One of the problems facing the poor of London in the 19th century was that, in many cases, they lacked access to adequate medical facilities should they fall ill.
There were dedicated medical practitioners who laboured to treat the poor of London; but, in an age before the National Health Service, medical treatment cost money; and there were doctors who didn’t see it as part of their remit to treat the sick poor of the Victorian metropolis without receiving, what they considered, adequate remuneration for their endeavours.
THE REMEMBER THE POOR BOX
St Bartholomew’s Hospital, in Giltspur Street, in the City of London, still displays two boxes that are of uncertain age – the consensus is that they date from the early 19th century – that were intended to encourage people to contribute money to the hospital’s coffers, in order that a fund might be set up with which to provide treatment for the poor who might – in fact who often did – fall sick and who, therefore, required medical treatment.

SHOCKING DEATH OF A WOMAN
However, those who found themselves in need of treatment were still dependent on a doctor actually being willing to go to the trouble of making the journey to administer to their sickbed needs, as can be seen from the following newspaper report, which was headlined “Shocking Death of A Woman”, and which appeared in Lloyd’s Weekly Newspaper on the 21st of July 1872.
The story concerned a lady by the name of Matilda Keene, who had been taken ill after having given birth to her fifteenth child.
The article went on to report that:-
“Yesterday, Mr. Payne held an inquest at St. Bartholomew’s hospital touching the death of Matilda Keene, aged 44 years, the wife of a carman, living at 2, Great Montague-court, Smithfield.
THE DOCTOR’S WOULD NOT COME
Samuel Keene, the husband, said that on Thursday afternoon his wife was taken ill, and he sent for Mrs. Watts, of the infirmary, who came and sent for a medical man – Dr. Mason, who did not come.
Dr. Wilson was also sent for, but he did not come.
Witness went to him, and said, “My wife’s life is at stake; if you can come and render any assistance I shall be much obliged to you.”
Dr Wilson told him, “I cannot, I have nothing to do with it. I am very tired, and have had under a month’s illness, and I am very weak today. I cannot come today unless you pay me my fee and my cab fare.”
Samuel Keene replied, “Is my wife’s life to be lost because of that?” and the doctor replied, “Well, she may not be so bad as you suppose; but if she is, I’ll go for 10 shillings down, and a cab.”
Witness’s wife was the mother of 15 children.
DR TANNER SENT FOR
Mrs. Watts said that Dr. Wilson and Dr. Mason were not dispensary surgeons.
Dr. Tanner is the dispensary doctor, and he resides in Newington-causeway.
He was ultimately sent for by witness [Mrs. Watts]; but she did not send for him at first, because he lived so far away.
DR. REED CALLED
Dr. Reed was called, and he prescribed for Mrs. Keene.
She would, in witness’s opinion, have died, even if the first doctors had seen her.
Dr. Charles Reed, partner of Dr. Mason, the parish surgeon, of No. 2 district of the City of London union, saw the patient, and he could not have done more for her than the nurse had done.
She died from loss of blood.
DR WILSON’S TESTIMONY
Dr. Wilson said that he had told the husband that he had rheumatic fever, and that he must treat the case as a private case.
Witness had had hundreds of wild goose chases.
A juror said a doctor was a public functionary, to which the doctor replied that a doctor is no more bound to go to a sick patient than a tailor is bound to give clothes to a naked man. The dispensary doctor was the proper man to have gone to.
THE JURY’S VERDICT
The jury returned a verdict, “That the deceased died from loss of blood before and after the birth of her child; and the majority of the jury are of opinion that if Dr. Wilson had attended the deceased when he was asked to do so, it would have been more satisfactory to the jury and to the husband of the woman who died.””
Thus the article ended with the jury’s verdict, and Mr Keene returned to their fifteen children, and to mourn the loss of his wife.
Evidently, the jury felt that the medical fraternity – and Dr. Wilson in particular – could have, and should have, done more to help the afflicted Mrs Keene, despite the fact that their intervention probably would have done nothing to save her life.
FREE AT THE POINT OF DELIVERY
The case, however, serves to remind us of the plight faced by many of the ordinary working poor of Victorian London; and it should make us relieved to live in an age when we have access to a National Health Service; one that was born out of a long-held belied that decent healthcare should be available to all, regardless of whether they were wealthy or poor.
Indeed, its launch, by the then Minister of Health, Aneurin Bevan, on 5 July 1948, was centred on three core principles:-
That the new service should meet the needs of all.
That it should be free at the point of delivery.
That it should be based on clinical need, not the ability to pay.
TOO LATE FOR MRS KEENE
Of course, the National Health Service, and its core principals, arrived 76 years too late for poor Matilda Keene.
Yet her case, together with the Remember The Poor’s boxes at St Bartholomew’s Hospital, serve as a reminder of how things used to be, and demonstrate why our National Health Service, was a hard won luxury that we should cherish and fight to preserve, come what may.