New Principles Unknown in 1834 in United Kingdom
New Principles Unknown in 1834 and the Principles of 1907
In this issue about new principles unknown in 1834, the book “English Poor Law Policy” [1] reads as follows: In the policy of the Central Authority, as we find it in 1907 in the statutes, orders and circulars in force, there are discoverable three separate principles, which were neither advocated nor condemned in the 1834 Report, because they were either unknown, or not considered relevant to the relief of the destitute. These are the Principle of Curative Treatment, the Principle of Universal Provision, and the Principle of Compulsion.
(i.) The Principle of Curative Treatment
The Principle of Curative Treatment-that is, of bringing about in the applicant actual physical or mental improvement, so as to render him positively more fit than if he had abstained from applying for relief-may be considered the direct opposite of the Principle of Less Eligibility. It might, indeed, be termed the Principle of Greater Eligibility. This principle has been gradually evolved by the Central Authority in the course of the last fifty or sixty years; but it has characterised in particular the administration of the Local Government Board ever since its establishment in 1871. We see it most thoroughly applied to the sick and the children; though not yet to all sections even of these classes.
With regard to the sick, the policy since 1865 has been to get them out of the general workhouse, and to get established, for their treatment, separate institutions as well built, as well equipped, and professionally as well staffed as the most efficient hospitals. The whole object is to cure the patients in the most rapid and thorough fashion. The very idea of “deterring” them from entrance has been avowedly discarded. Hence, in those unions in which the policy of the Central Authority has been thoroughly carried out, and where the poorer classes have (but for the Poor Law) to rely on their own independent exertions, those of them who, in illness, accept Poor Law relief, find their condition in every way more eligible than those who do not apply for it, or who are refused it because they are deemed “not destitute.”
The Principle of Curative Treatment has not been so consistently and universally pressed on local authorities in the case of outdoor medical relief. The Central Authority is “desirous of encouraging” the provision of professional trained nursing for those cases of sickness treated at home. But it has not yet seen its way to make (as in the Poor Law infirmary or workhouse sick ward) the provision of even one trained nurse compulsory in every union. With regard to the supply of drugs, etc., of standard quality, and to the free accessibility of medical advice at definite hours, it is only in the Metropolis that the Central Authority has pressed on boards of guardians the universal provision of well-equipped and well-staffed dispensaries; though these have, with the willing sanction of the Central Authority, been copied in a few other towns. On the other hand, the Principle of Curative Treatment may be said to have been accepted all over the country, though perhaps not consistently enforced, in the free supply of expensive drugs and surgical appliances, in the provision for difficult operations, and generally in the rising standard of qualification, attendance and remuneration expected for the district medical officers charged with the care of such of the sick paupers as are treated in their own homes. In all these respects, these patients are admittedly under better conditions than those who are just above the locally accepted definition of destitution. This is emphasised by the absence in 1907 of any political disqualification.
The application to the children of what we have called the “Principle of Curative Treatment” is of older date than its application to the sick-dating, indeed, from E. Carleton Tufnell’s Report of 1841. In all the development from the earliest “district school” to the most up-to-date “cottage home,” the whole policy of the Central Authority has been to provide the most efficient education for the child, so that it shall be positively more able to cope with the battle of life and less likely to fall again into the ranks of pauperism than the child of the lowest grade of independent labourer. In the Poor Law institutions for children sanctioned in recent years, the Principle of Greater Eligibility has been carried so far as to result in the provision, for the pauper child, of physical training, mental education, and prolonged supervisory care, extending over more years of life, and costing more per head per annum, than the corresponding provision usually made for children even of the lower middle class. In the same way, the Central Authority sanctions, even if it does not overtly encourage, the bestowal of elaborate and costly care and supervision in the launching into life of some sections of Poor Law children-going even so far as occasionally to sanction premiums, residential homes, or a “rate in aid” of their insufficient earnings as apprentices in skilled trades. But though the Principle of Curative Treatment has been carried to a high pitch in respect of some sections of the child pauper population, it has been scarcely at all applied to other sections. It is, indeed, not too much to say that, with regard to the children on outdoor relief, the contrary Principle of Less Eligibility is still the governing policy. An investigation into their condition might show that a large proportion of them, upon the relief afforded, are more likely to fall into disease, vice or pauperism than the average child of the lowest grade of independent labourer. For these children, the policy of the Central Authority does not include either supervision or systematic medical inspection, either the protection of the child’s leisure from industrial work or even any minimum provision for its maintenance, let alone any selection of a suitable skilled occupation for it or any subsidised apprenticeship. All that the Central Authority does for these 170,000 pauper children is to ask that they should be vaccinated and should be in regular attendance at a public elementary school-advantages which they share with the non-pauper children.
We do not find that the Principle of Curative Treatment has been deliberately applied to the other classes of paupers. To the aged, curative treatment is, indeed, scarcely applicable, but it is interesting to trace, in the policy of expressly directing the grant of adequate outdoor relief to the deserving aged, combined with the statutory requirement that a friendly society allowance is not to be taken into account in such grant, a sort of Principle of Greater Eligibility. With regard to the able-bodied, there is a certain premonition of the Principle of Curative Treatment in the farm colony as well as in the “mental instructor” sanctioned for the able-bodied ward of the workhouse. Indeed, there is only one class of paupers to which the Central Authority has rigidly refused to apply this new principle. From the casual ward every trace of curative treatment has been eliminated, and the Principle of Less Eligibility rigidly adhered to.
(ii.) The Principle of Universal Provision
But what is most strikingly new since 1834 in the policy of the Central Authority is the Principle of Universal Provision, that is, the provision by the State of particular services for all who will accept them, irrespective of “destitution” or inability to provide the services independently. We see this principle in most municipal action, but it impinges on the work of the Poor Law authorities most directly in such services as vaccination, sanitation, and education. From the standpoint of the Poor Law critic, this principle avoids the characteristic Poor Law dilemma, and escapes alike the horn of making the condition of the patient so bad as to be injurious to him, and that of making it better than the lot of the lowest grade of independent labourer. In providing vaccination, sanitation, and education-to say nothing of parks, museums, and libraries-indiscriminately for every one who is ready to accept them, the State does nothing to diminish the inequality of condition between the thrifty and the unthrifty-for it is a simple axiom that the addition of equals to unequals produces unequals-whilst it raises the standard of living of all. The most thrifty of artisans who discovers a public elementary school freely provided for his own children, does not find his advantage over his unthrifty neighbour thereby in the smallest degree diminished. It is this consideration which justifies the provision of municipal hospitals, and which, presumably, led the Central Authority of 1870 (under Mr. Goschen) to dwell upon the expediency of “free medicine to the poorer classes generally, as distinguished from actual paupers, and perfect accessibility to medical advice at all times under thorough organisation.” It is this principle that lies at the base of all schemes of non-contributory pensions to be given to persons on reaching a certain age. The controlling limits of the application of this Principle of Universal Provision in the mind of the Central Authority seem to have been, first, the consideration whether it is in the public interest desirable that the service in question should be as widely as possible enjoyed; and secondly, the consideration whether, as a matter of fact, such universal provision is found to diminish human productiveness or mental development.
With regard to vaccination, sanitation, and education, the policy of the Central Authority has long been based upon the Principle of Universal Provision. In its application to the pauper population, we need only refer particularly to the problem of the Poor Law child. As we have already stated, the Education Acts of 1870-1903 have enabled the Poor Law authorities to escape, in respect of mental training during school age, from the embarrassing dilemma of either placing the pauper child in a position of vantage, or of deliberately bringing up a couple of hundred thousand children in a state incompatible with future citizenship. In respect of everything beyond vaccination, sanitation, and education-together with hospitals in some places for some kinds of illness-the dilemma remains.
(iii.) The Principle of Compulsion
The Principle of Compulsion-in the sense of treating an individual in the way that the community deems best, whether he likes it or not-is, of course, as old as the lazarhouse, “Bedlam,” and the gaol. Such compulsory treatment may have for its object deterrent punishment, reformation and cure, or mere isolation from the world. In all three aspects this principle now forms an integral part of the policy of the Central Authority for one or other classes of destitute persons.
It is interesting to note that, although the Principle of Compulsion played a large part in the Elizabethan Poor Law, to which the 1834 Report purported to revert, it formed no part of “the principles of 1834.” It did not appear in any of the recommendations of the Report. What underlay the whole scheme of 1834 was the very opposite to compulsion. No power was given to any Poor Law authority-apart from the case of dangerous lunacy-to detain any pauper against his will, for any purpose whatsoever. Every inmate of the workhouse was to be free to discharge himself at the shortest notice compatible with the convenience of the establishment. The vagrant was to be at liberty to leave as early in the morning as he chose after his night’s lodging. The sick person, even if dangerous to others, or on the point of death, was to be permitted to leave the shelter of the workhouse, if he chose, with no more restraint than a warning from the medical officer. It was even open to doubt whether a board of guardians could legally detain the youngest orphan infant struggling to be free. The whole intention of the 1834 Report was, in fact, to make the pauper of any age feel that he was at all times an unwelcome guest.
Today we see the Central Authority making use of the Principle of Compulsion as part of its policy towards every class, except the deserving healthy aged. The wayfarer, whatever his character or conduct, is to be compulsorily detained, under penal conditions, for twenty-four hours, or, in certain cases, much longer, in order to deter him from ever again applying for a night’s lodging. The able-bodied man or woman in the workhouse is, under certain circumstances, to be compulsorily detained, for a day, or even a week, in order to deter him or her from passing too frequently “in and out.” Quite different are the objects, isolation from the public and their own cure, with which the infectious sick are now compulsorily detained in the workhouse infirmary or isolation hospital. We may note, too, that the power to detain lunatics, for isolation, if not for cure, has, since 1834, been stretched so as to include many harmless persons of defective mind, who are now regularly certified for detention. Finally, we have the compulsory detention of children, ranging from detention against the will of every one except the parent, in the case of children of indoor paupers, up to the complete parental authority exercised by the board of guardians over orphan or deserted children; and, in the guise of adoption, even extending to the age of sixteen, and against the will of the parents. And there are signs that the Principle of Compulsion-that is, the treatment of an individual in the way that the community deems best, whether he likes it or not-is about to form part of the policy for other sections of the destitute.
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