Their system was such that the work was almost entirely done by casual hands.

The cobbler told them the man's desperate plight, old, broken, dying, without help or money, reminded them that he had worked for them thirty years, and asked them to do something for him.
"Oh," said the manager, remembering Dan Cullen without having to refer to the books, "you see, we make it a rule never to help casuals, and we can do nothing." Nor did they do anything, not even sign a letter asking for Dan Cullen's admission to a hospital.

And it is not so easy to get into a hospital in London Town.

At Hampstead, if he passed the doctors, at least four months would elapse before he could get in, there were so many on the books ahead of him.

The cobbler finally got him into the Whitechapel Infirmary, where he visited him frequently.