Queen Mary and Westfield College London University PhD Thesis ...

predecessors to absenteeism. With the introduction of certification to Bethiem in the 1650s
and 60s (see chap. 6, infra), its physicians were obliged by order of court to preside over
every patient's admission to, and discharge from, the hospital. It was not, however, until the
hospital's re-siting at Moorfields that viewing applicants for admission became a weekly duty of
the Physician and Bethlem Sub-Committee, which, by the eighteenth century, convened for two
hours every Saturday morning' 0'. Yet Sub-Committee Minutes commencing from September
1709 reveal that both Richard Hale and James Monro attended virtually every meeting. By
the 1730s at least, the physician was also visiting the hospital on Mondays and Wednesdays,
on which days he was furnished with 'an Account of the...Patients' by the Porter, Nurse and
(presumably) the Matron'° 2. The same rate of attendance appears to have been sustained by one
or other of the Monros for much of the remainder of the period' 03 . Bowen's claim in 1783 that
'the physician visits the hospital three days a week', including every meeting of the Saturday
admitting Committee, was, in fact, no over-estimate 104 . What historians have also failed to
appreciate, is that, from the mid-eighteenth century, the bulk of the responsibility for medical
attention at the hospitals had been conferred on the Apothecary. Henceforth, the Apothecary
101 Originally, the 20 strong Bethiem Committee was only 'to meete once a fortnight or often[erj as to them [ha
members] shall seem meete' at new Bethlem and was merely to be responsible in a general way for the supervision
of affairs at the hospital, being a development from the building committee or 'committee for reparations', which
had all too occasionally inspected the management of old Bethiem. It was a rotational committee, half of whose
members were replaced every year on election day, and 4 of whom were responsible, in monthly rotation, for
examining the provisions and the general observance of the house rules. Soon afterwards, 4 more members were
added to its ranks. By 1685, the Committee was meeting on Saturdays and by the eighteenth century was meeting
every Saturday, being referred to as either the 'Weekly' or the 'Monthly' Committee. In 1709, the Committee
(consisting now of 42 governors) was asked to meet at Bethlem 'once besides Saturday every week...to inspect
the provisions', and by September, 7 governors were serving on a two monthly rotation, although as few as I and
as many as 9 might be present at any one sitting. See rep. BCGM, 16 Feb., 30 March 1677, 3 July 1685, 6 Nov.
1702, 25 Feb. 1709, & BSCM, paaaim, fols 336-7, 356, 361, 59, 119 & 465.
102 Unlike the Porter & Nurse, the Matron did not include this duty in the list of those she 'apprehended'
to belong to her office (indeed, she only mentioned 2 duties). One assumes, however, that the doctor received
accounts of ordinary women patients, as well as of male patients & of those sick patients under the Nurse's care.
See BCGM, 6 May 1736, fol. 391.
103 On first analysis, John and Thomas Monro may seem to have attended the meetings of the Bethiem
committees much less often. In the six years 1769-75, for example, John's presence is recorded in both the
Bethiem Sub and Grand Commitee Minutes only 74 times, suggesting that he attended such meetings little more
than once a month. Yet the minutes of actual admissions were separated at the back of Sub-Committee books
after about mid-century. Even a cursory examination of these minutes demonstrates that one of the Monros
continued to preside over almost every admission to Bethlem, although admissions did not occur every week.
The Monros' presence only seems to have been recorded in the ordinary Committee minutes when they were
attending in their capacity as governors, serving their rotation.
104 Historical Accoant, 9 & 11.
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