Paul Carter
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Steve King
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The patient’s view as history from below
Evidence from the Victorian poor, 1834–71
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This chapter challenges the widely held assumption that the voices of the very poorest of the sick are difficult and sometimes impossible to find. Drawing on material from a project which identifies such voices in the central administrative records of the New Poor Law, the chapter shows how often and with what force the sick poor were able to express their views on the medical welfare (broadly defined) offered to or imposed upon them. Few of these paupers and prospective paupers constructed their identities in terms of ‘being a patient’, except perhaps in the titular sense of entering or leaving the infirmary wards of workhouses. Rather, they thought and wrote of themselves as sick fathers, mothers, sons, daughters, citizens and members of the community from which they were drawn. Nonetheless, in a modern sense they were patients and the chapter shows how such people contested aspects of the medical welfare system both at the local level and through correspondence with the national administrative body for the New Poor Law. They were, perhaps surprisingly, often ‘successful’ in their contestation, displaying an agency that is rarely attributed to the very poorest in nineteenth- and early twentieth-century English and Welsh society. More than this, many of the issues that the poor and their advocates contested (who should decide when someone was sick enough to receive treatment; how far might it be reasonable to travel for medical care; and how responsive should healthcare systems be to the wishes of those who used them) have a striking resonance with the sorts of issues raised by and complained about by modern patients and patient groups.

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