Metropolitan Asylums Board

Last updated September 10, 2025

The Metropolitan Asylums Board (MAB) was established under Poor Law legislation to deal with London's sick and poor. It was established by the Metropolitan Poor Act 1867 (30 & 31 Vict. c. 6) and dissolved on 31st March 1930, when its functions were transferred to the London County Council.

Background to the establishment of the Metropolitan Asylums Board

The Act was passed following multiple campaigns to improve the medical and nursing care for sick paupers, by: the health section of the National Association for the Promotion of Social Science; the Workhouse Visiting Society; the Poor Law Medical Reform Association; Florence Nightingale enlisting multiple influential supporters such as Edwin Chadwick; the Lancet and the British Medical Association.^[1] In September 1866, the President of the Poor Law Board, Mr Gathorne Hardy, instructed two doctors, Dr W O Markham and Mr Uvedale Corbett, to visit all of London workhouses with a view to procuring information which might assist him in drafting new legislation for the reform of workhouse infirmaries.^[1] There was a particular concern that those suffering from infectious fevers and smallpox, and the insane, should be removed from the workhouses and treated in separate hospitals.^[2]

The first decades of Metropolitan Asylums Board

Metropolitan Poor Act 1867 (30 & 31 Vict. c. 6) instructed that all unions and parishes across London were combined for the reception and relief of the poor suffering from fever, smallpox or insanity under the Metropolitan Asylums District and its board of management.^[1] The area covered was defined through the Metropolis Management Act 1855, excluding the hamlet of Penge.

By 1868, the MAB had identified the need for more hospitals for people identified at the time as insane or imbeciles (people with severe learning difficulties ) or with smallpox or other infectious diseases. The MAB purchased land and commenced building asylums at Leavesden in Hertfordshire and Caterham in Surrey, and small pox and fever hospitals at Haverstock Hill in Hampstead, Homerton in East London and Stockwell in South London ^[3]

The MAB responsibilities were extended to cover people with cholera (1883) ; diphtheria (both pauper and non pauper,1888), Poor Law children and children with ringworm and opthalmia (1897), poor law boys training for sea service (1875).^[4]

The Metropolitan Asylums Board in the Twentieth Century

By 1900 the MAB was responsible for 2,486 beds in smallpox hospitals in country areas and 6,108 beds in fever hospitals in London.^[1]

The MAB's responsibilities were enlarged to include care of people with: measles (1911), puerperal fever(1912), trench fever, malaria , dysentry (1919), with tuberculosis but uninsured under the National Insurance Act 1911 , venereal disease (women and girls)1919, sane epileptics who were paupers (1916) , and women with carcinoma of the uterus (1928).^[4]

During its lifetime, MAB set up around forty institutions including : a hospital for venereal diseases (1920), five children's hospitals, 10 ambulance and river ambulance stations, and three research and pathology laboratories.^[4] At the time of its dissolution it was responsible for 38 Hospitals provided 22,572 beds. Of these beds, 9,387 were for the treatment of the mentally disordered and feeble minded and 8,421 were in isolation fever hospitals.^[4]