For many, the word ‘workhouse’ conjures up the image of an orphaned Oliver Twist begging for food from a cruel master. The reality, however, was somewhat different, and Britain’s system of poor relief arguably saved thousands of people from starvation over the course of its 300-year history.

The provision of state-provided poor relief was crystallised in the 1601 Poor Relief Act, which gave parish officials the legal ability to collect money from rate payers to spend on poor relief for the sick, elderly and infirm – the ‘deserving’ poor. Labelled ‘out relief’, handouts usually took the form of bread, clothing, fuel or money.

Though they were termed ‘workhouses’ from the 1620s, the early institutions that provided poor relief were, more often than not, non-residential, offering handouts in return for work. Much like today’s taxpayers, those funding poor relief were anxious to see their money well spent, wishing to deter those capable of working from claiming assistance. By the end of the 17th century, providing care under one roof was widely regarded as the most effective way of saving money and, as a result, the early 1700s saw a flurry of workhouses opening.

Yet workhouses only really became part of Britain’s social landscape after 1723, when Sir Edward Knatchbull’s Workhouse Test Act won parliamentary approval. The act embodied the principle that the prospect of the workhouse should act as a deterrent and that relief should only be available to those desperate enough to accept its regime. Its impact on the provision of poor relief was dramatic: by the 1770s the number of parish workhouses in England and Wales had soared to around 2,000.

Conditions during the early 19th century, though, meant the government was forced to reassess the way it helped the most impoverished members of society. The return of unemployed or injured servicemen from the Napoleonic Wars saw the national poor relief bill quadruple between 1795 and 1815, rising from £2 million to £8 million. To make matters worse, new Corn Laws restricted grain imports and pushed up the cost of bread.

The government’s response was to pass a Poor Law Amendment Act in 1834, based on the recommendation of a royal commission. The new system was still funded by rate payers, but was now administered by unions – groupings of parishes – presided over by a locally elected Board of Guardians. Each union was responsible for providing a central workhouse for its member parishes, and out relief was abolished except in special cases. For the able-bodied poor, it was the workhouse or nothing.

“Entering the workhouse was not simply a matter of turning up at the gate,” says Peter Higginbotham, author of The Workhouse Cookbook. “The poor would first meet with a relieving officer who toured the union on a regular basis. In most cases they would be ‘offered the house’ and given a ticket of admission. The family would then make its way to the workhouse where their clothes were put into storage, and they would be issued with a uniform, given a bath and subjected to a medical examination.”

Men and women were separated, as were the able-bodied and infirm. Those who were able to work did so for their bed and board. Women took on domestic chores such as cooking, laundry and sewing, while men performed physical labour, usually stone breaking, oakum picking or bone crushing. Conditions were basic: parents and children were permitted to meet briefly on a daily basis, or on Sundays. Inmates ate simple fare in a large communal dining hall, and were compelled to take regular, supervised baths.

Until 1860, medical provision in the workhouses was often dire, with nursing duties generally performed by elderly female inmates, many of whom could not read, were hard of hearing, visually impaired, and fond of a drink. Medical wards were frequently cramped and poorly ventilated but, following a sustained campaign led by the medical profession during the 1860s, the government passed the Metropolitan Poor Act, forcing London’s workhouses to run separate infirmaries, preferably on separate sites. Meanwhile, the Metropolitan Asylums Board (established in 1867) provided care for fever cases that would ordinarily have ended up in the infirmaries. By the 1880s, the unions widely employed trained nurses, and the poor could increasingly visit workhouse infirmaries for treatment without having to formally enter the institution.