The concept of purgatory instilled fear in the affluent for it promised suffering for the rich and unrepentant, who in the after-life would be judged by the poor and the meek. The Church had to coexist with the Crown. The power of the latter fluctuated depending on the skill and ability of the monarch, the extent to which the monarch was distracted by overseas exploits, and the level of control over their local agents – the sheriffs and sergeants. The Church continued to be the provider of hospitals for the sick and destitute. The only other health care was provided by a collection of self-taught healers including bone-setters, corn-cutters, herbalists, midwives, barbers and tooth-pullers. During the 17th century, immigration led to a four-fold increase in the population of London, most of which took place outside the City. Governance of the hospital was contested over several centuries between the Church, Crown and City.