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Archive: Ancient system of support at the heart of a nation; The Poor Law was the forerunner of the NHS. Chris Upton discovers how it dealt with its patients.

Byline: Chris Upton

We're constantly being told that the National Health Service has to adapt to survive. Exactly the same message was being broadcast two centuries ago, when the predecessor of the NHS was also in the throes of systemic change.

Go back to the early 19th century and one single institution represented the health service, the social services and the child support agency. It also, for good measure, dealt with delinquency, mental illness, vagrancy and (later on) civil registration and vaccination. They called it the Poor Law and it had been in operation since the reign of Elizabeth I.

The Poor Law was both resented and needed in equal measure. Every parish had its ratepayers on the one side and its poor on the other, and the one supported the other. At the heart of this system stood the workhouse. It did not accommodate all those who were unable to support themselves, but it did house the most acute cases, offering bed and board, medical treatment and (as the name implies) work to those who were capable of it.

Across the area we now call Birmingham there were eight parishes, each with its own workhouse. Some were little more than a converted house, or row of cottages, with a handful of occupants; others, like the one in Lichfield Street, could house up to 800 inmates.

The workhouse for the huge parish of Aston was near to the village green in Erdington, where the library now stands, and it was the first one built in the city, dating back to 1700.

While England remained an agricultural country the old Poor Law remained relatively efficient; it was local, small-scale and cost-effective. Come the advent of urbanisation and mass employment (and, of course, mass unemployment), however, and the system creaked alarmingly. By 1800 it was costing the country over pounds 4 million a year and the mood in government was for a radical overhaul.

So in 1834 came the New Poor Law, and all the parishes were forced to combine into larger units (called unions) in an effort to keep down costs.

Suddenly the workhouse at Erdington was no longer catering for the parishioners of Aston alone, but those of Sutton Coldfield, Curdworth, Minworth and Wishaw as well. The former parish workhouses were sold off (both land and materials) and the money made went to subsidise the costs to the ratepayers.

Ironically (and isn't this always the case?) a new system that was meant to save money began with massive expenditure. In most cases the new unions found it impossible to fit all their paupers into one of the old buildings.

The solution was either a spot of piecemeal expansion on the old site or (the more favoured route) to build a completely new union workhouse elsewhere.

Birmingham's new workhouse in Western Road cost over pounds 44,000, while that of Kings Norton Union (now part of Selly Oak Hospital) amounted to almost pounds 28,000.

Over at Aston Union the Board of Guardians of preferred to make do and mend. This was a body with a reputation for financial stringency.

In 1866, for example, when the master of the workhouse asked for permission to give the children nuts and oranges at Christmas, the board replied that 'it was not desirable to increase the usual allowance at the cost of the ratepayers'.

This was also the year that the union was celebrating the 30th anniversary of its foundation, and the clerk to the board congratulated the guardians on having reduced the rates from 3s 6d to 1s in the pound over this period. He even offered to supply the inmates with a celebratory dinner of roast beef, ale, tobacco, snuff and apples, but it had to be out of his own pocket.

In such a climate it was no wonder that the union was constantly having to advertise for a new master and mistress, as employees deserted for better-paid jobs in other authorities.

As elsewhere, Aston Union kept down the wage bill by employing its resident labourforce of paupers. On occasions this could have disastrous consequences as, for example, in 1868, when the nurse left others to administer ointment to patients suffering from Itch. Her deputees accidentally used a disinfectant - carbolic acid - instead and two inmates died as a result.

But by the 1860s even Aston Board of Guardians were having to admit that their old workhouse had gone as far as it could go. Not only was there no more land for additional wards, but the sewage from the institution was making it very unpopular with its neighbours.

By this date over 350 inmates were squeezed into the workhouse at Erdington. So the bullet was bitten, a site was identified at Gravelly Hill and an architect appointed. The latter was none other than Yeoville Thomason, who would be designing Birmingham Council House five years later.

The minutes of the board of guardians give a full account of the progress of the scheme, and a lengthy one it was, for the work was staggered over six years to reduce the size of loans.

First a children's workhouse was built on the new site and the young paupers moved across in October 1867, leaving their elders to wait a further four years, while the second stage of building commenced. And even then an infirmary (begun in 1872) was still to be added to the ensemble.

The result was Highcroft, a union workhouse that, like so many others, paved the way for the National Health Service. It still stands as Birmingham's best preserved workhouse building. Remarkably so, in fact, for not a single drawing or photograph survives of its not-so-illustrious predecessor on Erdington village green.


Clockwise from left: Highcroft Hospital, 2002; a modern artist's impression of what the original Aston Union Workhouse looked like; at work and at play - nurses pictured at the hospital 1938, and one of the monthly dances held for the patients in the 1960s
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Title Annotation:Features
Publication:The Birmingham Post (England)
Date:Mar 23, 2002
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