[375] _See_, for instance, _The Administration of Medical Relief to the Poor--Reports by the Poor Law Committee of the Provincial Medical and Surgical Association_, 1842; _Life and Times of Thomas Wakley_, by S. Squire Sprigge, 1897.
[376] Mr. Baines (President of the Poor Law Board), 12th July 1853; _Hansard_, vol. 129, p. 138.
[377] Sixteenth Annual Report, 1863-4, p. 108.
[378] Circular of 12th April 1865, in Eighteenth Annual Report, 1865-6, pp. 23-24.
[379] Some boards of guardians rebelled in this connection against a departure from the principle of "less eligibility" that they did not understand. When the circular of the Central Authority inviting compliance with the recommendation of the House of Commons Committee reached the Manchester Board of Guardians, it was referred to a committee. When the committee, after eighteen months' delay, recommended compliance, its report was rejected (MS. Minutes, Manchester Board of Guardians, 20th April 1865, and 25th October 1866).
[380] Twenty-second Annual Report, 1869-70, pp. xliv-lii.
The most remarkable change of front was, however, that relating to the institutional treatment of the sick. Down to 1847, it is not too much to say that "what may be called the hospital branch of Poor Law administration"[381] was ignored alike by Parliament, public opinion, and the Central Authority. We have shown that the institutional provision for the sick was not so much as mentioned in the Report of 1834, and that it remained practically ignored in all the Orders, Circulars, and Reports of the Poor Law Commissioners. The same is true of the first eighteen years of the Poor Law Board. Few and far between are the incidental references to the "sick wards" of the workhouses. There is not even a hint of a suggestion that relief to the sick poor could most advantageously take the form of an offer of "the House." On the contrary, it was held in 1848 that applicants for admission suffering from "fever" might even be refused admission, the relieving officer being enjoined to find lodging elsewhere for them,[382] though how this was to be done the Central Authority did not, in 1848, say. In 1857, the Metropolitan Boards of Guardians were recommended to send such cases to the London Fever Hospital[383] (involving a payment by the guardians of 7s. weekly). Finally, in 1864-5, we have an outburst of public indignation, at the condition into which the sick wards of the workhouses had been allowed to drift. The death of a pauper in Holborn workhouse, and of another in St. Giles's workhouse, under conditions which seemed to point to inhumanity and neglect, led to an enquiry by three doctors (Anstie, Carr, and Ernest Hart), commissioned by the _Lancet_ newspaper, the formation of an "Association for improving the condition of the sick poor," and a deputation to the Poor Law Board.[384] The publication of various reports on the workhouse infirmaries, in which terrible deficiencies were revealed,[385] led to public discussion and Parliamentary debates. The Central Authority at once accepted the new standpoint. It made no attempt to resist the provision of the necessarily costly institutional treatment for the sick poor, whether or not their ailments were infectious or otherwise dangerous to the public. The progressive improvement of "the hospital branch of Poor Law administration," to use the phrase of the Central Authority itself, which had in the preceding thirty years grown up unawares, was now definitely accepted as an important feature of its policy. Statutory powers were obtained for the provision of hospitals in the Metropolis by combinations of boards of guardians. Urgent letters were written pressing the boards of guardians to embark on the expenditure required to enable them to provide efficiently for the sick paupers.[386] From 1865 onward, we see the Central Authority, on the public-spirited initiative of Mr. W. Rathbone and the Liverpool Select Vestry, pressing on the boards of guardians the employment of salaried and qualified nurses to attend to the sick paupers, whatever their complaints.[387] We have even in 1867, so far as the sick are concerned, the explicit disavowal by the Central Authority of the very idea of the deterrent workhouse, which had formed so prominent a part of the policy of 1834-1847. Mr. Gathorne Hardy, speaking as President of the Poor Law Board, said "there is one thing ...