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CHAPTER VIII.

THE HOUSE OF HELP, AND HOSPITAL BEDS FOR THE POOR.

THE sound public economy of keeping the public health at the highest attainable pitch is pretty generally admitted, and pretty generally neglected, in England. Directly the maladministration, blundering, and confusion of the English poor-law régime is attacked, and a speaker or writer ventures to draw upon his foreign experiences for an amendment or a remedy, he is met with the old cries, which cover old errors, and opposed with prejudices which, albeit of ancient date, are in the heartiest strength even now. I have been greatly struck with the array of facts made by Dr. Rogers in an address to the Poor-law Medical Officers' Association, because they are all to the discredit of the English public men, who have been patching our Poor Laws for so many years past. These facts are blunders and shortcomings, which even

a peep at our more orderly neighbours would have taught them to deal with long ago. When I survey the establishments of the Paris Assistance Publique, and mark how they fit in one with another, all working in harmony to a common end; one real vital administration in the centre, making its vigour and heat felt to the remotest members of its body of employés; and then turn to the records of mistakes, and descriptions of bad payment and bad treatment, of medicines held back till the sick poor fall into the house, and the temporary public patient is shuffled by ignorant guardians and underpaid medical officials into chronic and, to the State, costly pauperism ; -I am indeed earnest in begging readers of professional and social authority to come hither, and speedily much of the mischief might be got under.

To begin with. They who would succeed as reformers of the sick-poor treatment in England must approach the British ratepayer through his breeches-pocket. Prove to him that sound public health means empty workhouses, and consequently very low rates. A sick creature is a dear creature. Our shrewd neighbours understand this, and have directed charity carefully to the convalescent poor. In London you are discussing convalescent hospitals. In Paris the poor sick workman, who needs fresh air and nutritious food to get back his normal allowances of heat and muscle, can repair to the

splendid establishment at Vincennes; the workwoman to the Vesinet. One of the finest charities in the French capital is that which gives timely help to the poor as they issue, discharged, from the hospitals. The London plan is to break up the home, to stint the sick diet and the drugs, and so keep up the stock of pauperism in the workhouse.

Out of the unassisted or ill-assisted sick poor of England, we have been told by an authority none have ventured to contradict, 72 per cent. of the English paupers, who collectively cost about £7,000,000 sterling per annum, are made; and yet the Poor-law Board will not move to stay the manufacture. The workhouse medical officer is underpaid and overworked; the methods of distributing the drugs he orders are left to the will of guardians, or if he has contracted to supply medicines as well as advice, it is at so low a rate that he cannot afford to give his patients the drugs they require! I have already dwelt on the manner in which these things are regulated in Paris, and regulated, let me add, without striking a death-blow at "local selfgovernment." The Central Store, the Central Pharmacy, the Central Meat Depôt, feed the twenty arrondissement Bureaux de Bienfaisance-each according to the wants it makes known. The arrondissement Bureau, in its turn, supplies the Maisons de Secours, or houses of help, within its

circumscription. Every part of Paris is duly provided with its House of Help, to which the poor resort in sickness or in an emergency. And the House of Help is a dispensary, as well as a place for medical consultations, and distributions of clothing. It is a pleasant sight to see how smoothly all the duties proceed of a morning; and how apt and gentle the sisters are in helping the poor to carry out the doctor's orders. It is the humane air that is upon the scene, the seemliness and the quiet, which strike the visitor who can remember the kind of treatment which the English workhouse poor experience—to our shame—but, let this be evermore insisted upon, to our wasteful cost as well.

There is a House of Help on the north side of the Mairie, by the Church of St. Germain l'Auxerrois, to which the properly curious Paris visitor may repair with advantage, furnished with a note from the Central Bureau. It is an excellent sample of the best of these establishments: a school; a consulting establishment; a dispensary; a store for linen that may be wanted on an emergency. It is administered and worked by a few gentle sisters, who surely here are doing woman's proper work.

Pray is there any sound reason why Houses of Help should not exist in London, and under the control of a central board, as well as that of an arrondissement bureau locally administered? The local authority is valuable; and is sensibly carried

out in Paris, where it is an honour in one's neighbourhood to be of the committee of the poor. There are in Paris no growths of poor through the maltreatment or neglect of the sick, like that which Dr. Rogers describes at Birmingham, and in several metropolitan parishes, where the manner in which the sick shall be treated is left to the temper, whim, or taste of guardians.

The care with which the sick poor are nursed back to perfect health by the plans now in full operation in and around Paris comes from that farseeing providence which is a prominent French characteristic. Inquire, and you will be told that to give health to the poor is the very cheapest way of assisting them. Can there be a doubt on the subject? The only capital they have in the world is their store of strength: let this fail, and the State must provide for them. Surely, then, it is best to prop up their strength.

The Poor-law Medical Officers' Association are at the root of the evil, when they insist on a complete reform of the medical treatment of the English poor (rather in the direction of Paris than of Ireland). If homes were broken up in Paris, as they are in London, because they want temporary relief, Napoleon's capital would not have its actual general holiday look. More timely help in England would decrease the pauperism; and improve the race. For the consequences of our fundamental