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Steven King

8 Institutions and the sick poor Introduction On 18 February 1812, John Mitchel, vicar of Iselworth (Hertfordshire), wrote to the overseer of Rotherfield Greys (Oxfordshire) concerning Anthony Harris, who ‘became deranged in his Intellect some months ago, & it is now no longer safe to himself & others’. Unfortunately Harris ‘On Thursday morning left his Home again, & has not since been heard of – His poor Wife is half distracted, & after walking yesterday 30 Miles, & making every Inquiry where there was a chance of any Intelligence, is very ill from Anxiety

in Sickness, medical welfare and the English poor, 1750–1834
Open Access (free)
George Campbell Gosling

3 Payment and the sick poor In 1935 Sir Alan Garrett Anderson, son of the pioneer of women in medicine, Elizabeth Garrett Anderson, was elected Conservative MP for the City of London. A year later he spoke in a parliamentary debate on the nation's voluntary hospitals: We have been told that they are passing through a lean time and are in competition with the municipal hospitals, but I

in Payment and philanthropy in British healthcare, 1918–48
Steven King

4 Treating the sick poor: a quantitative overview Introduction On 27 July 1806, Samuel Tibbs, overseer of Aldbury (Hertfordshire), wrote to his counterpart in St Albans (Hertfordshire) authorising payment of 2s 6d to Mrs Narroway ‘in her distress’. He added, however, that ‘we [the vestry] do not think she ought to be in the distress she says she is in’ and asked his fellow overseer to ‘have the goodness to attend her, and if what she relates is true, I will thank you to inform me of that or anything else relating to her, wishing to do all that is absolutely

in Sickness, medical welfare and the English poor, 1750–1834

This book examines the payment systems operating in British hospitals before the National Health Service (NHS). An overview of the British situation is given, locating the hospitals within both the domestic social and political context, before taking a wider international view. The book sets up the city of Bristol as a case study to explore the operation and meaning of hospital payments on the ground. The foundation of Bristol's historic wealth, and consequent philanthropic dynamism, was trade. The historic prominence of philanthropic associations in Bristol was acknowledged in a Ministry of Health report on the city in the 1930s. The distinctions in payment served to reinforce the differential class relations at the core of philanthropy. The act of payment heightens and diminishes the significance of 1948 as a watershed in the history of British healthcare. The book places the hospitals firmly within the local networks of care, charity and public services, shaped by the economics and politics of a wealthy southern city. It reflects the distinction drawn between and separation of working-class and middle-class patients as a defining characteristic of the system that emerged over the early twentieth century. The rhetorical and political strategies adopted by advocates of private provision were based on the premise that middle-class patients needed to be brought in to a revised notion of the sick poor. The book examines why the voluntary sector and wider mixed economies of healthcare, welfare and public services should be so well developed in Bristol.

Steven King

mid-1810s were different in scale and complexion. From this point medical welfare as a proportion of all spending increased in a sustained fashion, and the study has argued that once we allow for source lacunae which mean that we detect only a sub-sample of all spending on sickness, the sick poor were by some distance the key client group of the Old Poor Law by the 1820s. The so-called crisis of the Old Poor Law elides with sickness and response rather than the rise of the able-bodied welfare recipient. The response itself increasingly came to be numerically

in Sickness, medical welfare and the English poor, 1750–1834
Steven King

acknowledged customary rights to relief offers a more optimistic sense of the final decades of the Old Poor Law. Paul Slack’s reading of ‘signs that English society’s threshold of tolerance of deprivation was always low’ might easily be applied to many of the parishes whose archives underpin this study.67 The way in which parishes treated sick paupers like George Lewis is one such sign. The sick poor The character, scope and scale of medical welfare under the Old Poor Law are issues that have attracted relatively little historiographical attention in comparison to the post

in Sickness, medical welfare and the English poor, 1750–1834
Alun Withey

Medicine and micro-politics: medical provision and the poor law in early modern Wales Medical care, especially of the poor, also fell under the auspices of the parish, although this was by no means the only structure. Legally, the parish was bound to make provision for the sick poor, but other systems of relief, such as those of Dissenters, existed alongside. Quakers, for example, often used donations made from monthly and quarterly meetings, rather than by the parish, to provide for 179 WITHEY 9780719085468 PRINT.indd 179 20/10/2011 16:28 Domestic sickness and care

in Physick and the family
Open Access (free)
George Campbell Gosling

philanthropy. In the past these class distinctions had been enacted by providing a separate, institutional space where the sick poor would receive treatment. Admission to the hospital itself had been an act of separation. As technological advances and rising costs led the middle classes to arrive in the hospital as patients, this class differentiation became an internal event. The working classes submitted to a new form of charitable assessment

in Payment and philanthropy in British healthcare, 1918–48
Evidence from the Victorian poor, 1834–71
Paul Carter
and
Steve King

clients such as the middle classes) is a foundational question in any healthcare system. For the latter question to be answered in the affirmative, those same stakeholders have to create the mechanisms to both hear and act upon the poor voice. To understand how they did and do so, our chapter shifts attention back to the nineteenth century when systematic institutionalised provision for the sick poor started to become a reality under the New Poor Law. This is not an unproblematic exercise. The number and overall size of published and archival sources

in Patient voices in Britain, 1840–1948
Author:

This book explores the experiences of the sick poor between the 1750s and through the so-called crisis of the Old Poor Law ending in the 1830s. It provides a comprehensive and colourful overview of the nature, scale and negotiation of medical welfare. At its core stand the words and lives of the poor themselves, reconstructed in painstaking detail to show that medical welfare became a totemic issue for parochial authorities by the 1830s. The book suggests that the Old Poor Law confronted a rising tide of sickness by the early nineteenth century. While there are spectacular instances of parsimony and neglect in response to rising need, in most places and at most times, parish officers seem to have felt moral obligations to the sick. Indeed, we might construct their responses as considerate and generous. To some extent this reflected Christian paternalism but also other factors such as a growing sense that illness, even illness among the poor, was and should be remediable and a shared territory of negotiation between paupers, advocates and officials. The result was a canvas of medical welfare with extraordinary depth. By the 1820s, more of the ill-health of ordinary people was captured by the poor law and being doctored or sojourning in an institution became part of pauper and parochial expectation. These trends are brought to vivid life in the words of the poor and their advocates, such that the book genuinely offers a re-interpretation of the Old Poor Law from the bottom up.