Until the early 1990s, the village was dominated by St Mary's Hospital. This was constructed in 1836 by the Elham Poor Law Union as the workhouse for the communities of Acrise, Cheriton, Elham, Elmsted, Folkestone, Hawkinge, Hythe, Lyminge, Lympne, Monks Horton, Newington, Paddlesworth, Postling, Saltwood, Sandgate, Sellindge, Stanford, Stelling, Stelling Minnis, Stowting, and Swingfield. Prior to this each had relieved the poor the best way they could, usually by allowing them to remain in their own homes and giving them dole, although Elham and Newington each had a small local workhouse facility. In 1834 Parliament passed an Act reforming poor relief and suggested parishes might group together and provide cross-community facilities. This led to the birth of the Elham Poor Law Union in 1835, and the building of the workhouse at Etchinghill in 1836 at a cost of £6,500. The house was run by a husband and wife team entitled the ?Master? and ?Mistress?, assisted by a clerk who kept the accounts, a schoolmaster, a schoolmistress, and later also a nurse.
