Workhouse infirmaries housed the poorest patients and, in theory, kept them away from the more salubrious voluntary hospitals. Nursing standards were considered low since most carers were lay ‘handywomen' or even convalescent patients. Nevertheless, workhouse infirmaries such as this one in Birmingham, England, were constructed on an impressive scale and with the most recent hospital designs in mind. Most became the district general hospitals of the 20th century. The rise of such hospitals had important consequences for the medical profession because they gave doctors the opportunity of observing disease in large numbers of patients.Photolithograph by WH Ward (architect), reproduced in The Building News, 3 February 1888.