1858 The Lancet  
1858. POOR-RATES VERSUS SANITARY IMPROVEMENTS. INTIMATELY connected with the progress of sanitary improvement in the metropolis is the question of re-adjusting the incidence of the poor-rates. It has been authoritatively stated that the crushing pressure of the poor-rates is an effectual obstacle in the way of raising the necessary funds for sanitary works. It is of course an easy matter for the inhabitants of parishes like St. George's Hanover-square, or Paddington, which contribute not one
more » ... lling in the pound towards the support of the poor, to find a shilling or two more for the purpose of rendering their own dwelling-places more wholesome and pleasant. Add the most liberal sanitary rates to the poor-rates of these parishes and the sum will not equal that raised for the poor alone in the outlying parishes of the East and South of London. Under the Metropolis Local Management Act it is rendered imperative upon all parishes alike to carry out certain expensive works in their respective districts, and to contribute to a general fund for the execution of other works of presumed common metropolitan benefit. The leading idea of this Act is undoubtedly sound. If its principle could be fairly carried out through all the departments of local administration, the greatest practical advantage would result. But the efficiency of the Act is marred by the partiality of the application of the principle of consolidating the parochial administrations. If the question be the construction of a new park or a new street, neither of which can be of the remotest advantage to districts at a distance, all districts are, notwithstanding, equally taxed. The poorer districts of London, which have no park, and can get no park, are told that they must contribute, because the park, how far soever out of their reach, is a metropolitan improvement. They are informed that the metropolis is no longer a congeries of isolated parishes, but an integral town. But let the question be the maintenance of the poor, and the overburdened rate-payers of the East are told that each parish is a distinct community, and must support its own poor. It is in vain, in this case, for the oppressed parishes to urge that the London poor are not parochial, but metropolitan encumbrances. St. George's Hanover-square, with a charity beginning and ending at home, repudiates the doctrine. The aristocratic BUMBLES resolutely drive away the poor from the doors of the wealthy, and thrust them upon the shoulders of those who are scarcely above pauperism themselves. St. George's, which, from its central position, is defended against the irruption of paupers, by the outlying parishes, has the audacity to declare that the enemy is not a common enemy, but the enemy of the advanced posts, which receives the attack. An idea of the monstrosity of this argument may be gained from a return lately made, on the motion of Mr. J. LocKF, M.P. for Southwark. By this document it appears that during the year, ending Lady-day, 1857, the rich parish of St. George's, Hanover-square, relieved 210 casual paupers, whilst the poor parish of Shoreditch relieved 13,270; Whitechapel, 6450; Southwark, 12,95S. Why is it that this grievous burden is so unequally distributed ? Why should 13,000 destitute per-sons be lodged and fed in Shoreditch, and only 200 in St. George's? Do the 13,000 belong to Shoreditch in any equitable sense any more than they do to St. George's? They are vagrants, outcasts, the dregs of the metropolitan and country populations, having no greater claim upon the legal or spontaneous charity of one parish than of another. Why do they not knock at the doors of the St. George's workhouse ? Where there is wealth charity should abound. The property-tax valuation, which is still an inadequate index of the actual means of the individual inhabitants of St. George's, is £ 1,080,555, that of Shoreditch is .6255,425. One-fifth of the property, according to this test, supports nearly the whole of the burden. But the full extent of the iniquitous disproportion is not seen by this test. Although the property-tax valuation of the houses in St. George's exceeds one million, the rateable value assessed to the poor barely exceeds three-quarters of a million, whilst upon this low assessment of '75, the amount expended upon the poor is only sixpence halfpenny in the pound. In Shoreditch, on the other hand, the property-tax valuation and the poor-rate assessment are nearly identical; and yet the amount expended on the poor equals 2s. 10'3/.4d. in the pound. If the millionaire of Belgravia bestows ten guineas on an hospital, where he can send his servants for gratuitous medical relief, his name is advertised in the daily papers as a benevolent patron of charitable institutions. The struggles of the poor ratepayer, whose family is pinched to support the workhouse, are unrecorded and unhonoured. Nor this alone. The expulsion of the poor from the rich quarters of the town-an operation which has mainly taken place within the last twenty yearshas, by throwing them upon the outlying parishes, not only increased the poor-rate in these latter, but also greatly aggravated the necessity for sanitary improvements. The overcrowding of poor people in certain districts has so far exceeded the capacity of the dwellings and the provisions for sewerage that the value of life is sensibly diminished. The ratepayer of such a district is not only robbed of his purse, but of his health. The poor thrust upon him eat up his earnings, and leave him without the means of protecting his health. The only resource left him to find the money required for sanitary works, and the other demands of the Metropolis Local Management Act, is to borrow it. He must mortgage the labour of himself and children to keep Fever and Cholera from his door. This injustice is the chief obstacle to the uniform and effectual working of the Act. It has been strained to the utmost limit of endurance. Never can it act efficiently and harmoniously until the metropolis is treated as one integral town for the relief of pauperism, as well as for the other departments of municipal administration. AMONGST the many great grievances which, alas! afflict our profession, if we were called upon to signalize one more injurious than the others, it would be the extent to which advice and aid in various ways are called for and supplied without payment. Why, we would inquire, is a medical man to be the only individual in the whole community called upon and expected to act thus, professionally ? In an hospital the chaplain is paid; the secretary; the solicitor; the medical man alone, the most essential person in the institution, remains, as a general rule, without remuneration. Of course,
doi:10.1016/s0140-6736(02)76116-3 fatcat:bhg2wfsvy5gyll4uwdt36tn2zm