Saturday, April 25th, 2020

Prior to the Poor Law Act of 1838, a dispensary doctor could be employed for the giving of medicine and advice free to the poor. However, to pay for the service local donations were collected and the grand jury, which today would be similar to a County Council, was required to match the donations with local taxes. In general, there were few dispensaries and they were unevenly spread across pre-famine Ireland. The Poor Law Act of 1838 divided Ireland into 130 administrative units called Poor Law Unions. This Act is often cited as the first real effort to put in place a public health system. Each Union had its own workhouse governed by the Poor Law Guardians who were elected by the rate payers. The existing dispensaries were now run by the Guardians and new dispensaries were established.

The dispensary system generated a substantial amount of criticism. Although the Guardians were elected they were all men and came from the upper classes. As highlighted in our last post, the Guardians “elected” the medical staff to treat the poor within their districts.  The newspapers are full of reports of conflicts between Guardians over these “elections.” Other controversies arose around decisions regarding the award of contracts as well as to who was eligible for free services, and the nature of the free services.

In general, for medical treatment a ticket system was utilised. The Guardians were each issued with a ticket book. The Guardian would scrutinise the request for services and issue a ticket if he deemed it appropriate. In many cases the persons seeking medical services had to ask their landlord for a ticket. A black ticket entitled the recipient to see the doctor in the dispensary, and a red ticket entitled the recipient to have the doctor call to the recipient’s home. The red ticket was meant to convey urgency, and the doctor would be required to attend the patient as soon as able.

There are numerous complaints of favourtism and graft surrounding the dispensary ticket system. Around the turn of the 20^th Century due to the ongoing abuse of the system auditors were appointed by the Government. Any Poor Law Guardian wrongfully providing “outdoor relief” or dispensary tickets to a person not eligible was made to bear the cost of the support wrongly provided. Outdoor relief was support provided without requiring the person to enter the workhouse. Due to the stigma attached to entering the workhouse outdoor relief was preferred by the poor and discouraged by the authorities. The workhouse and Poor Law Union system were not abolished until after Irish Independence in 1922. The dispensary system, for the provision of medical services, continued until 1972 when the medical card was introduced. Today, Danny Dowling related that when he was about 13 (around 1940) he was asked to take a ticket to Rosbercon to get Dr. Fitzgerald for an elderly neighbour. The Greens, of Jamestown, were in charge of the tickets, and Danny rode his bicycle to Rosbercon.

In terms of the parish of Glenmore during the Poor Law Union it was in the Kilmakevogue Dispensary District which fell under the control of the Waterford Poor Law Union. The workhouses of the Waterford Union were all located in Waterford. A description of the vastness of the Kilmakevogue Dispensary District was articulated by the Glenmore Parish Priest, Rev. Robert Phelan, in 1912 when he was seeking a fairer proportion of medical services for the poor of Slieverue and Glenmore.

“It is 18 Irish miles long, extending from a point near Harristown; five miles north of Mullinavat village to the Barrow; 13 Irish miles south of Mullinavat, and varies in breadth from Lukeswell to Kilmacow village, from the bounds of New Ross to Slieverue village and from Ballyverneen Pill to Ballinlaw Ferry. It includes the greater part of the parish of Glenmore, a part of Slieverue and Kilmacow parishes, and all Mullinavat parish, and is intersected by the Bishop’s Mountain, which forms a natural barrier dividing Glenmore parish from Mullinavat parish, thus cutting off all traffic between the parishes. The extent and general hilly formation of the district make it impossible for one doctor to work it without very great hardship to his patients and himself and at a cost for car hire almost equal to his salary. The roads are soft and bad, and after heavy rain almost dangerous to traffic…” (New Ross Standard—Friday, 13 Dec. 1912).

Today, Danny stated that he believes that there was no dispensary in Glenmore until the 1840’s. A newspaper article in 1846 supports this observation as a Glenmore district was formed when the Guardians agreed to appoint Dr. Boyd to the Kilcolum, Kilbride and Rathpatrick electoral divisions within the Kilmakevogue Dispensary district (Waterford Chronicle, 27 May 1846). On 14 October 1853, an advertisement appeared in the Waterford News seeking a medical officer for the Kilmackevogue Dispensary District. The salary was £80 a year and the area to be covered was 30,000 acres, with a population of 8,000. The election for the post was to take place at Glenmore on the 1st of November 1853. Candidates were instructed to send their qualifications to Robert Grant, Honorary Secretary, of Haggard, Glenmore.

Danny believes that the first dispensary was located in attached premises adjoining the Gaffney shop and currently the end of Danny’s house in the Village. However, Danny stated that an old man years ago told him that the dispensary was once located in an outbuilding near where the current Glenmore Pub is located. The Waterford News of 18 September 1857 provides an account of the report of Dr. Purcell, the medical inspector. When Dr. Purcell went to visit the Glenmore dispensary he found that it had been converted into a public house, by the owner and caretaker. Unfortunately, the owner is not identified. The room where the committee held their meetings was converted to a whiskey shop and the patients’ room was a drinking room. This conversion had been done with the “approbation of the managing committee.” The Guardians were requested to immediately provide other and more suitable premises for a Glenmore dispensary.

Whether the Gaffney dispensary was the first or second dispensary is not known, however, by 1874 Gaffney was reported in the newspapers as being the caretaker of the Glenmore dispensary. Mr. Duggan, the Guardian, proposed that the salary of Nicholas Gaffney, the caretaker of the Glenmore dispensary, be raised from 9d a month to 16d per month. Dr. Mackesy, of Waterford, seconded the motion and it passed with one dissenting vote.

Eventually, due to the fact that the Kilmakevogue Dispensary district was so large dispensary buildings were established at Mullinavat, Slieverue and Glenmore. The doctor established hours at the various dispensaries and did his best to respond to the needs of the poor in the district. The dispensary doctor was required to provide and pay for his own horse and car. Danny does not believe that a dispensary doctor ever lived in Glenmore. The doctors were generally based in Mullinavat, and over the years much has been written about the poor quality of the house provided to the dispensary doctor in Mullinavat. The work of the dispensary doctor has been described as a hopeless and thankless job (John Dorney, A Hopeless and Thankless Job: The Dispensary Doctor in Ireland (2017) available at https://www.theirishstory.com/2019/12/13/a-hopeless-and-thankless-job-the-dispensary-doctor-in-ireland/#.XqQyCGhKhPY. ) The next post will highlight the trials and tribulations of Dr. James Butler Norris Cane who for 38 years was the dispensary doctor of Glenmore.

In 1906 P.N. O’Gorman & Co., of New Ross, purchased the premises of Nicholas Gaffney and was prepared to take over the Glenmore dispensary and caretaking on the same terms. This was accepted by the Guardians. (Waterford Standard, 31 March 1906). In June 1908 the medical inspector issued a report concerning the poor condition of the Slieverue and Glenmore dispensaries. Repairs were immediately commenced in both dispensaries and it was reported that the Glenmore dispensary was temporarily moved to allow for the repairs.

By August there was an open and very public dispute with the newspaper labelling the meeting of the Guardians as heated. The dispute centred on whether the dispensary should remain where it had been or move. It was agreed to put in place a Glenmore Committee to review and make recommendations. Only after the committee was agreed was a letter from Robert Fluskey provided to the Guardians. Fluskey offered a detached house with sanitary accommodation and stabling for the doctor’s horse at the rent of £3, 17s., 6d.. P.N. O’Gorman was getting £13. Various Guardians expressed outrage that the letter was withheld and the arguments erupted again. (Waterford Standard, 22 August 1908). Eventually the Glenmore committee met and more battles took place until it was agreed to recommend to the Guardians that the dispensary stay in the P.N. O’Gorman building with extensive repairs and improvements being carried out at the landlord’s expense. (Waterford Standard, 19 September 1908). This dispensary was later incorporated into the end of Danny’s house.

Danny believes that the last dispensary that was built on the hill (just above the barracks) in the late 1940’s. Prior to it being built a temporary dispensary was on that spot until the new one was built. After 1974 the last dispensary was used infrequently by the public health nurse until it was eventually sold around 2000 and became a house.

The featured photo is a Google Earth view of Glenmore Village.

Further reading: Brian Donnelly, “The Historical Development of Irish Hospitals and the Importance of their Records,” in National Archives, Survey of Hospital Archives in Ireland (2016) p. 5-10 available at https://www.nationalarchives.ie/wp-content/uploads/2019/03/PRF_106780_SURVEY_OF_HOSPITAL_BOOK_V7.pdf

Dr. Kathleen Moore Walsh