In February 1864, an Association was set up for improving Workhouse Infirmaries. The Committee included the Arch Bishop of York, The Earl of Carnavon, Charles Dickens and John Stuart Mills. Miss Nightingale felt that they did not pay enough attention to nursing. Mr Villiers, President of the Poor Law Board, set up an enquiry in July 1865. The Metropolitan Workhouse Bill was drafted, but it fell short of requirements of the reformers. Miss Nightingale and Mr Farnall, Poor Law Inspector for the Metropolitan District, with the support of Palmerston prepared a new draft.
Disaster then stuck, on 18th October 1865 Lord Palmerston died, and the Whig Government fell, and with it the hopes of reformers. Charles Villers was also a member of the Whig Government. The Tory administration was under Lord Derby, and Mr Villiers was replaced by Mr Gathorne Hardy. Miss Nightingale wrote to him offering her help. He never met her, or asked her advice, or even wrote to her. He appointed a committee to report on the requisite amount of space, and other matters in relation to Workhouse Infirmaries. Sir Thomas Watson, President of the Royal College of Physicians was Chairman. Miss Nightingale tried to put forward her ideas on nursing, but failed.
When the Bill was drafted the advice of Edwin Chadwick, Mills, and Miss Nightingale were ignored. Edwin Chadwick (1801-1890) was a sharp minded north country man who since 1834, was Secretary of the Poor Law Commissioners. In 1842 the `Report on the Sanitary Conditions of the Labouring Population` was published. It reported details of overcrowding, filth, bad drainage, inadequate water supplies, which bought disease, and an early average of death among the, poor, also led to drunkenness, crime, prostitution and vice. The Government set up a commission of inquiry into the `Health of Towns`. Two reports were published in 1844 and 1845, based on enquires into sanitary conditions in a group of large industrial towns. This led to reforms in the 1840`s and 1850`s. The Public Health Act in 1848, setting up central Board of Health Act which contained detailed regulations about sanitation. The Central Board had little real power or money to spend and only survived 10 years, Chadwick was dismissed in 1854
A hospital authority for lunatics and fevers was set up, which left the non-infectious poor sick under the Poor Law Boards Union. Miss Nightingale read Sir Harry Verney’s advance copy of the Bill. Sir Harry and other Fund Council members who were MP`s urged for amendments. In the end a clause was inserted that the new hospital should be used for training nurses.
The Metropolitan Poor Act became law on 29th March, 1867 the following year the Poor Law Amendment Act gave similar powers to provincial authorities.
The main objectives of the Bill was to provide separate accommodation for fever cases and lunatics. The Metropolitan Asylums Board was then set up with the power to build and run hospitals from a Common Fund. It became unlikely that paupers would go either to the fever or the lunatic asylum, to get preferential treatment. The sick Asylums Districts and Poor Law Unions were reorganised and encouraged to build separate infirmaries for non-infectious cases. One of the first Unions to take advantage of the Bill Was St Pancras. It was improved and partly rebuilt, and had sixteen pad non-pauper nurses.
The Chairman of the Reform Group Mr Wyatt had decided that a new Infirmary should be built at Upper Holloway, Highgate. He appealed to the Nightingale Fund to help in providing nursing staff for part of the new hospital. During the planning and building of the new Infirmary there were changes in control and the Fund found difficulty in setting up a nursing system. The Infirmary was controlled by the Central London Sick Asylum, and the old Poor Law Board was replaced by a new Local Government Board.
Permission was in the end received for a training school for the London Sick Asylums District. There was doubt never the less about the legality of the Matron having the power to select or dismiss probationers without reference to the authority