1902 Encyclopedia > England > Hospitals and Charitable Institutions.

(Part 13)


Part 13. Hospitals and Charitable Institutions.

No country in the world is so rich in charitable institutions of every description as England. The relations between the vast pauperism and the equally vast flow of charity designed to remedy it have been keenly discussed; and while many insist that the latter is simply an offspring of the former, there are others no less confident in maintaining that he abundance of charity has given rise to the very evil it was expected to care. Probably the truth lies midway between the conflicting arguments. If indigence give rise to charity, the excess of the latter could scarcely fail in its turn to beget improvidence, and, with it, poverty. There can be little doubt that, in modern times at any rate, and immerse multiplication of charitable institutions has served to foster idleness among the lower classes in large towns, and thus has swelled the ranks of hereditary pauperism. Legislation has not remained ignorant of this fact, and hence a large number of laws for regulating the uses and abuses of charity.

The oldest of these regulations were made in the same reign which laid the foundation of the poor-law, that of Elizabeth. By the Act of 43 Elizabeth c. 4, passed in 1601, usually known as the Statute of Charitable Uses, a rather wide definition was given of what was considered to be within the realm of charity. It might be used, declared the Act, "for relief of aged, impotent, and poor people; for maintenance of sick and maimed soldiers and mariners; for schools of learning, free schools, and scholars in universities; for repair of bridges, ports, havens, causeways, churches, sea-banks, and highway; for education and preferment of orphans; for relief, stock, or maintenance of houses of correction; for marriages of poor maids; for supportation, aid, and help of young tradersmen, handicraftsmen, and persons decayed; for relief or redemption of prisoners or captives; and for aid or ease of any poor inhabitants concerning payments of fifteen, setting out of soldiers, and other taxes." It is clear from the wording of this statute that, at the time it was made, organized charitable institutions were already numerous in England. In order that they might be well managed, and their funds employed for none but legitimate purposes, the Act ordered that commissioners should be appointed by the lord chancellor, four for each diocese, to act under the bishop, and "inquire by a jury concerning charities." It does not appear that much action was ever taken under the statute, cumbrous in all its prescriptions, and it has fallen into disuse before the middle of the last century, when it was gradually replaced by other legislative enactments.

No general record of charitable institutions is known to have exited until the close of the 18th century, when the subject came to occupy the serious attention of parliament. In manifested itself chiefly in the passing of a statute, 26 Geo. III. C. 58, generally called the Gilbert Act, which gave orders "for procuring, upon oath, returns of all charitable donations for the benefit of poor persons in the several parishes in England." The return obtained under this Act were examined and reported on by a committee of the House of Commons, which sat in 1786 and 1788, when it appeared that out of 13,000 parishes and townships in England and Wales, only 14 had omitted reporting their charities. The aggregate annual income of those reported upon amounted to £528,710, but it was generally held that this sum was a gross understatement. Consequently, there was more legislation, though at considerable intervals, on the subject of charities. Under an Act of 52 George III. c. 102, passed in 1812, stringent regulations were laid down for ascertaining the nature and income of all the charitable institutions in England; but the Act was never properly enforced, and remained to all intents and purposes a dead letter. More effective, although limited in scope, was an Act of 58 George III. c. 91, passed in 1818, which ordered an inquiry into the educational charities of England. It was this statute which first instituted the "Charity Commissioners for England and Wales."

The actual functions of this board, in superintending all charities, and making annual reports upon them to parliament, were defined by the Charitable Trusts Act of 1853, to which amendments were passed in 1855, in 1860, and in 1869. By these statutes, the "Charity Commissioners for England and Wales" are invested with great powers, some of them distinctly judicial in their natural, and the rest of an administrative character. They may compel the trustees and administrators of all endowed charitable institutions to keep full account of their receipts and disbursements, and to forward them every year; and they may likewise order special inquiries into the circumstance of individual charities, and enforce the production of all required information. Possessed of such powers, the commissioners have been enabled to publish a number of valuable annual reports, beginning with the year 1852, on the number and character of the net-work of charitable institutions spread all over England, tending to alleviate misery and to promote greater welfare, or at least designed to do so. Still these reports are far from giving a complete picture of the vast extent of organized charity, since the action of the Charity Commissioners does not embrace any but endowed charities, and not all even of this class. Specially exempted from the operations of the Charitable Trusts Act of 1853, and its subsequent amendments, are the charities of the universities and their colleges, those of Eton and Winchester, of the various cathedral foundations, of all friendly and benefit societies, and of all institutions wholly maintained by voluntary contributions. Among these and other exemptions fall a number of charitable institutions as important of their kind as ancient in origin—the Hospitals.

There can be little doubt that hospital were, if not the very oldest, at least among the most ancient, of English charitable institutions. The earliest of these establishments probably grew up in the time of the crusades, or soon after, necessitated by the spread of new diseases, introduced by the knights and their followers returning from the East. How terrible were the ravages made by some of these diseases, such as leprosy, is shown by the fact that there were counted in France, in the year 1225, upwards of 2000 hospitals, going by the distinctive name of "leprosoria." England must have suffered, as well as France, from the influx of the infectious maladies from the same source, although the English crusaders were much less numerous, and many of them belonged to a better class. Neither in France nor in England any trace is left of the "leprosoria" of the 13th century, all the existing hospitals being of more modern foundation.

The most ancient in the list of English hospitals is that of St Bartholomew, London, which had its origin in a priory of the same name, founded by Rahere, a minstrel of King Henry II., about the year 1100. A quarter of a century later, Rahere obtained from the king the grant of a piece of waste ground, adjoining the monastery, where he built and endowed a hospital "for a master, brethren, and sisters, and for the entertainment of poor, diseased people till they get well." At the dissolution of the monasteries, in the reign of Henry VIII., St Bartholomew contained 100 beds, with one physician and three surgeons. The hospital was refounded, on a new basis, in 1544, and incorporated by charter in 1546. St Bartholomew, on account of its age no less than of the excellency of its medical staff, continues to stand in the foremost rank of English hospitals, as of the endowed charities of the county in general. Its average annual income, in recent years, amounted to about £40,000, derived mainly from rents and funded property. In 1876 St Bartholomew’s Hospital had 5672 in-parents and 19,576 out-patients, together with 153,905 other patients attending for temporary medical and surgical attendance, thus affording relief to 179,153 persons in the course of the year.

The management of the oldest of English hospitals was united, in 1782, with that of four other charitable institutions of the same kind in London, namely, Bethlehem, St Thomas’s, Christ’s Hospital, and Bridewell. The union was effected under the Act 22 George III. c. 77, and from it the joined institutions were called "the five royal hospitals," their superintendence being place under "the pious care of the lord mayor of London." Only three out of the "five royal hospital." St Bartholomew, Bethlehem, and St Thomas, now remain institutions in the same sense, the others two, Christ’s Hospital and Bridewell, having been diverted entirely from their original design. Bethlehem Hospital, like St Bartholomew’s originally a priory, founded in 1247, under the name of St Mary of Bethlehem, by Simon Fitz Mary, sheriff of London, was given, with all its revenues, by Henry VIII. In 1547, to the city of an institution of the kind previously founded in Granada, Spain, it was the first lunatic hospital in Europe, and as such acquired large fame, though for a long time not well deserved, the unhappy inmates being treated more like caged animals than human sufferers. Bethlehem Hospital had its first site in Bishopsgate Street, from which it was transferred to Moorfields, in the city of London, in 1675, and finally to its present place, St George’s Fields, Lambeth, in 1814. The income of Bethlehem Hospital in the year 1876 amounted to £25,184. More wealthy than Bethlehem, and with revenue equal to those of St Bartholomew, is the third of the "royal hospital," St Thomas likewise originally a priory, and converted into a hospital in 1553. The old building, in Southwark, near London Bridge, was leveled to the ground in 1862, to make room for the South-Eastern Railway, when a new and larger edifice was erected in Stangate, Lambeth, facing the Houses of Parliament, and opened in 1871. of the two converted "royal hospital," the first, Christ’s Hospital, Newgate Street, London, founded in 1553, is solely devoted to the education of upwards of a thousand boys, out of revenues of about £58,000 per annum; while the second, Bridewell Hospital, has become an industrial school, its annual income of nearly £15,000 being employed in the training of 150 boys and as many girls, under a scheme settled in 1860 by the "Charity Commissioners of England and Wales."

There are no official statistics regarding either the total number of hospitals in England, or their revenues, the great majority of these institutions being maintained by voluntary contributions, and therefore, as previously mentioned, by law exempt from the supervision of the Charity Commissioners. In a few provincial towns, such as Salisbury, Cambridge, Bristol, Winchester, and York, there are hospitals dating back to the first part of the 18th century, and with more or less considerable revenues; but otherwise the metropolis is the chief home of all these charitable institutions, both on account of its wealth, and in connexion with the study of medicine necessarily demanding centralization. Besides the "royal hospitals" there are others, endowed and unendowed, possessed of large revenues. Foremost among them stand Guv’s Hospital Southwark, founded in 1721, which has an annual income from investments of over £40,000, and relieves 5000 in-patients and 85,000 out-patients in the course of the year; and the London Hospital, established in 1740, and supported mainly by voluntary contributions, which maintains 6300 inpatients and 46,000 out-patients, at a cost of £44,700 per annum. Among the other principal metropolitan hospitals are that of Westminster, founded in 1719, with an annual income of £13,000 per annum, relieving 2000 in-patients and 20,000 out-patinets; St George’s, at Hyde Park Corner, opened 1733, disbursing £28,000 a year for 4000 inpatients and 17,000 out-patients; and the Royal Free Hospital, Gray’s In Road, which spends £22,000 in relieving annually 2000 in-patients and 26,000 out-patients. There were altogether 115 hospitals in the metropolis at the end of 1877, of which number 16 ranked as "general" hospitals, for the treatment of all diseases, while the rest were devoted to special maladies of infirmities. To aid in the maintenance of all these institutions, involving an aggregate expenditure of over a million sterling per annum, there has been made, since 1783, in the middle of June an annual collection in most of the churches and chapels of London, known as that of the "hospital Sunday." The collection produced over £25,000 in June 1877, and not much less in the preceding years. The receipts of 1877 were distributed among seventy-six general and special hospitals, including four medical institutions and forty-three dispensaries, the former receiving £22,747, and the latter £2223. In addition to the "hospital Sunday" there was started in the metropolis, in 1875, a "hospital Saturday" collection, made later in the year, the object being to let the so-called working classes contribute to institutions maintained almost exclusively for their own benefits; but the receipts in 1876 and 1877 were comparatively small, with large expenses of collection.

Endowed Charities—While no authentic information exists regarding the number and income of the charitable institutions maintaoined by voluntary contributions, the Charity Commissioners for England and Wales have issued from time to time, in their reports to parliament, accounts of the financial state of the endowed charities placed under their control. Appended to one of these reports, issued in June 1877, was a series of tabular summaries, giving an account of the income, both from landed property and invested funds, of all the endowed charities under the superintendence of the commissioners in England and Wales. Of these the following is an abstract:—


It will be seen from the preceding table that the endowment of the mass of the charities is mainly in land. The total are of land belonging to the endowed charities at the date of the report, June 1877, amounted to 524,311 acres, which brought an annual rental of £1,443,177. Rent charges and fixed annual payments for land produced a further sum of £115,073, bringing the total income form real estate up to £1,558,250. The annual income from personality in 1877 amounted to £640,213, produced from £17,418,250 of invested stock and £2,197,478 of other investments. Calculated at the rate of 4 per cent. Interest, the total revenue of the endowed charities of England and Wales represented, in 1877, a capital of close upon fifty-five millions sterling.

Under the provisions of the Charitable Trusts Act of 1853, the personalty of the endowed charities has to be gradually transferred to the "Official Trustees of Charitable Funds," consisting of two persons appointed by the lord chancellor, who are invested with large powers both of transferment and re-transferment. Under very slow but steady progress, the work has been going on since the year 1854, and according to the twenty-fourth annual report of the Charity Commissioners, issued in 1877, the total sum of stocks and investments held by the "Official Trustees" at the end of 1876 amounted to £7,177,942, after deducting a sum of £837,430 as re-transferments.

The vastness of the work of the Charity Commissioners and "Official Trustees" is shown by the fact that the seven millions sterling standing in the names of the latter at the end of the year 1876 were divided in no less than 8244 separate accounts.

The annual income of upwards of two millions sterling divided among the endowed charitable institutions of England and Wales may be thus analyzed as to origin:—


The principal objects to which this annual income is devoted were stated as follows in the twenty-fourth annual report of the Charity Commissioners, issued ij 1877:—


Educational Charities.—It will be seen from the preceding statement that about one-third of the total annual income of endowed charities of England and Wales is for purposes of education. The sum probably represents but a fraction of the actual devoted to education, since the majority of the institutions promoting it depend either wholly or in part upon voluntary contributions, and very few of them are largely endowed. Among the more important charities for educational purposes are the Society for Promoting Christian Knowledge, founded in 1698, the income of which in 1876 was £52,851, including legacies of £16,000; the National Society, established in 1811 under which are 13,000 schools, which had an income of £26,931 in 1876; and Dulwich College, founded by Edward Alleyn in 1619, and reorganized by Act of Parliament in 1858, which has an annual income of over £16,000. As before mentioned, the English universities and colleges, as well as the schools of Eton and Winchester, together with all cathedral foundations, are specially exempt from the control of the Charity Commissioners, and no account is therefore given in the annual reports of their revenues.

Asylums and Almshouses.—While one-third of the annual income of the endowed charities is for educational purposes, one-fourth is for the maintenance of asylums and alms houses. These charitable institutions are numerous all over England, and many of them of ancient date, but the incomes of the majority of them are very small. In the metropolis alone there are over 100 asylums and almshouses, and the total number of them in England and Wales is considerably more than 1000. Among the most notable of these institutions are the Charter House of London, established in 1611, which has an annual income of £25,000; the almshouses of the Mercer’s Company, dating back to 1393, endowed to the same amount; and Morden College, Blackheath, near Greenwich, founded 1695, with revenues of over £10,000.

Distribution of Charities.—There is a curious agglomeration of endowed charitable institutions in many parts and districts of England. Thus the small town of Baldock, in Hertforshire, has 17 charities; the village of Banstead, Surrey, 21; and the city of Norwich, 28 different charities, mostly of ancient date. Probably a sort of competition for becoming founders of charitable institutions, with the names of the originators going down to posterity, existed in these and many more small places for some period, which led to their becoming rich in bequests, not always to the advantage of future generations, while other towns, some thickly inhabited, remained without these foundations. It is stated by the Charity Commissioners for England and Wales in their fourth annual report, published in 1877, that great reforms in the still existing irregular distribution of charities, arising from endowments, are urgently required. "The case of a parish," says the report, "has been brought to our notice, which is in possession of parochial charities to the value of upwards of £800 a year, the population of which is at present 46, of which number it is believed that only four or five sleep within the parish, and not one of whom could properly come under the designation of poor." It is estimated that the total amount raised annually for charitable purposes in England amounts to, if it does not exceed, the millions sterling—a sum strikingly indicative, in its abundance, as of national kindness, so of national wealth.

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