Wednesday, 4 May 2016

Local Health Authority Day Nurseries by Angela Davis

Local health authority day nurseries in post-1945 England 


In this month's blog Dr Angela Davis (University of Warwick) considers the fate of local health authority day nurseries in England from 1945 to the 1970s. While the national trajectory during this period may have been one of decline, this trend masks considerable local variation with some authorities regarding the day nursery as an intrinsic part of the health service and others considering them, at best, marginal.


War Nurseries


Handing over the Women's Voluntary Service War Nursery,
Manor House, Wendover, Buckinghamshire, England, UK,
1941, © IWM (D 2424).
In a Ministry of Health Circular in 1945 the Minister of Health for England and Wales declared that the right policy to pursue would be to positively discourage mothers of young children under two from going out to work and to make provision for children between two and five by way of Nursery Schools and Nursery classes.

From the numerous and widely used local authority administered day nurseries, commonly known as ‘war nurseries’, which were open to all working mothers during World War Two (in 1944 there were around 1,450 full-time nurseries and 109 part-time nurseries), in the late 1970s the day nursery service had become a much more limited form of provision intended to prevent children being harmed by inadequate homes or parents and to avoid the last resort of resort of residential care, including children from difficult family backgrounds, one-parent households, and some handicapped children.

Local Variation


However these national trends figures mask the very real variation at the local level that took place. State-provided day nurseries remained the responsibility of Ministry of Health in the years after the war (responsibility was finally transferred to the Social Services Departments in 1971), and administered through the local health authorities. The local health authority day nurseries were under the ultimate control of the medical officer of health for the area and these medical Officers of Health had very different attitudes about the importance of the provision of day nurseries. While some thought the service was an intrinsic part of the health and welfare provision in their area others were keen to cease providing the service altogether. Throughout the period the provision offered by London Local Authorities was higher than anywhere else in the country. In contrast, the provision offered in rural areas was the most limited. In order to consider these local differences more fully, will look at three case studies – Coventry, Camden (London) and Oxfordshire.

London Borough of Camden


The London Borough of Camden was created in 1965 from the former area of the metropolitan boroughs of Hampstead, Holborn, and St Pancras, which had formed part of the County of London. In 1948 there were 23 day nurseries in the health division area 2, which most closely resembled the later borough of Camden. These nurseries had places for 1,398 children. The divisional health officer explained that many of the wartime nurseries that had been requisitioned for the duration of the war had since been returned to their original uses. As a result, the number of children on the waiting list, which numbered 3,121, far exceeded the number of places available and therefore a scheme of priorities for admissions to day nurseries has been drawn up to take into account of economic and health factors. The cost to parents at this time was negligible. A standard charge of 1s. a day was made for each child placed which covered the cost of the midday meal. However, even the following year, the tone of the reports was changing with the London County Council Medical Officer now stressing that the high cost of maintaining a child in a day nursery caused concern, and attempts were being made to effect economies. Instructions were issued as to economical ordering of supplies and preparation of meals. By 1951 it had become policy that the total day nursery provision should be kept at its existing level, although notably no expansion was planned. Moreover attendances at the nurseries were to be continually under review and closures and amalgamations were to take place when possible. The ratio of staff to children reduced. Nurseries were now to be closed on Saturdays and the priorities for admission were tightened.

Policy Reversal


Annual Report of the Medical Officer of Health
and Principal School Medical Officer for the
year 1965 by Wilfrid G. Harding (1966). Wellcome
Library, London's Pulse: Medical Officer of Health
Reports 1848-1972.
Interestingly, in 1953 there seemed to be a reversal in policy. The priorities for admission were softened. A third group was introduced, namely the children of working mothers whereby the parents income exceeded 9 pounds a week. Why did this occur? It seems clear that the council were concerned about falling attendances that had resulted from a central government order increase the charges for day nurseries with the charges for children at the nurseries was raised to a minimum of 4s. a day. As demand grew in the years that followed, however, the number of children admitted from priority group 3 was again reduced. Other groups were also seen as more needy, particularly those from ethnic minority backgrounds, but also children with disabilities. However there was no growth in the number of day nurseries to match the increased demand. In 1965, the report of the new Camden health authority, reported that the council had ten nurseries providing 541 places for children under five. This compared to the 23 nurseries with places for 1,398 that had existed in 1948.



Cutting Costs


So what do these reports from Camden reveal? Firstly, they indicate that provision declined rapidly after World War Two, but mainly from a desire to cut costs. Nowhere is it mentioned that the policy of the council was that the place of young children was to be with their mothers. The priorities for admission reflected this overriding economic concern. Priorities were tightened when the nurseries were over-subscribed and reduced when attendances fell. The authority seemed to be guided above all by a desire for the day nurseries to be cost effective and seemed to view them a worrying expense rather than an essential part of their service.

Coventry


Portrait of Sir A. Massey.
Wellcome Library, London.
But not all authorities viewed day nurseries in the same way. In his Annual Report from 1944 Arthur Massey, the Coventry Medical Officer of Health stated that, ‘There is no doubt that there is a useful place in the peace-time maternity and child welfare scheme for day nurseries, for they offer valuable medical, nursing and educational care to the children in attendance. Moreover they could provide for the occasional care of children of mothers needing respite from the continual round of domestic work’ (p. 7).

It is clear from the outset that Coventry envisaged a wider for their day nurseries than the belief of central government that they should only be for children in ‘special need’. In consequence every effort was made to keep the nine day nurseries that had existed during the war in operation in the years that followed.

Reducing Charges


Coventry health authority also reacted in a very different way to London in response to Ministry of Health Circular No. 23/52 which increased the daily charges of the nurseries. Like London, Coventry quickly saw a fall in numbers, but unlike London, who responded by opening up the nurseries to non-priority groups, Coventry responded by reducing the charges. Moreover, rather than aiming to simply maintain provision at the level of the early 1950s as London did, Coventry wanted to increase day nursery provision. They were certainly not seeking to reduce their number of nurseries. Indeed the poor state of the current nurseries, the need to build new nurseries, and the increasing demand upon places was a constant refrain in the annual reports. By the mid-1960s, the medical officer reported that they could no longer offer places even to those deemed of high priority. Moreover in his report from 1969 the then Medical Officer of Health Thomas Clayton clearly indicated that he would like to reduce the stringency of the priorities imposed, stating: ‘The slowly declining birth rate has as yet had little effect on the under 5 population and the static day nursery provision is gradually becoming more inadequate. (p. 38). Moreover, unlike in Camden, the Medical Officer could report in 1970 that the number of day nurseries in Coventry had remained at the same level as at the end of the war. In 1948 there were 9 nurseries with 88,650 attendances. In 1970 there were still nine nurseries with 89,437 attendances.

An Essential Part of Health Authority Provision


So from the Coventry experience we can see that some local health authorities took a far more active approach to the provision of day nursery provision than my other case studies. The Coventry Medical Officer of Health saw day nurseries as an essential part of health authority provision in the area. Rather than seeking to reduce the service or being concerned about the cost of providing day nurseries, he was constantly wanting to expand the number of nurseries and places he could offer, and indeed make them available to children without ‘special needs’. Moreover, he was clearly frustrated with the lack of encouragement he received in this ambition from central government.

Oxfordshire


A Nursery School: Watlington Park Children
in Wartime - Five Lithographs by Ethel Gabain.
© IWM (Art.IWM ART LD 263).
The provision of day nurseries in Oxfordshire was considerably lower than in either Camden or Coventry. From the seven war nurseries that had been open throughout the county in 1945, only 2 remained in 1948, accommodating about 80 children.

The Medical Officer noted that they were ‘primarily intended for mothers who are forced by economic circumstances to go out to work. By 1951, there was only one day nursery provided by the county, in Banbury, accommodating 40 children. In 1960 the Medical Officer of Health was questioning the nursery’s continued existence. While the nursery did stay open, it was clearly not viewed as an essential service.

Better off at Home with Mother


The reason for this ambivalence may be in the Oxfordshire local health authority’s attitude towards the institutional care of children. They clearly felt that young children were better off with their mothers and in his 1966 report stated: ‘attendances under the age of two and a half are discouraged’ (pp. 18-19). However, the annual reports also documented the growing demand for day nursery care in Oxfordshire, which the Medical Officer of Health attributed to the increasing urbanisation of Oxfordshire. However, even in 1970, there remained only one nursery in the County. So it is clear that day nursery provision was considered as being rather marginal to the Oxfordshire local health authority. They were unsure about whether they should provide such a service and indeed whether young children should be in day nurseries at all.

Variable Provision


The provision local health authority day nurseries in postwar England was highly variable. It depended on the different material conditions and make-up of the populations in different areas, but also upon on local policies and personalities. For example the Medical Officer in Coventry championed day nurseries in a way that was not seen in Camden and which may account for the continued level of nursery places throughout the decades after the wars.

Angela Davis

Dr Angela Davis, Centre for the
History of Medicine, School of
History, University of Warwick.

Angela Davis is a Senior Research Fellow (Wellcome University Award) in the Department of History at the University of Warwick. Her research interests concern parenthood and childcare in Britain and Israel and the use oral history. Her book Pre-school Childcare, 1939-2010: Theory Practice and Experience was published with Manchester University Press in 2015.

You can listen to a podcast below of a talk by Angela, 'Developing Bodies and Minds: Children's Experiences of Preschool Childcare, Britain c.1939-1979',  given as part of the CHOMI Seminar Series, 29 January 2015.



Monday, 11 April 2016

The Cost of Insanity by Alice Mauger

The Cost of Insanity: Public, Voluntary and Private Asylum Care in Nineteenth-Century Ireland

How did Irish medical practitioners and lay people interpret and define mental illness? What behaviours were considered so out of the ordinary that they warranted locking up, in some cases never to return to society? Did exhibiting behaviour that threatened land and property interests, the financial success of the family or even just that which caused embarrassment eclipse familial devotion and render some individuals 'unmanageable'? These questions are addressed in this month's post by Dr Alice Mauger. In 2014, Alice successfully completed her doctoral thesis at the UCD Centre for the History of Medicine in Ireland on domestic and institutional provision for the non-pauper insane in Ireland during the nineteenth century.

The Evolution of Asylum Care


Paying patients in the Richmond District Asylum (1885-1900).
Pictures courtesy of the Grangegorman Community Museum
The nineteenth century saw the evolution of asylum care in Ireland. While Jonathan Swift famously left most of his fortune to found Ireland's first lunatic asylum in 1746, it would be 70 years before the government followed his lead. In 1817 it enacted legislation permitting districts throughout Ireland to form asylums and by 1900, twenty-two such hospitals accommodated almost 16,000 patients. Growing demand for care for other social groups prompted the decision, in 1870, to admit some fee-paying patients, charged between £6 and £24 per annum, depending on their means. Out of this 16,000 only around 3% actually paid for their care. Private asylums, meanwhile, charged extremely high fees that were out of reach for the majority of society (usually several hundred pounds per year) and by 1900, thirteen private asylums housed 300 patients. Occupying a sort of middle ground, voluntary asylums, established by philanthropists, offered less expensive accommodation to those who could not afford high private asylum fees (from around £24 to a few hundred pounds). By 1900, these four voluntary asylum had outstripped the thirteen private ones, providing for 400 patients.

The Road to Committal


Advertisement for Farnham House, Private Asylum and
Hospital for the Insane, Finglas Dublin.
Source: Medical Directory (London, 1899), p. 1616.
Families were usually responsible for determining when it was time to commit a patient, where to send them and how much they should pay for their care. Factors such as cost, spending power, standard of accommodation, a hospital's religious ethos and the sort of people confined there all coloured these decisions. Broadly speaking, certain social groups (of the same religion) chose certain asylums.

Once admitted, patients were assessed by the medical authorities who determined a cause for their illness along with a diagnosis. This process was based on the medical certificate obtained prior to committal; evidence supplied by the patient and family; and the medical practitioner's own views. The two primary nineteenth-century diagnoses – mania and melancholia – reveal relatively little about reasons for committal. The causes named, however, were far more colourful and wide-ranging and expose much about contemporary perceptions of the life events or circumstances that led to mental illness and therefore committal. Given causes encompassed a range of 'psychological' factors such as grief, bereavement, business or money anxieties and religion, and physical influences including accidents and injuries, physical illnesses, hereditary and alcohol. These later two were the most frequently employed, demonstrating widespread medical understandings of the physical nature of insanity. However, many patients, families and increasingly asylum doctors, reported that fears about financial stability, land interests and the state of the economy had caused the illness.1 In reality, it was often these anxieties that resulted in committal, especially among those with a degree of resources, such as white-collar workers, shopkeepers and farmers.

The Case of John D


Entries in Casebook 2, c.1898.
Source: St John of God's Hospital,
Patient Records.
Land and property interests certainly featured in the case of John D. In 1891, at the age of 77, John was committed to the Enniscorthy lunatic asylum by this two sons. John's sons provided details of his personal history to the asylum authorities; details which were later transcribed by the asylum's Resident Medical Superintendent, Dr Thomas Drapes, into his case notes. Reportedly a 'healthy old man', the first symptom noticed by John's sons was that he wanted to marry his servant, a girl of twenty:

Says if he doesn't marry her his soul is lost and that he'll burn in hell ... he is very supple and has often tried to take away across the country to get to this girl ... Son says he won't allow bedclothes to be changed or bed made since the girl left, as he says no one can make it but her.2
While John was a patient in the asylum, this girl visited him disguised as his niece. Following this, John's sons told Drapes to prevent any further communication between the pair. They were very much against the proposed marriage, insisting that 'she and her family are a designing lot' and 'all encourage her to get him to marry her'. One son informed Drapes that in his opinion his father would have married '"anything in petticoats" for past two years or so'. Allegedly, the girls he proposed to were 'not at all suitable, and "strealish" in appearance and habits'.

Underlying this narrative were anxieties about John's property. A farmer and a shopkeeper, John was certainly not a pauper. His maintenance in the asylum was £18 per annum and while he was in the asylum, John presented Drapes with a further £16 'to keep for him'. The sons made clear their anxieties about the family business. On one visit they stated that lately, their father 'was not capable of properly doing business in his shop'.

The real motivation for committing John, however, became clear when the patient later informed Drapes that 'he gave his sons up his land, but wished to retain his shop for himself and get a wife to mind it for him'. John also gave what Drapes termed a 'rational explanation' for his romance with the servant girl, explaining that:

the girl had been so spoken of in connection with him that her character had suffered, and that if he did not make her the only reparation he could by marrying her, he would suffer in the next world.3

Just two months after his committal Drapes discharged John. In his notes he wrote that this was 'greatly against the wishes of his sons, but I have not been able to find any distinct evidence of his insanity'.4 By 1901, John, now aged 87, had married a woman of 27, possibly the servant girl. However, ten years later, it was his son who resided at this address with his own wife and six children suggesting that he had ultimately inherited the property.5 The most plausible explanation for this outcome was that John's young wife had not borne him any children, which would have prevented her from being entitled to property rights following his death.

Conclusions


The case of John D adheres comfortably both to contemporary public hysteria over the perceived vulnerability of private patients to wrongful confinement and commonly held representations of the rural Irish.6 Although some historians have emphasised the detrimental impact of issues such as the consolidation of landholdings, emigration, land hunger and Famine memories on emotional familial bonds, historians of psychiatry have identified the 'range of familial emotional contexts' which asylum patients came from.7 Families often sent letters querying treatment, offering advice and enclosing food and money for patients.8

Yet, in cases where property or business interests were at stake, these factors tended to eclipse those of familial devotion. In fact, the high numbers of fee-paying patients who were unable to control their business or function in their profession suggests this was a major reason for committal. While the extent to which John D actually struggled in his shop is difficult to ascertain, it is conceivable that a number of other relatives' claims regarding patients' incapacity to work were genuine.

The association between working life and mental illness speaks volumes about contemporary society's interpretation of insanity and what drove families to commit relatives to asylums. In relation to social status, those unable to maintain their position within their given occupation were defined in terms of this failure. Land disputes and an inability to manage one's affairs threatened to shatter emotional familial bonds. In these cases, families may have viewed committal as a last resort in order to protect their resources or livelihood. After all, in smaller rural towns, relatives would have little control over the actions or interactions of a mentally-ill person positioned behind the shop-counter or at a farmers' market.

Dr Alice Mauger


Dr Alice Mauger was awarded a PhD by University College Dublin in 2014 for her thesis which examined institutions for the non-pauper insane in nineteenth-century Ireland. Prior to this she completed the MA programme on the Social and Cultural History of Medicine at the UCD Centre for the History of Medicine in Ireland, UCD. Both her MA and PhD were funded by the Wellcome Trust. Dr Mauger has published on the history of psychiatry in Ireland and is currently writing a monograph stemming from her doctoral research.
Below you can listen to Alice's talk, entitled 'The Cost of Insanity', given on 4 February 2016 as part of the UCD Centre for the History of Medicine in Ireland Seminar Series.



1 Fears of poverty and unemployment among pauper asylum patients are discussed by: Akihito Suzuki, 'Lunacy and labouring men: narratives of male vulnerability in mid-Victorian London' in Roberta Bivins and John V. Pickstone (eds), Medicine, Madness and Social History: Essays in Honour of Roy Porter (Basingstoke, 2007), p. 118; and, Catherine Cox, Negotiating Insanity in the Southeast of Ireland, 1820-1900 (Manchester, 2012), pp 59, 121.
2 Clinical Record Volume No. 3 (Wexford County Council, St Senan's Hospital, Enniscorthy, p. 264)
3 Ibid.
4 Ibid.
5 Census of Ireland 1901.
6 David Fitzpatrick, 'Marriage in post-Famine Ireland', in Art Cosgrave (ed.), Marriage in Ireland (Dublin, 1985), pp 116-31; Timothy Guinnane, The Vanishing Irish: Households, Migration, and the Rural Economy in Ireland, 1850-1914 (Princeton, 1997).
7 Cox, Negotiating Insanity, pp 108-9; Guinnane, The Vanishing Irish, pp 142-43, 230-35.
8 Oonagh Walsh, 'Lunatic and criminal alliances in nineteenth-century Ireland' in Peter Bartlett and David Wright (eds), Outside the Walls of the Asylum: The History of Care in the Community 1750-2000 (London and New Brunswick, 2001), p. 145.

Friday, 18 March 2016

Wellcome Trust Master's Award Scheme

Wellcome Trust Master's Award Scheme

The UCD Centre for the History of Medicine in Ireland (CHOMI) seeks a candidate for the 2016 Wellcome Trust's Master's Award scheme, offering fees and living allowance for one year of taught Master's study in the history of medicine or medical humanities.
UCD can propose one candidate per year to the Wellcome Trust, which considers applications from various institutions and determines whether funding is awarded. It is a highly competitive international competition. CHOMI has a strong track record of successful applications to the Master's scheme and many of the successful applicants have gone on to secure funding for doctoral studies. Details of the CHOMI MA programme are available at here.
Applications from international students are welcome. In addition to a living allowance, the scheme covers full fees for all Republic of Ireland, UK and European Union students, or full overseas fees for students from a list of eligible countries .

Application Process: Step 1

CHOMI runs an internal selection process to identify the strongest candidate to put forward for the Wellcome Trust competition. We now invite expressions of interest. 
Applicants must be strongly committed to developing a research career, and must have, or be predicted to have, at least a very high upper second-class degree at undergraduate level or an international equivalent .
If you would like to express an interest or discuss the possibility of an application, please contact the Director of CHOMI, Dr Catherine Cox (catherine.cox@ucd.ie)
The deadline for preliminary applications is Monday 11 April 2016. Preliminary applications should be sent to catherine.cox@ucd.ie
Your preliminary application should include:
  1. 750-word statement outlining your relevant experience to date and your priorities for future research. If you have already developed a more concrete research proposal, please describe it here.
  2. Current CV, 1 to 2 pages in length

Application Process: Step 2

If you are successful in your application to the internal CHOMI competition, you will then work with a CHOMI staff member in developing your final application to the Wellcome Trust.  You will need to be available to work on completing the proposal to a deadline in April, in order to meet the Trust's final deadline of Tuesday 3 May.

Full details of the Trust's policy on selection and entry requirements are provided here

Friday, 4 March 2016

MA in the History of Welfare and Medicine in Society


MA History of Welfare & Medicine in Society
Programme Director: Dr Catherine Cox
catherine.cox@ucd.ie

About the MA

Medicine, illness and welfare occupy a central place in all our lives. The MA is designed to enable you to understand the place of medicine and welfare in society and history (c1750-1980) and engage with critical debates through various media, including film, literature, and art, amongst others. 

The modules on the programme explore the main trends within welfare and medical history from social history, gender history, post-colonial history to individual experiences of poverty, and of illness throughout history. You will explore how medicine and welfare regimes and policies culturally constructed conceptions of femininity and masculinity.

The modules are taught through seminar and you will develop expertise in presenting, analytical thinking, effective communication, and writing with clarity and precision. You will also partake in a lively seminar series and benefit from a vibrant postgraduate research community.

The dissertation, at the core the MA, allows you to engage your own research-based interests.

Your fellow students will be from diverse academic backgrounds and the MA is popular among healthcare professionals keen to understand the historical contexts that shaped current practices and systems.

The MA has a reputation for excellence and is taught be lecturers with international profiles in the field. 

Dr Catherine Cox, Director and
Co-Founder of the UCD Centre for
the History of Medicine in Ireland

Why do this MA?

Graduates have secured employment in the fields of media, education, politics and in private and public sector management and policy.

Graduates have also proceeded to PhD studies at Irish, British, and European institutions, securing prestigious external funding.

Funding

To apply for the acclaimed Wellcome Trust Masters Scholarship, please contact MA Director, Dr Catherine Cox.

Further Details

Please see the course description for the MA in the History of Welfare & Medicine in Society at UCD Graduates Studies

Monday, 22 February 2016

Parochial Officers of Health in pre-Famine Dublin by Ciarán McCabe

In this month's blog Dr Ciaran McCabe, an Irish Research Council funded postdoctoral fellow  (NUI Galway), considers the oft-neglected figure of the parochial health officer and his role in the prevention of contagion and fighting fever epidemics in early nineteenth-century Ireland. In 2011, Dr McCabe successfully completed a MA thesis at the Centre for the History of Medicine in Ireland, UCD, on the impact of the 1817-19 and 1826-27 fever epidemics on the Cork Street Fever Hospital, Dublin. 

Preventing the Danger of Contagion and Other Evils


The Fever Act of 1819 empowered parish 
vestries to elect unpaid officers of health
From the middle of the seventeenth century, civil parish vestries in Ireland carried out functions which we would today associate with local government services: fire-fighting, tree planting, public lighting, and the repair of roads. Parishes also undertook to provide some assistance to local parishioners in distress and this relief included the support of local 'foundlings', the purchase of coffins for local paupers, payments of cash to widows and the maintenance of an alms-house, typically inhabited by local widows. Parish vestries were of such importance as units of local government that it was upon them that powers were bestowed for the prevention of contagion in response to the 1817-19 fever epidemic. The 1819 Fever Act empowered parish vestries to elect unpaid officers of health, who had the authority to direct that tenements, lanes and streets be cleaned, and that nuisances be removed from the streets. These officers also had the power to apprehend and dismiss from the parish 'all idle poor Persons, Men, Women, or Children, and all Persons who may be found begging or seeking Relief' in the interest of 'preventing the Danger of Contagion and other Evils'.1

Officers of Health: Respectable Parishioners


The positions of officers of health were filled by respectable parishioners, who also typically served as churchwardens, sidesmen and overseers. To these men (and they were invariably men), such voluntary service gave them an opportunity to display their civil responsibilities, as well as asserting their prominence within the community. Toby Barnard has argued that 'as in England, so in Protestant Ireland, a willingness regularly to assume the burdens of parochial office may have helped the middling sort to define and so distinguish themselves from the lower ranks'.2 Among the officers of health in St Michan's parish in the 1830s were Mark Flower of Old Church Street and merchant William Hill of 47 Pill Lane, who also served together as sidesmen and overseers of licenced houses.3 In some instances, parishioners who were qualified medical practitioners  were elected to serve as officers of health, such as David Brereton MD in St Michan's in 1831.4 In St Thomas's parish in 1828, four of the ten elected officers of health were medical practitioners.5

The Fever Act (1819)


A notice issued by the officers of
health in St Werburgh parish,
November 1831
The Fever Act was passed in June 1819, by which point the nationwide fever epidemic had petered out. With the emergency over, parishes were slow to fill the positions of officers of health, which, while not encompassing any salary, required the levying of a parish cess to cover expenses. Shortly after the legislation was passed, the Head of Police wrote to each of the Dublin parishes, reminding them of of their duties to elect officers under the new Fever Act.6 In St Catherine's the first officers of health were appointed two months after the legislation was passed while it took nine months for the first officers to be appointed in St Werburgh's parish.7 Such delays could be criticised, yet on the other hand, given that the worst of the epidemic had passed, parishes were understandably reluctant to assume additional expenditure on unnecessary undertakings.



Cholera Epidemic


Freeman’s Journal, 17 November 1831. The parish vestry 
of St Anne’s in Dublin city appointed officers of health in 
late-1831, following reports that cholera had reached
 England and was believed likely to spread to Ireland
For the first decade after the enactment of the 1819 fever legislation, many parishes avoided filling these positions. Parish expenditure had to be raised through the taxation of local parishioners, who, in some cases in Dublin city, paid up to sixteen different taxes to various local authorities.8 The significance of the 1819 Fever Act, empowering parish vestries to spearhead the local responses to epidemic disease, was not realised until more than a decade after its enactment, when cholera made its first appearance in western Europe. In late-1831, when reports reached Ireland that cholera had been identified in England, parish vestries throughout the country held emergency meetings, drawing on their powers under the 1819 act and rapidly appointing officers of health as a measure to prevent – albeit unsuccessfully – the introduction and propagation of cholera.

To Guard Against Contagion


In St Andrew's parish in December 1831, a cess was levied on parishioners to enable the work of the officers of health by means of 'cleansing & whitewashing the dwellings of the poor in order to guard against contagion'.9 Two weeks earlier in St Catherine's parish, the sum of £50 was levied on parishioners following reports 'that a pestilential has raged in several parts of Europe form sometime under the name of Cholera Morbus, which it is feared may shortly extend its ravages to this Kingdom'.10 Cholera eventually reached Ireland in the spring of 1832 and throughout the epidemic, parochial officers of health carried out measures to mitigate the impact of the contagion. A question which remains unanswered is how the parochial officers of health interacted with other authorities, such as the state-run Board of Health. The rejection in October 1832 by officers of St James's parish of the Board of Health's right to interfere in parochial matters suggests the existence of inherent tensions between these parties, yet the extent to which this single instance is representative of a wider trend is as of yet unclear.11

A dead cholera victim in Sunderland, 1832. Following the outbreak of cholera in north-east
England, Irish parish vestries rushed to appoint officers of health. Wellcome Images


The Decline of the Parochial Officer of Health


Some parishes continued to appoint officers of health throughout the 1830s but the practice declined by the 1840s; yet there are some instances of officers being appointed by parishes in Ulster into the 1850s.12 The power of parish vestries to appoint officers of health was repealed by the 1866 Sanitary Act,13 which extended earlier legislation for England to Ireland and was passed at the height of yet another cholera epidemic. Responsibility for sanitary regulations was transferred to a new Public Health Committee, which operated under the auspices of Dublin Corporation.14 As well as reflecting wider developments in public health reform in this period, the decline of the parochial officer of health was also a symptom of the gradual removal of civil functions from Irish parish vestries. Although constituting relatively short-lived positions with limited powers, and whose efficacy in mitigating the impact of contagion is difficult to gauge, parochial officers of health remain an interesting and neglected part of the social and medical landscape of nineteenth-century Ireland.

Dr Ciarán McCabe


Dr Ciarán McCabe is an Irish Research Council Government of Ireland postdoctoral fellow at the Moore Institute, NUI Galway. In 2015 he was awarded a PhD by Maynooth University for his thesis which examined begging and alms-giving in pre-Famine Ireland. He is currently writing a monograph arising from his doctoral research. Dr McCabe holds a Masters in the Social and Cultural History of Medicine from the Centre for the History of Medicine in Ireland (CHOMI), UCD and also serves as compiler for Irish History Online.




1 An act to establish Regulations for preventing Contagious Diseases in Ireland', 59 Geo. III, c. 41 (14 June 1819).
2 Toby Barnard, A New Anatomy of Ireland: The Irish Protestants, 1649-1770 (New Haven and London), 2003), p. 242.
3 St Michan's parish, Dublin, vestry minute book, 7 April 1828 (Representative Church Body Library (RCBL), St Michan's parish, Dublin, vestry minute books, P 276.05.5; ibid., 23 December 1828; ibid., 9 April 1832; 20 April 1835. Hill also served as churchwarden: ibid., 4 April 1836.
4 St Michan's parish, Dublin, vestry minute book, 23 November 1831.
5 St Thomas parish, Dublin, vestry minute book, 7 April 1828 (RCBL, St Thomas's parish, Dublin, vestry minute books, P 80.5.2).
6 Saunder's Newsletter, 19 August 1819.
7 St Catherine's parish, Dublin, vestry minutes, 24 August 1819 (RCBL, St Catherine's parish, Dublin, vestry minute books, P 117.05.7); St Werburgh's parish, Dublin, vestry minutes, 25 March 1820 (RCBL, St Werburgh's parish, Dublin, vestry minute books, P 326.05.2).
8 Jacinta Prunty, Dublin Slums, 1800-1925: A Study in Urban Geography (Dublin, 1998), p. 67.
9 St Andrew's parish, Dublin, vestry minutes, 12 December 1831 (RCBL, St Andrew's parish, Dublin vestry minute books, P 059.05.2).
10 St Catherine's parish, Dublin, vestry minutes, 28 November 1831.
11 The Pilot, 12 October 1832.
12 Belfast Newsletter, 28 August 1851, 14 April 1852, 3 May 1854.
13 'An act to amend the Law relating to Public Health', 29 & 30 Vict., c. 90, s. 69 (7 August 1866).
14 Prunty, Dublin Slums, pp 70-71.

Friday, 5 February 2016

Website Launch: Exploring the History of Prisoner Health

A new website, Exploring the History of Prisoner Health - or histprisonhealth.com - has been launched by the team (co-PIs Dr Catherine Cox (CHOMI, UCD) and Professor Hilary Marland (CHM, University of Warwick)) researching the Wellcome Trust-funded project, 'Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000'.



Policy Workshop

Exploring the History of Prisoner Health, has been launched in advance of the project's upcoming policy workshop, The Prison and Mental Health - From Confinement to Diversion, which is going to be held in the Shard, London, 12 February. The workshop itself aims  to explore the potential for historians, criminologists, NGOs, policy makers and prison service employees to share ideas and information around the theme of mental health in the prison system.

Project Themes

The website's blog details some of the main project research strands on prisoner mental illness, physical health, juvenile prisoners, political prisoners, as well as the Prison Medical Service. Content will be developed as research progresses and new strands come on board.


Tuesday, 26 January 2016

'The Vast and Often Unpermitted Collection Being Organised in my Diocese': The Central Remedial Clinic, the Catholic Church, and Polio Rehabilitation in Dublin During the 1950s by Stephen Bance

As the incidence of polio began to rise in Ireland, voluntary organisations such as the Central Remedial Clinic were created to rehabilitate survivors of the disease. In this month's blog post Stephen Bance, PhD candidate at the Centre for the History of Medicine in Ireland, UCD, writes about Archbishop John Charles McQuaid's refusal to support the Central Remedial Clinic, given that it was not '100 per cent Catholic'. Others such as Bing Crosby saw no such problem, and were happy to lend a helping hand.


The Central Remedial Clinic


Occupational Therapy was an important part of the rehabilitation
process for polio survivors.
Source: Polio Journal: Official Publication of the Infantile
Paralysis Fellowship, Ireland
, 3:4 (1956), Front Cover.
The creation of rehabilitation facilities for polio survivors in Ireland during the mid-twentieth century was pioneered by voluntary groups. The most active and successful of these organisations was the Central Remedial Clinic (CRC). The CRC was established in 1950 by the remedial gymnast Kathleen O'Rourke and Lady Valerie Goulding, who became a central figure in rehabilitation and philanthropy in Ireland. As a civil-run, non-denominational organisation, the CRC depended upon revenue acquired through fundraising projects, and the success of these enterprises led to their expansion throughout the 1950s. During the same period, the polio rehabilitation unit at Baldoyle Orthopaedic Hospital, which was run by the Sisters of Mercy and was under the patronage of the Archbishop of Dublin John Charles McQuaid, sought public funds to renovate and improve their facility. The Baldoyle Polio Unit, established in 1943, had fallen into a state of disrepair by the early 1950s. The accommodation for patients on site was limited to a collection of dilapidated huts.1 Reverend Mother Mary Polycarp, who was in charge of the facility, wrote to McQuaid detailing the many anxious nights she had spent praying that the huts would not be 'blown down on the little patients who are in danger'.2

Bing Crosby and the CRC


Bing Crosby, 1967, with his horse Dominion Day, which won the
Blandford Stakes at the Curragh with trainer Paddy Prendergast.
Crosby took part in fundraising drives for the CRC.
Source: Dermot Barry/Irish Times.
With no state aid being made available, both the CRC and the Baldoyle Polio Unit began fundraising campaigns.3 The fundraising methods employed by the Baldoyle committee included radio broadcasts, newspaper advertisements, flag days, sweepstakes and sales of work.4 The CRC used similar methods; however, they also harnessed the allure of celebrity to bolster the public profile of their events. For example, a recorded appeal by Bing Crosby was aired on Radio Éireann in 1958,5 and Crosby later visited Dublin to speak at a CRC fundraising dinner.6

100 per cent Catholic, Only


Archbishop John Charles McQuaid, 1956, at the opening of
Our Lady's Children's Hospital, Crumlin. Source.
As the popularity and success of the CRC's fundraising became evident, Archbishop McQuaid wrote to Mother Polycarp expressing his frustration at the 'vast and often unpermitted collection being organised in my diocese by so many persons.'7 Given the influence that McQuaid wielded within the voluntary sector, the CRC asked the Archbishop if he would be prepared to be represented on the trustees committee.8 McQuaid declined due to the fact that Lady Goulding was not a Catholic, stating that it wasn't his policy 'to belong to something unless it was one hundred per cent Catholic'.9

Baldoyle

The Baldoyle fundraising campaign was cut short when McQuaid and the building committee entered into a bargaining process with the Department of Health in order to complete the renovations. The Minister for Health, T.F. O'Higgins, offered to provide funding for the project on condition that the remit of the Baldoyle unit would be expanded to cater for cerebral palsy cases as well as polio cases. This proposal was accepted, and the government provided a £40,000 grant to finish the construction process.10 The hospital was opened in July 1956. The new facility could accommodate 114 patients and included a school, an occupational therapy unit and a phyisotherapy unit.11
The Archbishop of Dublin, Most Rev. Dr.
McQuaid, inspecting the occupational therapy
department after he had opened and blessed the
new Physiotherapy Unit in St. Mary's
Orthopaedic Hospital, Baldoyle.
Source: Irish Independent, 22 November 1957

Expansion of the CRC


Lady Valerie Goulding with President Eamon de Valera
and children at the Central Remedial Clinic in the early 1970s.
Source: Irish Independent.
The success of the fundraising initiatives undertaken by the CRC meant that they expanded independently of the state. A new clinic was opened in Goatstown in January 1955 while a school with the capacity to educate twenty pupils was established on the premises in 1957.12 By the end of 1958, 700 patients were being treated annually.13 A new occupational therapy unit was built in November 1961 and a workshop was opened in March 1963.14 In December 1968, President de Valera opened the newest branch of the CRC at Clontarf.15 The Clontarf clinic was the first purpose built complex of its kind in Ireland, and cost approximately £250,000.16

An Absolutist Approach


McQuaid's snubbing of the CRC conformed to his absolutist approach to voluntarism along denominational lines; a similar situation had unfolded in 1943 when the presence of the Protestant Dorothy Price on the overwhelmingly Catholic executive committe of the National Anti-Tuberculosis League (NATL) led the Archbishop to publicly back the Red Cross Society as a Catholic alternative to the NATL.17 Similarly, the Baldoyle polio facility provided a 'one hundred per cent Catholic' alternative,and Reverend Mother Polycarp was optimistic that her unit could eventually replace the CRC. She wrote to McQuaid in 1957 stating that: 'when some of the Catholic doctors who are working with Lady Goulding realise your interest in the hospital they may send some of their little polio children on to us. I hope they do, for the children's sake'.18 This denominational approach to welfare was inherently divisive, but extremely prevalent in mid-twentieth century Ireland.19

Denominational Welfare


McQuaid's hostility towards the CRC was symptomatic of his combative attitude towards non-Catholic charitable organisations generally. Throughout the mid-twentieth century, the Archbishop readily pitched his organisation against other non-Catholic agencies, such as the St. John's Ambulance Brigade and the NATL.20The social work undertaken by the Archbishop was underpinned by the conviction that the protection of Catholic children meant the protection of the next generation of souls.21 However, unlike his response to the NATL in 1943, McQuaid declined to publicly articulate his aversion to the CRC. Definitive reasons for this discreet approach are not clear, however the series of very public altercations involving the Catholic hierarchy, the state and medical community during the previous decade, not least the Mother and Child Controversy, may have tempered somewhat McQuaid's desire to openly oppose the activities of non-Catholic voluntarism in the field of polio rehabilitation.

Stephen Bance

Stephen Bance is an Irish Research Council funded PhD Candidate at the Centre for the History of Medicine in Ireland (CHOMI), UCD. His thesis is provisionally titled, '"Crippled, Maimed, Lamed, Shattered and Broken": The Irish Experience of Polio, 1942-1970'. His PhD supervisor is Dr Catherine Cox. He received his BA in Single Honours History (UCD) in 2012, and went on to successfully complete the CHOMI MA programme on the Social and Cultural History of Medicine the following year.







1 Letter of appeal Joseph Bryan, Treasurer Baldoyle Building Committee, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.
2 Letter Sister M. Polycarp to John Charles McQuaid, Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.
3 Letter Desmond O'Callaghan, Honorary Secretary, Baldoyle Building Committee, to Sister M. Polycarp, 16 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.
4 Ibid.
5 Irish Times, 13 Mar. 1958.
6 Jacqueline Hayden, Lady G- A Biography of the Honourable Lady Goulding LL D (Dublin, 1994), p. 108.
7 Letter from John Charles McQuaid to Sister M. Polycarp, 11 Jan. 1952, DDA L Files, Baldoyle Orthopaedic Hospital 3/2.
8 Letter from Father Paddy Crean to John Charles McQuaid, 13 May 1951, DDA L Files, Central Remedial Clinic 9/2.
9 Hayden, Lady G-, p. 103.
10 Irish Times, 5 July 1956.
11 Ibid.
12 Irish Times, 13 Jan 1955; Irish Times, 21 Feb. 1957.
13 Irish Times, 1 Sept. 1958.
14 Irish Times, 2 Nov. 1961; Irish Times, 15 Mar. 1963.
15 Irish Times, 11 Jan. 1966.
16 Irish Times, 17 Jan. 1966.
17 See Anne MacLellan, '"That Preventable and Curable Disease": Dr Dorothy Price and the Eradication of Tuberculosis in Ireland, 1930-1960' (PhD Thesis, University College Dublin, 2011), p. 108.
18 Letter from Sister M. Polycarp to John Charles McQuaid, 22 Nov. 1957, DDA Files, Central Remedial Clinic 9/1.
19 Lindsey Earner-Byrne, Mother and Child: Maternity and Child Welfare in Dublin 1922-60 (Manchester, 2007), p. 223.
20 Lindsey Earner-Byrne, 'Managing Motherhood: Negotiating a Maternity Service for Catholic Mothers in Dublin, 1930-54', Social History of Medicine 19:2 (2006), 267.
21 Ibid.