The Monros were also owners of private 'madhouses' in Hackney and Clerkenwell, and visiting physicians to scores of others. Indeed the family name 'Monro', became synonymous with the very word 'mad-doctor'. Absenteeism of the medical officers at Bethlem led to patients too often being at the mercy of untrained and overstretched staff. This was a central point of the shocking revelations of the Parliamentary enquiry into 'madhouses' in 1815/16. James Monro, and his son John, had already suffered a public scandal with the publication of 'A Treatise on Madness' in 1758. Here, William Battie, physician to the London asylum of St. Luke's, argued that Bethlem and the treatment doled out by the Monros, was antiquated, negligent and abusive. So began the great rivalry between the two establishments