The Elderly and the Workhouse

Resources from our extensive archive of geriatric medicine
Alistair Ritch
Date Published:
08 November 2015
Last updated: 
08 November 2015

The chronicle of care of older people in Britain, especially the infirm, stretches back hundreds of years.  In those early days, illness would be managed within the family, perhaps with aid from local herbalists.  When available, almshouses provided free or subsidised housing for frail elderly who could no longer work. Support from the local monastery/infirmary disappeared when they were dissolved in the 1530s.

Authorities responded to the increasing population and the consequences of the closure of the monasteries with the 1601 Poor Relief Act.   This permitted parish officials to collect money from ratepayers to pay for relief for the local sick, elderly and infirm.  This might be either ‘indoor relief’ i.e. accommodation, or ‘out relief’ with handouts of bread, clothing, fuel or money.  Authorities sought to distinguish between the ‘deserving poor’, whose troubles were due to circumstances beyond their control, and lazy individuals, but they never really succeeded.  To discourage the indolent, the 1723 Workhouse Test Act, made it clear that entering the workhouse was not to be an easy option.  Those who could work had to do so.  

By the 1830s, the government faced further difficulties.  The cost of poor relief had risen sharply due to unemployment with the end of the Napoleonic wars, population relocations from the rural to urban areas, poor harvests and the Corn Laws that imposed restrictions and tariffs on imported grain.  The 1832 Royal Commission was set up to review the situation.

This Act followed the Commission’s report.  It largely abolished out door relief and grouped parishes together into larger administrative Unions, run by a Board of Governors who had to ensure that the workhouse acted as a deterrent. To discourage dependency, workhouse conditions were worse than the lowest standard of the independent labourer and the quantity of work required exceeded that required of those in prison.  

The Act recognised four types of inmate:  the aged and totally ‘impotent’ (i.e. destitute through no fault of their own); children; able-bodied females; and able-bodied males.  Accommodation was supposed to vary according to the individual requirements of these groups but since it was difficult to predict numbers, many workhouses opted for ‘general mixed’ accommodation.    

The admission routine

A request to enter a workhouse was made to the relieving officer who issued a ticket for admission. On arrival, families had their clothes put into storage, were given a uniform, bath, and medical examination.  Men and women were separated, as were the able-bodied and infirm. Should an inmate’s situation improve, discharge could be arranged provided notice was given to allow the return of the uniform and personal possessions.  Reports show that a substantial number of inmates had lived in the workhouse for more than ten years and some had never lived anywhere else. 

The day began with the sounding of the rising bell at 6am (7am in winter).  Breakfast followed at 6.30am followed by work at 7am until dinner at 12midday until 1 pm.  Work finished at 6pm, followed by supper until 7pm.  Bedtime was 8pm.   The type of work varied with the sexes. Women were required to carry out domestic chores including cooking, laundry and sewing, while men laboured at stone breaking, oakum picking or bone crushing. Parents and children met briefly on a daily basis, or on Sundays. 


Meals were simple, and varied with the area of the country and time of year.   Breakfast consisted of bread and cheese or broth.  The mid-day dinner was thick broth with meat on two days a week. Supper replicated the earlier meals with broth or bread and cheese. Gruel - a thin porridge often based on a cereal such as oatmeal - appeared in the early 1700s. Women had tea to drink; girls had milk, while men/boys had beer or tea.  After the 1834 Act, the Commissioners issued weekly meal plans, which were still plain and repetitive, but now included potatoes, rice and suet puddings.  Attempts to improve the diet and reduce wastage had limited success. 

When an inmate died in the workhouse, the death was notified to the family who could arrange a funeral.  If this did not happen, usually because of expense, the Guardians arranged a burial in a local cemetery or burial ground.  The cheapest possible coffin or shroud was used with the body placed in an unmarked grave, sometimes even in un-consecrated ground!  
Prior to the 1834 Act workhouses had no systematic arrangements for recording births or deaths.  This was resolved in 1837 when registration districts were introduced with offices in many Unions.  In 1904, the stigma of being born in a workhouse was removed by the use of an anonymous/neutral address.  In 1918, a similar practice was followed for deaths. 

Many early workhouses were ‘working houses’ where work was done but were not residential.  Purpose built workhouses emerged in the 18th century with size increasing as parishes amalgamated into larger Unions.  Designs incorporated separate accommodation for men and women, the aged and infirm, and exercise yards.  In 1835, the Poor Law Commissioners published their plans for model workhouses with variations allowed for local circumstances.  Examples included:

1.    The Courtyard plan had accommodation on three sides of a quadrangle and administration offices on the fourth side. 
2.    The Square/Cruciate plan had work areas along the sides and accommodation in the cruciform buildings.  The Y shaped building was a variation.
3.    The Corridor plan buildings were rather grand and less forbidding.  They had a separate entrance block, linear main block with the hospital block placed in parallel with each other.  
4.    The Pavilion block concept incorporated the new ideas of sanitation. 

An early architect was Sampson Kempthorne and his assistant George Gilbert Scott.  The latter developed his own practice, was joined by William Moffatt and their work can be seen in the West Country.  Later, of course, Gilbert Scott was celebrated for his Gothic revival buildings. 

Medical supervision was slow to improve from a low base. Only doctors unable to establish a private practice would consider working in a workhouse.  The salary was meagre and had to be used to pay for patients’ medicines and appliances.  Doctors were required to classify inmates such as those who were mobile but not physically fit and those who would be fit enough to withstand punishment if this was ordered.  The 1858 Medical Act, which set up the General Medical Council, forced Boards of Governors to employ doctors qualified in both medicine and surgery.  

Workhouse nursing was also of questionable quality since nurses were untrained.  Elderly female inmates, many of whom could not read, were deaf, visually impaired, and fond of drink, generally performed nursing duties. Their pay was paltry.  However, by the 1880s, the Unions increasingly employed trained nurses.

Quality of care

It is a sad fact that good news attracts little publicity, while bad news and scandals have the opposite effect.  The workhouse was no exception. 

Bridgewater.  This workhouse had 40 beds but housed over 100 people while upgrading building work proceeded elsewhere.  The overcrowding relied on at least two adults or six children sharing each bed.  In the winter of 1836-7, a severe outbreak of dysentery led to many inmate deaths.  Their diet was blamed and the Guardians were accused of deliberately placing a vagrant with fever in the workhouse with the aim of infecting and killing inmates.  New inmates were admitted while an outbreak of typhus fever was raging, resulting in the death of three children from one family.

Andover.  In 1845, the Master of the Andover Workhouse and his wife ran the institution like a harsh penal colony.  Conditions became so desperate that male inmates deliberately committed crimes in order to be sent to prison, where the food and working conditions were far better.  Staff feared for their jobs if they complained. 

Finally, a Guardian witnessed male inmates fighting over bones that they were supposed to crush into fertiliser. They were so desperate for food that they picked marrow and gristle from rotting bones. A subsequent Parliamentary Committee found that inmates had a starvation diet while being required to use 28 lb. “rammers” to smash rotten, stinking bones. The Master at Andover thought the arrangements were financially excellent since he bought bones at 17 shillings a ton and sold the bone dust at 24 shillings a ton.  

Huddersfield.  This workhouse scandal occurred in 1848 when it was reported that inmates went for nine weeks without change of linen or bed clothing   Beds in which typhus patients died, were repeatedly used for new patients, without ‘any change or attempt at purification’.  Beds were only bags of straw and shavings, and swarmed with lice.  Two patients suffering from infectious fever were almost constantly kept together in the same bed.  A living patient occupied the same bed with a corpse for a considerable period.  

The Lancet Sanitary Commission reported in 1866.  It stated that ‘State hospitals are in workhouse wards.  They are closed against observation.  They contravene the rules of hygiene… The doctor and the patient are alike the objects of a pinching parsimony’.  ‘The fate of the ‘infirm’ inmates of crowded workhouses is lamentable in the extreme; they lead a life which would be like that of a vegetable, were it not that it preserves the doubtful privilege of sensibility to pain and mental misery’.  ‘If all the infirm were medically treated there would be a very large percentage of recovery’.  The Editor of the Lancet called workhouses ‘The Antechambers of the Grave’.  

During the 1940s the government authorised a survey of UK hospitals in preparation for the forthcoming NHS.  All reports were devastating in their criticisms of the quality of services and accommodation provided for older people.  

The end of the workhouse or was it?  It was not until the 1948 National Assistance Act that the last vestiges of the Poor Law and the workhouses disappeared or were supposed to.  Many buildings continued in use as old people’s homes administered by local authorities.  As late as 1960, more than 50 per cent of local authority accommodation for the elderly was in former workhouses. Camberwell workhouse continued as a shelter for more than 1000 homeless men until 1985.  

Pioneering geriatricians worked in unsuitable workhouse infirmaries for many years.  The 1961 Sheldon report, Geriatric Services in Birmingham Regional Hospital Board, which identified many deficiencies, caused uproar.  The 1971 South East Metropolitan Regional Hospital Board report on Development of Services for the Elderly and Elderly Confused just added fuel to the fire.  Other reports identified geriatric wards lit by gas; some with leaky roofs and even lacking any form of heating!  To add insult to injury, geriatricians received considerable hostile response when they started the ‘cruel’ practice of mobilising long stay patients who were normally kept in bed. 

Coda.  Many famous people were born or worked in a workhouse.  Probably the most well-known was Charlie Chaplin, who was admitted with his mother and half-brother to Lambeth workhouse in 1896 before he was transferred to Hanwell poor law school.  The author Catherine Cookson worked in the laundry in several workhouses and writer Len Deighton was born in St. Marylebone workhouse.  The journalist and TV personality Gilbert Harding was born in Hereford workhouse.  The journalist and explorer, Henry Morton Stanley was an inmate of St. Asaph workhouse.    
It is hardly surprising that the fear of the workhouse persisted for so long in the minds of older people. 

Further reading: 

M. A. Crowther The workhouse system 1834-1929.  Batsford Academic and Educational Ltd, 1981
Peter Higginbotham, The workhouse Encyclopaedia.  The Hill Press, Gloucestershire.2012
Alistair Ritch,  English Poor Law Institutional Care for Older People: Identifying the ‘Aged and Infirm’ and the ‘Sick’ in Birmingham Workhouse, 1852–1912.  Social History of Medicine Vol. 27, No. 1, pp. 64–85


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