of public and private establishments for the reception of the insane, the number of patients is restricted within the limits of the accommodation afforded, and salutary regulations are enforced. All private asylums must be licensed, even where a single patient only is received. Every care which experience can suggest is bestowed on the internal arrangements and organization of the larger establishments, and those more recently constructed asylums are regarded as models of their kind. Restraint is only resorted to when absolutely necessary for the safety of the patients or their attendants; and the method of moral treatment, which includes the exercise of a mild but firm disciplinary power, has been extended to the employment of all the means calculated to improve the bodily and mental health. Appropriate manual labour, athletic exercises and games, reading and lectures, concerts, and other recreations, now fill a regular place in the treatment of the patients; and the conveniences, the comforts, and even in a small degree the luxuries of life are introduced into their apartments. There is reason to believe that by this gentle and judicious treatment a large increase has taken place in the number of cases of insanity which have been cured, especially in the early stages of the disease. At the date of the Census there were in the principal civil lunatic asylums and establishments for the reception of the insane 24,345 persons, viz. 11,249 males and 13,096 females. This number is defective as regards the total amount of persons labouring under aberration of mind, as it not only excludes some lunatics in licensed houses where a very small number are received, and lunatics at large or in the custody of their relatives, but also the patients in military and naval asylums, as well as lunatic paupers in workhouses, and a few criminal lunatics in gaols, who are not distinguished from other inmates in the returns from those institutions. The number thus understated furnishes a ratio of 1 lunatic patient in an asylum to every 824 inhabitants of England and Wales. In 1851 the aggregate number returned in like manner was 16,426, or 1 in every 1,091 of the population. It will be observed that the excess in the number of lunatics in asylums in 1861 over those in 1851 amounts to no less than 7,919. To what is this increase to be ascribed ? Are we to conclude that there is an increased liability to mental maladies among the people of this country, or are we to look to other circumstances for an explanation of this remarkable difference ? The explanation is partly to be found in the fact that the increase has been principally in public asylums, and is limited almost entirely to pauper and criminal patients. Since 1851 pauper lunatics, returned in that year at the workhouses, have been freely removed to county lunatic asylums; but making every allowance for this circumstance, it is obvious that other influences have been in operation which have had the effect of increasing the number of lunatics in asylums. The Commissioners in Lunacy are of opinion that the increased number of pauper lunatics is chiefly due to the agency of three causes,—(1) the discovery of fit objects for treatment previously unnoticed, and the classification as insane of many persons formerly looked upon as ordinary paupers; (2) the increased number of these sent to asylums; and (3) the prolongation of their life when thus brought under care.5
To what extent the removal of pauper lunatics from workhouses and cottages has tended to prolong life has not been determined; but there can be no doubt that when destitute and diseased persons are placed under care in well-regulated establishments specially adapted for their protection and treatment, and in which they receive an abundant diet and careful medical attendance, the result will be a diminution of the rate of mortality amongst them. These considerations furnish sufficient reason for rejecting the inference suggested by the increased return of paupers in asylums that the inhabitants of this country are more prone than formerly to attacks of insanity. In proportion to the population the lunatics in asylums were by far the most numerous in the South-midland Division (including Middlesex extra-metropolitan, wherein Hanwell, Colney Hatch, and other large establishments are included); the South-western Counties, Wilts, Dorset, Devon, Cornwall, and Somerset, follow next in order, then the West-midland, South-eastern, Eastern, and London; the ratios in the Welsh and the Northern Divisions are lowest of all. The average proportion of lunatics in asylums to every 10,000 males and as many females living in England and Wales is 11.5 of males and 12.7 of females. In each of the 11 statistical divisions, with the exception of London, the number is considerably larger than at the previous Census; and the diminution in the return for London is owing to the patients having been transferred to establishments beyond the metropolitan limits.6
According to a return by the Commissioners in Lunacy there were, on 31st December 1861, 42 county and borough lunatic asylums, 16 hospitals, and 105 licensed houses, in several of which paupers were received; in these 163 establishments there were in all 26,199 lunatics at that date. As regards the ages
of the patients in lunatic asylums, the Summary Table XXXVIII. (Vol. II. p. xcvii.) furnishes the following results:— After the 40th year, mental maladies are more common amongst women than men, but the excess of females above 60 must be considered as partly due to the superior longevity of that sex. The former occupations
of the insane are returned in Summary Table XL VI. (Vol. II. p. cviii.) according to the best information which the principal resident officers of the institutions could furnish. It will be seen by this Table, which deserves an attentive examination, that the professional and educated classes furnish a large number of patients: of clergymen and ministers of various religious denominations 95 are returned; of barristers and solicitors 82; physicians and surgeons 66; officers of the army and navy 113 (the military and naval asylums are excluded); schoolmasters and others engaged in tuition—men 77, women 250. Amongst the largest items are: agricultural and other labourers 2,587 (both sexes); female and domestic servants 2,707; shoemakers 560; milliners, dressmakers, seamstresses, &c. 884; tailors 296. The table includes 142 men and 699 women described as of independent means or "annuitants." The hospitals and medical, charities of this country have not unjustly been regarded as objects of national pride, supported as they are almost exclusively by private benevolence; and so extensive is the range of benefits they afford, that there is scarcely any form of bodily suffering to which the doors of one or other of these institutions are not open. Next to the adoption of proper measures for the prevention of disease, a suitable provision for the speedy restoration of the sick to health is obviously of the greatest importance to the community. Unfortunately, the force of the old truism,—" prevention is better than cure"—has yet to be recognized in many places where hospitals and infirmaries have been established for the medical and surgical treatment of the poor when sick, but where the sanitary measures which would tend to preserve them in health are still in a great measure neglected. The hospitals for the sick in England are of three kinds:—General Hospitals,
in which are received as in-patients or treated as out-patients, according to the urgency and severity of the cases, persons suffering from diseases (with certain exceptions), accidents, injuries, and deformities; Special Hospitals,
which receive patients suffering from one class of diseases, as fever, small-pox, cancer, or consumption; and Class Hospitals,
which receive only one description of persons, as soldiers, sailors, women, children, &c. In some parts of England hospitals are called infirmaries. Dispensaries are medical charities for out-patients only, who are often visited at their homes.7
Exclusive of the patients in the military and naval hospitals, and in the sick wards of workhouses, prisons, &c., (which are excepted from the Tables, as was done in 1851) there were in hospitals in England and Wales on the day of the Census 10,414 patients, of whom 5,970 were males and 4,444 females. In 1851 the number of in-patients was 8,617, and the increase of 1,797 persons enumerated in these establishments may be ascribed to the additional accommodation for the sick afforded through the erection of new hospitals, and the enlargement of those already established. The above figures give the ratios of 1 in 1,927 of the population in civil hospitals in 1861, and 1 in 2,080 in 1851. By far the highest ratio of the sick in hospitals is found in London, where 17.0 males and 12.6 females in every 10,000 of each-sex were enumerated in these institutions, which contained 4,102 out of the 10,414 patients. Many of the patients came from the country, attracted by the great reputation of the medical staff of the metropolitan hospitals, or sent up by country practitioners. Next to the metropolis, the patients were most numerous in proportion to the population in the counties of Gloucester and Warwick, Oxford, Norfolk, and Hereford. The statistical Division
in which they were proportionately least numerous is the Welsh, then the North-western (Cheshire and Lancashire), and the Northern. The Ages
of the sick in hospitals will be found in Summary Table XXXIX. (Vol. II. p. xcvii.); the following is an abstract of the aggregate results for England and Wales:— It will be seen that 3,433 of the patients, about one third, were under 20 years of age, and that after that age the men in hospitals are much more numerous than the women, a result partly due to the accidents and injuries to which the former are more particularly exposed by their avocations. Although the primary design of these institutions is to afford a refuge to persons who are unable to pay for private medical or surgical aid, there is good reason for believing that their benefits are not mainly conferred on those for whose special relief they were established, but frequently on workmen in receipt of high wages, and their families, who are scarcely to be regarded as proper objects of such charities. That the class of artisans and other working-men in our towns are, when employed, well able to set aside a small sum from their earnings to join a sick club or other provident society to provide for the evil days of sickness cannot be questioned; but it is said by competent judges that the indiscriminate manner in which gratuitous medical relief is afforded at the hospitals, more especially in London, only tends to encourage in the workman habits of improvidence.8
The table showing the occupations of the patients in hospitals (Summary Table XL VII, Vol, II., p. cix.) presents a great variety of employments, and although many of the patients. persons belonged to the class of workpeople who receive high wages when employed, it is of course impossible to conjecture how far their altered circumstances, when deprived of employment through sickness or accident, might have rendered them fit objects of charity. The following are some of the principal items in the table: — Males.—
Agricultural labourers, 665; labourer undefined, 582; seamen. 373; shoemakers, 175; domestic servants, 149; cabmen, coachmen, carmen, and carters, 168; carpenters and joiners, 144; coal miners, 120; bricklayers, 105; messengers and errand boys, 102; horsekeepers and grooms, 89; plumbers, 88; tailors, 88; iron manufacture, 76; masons, 73; clerks and commercial travellers, 63. Females.
—Domestic servants, 1,369, of whom 486 were under 20 years of age; milliners, dressmakers, and seamstresses, 320; laundresses and washerwomen, 123; charwomen, 67; cotton manufacture, 62; wives and widows, not otherwise described, 777. Of late years the various matters connected with hospital administration have received the careful attention of members of the medical profession and others well qualified by long practical experience to speak with authority on such subjects. The labours of Miss Nightingale may be said to have created a new era in hospital management, and the reforms advocated by that lady will, we may fairly hope, ere long be carried out in some of the most important of these institutions.9
1
See Population Tables, Vol.I., p. 215, for the Table relating to Div. I., London; a similar Table is given for each of the other Divisions. 2
Population Tables, Vol.II. Summary Tables XLIV.-XLVII., pp. ciii-cx. 3
House of Commons paper, No. 490. Session 1861. The reasons assigned why the 14,216 persons included in the return are unable to maintain themselves are classed under the following heads: old age and infirmity, 5,932; mental disease, epilepsy, palsy, and "weak mind", 4,989; bodily disease, 924; bodily defects (including 429 blind, 165 bad sight, and 197 deaf-and-dumb), 1,619; moral defects, including intemperance, 182; other causes, including orphanage, 570. Pauper lunatics in Asylums are not included in the Return. 4
Summary Table No. XXXVI. in Vol. II., p,
xcvi. 5
Fifteenth Report of Commissioners in Lunacy, p. 78. 6
The following table shows the number of patients in Lunatic Asylums returned in 1851 and 1861 in each of the 11 Divisions of England and Wales: — TABLE XXV. 7
The numerous hospitals or almshouses for the reception and permanent board of poor old persons of both sexes are not embraced within the purview of this section. 8
This has been forcibly pointed out in papers by Dr. Guy of King's College, Dr. Markham, and others. According to an authentic statement, the wages paid to artificers and other workpeople in London are as follows: 9
See "Notes on Hospitals"
, of which a third edition has recently been published.X.—PUBLIC INSTITUTIONS.—INMATES OF WORKHOUSES, PRISONS, LUNATIC ASYLUMS, AND HOSPITALS.
1. Inmates of Workhouses
Expense of relief to the poor in England
AGES
Under 20years
20 and under 60
60 and upwards
TOTAL
Males
Females
Males
Females
Males
Females
Males
Females
Can wholly or partially support themselves
Living on their Means
—
—
—
—
—
2
—
2
Farmer (Farming his own land)
—
—
1
—
—
—
1
—
Heraldic artist and Engraver
—
—
1
—
—
—
1
—
Carpenter
1
—
—
—
—
—
1
—
Glazier
—
—
1
—
—
—
1
—
Mason
—
—
1
—
—
—
1
—
Sawyer
—
—
1
—
—
—
1
—
Basket-Maker
1
—
—
—
—
—
1
—
Limestone Quarryman
—
—
1
—
—
—
1
—
Glove Maker
—
—
—
1
—
—
—
1
Day and agricultural labourers
—
—
13
1
2
—
15
1
Needlework
—
—
—
3
—
—
—
3
Unable to support themselves
Supported by relatives
—
1
2
10
—
—
2
11
Paupers
1
—
5
1
—
3
6
4
Children
13
16
—
—
—
—
13
16
Occupation not stated
1
1
5
5
—
—
6
6
TOTAL
17
18
31
21
2
5
50
44
Numbers of persons in receipt of relief
Total
In-door
Out-door
1862
948,198
143,926
804,272
1863
1,091,873
143,661
948,212
Paupers in workhouses
Distribution of paupers
Sexes
Ages
Occupations
2. Prisoners.
16 & 17 Vict. C. 99
20 & 21 Vict. C. 3
Criminal statistics
Number of prisoners
Ages
1851
1861
Under 20 years
5,976
6,281
20 and under 60
17,280
19,166
60 and upwards
512
649
Total
23,768
20,096
Occupations
3. Inmates of Lunatic Asylums
Treatment of the insane
Number of the insane in asylumns
Causes of increase of pauper lunatics
Distribution
Ages
Males
Females
Under 20 years
364
298
20 and under 40 years
4,700
4,763
40 and under 60 years
4,583
5,687
60 and under 80 years
1,530
2,252
80 and upwards
72
96
11,249
13,096
Former occupations
4. Patients in Hospitals.
Various kinds of hospitals
Number of in-patients
Distribution
Ages
Males
Females
Under 10 years
510
409
10 and under 20
1,263
1,251
20 and under 40
2,439
1,901
40 and under 60
1,382
685
60 and under 80
364
192
80 and upwards
12
6
Total
5,970
4,444
Occupations of hospital patients
Division
1851
1861
1. London
4,161
3,037
2. South-Eastern
1,143
2,198
3. South Midland
1,937
4,686
4. Eastern
770
1,288
5. South-Western
2,059
2,688
6. West-Midland
1,817
3,209
7. North-Midland
598
1,177
8. North-western
1,700
2,546
9. Yorkshire
1,411
1,895
10. Northern
495
736
11. Welsh
335
885
Total England and Wales
16,426
24,345
Bricklayers, 33s. per week.
Painters, 32s. per week.
Carpenters, 32s.
Plumbers, 33s.
Masons, 32s.,
Labourers, 20s