Presupuesto de Producción Radial “Iluminando tu Amanecer”
CONCLUSIONES Y RECOMENDACIONES
The overwhelming majority of aged patients who arrived at Hanwell had passed through the workhouse, and it was from there that their certification was solicited and their admission to Hanwell secured. Families could choose to send their
unmanageable aged relatives to the workhouse, but it was the people who managed and worked at London’s workhouses and infirmaries – the Guardians, the masters, the medical officers, and the attendants – who were the key agents in the admission of aged patients to Hanwell. Thus, the capacity and willingness of the workhouse
130
and its inhabitants to manage and tolerate senile residents can be considered the most important factor in determining the admission of aged patients to Hanwell.
The asylum records do not contain consistent information about how long their new patients had spent in the workhouse prior to admission. Some, it seems, had been there for several years, entering initially due to bodily infirmity or
financial need, only to have their mental symptoms develop – or be noticed – some time after their arrival. Others were sent to the workhouse by their families – either directly or through the Relieving Officer – on account of their mental symptoms, and were swiftly certified and sent on to Hanwell in a matter of days. The practice of using the workhouse as a ‘holding area’, or ‘filtering stage’ in the road to the asylum took place across the country, and was particularly common in London.131
Elaine Murphy, in her study of the East London Poor Law Unions in the mid- nineteenth century, found that the workhouse constituted ‘the first point of admission’ for insane paupers, who were brought to the workhouse by the
Receiving Officer to be assessed in situ, and often remained there for some weeks to see if they would recover. 132 This practice became even more important in 1889,
when the management of Hanwell and the other county asylums in the new administrative county of London was taken over by the LCC. From this point on, any London Poor Law Union seeking asylum admission for one of its paupers had to apply centrally to the LCC, and await a decision as to where they would be placed. This did not, however, alter the balance of power in controlling which patients were admitted to the asylum. Even after 1889, the LCC was obliged to find space in their county asylums for any patient who had been certified as a lunatic in needs of detainment in the asylum.133 Beyond communicating their displeasure to
the Lunacy Commissioners, the Local Government Board and to the individual boards of Guardians, there was essentially nothing the Hanwell management
131
Richard Adair, Bill Forsythe and Joseph Melling, ‘A Danger to the Public? Disposing of Pauper Lunatics in Late-Victorian and Edwardian England: Plympton St Mary Union and the Devon County Asylum, 1867-1914’, Medical History 42 (1998), p. 155.
132
Murphy, ‘The Lunacy Commissioners and the East London Guardians, 1845-1867’, p. 513.
133The Fourteenth Annual Report of the [LCC] Asylums Committee (1902-3), p. 6. See also
The
Thirty-Second Report of the Committee of Visitors of the County Lunatic Asylum at Hanwell (1877),
committee could do to prevent the arrival of aged patients. As discussed in the previous chapter, this was a cause of significant tension between the asylum and London’s Poor Law Guardians.
More broadly speaking, money was at the heart of the tensions between the Poor Law and the asylum. For the first thirty years of their existence, the Lunacy Commissioners railed against Poor Law Guardians for retaining lunatics in the workhouse, where they could be supported much more cheaply, rather than sending them to the asylum where they could be cured. After the introduction of the four-shilling grant in 1874, they began to accuse workhouse officials of being too
eager to send slightly disruptive and difficult inmates to the asylum. Even after the introduction of the four-shilling grant, however, it generally remained cheaper for lunatics to be maintained in the workhouse. Joseph Melling and Bill Forsythe, for example, in their study of the administration of lunacy in Devon, have suggested that ‘the comparative high cost of asylum care would have led to a reluctance among asylum personnel to send paupers on to Exminster [asylum]’, all the way up to the early years of the twentieth century.134 In London, however, the situation was
rather different. In 1867, the Metropolitan Poor Act introduced the Common Poor Fund, designed to equalise the burden of paying for sick paupers between the unequally wealthy London Poor Law Unions. This central fund paid for, among other things, the maintenance of London’s pauper lunatics in county asylums. This put London Poor Law Unions – particularly the poorer ones – in a very different financial position with relation to lunacy than those in the rest of the country.135
Furthermore, historian David Cochrane has argued that the differentiation between the cost of maintaining a pauper lunatic in a workhouse and an asylum was
‘flattened’ by the universally high cost of pauper maintenance in London in the last three decades of the nineteenth century. It was not that it was particularly cheap for a pauper to be maintained in a London asylum, but rather that it was almost as
134
Joseph Melling and Bill Forsythe, The Politics of Madness: the State, Insanity and Society in England, 1845-1914 (London, 2006), p. 36.
135
Murphy, ‘The Lunacy Commissioners and the East London Guardians, 1845-1867’, pp. 519-21; David R. Green, Pauper Capital: London and the Poor Law, 1790-1870 (Farnham, 2010), pp. 238-39.
expensive for them to be maintained in the workhouse.136 There was, then, no real
financial incentive nor disincentive for London Poor Law Guardians to send more or fewer of their paupers to an asylum, or to maintain lunatics in the workhouse.
Instead, the evidence from the admissions records of Hanwell supports Peter Bartlett’s argument that it was ‘the problem of order’ which ultimately determined the movement of an individual from a workhouse to an asylum.137
Order and the ‘power of rule’ were central to the rhetoric of efficiency in which the institutions and policies of the New Poor Law were produced. Under the New Poor Law, the workhouse was framed as a site of moral regulation, in which orderly and productive behaviour was to be encouraged. Peter Bartlett, and workhouse
historian Felix Driver, have interpreted this drive for order through Michel Foucault’s concept of ‘disciplinary power’.138 This can be described as system for
organising institutional regimes, in which individual behaviour is monitored and prescribed to a minute degree, in an attempt to normalise that behaviour, and create productive social actors.139 Thus, Emma Sophia Casswell was removed from the
Hampstead workhouse in part because she ‘[would] not conform to the rules of this institution’.140 At the same time, Driver recognises the insufficiency of Foucault’s
model to account for the multiplicity of roles performed by the Victorian
workhouse, as spaces of confinement and care as well as moral regulation.141 Whilst
a useful starting point for thinking about the desire to manage and control activity within the workhouse, this model does not quite account for the problems caused by senile patients. Disciplinary power is, as Foucault describes it, directed at actions performed by a necessarily active body, seeking to make the individual more
136
David Cochrane, ''Humane, Economical and Medically Wise': the LCC as Administrators of Victorian Lunacy Policy', in William F. Bynum and Roy Porter (eds), The Anatomy of Madness: Essays in the History of Psychiatry, Vol. III (London, 1988), pp. 249-52.
137
Bartlett, The Poor Law of Lunacy, pp. 179-82.
138
Felix Driver, Power and Pauperism: the Workhouse System, 1834-1884 (Cambridge, 1993), p. 11.
139 Michel Foucault, Discipline and Punish: the Birth of the Prison (New York, 1977), p. 139. 140
Emma Sophia Casswell, H11/HLL/B/19/036 (1891), p.172.
141
efficient, more economic, and more controlled.142 What was desired of these aged
patients was not efficient activity, but inactivity.
The desire for inactivity is communicated through the frequent reference to ‘restlessness’ in the medical certificates and the case history narratives. The term ‘restlessness’ adds depth to the idea of unmanageability: it suggests a constant movement and activity that is neither desired nor controllable. What is desired of the restless person is that they rest. Thus, senile patients disrupted the order of the workhouse by failing to perform the role of docile dependents. Several of the medical certificates in this sample mention the trouble caused by aged patients who refused to stay in bed. The head nurse at the Paddington Infirmary complained that she ‘had great difficulty keeping [Mary] in bed, by night or day’.143 John Auger,
who entered the workhouse apparently for the first time at the age of 79, ‘walked about the ward, rattled and knocked at doors [and] asked why he should go to bed’.144 Martin Bates ‘cut the head [of a workhouse nurse] open in two places [who
was] endeavouring to make him comfortable in his bed’.145 These patients not only
presented the challenge of needing to be looked after, but resisted the attempts of those around them to meet this challenge.
This information, like much of the evidence of insanity included in the medical certificates of Hanwell’s aged admissions, was provided by nurses and attendants of the workhouse. Henry Rayner, Superintendent of Hanwell in the 1870s and 80s, was sceptical of such statements. In his annual report of 1877, he wrote that he was
frequently at a loss to recognise in the helpless, childish, bed- ridden and often moribund old man, the dangerous and violent lunatic described in the certificate under the head of “Facts
142
Foucault, Discipline and Punish: the Birth of the Prison, p. 139.
143 Mary Carter, H11/HLL/B/19/23 (1872), p. 69. 144
John Auger, H11/HLL/B/20/011 (1871), p. 71.
145
Indicating Insanity”, communicated to the medical man, usually by the nurse or attendant on the patient.146
This was a blatant accusation of deceit on the part of the workhouse attendants who, he claimed, exaggerated the violent tendencies of their charges in order to secure their admission to the asylum. Henry Rayner’s assessment, however, is not borne out by the evidence in Hanwell’s own case books. The medical certificates examined in this study offer few examples of violent and dangerous acts. Far more common were descriptions of comparatively minor, but no less troublesome, acts of disturbance. The nurse of St George’s workhouse informed the certifying doctor that Ann Allcock ‘scream[ed] and shout[ed] often at night for hours at a time, disturbing everybody in the house at a long distance from the ward.’147 Rebecca
Brookman ‘[did] not allow[] any of the inmates of the ward to sleep with her continual vociferations’.148 Other patients physically spread their disruption about
the ward by ‘interfering’ with other patients. Ann Foley ‘constantly undressed herself [and] wander[ed] about the house and premises, [got] out of bed at night, pull[ed] the clothes off other beds and frighten[ed] the people’. George Connigton took this one step further, ‘throw[ing] off his bedclothes’ and ‘get[ting] into other patients beds’. These were uncontained people, whose disruption and disorder leaked beyond the boundaries of their own person and rendered the people around them as disturbed as they were. If their symptoms could not be contained within their person, or within a more appropriate time of day, then they were sent to have their symptoms contained within the walls of the asylum.