Gender, Health and Welfare

Anne Digby, John Stewart

• Publisher: Routledge
• Year: 2015
• Print ISBN:
  9780415128865
• eBook ISBN:
  9781134662654
• Topic: Politics & International Relations
• Subtopic: Health Care Delivery
• Index: Politics & International Relations

Gender, Health and Welfare deals primarily with the century before the creation of the classic welfare state in Britain. It provides a stimulating introduction to an historical era which saw a huge expansion in welfare services, both state and voluntary, and during which women emerged as significant 'consumers' and 'providers' of various measures.

Chapter 1

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Welfare in context

Anne Digby and John Stewart

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This volume is concerned with the exploration of a number of themes including the gendered allocation of welfare resources in society and the role of family and state in influencing this division; the effect of gender in the creation and adoption of policies concerning health and welfare by pressure groups, political parties, and government at both local and national levels; and the extent to which the balance of voluntary and statutory bodies alters the nature of welfare, not least because of the differential involvement of men and women. These issues involve not only structure but agency and thus include discussions of the ways in which welfare agendas are shaped in different contexts. A significant theme is the role of female agency in networks during the earlier development of welfare policies and systems, while another key area of debate is whether women should continue to be interpreted as being primarily consumers of welfare, rather than providers/ producers/managers of welfare. These related issues give analytical coherence to an interconnected series of case studies from the mid-nineteenth to the mid-twentieth century, which centre on Britain within a wider international setting. This first chapter provides a general historiographical and a discussion of the contribution that a gendered analysis can make to it.

BEFORE THE CLASSIC WELFARE STATE

The century which ended with the creation of the ‘classic’ welfare state saw a fundamental change in the role of the British state. The mid-nineteenth century was an era of laissez-faire when central government adopted a minimalist role in social and economic affairs. In social policy, the single most important piece of legislation remained the 1834 Poor Law Act, motivated in part by Malthusian and Benthamite ideology stressing both individual moral—and thereby social and economic—responsibility and administrative efficiency. After World War II, such ideas appeared to have been discarded; the Labour government, drawing on a mixture of Keynesian economics and labourist concerns for social justice, intervened on an unprecedented scale in both economy and society. Particularly as enshrined in health provision, the stress was on universal, comprehensive and free services, stripped of the stigma associated with nineteenth-century notions of pauperism and the undeserving poor.¹

This is a rather stark way of presenting an immensely complex period. Local bodies remained important providers of welfare, and key institutions such as the Treasury were long hostile to the kind of government expenditure which large-scale social welfare involved. Furthermore, recent work has stressed the continuing role of the non-state sector in providing welfare. This is significant for the volume of resources which the voluntary sector has, historically, distributed. In Britain, where the state has always been relatively ‘weak’, this is important. There is, therefore, a ‘mixed economy’ of welfare. Moreover, the complex relationship between the voluntary sector, the state, and society not only puts a new perspective on the state’s role, it also suggests there is no ‘linear’ progression from the ‘individualism’ of the nineteenth century to the ‘collectivism’ of the post-World War II era. It is striking, for example, that the individual most associated with the creation of the welfare state, William Beveridge, also wrote Voluntary Action (1948). At a time when the impetus appeared to be towards more state direction, this work extolled the virtues of the voluntary sector even as the state appeared to be trying to take more of a role to itself.² A number of the contributions to this volume discuss the role of non-state welfare, for example that of Caroline Morrell on Octavia Hill and housing. When we speak of a century of dramatic change, therefore, it is not in a simplistic spirit of Whiggish interpretation of an ‘inevitable’ welfare state, and with it a final achievement of citizen rights. So what was it about the century after the Great Exhibition that made it so crucial in modern British social welfare history; what were the particular historical events and trends that led to the creation of the welfare state? Among the most important factors were: the changing intellectual climate; the influence of war; and political change, most notably the rise of Labour and the enfranchisement of women.

First, then, what changes took place in the intellectual climate?³ If political economy dominated the mid-Victorian period, by the end of the nineteenth century there were a number of challenges to its claim to have discovered the ‘natural laws’ of the economy. On an empirical—but extremely important—level the findings of social investigators suggested that phenomena such as unemployment, poor housing, and the poverty of the old could not simply be explained by individual moral shortcomings. In economics, the work of Marshall questioned the tenets of classical liberal thought, while in philosophy a new, and more positive, conception of the state was emerging. In a complex way, all of these fed into the phenomenon of ‘New Liberalism’, an adaptation of liberal ideology which stressed a greater role for the state in social welfare matters and a more ‘organic’ view of society. This in turn influenced the welfare legislation of 1906 to 1914.⁴ The period between the mid-nineteenth and early twentieth centuries saw, therefore, what some political scientists have described as the beginnings of the ‘rise of collectivism’, a point cogently made by a contemporary critic of such trends, A.V.Dicey.⁵ All this is not to suggest that the key ideas of Victorian liberalism were redundant by 1914. The persistence of the ‘Treasury View’ in the interwar period demonstrated the intellectual legacy of the nineteenth century, specifically regarding balanced budgets and minimum levels of public expenditure. But the era of mass unemployment, Soviet Five-Year Plans and Roosevelt’s New Deal saw a continuing critique of unbridled capitalism. Keynes and Beveridge, in many respects the intellectual founders of the welfare state, are central here, although note should also be made of bodies such as Political and Economic Planning and the social democratic theorists around the Labour Party. With the success of Labour in both the wartime coalition and the 1945 election, it did at last appear as if the tenets of the ‘dismal science’ had been rejected, and that an era of managed, welfare capitalism had arrived.⁶

Turning now to our second general causal factor, was there, as one commentator on welfare provision has suggested, a ‘close association between warfare and welfare’? From the last decades of the nineteenth century concern about the condition of the mass of the population was partly motivated by the more tense and competitive international situation.⁷ Amid fears of declining relative international position and a possibly ‘degenerating’ race, ameliorative social policy became a major political issue, especially after the Anglo-Boer War débâcle. Like ‘New Liberalism’, this was to feed into the welfare reforms of 1906–14, particularly in respect of children and of health, since attention to these was perceived as potentially averting racial decline.⁸ During World War I, the state took further ‘collectivist’ measures, and was concerned to maintain civilian morale by promises of ‘reconstruction’. Although in many crucial areas such promises were not honoured, the war did raise expectations of social reform.⁹ The 1920s and 1930s therefore saw an increase in social welfare provision, despite the economic constraints imposed by conventional fiscal policy. Moreover, an apparently declining population and the rise of militaristic foreign powers made health and social conditions a continuing source of concern, and it is in this context that the reports and recommendations of the 1930s, again principally about health care provision, need to be placed.¹⁰

What impact, then, did World War II have on the existing impetus towards social reform? This is the subject of a vigorous and ongoing historical debate. The reforming proposals and measures of the 1930s are seen by some as, effectively, constituting the welfare state in embryo, although the unplanned and uncoordinated nature of the services is generally acknowledged. Others emphasise the fundamental shift in the political mood of the period 1939–45. The welfare state was, according to this approach, very much the creation of the war itself, and increased welfare provision something advocated by all major political parties—an instance of the idea of ‘convergence’ in interpretations of social welfare. Others stress the novelty of Labour’s post-war legislation, and the continuing hostility of the Conservatives towards comprehensively planned welfare provision. This is related to the debate over ‘consensus’; whether there was a general political agreement on the aims and structures of the ‘welfare state’; and whether, later on, the post–1979 Conservative administrations sought to break out of a supposedly established consensual ideological pattern.¹¹ What is clear is that because of the nature of the conflict, the state took control of areas of social and economic life previously deemed out of bounds. As the war progressed, there was a popular desire not to return to the ‘free market’ conditions of the 1930s, and, as soon as the fighting finished, for the fulfilment of the sort of welfare promises broken after 1918. The impact of the Beveridge Report of 1942 and the inclusion of the phrase ‘social security’ in the Atlantic Charter—a declaration of Allied War Aims—are commonly cited indicators of this groundswell of popular opinion, with the landslide victory of the Labour Party in 1945 its political expression. ¹² There is thus a sound argument for seeing Britain’s participation in major wars from around the late nineteenth century as important in bringing about social reform.

If changes in the intellectual climate and the impact of war were significant in setting the agenda for increased welfare provision, then it must be acknowledged that the pressures of a changing political system also had a role. The arrival of the working class on the national political stage, a process which began with the 1867 Reform Act, had at least two consequences for social policy. First, the British version of socialism was not, unlike some of its European counterparts, ever revolutionary. Instead, whatever the rhetoric, its essential aim was a better deal for the working class within capitalist society. This meant that the organised working class, and particularly in the twentieth century the Labour Party, sought economic and social reform. By World War II, Labour can be seen in important respects as the descendant of ‘New Liberalism’, as its acceptance of key aspects of the ideas of Keynes and Beveridge, both committed Liberals, attests.¹³ In short, Labour identified itself as a party of reform, and as it rose in influence so it was able to help set the welfare agenda. Second, the reaction of other political parties to the rise of the working class also has to be taken into account. It would be wrong to see only the Labour Pa...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• List of illustrations
• Notes on contributors
• Editors' note to the paperback edition
• Acknowledgements
• 1 Welfare in context
• 2 Excess female mortality: constructing survival during development in Meiji Japan and Victorian England
• 3 Poverty, health and the politics of gender in Britain, 1870-1948
• 4 Octavia Hill and women's networks in housing
• 5 Late nineteenth-century philanthropy: the case of Louisa Twining
• 6 The campaign for birth control in Britain in the 1920s
• 7 'The children's party, therefore the women's party': the Labour Party and child welfare in inter-war Britain
• 8 Gender, welfare and old age in Britain, 1870s-1940s
• 9 Gender and welfare in the late nineteenth and early twentieth centuries
• Index