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 soconsistently 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 headper 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 paupersto 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,[842]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."[843]It is this principle that lies at the base of all schemes of non-contributory pensions to be given to persons on reachinga 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 againsthis 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.
C.—The Contrast between 1834 and 1907
It is not without interest to contrast the three "principles of 1834" with the three "principles of 1907." In both cases the three principles hang together, and form, in fact, only aspects of a single philosophy of life.
The "principles of 1834" plainly embody the doctrine oflaisser faire. They assume the non-responsibility of the community for anything beyond keeping the destitute applicant alive. They rely, for inducing the individual to support himself independently, on the pressure that results from his being, in the competitive struggle, simply "let alone." As the only alternative to self-support, there is to be presented to him, uniformly throughout the country, the undeviating regimen of the workhouse, with conditions "less eligible" than those of the lowest grade of independent labourer.
The "principles of 1907" embody the doctrine of a mutual obligation between the individual and the community. The universal maintenance of a definite minimum of civilised life—seen to be in the interest of the community no less than in that of the individual—becomes the joint responsibility of an indissoluble partnership. The community recognises a duty in the curative treatment of all who are in need of it; a duty most clearly seen in the medical treatment of the sick and the education of the children. Once this corporate responsibility is accepted, it becomes a question whether the universal provision of any necessary common service is not the most advantageous method of fulfilling such responsibility—a method which has, at any rate, the advantage of leaving unimpaired the salutary inequality between the thrifty and the unthrifty. It is, moreover, an inevitable complement of this corporate responsibility and of the recognition of the indissoluble partnership, that new and enlarged obligations, unknown in a state oflaisser faire, are placed upon the individual—such as the obligation of the parent to keep his children in health, and to send them to school at the time and in the condition insisted upon; the obligation of the young person to be well-conducted and to learn; the obligation of the adult not to infect his environment and to submit when required tohospital treatment. To enforce these obligations—all new since 1834—upon the individual citizen, experience shows that some other pressure on his volition is required than that which results from merely leaving him alone. Hence the community, by the combination of the principles of Curative Treatment, Universal Provision and Compulsion, deliberately "weights" the alternatives, in the guise of a series of experiments upon volition. The individual retains as much freedom of choice as—if not more than—he ever enjoyed before. But the father finds it made more easy for him to get his children educated, and made more disagreeable for him to neglect them. It is made more easy for the mother to keep her infants in health, and more disagreeable for her to let them die. The man suffering from disease finds it made more easy for him to get cured without infecting his neighbours, and made more disagreeable for him not to take all the necessary precautions. The labour exchanges and the farm colonies aim at making it more easy for the wage-earner to get a situation; perhaps the reformatory establishment, with powers of detention, is needed to make it more disagreeable for him not to accept and retain that situation. We must, in fact, recognise that the "principles of 1907," to which experience has gradually brought the Central Authority, "hang together" in theory and practice no less than did those of 1834.
D.—No Man's Land
But although the aforesaid "principles of 1907" demonstrably emerge in the statutes and orders, circulars and particular decisions of the Central Authority, and although they have severally received the most authoritative sanction for particular classes or on particular occasions, they have, as a whole, not been consciously substituted for the "principles of 1834." Indeed, it is open to question whether successive presidents and particular officials, if suddenly cross-examined, might not reveal a complete unconsciousness of there being any new principles at all, and whether they might not profess to be still standing on the policy of 1834! The result is, on the one hand, a lack of clear exposition of policy, and, on theother, a failure to apply any policy at all, either systematically or with the necessary qualifications and safeguards. Accordingly, the boards of guardians are in a state of hopeless bewilderment. They dimly realise that, in one crucial instance after another, the Principle of National Uniformity, the Principle of Less Eligibility, and the Workhouse System, have been authoritatively abandoned. They vaguely perceive, with regard to one section of paupers after another, that the Local Government Board directs them to act upon lines inconsistent with those laid down in 1834. But they are not explicitly told what are the new principles, to what classes of paupers they are to be applied, and what safeguards and qualifications they demand. There is, in fact, to-day, a sort of "No Man's Land" in Poor Law administration, in which the principles of 1834 have beende factoabandoned, without the principles of 1907 being consciously substituted. Owing to this lack of central direction, we find diversity without deliberation, indulgence without cure, and relief without discipline. It is an incident of this failure consciously and explicitly to adopt deliberate principles of action, that no attention has been paid to their limitations and qualifications. The principles of 1834 were such as could be mechanically and universally applied, if only any Government had dared to do it. The principles to which the experience of the past seventy years has unconsciously led the Central Authority need to be carefully thought out in their application to particular classes. These principles are, in fact, not all of universal application. There are classes (e.g.the aged) not susceptible of Curative Treatment; there are only a few sections (e.g.lunatics, infectious disease patients and the incorrigible loafers) who need Compulsion; whilst, in our present civilisation, Universal Provision (e.g.education and sanitation in their widest interpretation, and old-age pensions) will be limited to particular services. This demarcation of the application of the principles on which the Central Authority is already proceeding, is not being discovered, or even sought after. It is here that the Poor Law Commission of 1905-9 will have its greatest effect. Its criticisms and its recommendations will be operative, whatever may be the legislative outcome, in deciding to what extent, and in what particular directions there will bean increasing application of the Principle of Curative Treatment, the Principle of Compulsion, and the Principle of Universal Provision respectively; or, on the other hand, to what extent and in what direction we shall seek to revive one or other of the principles of 1834.
THE MAJORITY REPORT OF THE ROYAL COMMISSION OF 1905-1909
The analysis of Poor Law Policy contained in the preceding chapters, and the comparative statement of principles to which it led, was made the subject of a report to the Royal Commission on the Poor Law in the very middle of its career. We have thought it convenient to leave the analysis and the statement—subject to the correction of a few trifling errors—exactly as they were written in July 1907. We have now to examine the Report of the Royal Commission itself, and to see how far that body responded to the suggestion that it should formulate a definite body of principles upon which public assistance should proceed.[844]
The Principles of 1907
We turn first to the Report signed by the Majority of the Commissioners, including those members who were, or had been, members of the Charity Organisation Society. It is not easy to be sure what are the principles which the signatories of this Report wish to see accepted by the public.The whole wording of the lengthy document points in one direction, and nearly all its definite proposals in another. Thus, in the drastic criticism of the present Poor Law; in the phraseology running all through the Report, and in some of the detailed recommendations, we find a very definite, if generally tacit, abandonment of the "Principles of 1834," and a seeming adoption of what we have called the "Principles of 1907," as set forth in the preceding chapters. Indeed, the Majority Report is in one place explicit in its repudiation of the "Principles of 1834," arguing that, whatever may have been their validity three-quarters of a century ago, they are no longer applicable even to the able-bodied. "The administrators of the present Poor Law," it was expressly declared without dissent from any Commissioner, "are in fact endeavouring to apply the rigid system of 1834 to a condition of affairs which it was never intended to meet. What is wanted is not to abolish the Poor Law, but to widen, strengthen, and humanise the Poor Law, so as to make it respond to a demand for a more considerate, elastic, and, so far as possible, curative treatment of the Able-bodied."[845]This interpretation of the Majority Report finds support in the fact that what we have termed the "Principles of 1907" are repeatedly endorsed. Thus, the Principle of Curative Treatment is expressed almost on every page. It is, in fact, owing to the assertion and reassertion of this principle that the Majority Report owed its instantaneous popularity with the benevolent public. In sharp contrast with every previous Poor Law Report, this one urged that the children were to be brought up in the best possible way; the sick were to be given the most curative treatment; the mentally defective were to be treated solely with a view to their amelioration; the physically defective and the infirm were to have the specialised treatment and the appliances best calculated to remedy their defects; even the able-bodied, whether the unemployed or the vagrants, the honest working-men or the wastrels, were to be dealt with by home treatment or in establishments of which the aim was to be training andreform. The Principle of Curative Treatment was made, in fact, the basis of all the methods proposed for the treatment of all the different sections of the pauper host.
The Principle of Compulsion,—alien, as we have shown, to the whole spirit of the Report of 1834—had, by 1907, only been adopted here and there. The Majority proposals of 1909, far from reverting in this respect to those of 1834, not only heartily adopt such compulsion as has already entered into the Poor Law, but also carry the principle much further. These proposals involve the compulsory enforcement of pauperism on whole sections of the community who are considered to need public assistance, but who do not wish to accept it—on the helpless and friendless aged who get into an insanitary condition; on the children of "Ins and Outs," and of other parents who are leading improper lives; on the feeble-minded who are, nevertheless, not so mentally defective as to be able to be certified as of unsound mind; on sick persons not properly cared for in their own homes; on children suffering from ophthalmia or other contagious diseases; on persons of either sex suffering from venereal diseases; on "unmarried mothers" resorting to the workhouse in their hour of need; and on able-bodied men and women who become repeatedly chargeable owing to their own misconduct. All these persons so diverse in their characters, their circumstances, and their needs, ought, it is expressly recommended, to be compulsorily detained in a Poor Law Institution or at the Poor Law expense, at the instance of the new Poor Law Authority. Whenever deemed necessary, they are to be made subject to what is euphemistically called "An Order for Continuous Treatment," under which their compulsory detention may extend to as long as three years. "The term detention," it is said, "is perhaps, however, infelicitous. It is generally associated with the idea of punishment by imprisonment. Our primary object in proposing detention is neither punishment nor imprisonment. We aim at affording opportunities for applying ameliorative treatment to particular individuals over a continuous period. We desire to substitute for the present system of incontinuous and inefficacious relief a continuity of care and treatment which shall benefit both the recipient and the community.... All these cases havethis common characteristic, viz. that the absence of power of continuous treatment constitutes a danger either to the individual or the State."[846]
Finally, the third of the "Principles of 1907"—that of Universal Provision—far from meeting with objection, receives repeated endorsement. The Majority accept, without a word of criticism, the provision of national pensions for all the persons over seventy years of age below a certain income-limit, and they do not even suggest the maintenance of the present temporary disqualification of those who have received parochial relief since January 1, 1908. They endorse the universal provision by the Local Education Authority of medical inspection and diagnosis for all children in attendance at the public elementary schools; though they think that the contemplated provision of medical treatment for these children should not be a function of the Local Education Authority. They even recommend the universal provision of medical attendance for every sick person who applies for it, with free choice of doctors; though it is urged that inquiry should be subsequently made as to the applicants' means, and that such as may be found to be able to pay for the service rendered to them should be required to do so. Hospital accommodation and treatment is, moreover, to be provided at the public expense, without charge and without disfranchisement wherever it is deemed to be required, including whatever is necessary for the proper treatment of phthisis. Finally, the National Government is to undertake an entirely new service; to be available without charge to every one who cares to use it, irrespective of his affluence; and to be as ubiquitous and as universal as the Post Office. By a national system of Labour Exchanges, the present disjointed efforts of innumerable seekers after jobs are to be replaced by a public organisation, the business of which will be to know all the vacancies and all the applicants, and to find a man for every job, if not a job for every man. All this represents, not only the endorsement of the Principle of Universal Provision so far as it has already gone, but also a considerable further increase of the communistic activity of the State.
The Plea for a Single Destitution Authority
When, however, we study the detailed recommendations of the Majority Report, and consider the probable working of the machinery that they would set up, we discover, notwithstanding all the elaborately sympathetic phrases, a very definite trend backward to the "Principles of 1834," in a manner which seems to us calculated ingeniously to nullify the apparent repudiation, and in reality to leave the situation more confused than before.
We have to note, in the first place, that the Majority Report lays the utmost stress on the importance of retaining in each locality what is definitely a "Destitution Authority." "It should," they declare, "be a fundamental condition of the assistance system of the future that the responsibility for the due and effective relief of all necessitous persons at the public expense should be in the hands of one, and only one, authority in each County and County Borough."[847]To this principle they recur again and again as of paramount importance. In retaining this General Destitution Authority, and in emphasising the necessity for the treatment of all sections—the infants, the children, the sick, the aged, the prematurely incapacitated, the able-bodied unemployed—being committed to its charge, the Majority Report may fairly claim to be standing on the same ground as the authors of the 1834 Report, though with a significant difference. To the Royal Commission of 1834 the single all-embracing Destitution Authority was not a matter of principle at all, but a necessity, which no one questioned. Throughout the whole country there had been only one kind of Local Authority which gave any sort of public assistance to the poor, and that was the Poor Law Authority. The 1834 Report could, accordingly, take it for granted that all sections of the persons to be relieved at the public expense on the ground of their necessities must be dealt with, as destitute persons, by one and the same authority. In 1909 the position has become quite different. There have grown up, since 1834, other public authorities in each district, which provide, independently of the Poor Law, this or that form of public assistance to persons who require it, sometimes to all whoapply, sometimes to those only who prove their need. The Local Education Authorities, the Local Health Authorities, the Local Lunacy Authorities, the Local Pension Authorities, and the Local Unemployed Authorities are, in fact, spending in the aggregate on the children, the sick, the mentally defective, the aged and the able-bodied unemployed, in their several forms of public assistance, out of the same fund of rates and taxes,more than twice as much every year as all the Poor Law Authorities put together. To the Royal Commission of 1909 the retention of a general Destitution Authority, dealing with all sections of destitute persons as destitute persons, was, therefore, not a necessity. It was a deliberate choice, and we find them erecting it into a principle. This principle does not, as might perhaps be supposed, apply only to the provision of maintenance. It is expressly asserted that the schooling and industrial training of the persons relieved and the medical attendance of the sick, so far as it is provided at the public expense, must equally form part of the work of the new Poor Law Authorities. Even the provision of Day Industrial Schools for destitute uncared-for children, of public Sanatoria for phthisis patients, and of Rescue Homes for girl mothers, in so far as undertaken at the public expense, must be the work of the new Poor Law Authorities.[848]It is part of the same idea to insist on the importance of there being established a single "Public Assistance Service ... which should include all officers concerned with the supervision control and disciplinary treatment of the poor ... not only the ... relieving officers both male and female" but also "masters, matrons, and superintendents of institutions of every grade," whether for the children, the sick, or the able-bodied unemployed. All these officers, whatever their technical duties, are to have a certain common training, to receivecertificates of different grades, to enjoy opportunities of promotion from one post to another, and to be made to realise, throughout their whole service, that they are "concerned with the moral training of those committed to their care."[849]Thus, all the various specialised institutions, which are to replace the General Mixed Workhouse—the nursery, the residential school, the hospital, the dispensary, the "industrial institution" for the able-bodied, the Rescue Home for girl mothers, the phthisis sanatorium and the home for the helpless aged—are to be administered by officers of a single homogeneous interchangeable service, deliberately focusing their attention on the moral accompaniments assumed to be characteristic of destitute persons as such, whether these are children or adults, sick or whole. "From the point of view thus indicated," explains an authoritative exponent of the Majority Report, "there is, as it were, an army of social healers to be trained and organised; and it is like the army of war in the fundamental fact that it is to be disciplined and animated with a single spirit and purpose, however varied and specialised may be the duties that fall within its range. The whole of these proposals are founded on the conviction that there is a problem common and peculiar to the entire range of destitution or necessitousness, demanding a common and peculiar method of dealing with it."[850]This, indeed, is the fundamental difference between the Majority Report and the Minority Report. "The antagonism," continues this exponent, "cannot be put too strongly. The Majority proceed upon the principle that where there is a failure of social self-maintenance in the sense above defined, there is a defect in the citizen character, or at least a grave danger to its integrity; and that, therefore, every case of this kind raises a problem which is 'moral' in the sense of affecting the whole capacity of self-management, to begin with in the person who has failed, and secondarily in the whole community so far as influenced by expectation and example."[851]
In this cogent argument for the retention of the Category of the Destitute, and of one Authority, and one Authority only, for all classes of destitute persons, we see two distinct andseparate assumptions, one as to fact, and the other as to social expediency. We have first the suggestion that, in all classes of persons who need maintenance at the hands of the State, there is, as a matter of fact, a moral defect, common to the whole class and requiring specific treatment. Secondly, we see creeping out from behind this suggestion a further assumption as to the policy which ought to be pursued by the Poor Law Authority. This Authority, which is to have in its charge all the heterogeneous population of infants, children, sick and mentally defective persons, the aged and the infirm, the widows, the vagrants, and the unemployed, is to treat them, not with a single eye, to what is best calculated to turn them, or any of them, into efficient citizens, not even with a single eye to what will most successfully remedy the "moral defect" which they are assumed all to possess, but with the quite different object of warning off or deterring, "by expectation and example," other persons from applying for like treatment. In other words, we must, by keeping all the different varieties of people who require State aid under one Authority, and under one that assumes the existence of this "moral defect," retain for all alike, not only the "stigma of pauperism," but also a method of provision which will "deter" others from coming to be treated. We find ourselves, in short, back at the "Principles of 1834."[852]
The Reversion to 1834
With this clue to their meaning, it becomes possible to understand the main constructive proposals of the Majority Commissioners. The most distinctive feature of these proposals, as well as the most novel, is the setting up in every district, side by side, of two separate organisations for the assistance of the poor; one to deal with one set of people and the other with another set; one, the "Public Assistance Authority," to administer the Poor Law, at the expense of the rates, whilst the other, the Voluntary Aid Committee, to carry out the desiresof the charitable, mainly out of private funds.[853]This proposal is, in our judgment, a bold attempt to get back the "Principles of 1834" in all their austerity. From the writings of Chadwick and Nassau Senior down to the latest pronouncements of the Charity Organisation Society, it has always been held that any Poor Law administration according to the "Principles of 1834," involved the co-existence of voluntary charity sufficiently well-organised to prevent the deserving person from falling under the deterrent conditions of the Poor Law, and from being subject to the stigma of pauperism. According to this view, which received the endorsement of Mr. (afterwards Lord) Goschen's celebrated Minute of 1870, the public assistance of the Poor Law Authority isdesigned and intended only for the undeserving, it being assumed that those worthy of anything better than the Poor Law supplied ought to be provided for by organised charity. When we find the Majority Report explicitly "accepting the principle of Mr. Goschen's Minute";[854]setting up in every district a Voluntary Aid Committee to carry out this principle; definitely recommending that rules should be maderequiringcertain classes of applicants to apply to the Voluntary Aid Committee, and certain others to the public Authority, whether the applicants like it or not;[855]and expressly stipulating that the treatment provided by the latter is to be "less eligible" than that which the former may be pleased to prescribe,[856]we cannot help feeling that the policy of the future "Public Assistance Authority" is, after all, to be the Poor Law of 1834, dealing only (as is assumed) with the worthless and the undeserving whom the charitable have, because of their character, refused to aid, and to whom the New Poor Law is to extend only "less eligible" treatment.[857]If the new Public Assistance Authorities are really intended to proceed on "curative and restorative" principles, and"to widen, strengthen, and humanise the Poor Law," why is so much stress laid on Mr. Goschen's Minute (which was based on a "deterrent" and "negative" Poor Law), and why is it so important to rescue, by means of a Voluntary Aid Committee, all the deserving cases from the clutches of the Public Assistance Authority? If the treatment applied by the Public Assistance Authority is really to be that calculated to be what is most "curative and restorative" to them, why should the "deserving" cases be debarred from it? In this ingenious mapping out of the relative spheres of Voluntary Charity and the Poor Law, we see embodied, in the most plausible and the most practical form, the two-fold assumption of Professor Bosanquet, namely, that those for whom provision is made by the Poor Law are persons with a moral defect, whom it is necessary to treat in such a way as to discourage, "by expectation and example," others from applying for the public treatment.
We are not ourselves surprised to find the Majority Report, which started out with an acceptance of the "Principles of 1907," thus reverting in its practical proposals to the "Principles of 1834." What was brought out by the elaborate investigations of the Royal Commission of 1905-9 was that, however successful the new principles had proved in other hands, it was neither expedient nor practicable for a Poor Law Authority, just because it was a Poor Law Authority, to administer relief on the lines of Curative Treatment, Compulsion, and Universal Provision. Thus, the two halves of the Majority Report are incompatible with each other. If there is to be, under the name of the Public Assistance Authority, a general Destitution Authority, there cannot, in fact, be any universal or whole-hearted adoption of the "Principles of 1907," even to the extent to which they receive apparent endorsement.
The mutual Incompatibility of the Proposals of the Majority Report
Now, in our judgment, both the positions successively taken up in the Majority Report are untenable. We propose first to show that it is not possible for the "Principles of 1907" (to which, as we have seen, three-quarters of a century of experience has driven the Local Government Board) to be carried out by a Destitution Authority, either efficiently or economically, or, indeed, without danger. It was just this impossibility that has led to the "diversity without deliberation, indulgence without cure, and relief without discipline," which marks the Poor Law administration of to-day, and which caused the appointment of the Royal Commission. On this point we agree with those who stand on the old lines.If there is to be a Poor Law Authority, there is no safety but in the "Principles of 1834."On the other hand, we hold public opinion to be justified in condemning these principles, and in demanding the application of Curative Treatment, Compulsion, and Universal Provision. But the economical and efficient administration of these three principles involves the acceptance of another, the Principle of Prevention—the principle of actively preventing the severalcausesof destitution, and of arresting their operation at the incipient stage, whether by operating on the individual or on the environment. Without the thorough-going application of this Principle of Prevention by the various Public Authorities concerned, Curative and Restorative Treatment inevitably undermines the motive of self-maintenance and weakens parental responsibility, Compulsion strikes at the consciousness of personal freedom, and Universal Provision tends to degrade into an unenlightened communism.
The incompatibility of the Principles of 1907 with the very nature of a general Destitution Authority will, we think, be clear to any one who will consider the subject in detail.
(i.)The Principle of Curative Treatment and a Destitution Authority
It is, to begin with, an inherent drawback of any general Destitution Authority for the work of Curative Treatment that it is necessarily a "mixed" Authority, having to deal, not withpatients suffering from any one disease, but with persons of the most diverse needs, and requiring treatment of very different nature. To entrust to one and the same Authority the care of the infants and the aged, the children and the able-bodied adults, the sick and the healthy, maids and widows; and to instruct that Authority to adopt "curative and restorative treatment," is inevitably to concentrate attention, not on the different methods that their several necessities require, but on their one common attribute of destitution, and on the one common remedy of "relief" upon whatever terms, strict or lax, that may be in fashion. To a Destitution Authority, however constituted, a sick person is not wholly a patient, he is also a pauper; and too often his character of pauper interferes with his being regarded with a single eye as a patient to be cured. To such an Authority a destitute child is not merely, or even mainly, a future citizen, to be nurtured and trained in the wisest way for the service of the community; the fact that the child is a pauper cannot by a Destitution Authority be forgotten, and all experience shows that this remembrance injuriously affects what is done for the child.
A further drawback is that the "mixed" Authority, having to deal simultaneously with all sections and all kinds of persons, tends invariably to a service of "mixed" officials; and with a Destitution Authority this service is almost necessarily composed of "Destitution" officials. They are not, and can scarcely be, specially trained to deal with infants, or with children, or with able-bodied adults, or with the sick, or with the mentally defective, or with the aged. The specialist training and experience that they acquire is not with any of these, but with the one common attribute of destitution. Thus the typical Relieving Officer or Workhouse Master has not, and can seldom hope to have, the specialist knowledge that would fit him to be a competent inspector of boarded-out girls, a useful guardian of feeble-minded boys, a successful administrator of a Rescue Home, a skilled superintendent of a phthisis sanatorium, a happy adviser in discovering situations for men out of work, or an expert trainer for those who have to be prepared for new occupations. Even when public-spirited Boards of Guardians, under the wisest administrative guidance, persistently strive to make "a classified Poor Law," they fail to attain, in fact, the classificationthat they desire. This is seen in the persistence of the General Mixed Workhouse, in spite of the explicit condemnation of a succession of expert critics. It is seen in the fact that, after twenty years of "scattered homes" for children, we still find the Guardians unable to resist the temptation of putting into them, along with the children, feeble-minded and morally perverted girls in their adolescence. It is seen in the fact that, after fifty years of Poor Law Schools, there is still no classification of the pupils according to their educational needs; and we find everywhere, sitting side by side, in the same school, the feeble-minded child, the merely backward child, the precocious young scholar, and the incipient criminal, all submitted to the same curriculum, with the same books, under the same teacher. Even in the latest efforts at classification, by a model Board of Guardians, we find, housed on the same site and managed by the same superintendent, the most deserving aged persons, the epileptic patients, and the able-bodied men relegated to the discipline of "test labour." Such specialised institutions as have come into existence under a Destitution Authority are, in fact, perpetually crumbling back into the General Mixed Workhouse. We see no reason to expect that a general Destitution Authority that was nominated, instead of being elected, would be free from this besetting tendency.
But the inherent incapacity of any Destitution Authority to cope with the task comes out most strongly in its inevitable failure to deal with the "incipient stage." By the very nature of a Destitution Authority it can deal only with cases of destitution, and the greatest stress is laid, and rightly laid, on the necessity for this limitation. This means that it never does, and never can, deal with any disease or any moral defect, or any injurious influence of any kind,in its incipient stage. An independent citizen who begins in any way to be adversely affected in mind, body, or estate, in such a manner as to be reduced to a state of destitution, does not, in most cases, suddenly, or even quickly, reach that depth. The evil influence takes some time to bring him down. All that time, whilst the progress of the disease may still be arrested, and a cure is possible, Destitution Authority does not hear of the case, and would be legally precluded from intervening, even if itdid hear of it,because there is not yet any destitution. Eventually, when the case has become so bad that employment is lost, savings are dissipated and friends exhausted, resort is had to the Destitution Authority. But the case is then too far gone for any useful intervention. All that can then be done is, whatever the case, to administer "relief," and ease the patient's sinking into senility or the grave. This inherent defect of a Destitution Authority, which no alteration of name or composition or policy can remedy, must for ever prevent it applying curative or restorative treatment in any really effective way. No Poor Law and no Poor Law Authority, just because it is a Poor Law and a Poor Law Authority, can ever reach out to anticipate and ward off destitutionbefore it has occurred. And this failure to get hold of the incipient case applies to all the various kinds of adverse influences that cause destitution. It is, perhaps, most clearly seen in such physical diseases as phthisis, to which one-seventh of all the pauperism is due. Here the interval between the detection of the disease and its development to such an extent as to bring wage-earning employment to an end may often be several years. If treated at the early stage, before destitution has set in, the disease is often curable. If not treated until the patient is so ill as to be unable to earn wages, the case is invariably incurable. It is needless to instance other physical diseases of like kind. We may adduce unemployment as an example of an equally dangerous complaint, apt to be curable if dealt with at once; and only too likely to be hopeless if left until destitution has set in. The case of the infant or child suffering from neglect is another patent example. In short, if the Public Authority must in all cases hold its hand until destitution has set in,as any Destitution Authority must do, it might as well abandon all hope, in the vast majority of cases, of any effective curative or restorative treatment. It never gets the cases until they are too far gone. We might as well run a hospital on the plan of never consenting to admit any case until mortification had set in!
Now, it becomes more and more apparent that it is a useless extravagance to adopt the policy of curative and restorative treatment, unless we are prepared to "search out" the casesthat need dealing with,—the infants and children who are just beginning to be neglected by their parents and guardians, the persons of all ages who are just beginning to suffer from disease, the feeble-minded lacking ameliorating care, the man just smitten with unemployment—at the stage in their complaint at which the application of our treatment has, at any rate, some chance of yielding effective results. The Local Education Authority or the Local Health Authority understands at once that it cannot do its work if it waits until it is applied to. It accordinglysearches outilliterate children of school age, or persons smitten with infectious disease. But a Destitution Authority, administering a Poor Law, cannot in this way "search out" the cases needing its attention without thereby offering assistance to those who are not pecuniarily destitute. Accordingly, it is of the very nature of any Destitution Authority to restrict its operations as much as possible, to deter people from coming, or to wait, at any rate, until it is applied to. It is from this inability to adopt a policy of "searching out" that a Destitution Authority never gets hold of the case in its incipient stage, and is never really preventive of destitution.
An instance of the impracticability of the application of curative and restorative treatment by a Poor Law Authority, just because it is a Poor Law Authority, is afforded by the ebb and flow of the whole class of "Ins and Outs." This well-known class, in all its varieties, comprises the able-bodied or semi-able-bodied frequenter of urban workhouses, the customer of the casual wards, the inebriate in his recurring attacks ofdelirium tremens, the feeble-minded girl in her annual confinements, and, last but not by any means least important, the unfortunate infants and children dragged to and fro by their parents. Whatever their sex, their age, their health, their character, or their conduct, these "Ins and Outs" come at the crisis of their destitution, and go as soon as they can see their way to some sort of a living outside, choosing their own times and seasons for demanding the maintenance which a Poor Law Authority dare not withhold, and for resuming the liberty which it cannot refuse. So long as the conditions offered by the Poor Law Authority are "deterrent," few will apply for this maintenance; the vagrant,the able-bodied loafer, the temporarily sick, the disabled drunkard, parents with neglected children, the epileptic and the feeble-minded preferring, even at the cost of foregoing the treatment that they really need, such other forms of parasitism as free shelters, the doles of the charitable, the gifts of friends and relations, or the earnings of their unfortunate dependents. But let the conditions offered by the Poor Law Authority be "curative and restorative" in their character, and all classes of "Ins and Outs" will clamour for the hospitality of the Poor Law whenever their other means of parasitism show signs of falling short. Whether they come in or remain out, a Poor Law Authority, just because it is a Poor Law Authority, is wholly unable to enforce on them, before they are destitute, the sort of conduct that would prevent theirbecomingdestitute, and would thus preserve the community from the danger and cost of their parasitic existence. The Poor Law Authority is thus incapable, not (as is often supposed) because it has no adequate powers of detention, and because it must let its patients go whenever they please. Its incapacity depends on the more fundamental and less curable defect that, as a Destitution Authority, it is inherently incapable of bringing pressure to bear on the lives and wills of these people, at the time when such pressure may be effective, namely,long before they have become destitute, at the moment when they are taking the first step towards the evil parasitism to which they eventually succumb.
(ii.)The Principle of Compulsion and a Destitution Authority
It has usually been considered impracticable to combine any powers of compulsion with a Poor Law system. The Majority Report proposes, however, to endow its new Public Assistance Authority with extensive powers of compulsory treatment; that is to say, to enable the administrators of the Poor Law to dispense with its limitation to those who are actually destitute and unable to maintain themselves, whenever such administrators choose to consider it expedient to compel particular persons, who claim not to be destitute, to become or to continue paupers, with the object of segregating them from their fellows. Such an extension of the powers ofthe Public Assistance Authority would be inconsistent with one of the cardinal principles of the Majority Report, namely, that the area of the operations of the Poor Law should not be extended.[858]What is more important is that it does not seem at all probable that any House of Commons would consent to give to any Destitution Authority, maintaining the stigma of pauperism, the power to make a man a pauper against his will.
So far as compelling persons who are ill, and who need treatment, to come in and be treated for their own good, or for the health of the neighbourhood, this is a power which Parliament has already, in certain cases, conceded to the Local Health Authority, which has no stigma of pauperism, and which has, moreover, the machinery for searching out the cases, irrespective of their affluence. These powers could easily be extended. It would seem both futile and unnecessary, with regard to persons whose need is nursing and medical attendance, and who may not be pecuniarily destitute, to confer a similar power also on the Destitution Authority, which has no such machinery for searching out cases, and no particular responsibility for the Public Health.
With regard to the second great class of those whom it is desired to segregate compulsorily against their will, namely, the feeble-minded, the whole weight of expert opinion is against conferring this power upon either the existing Board of Guardians or any Poor Law Authority, and in favour of entrusting it to the Lunacy Authority, an Authority which—in contrast with any Destitution Authority—will treat these unfortunate persons in respect of their ascertained defect, and not in respect of their destitution, or in respect of any moral defect assumed to be connected therewith.
When we come to the children, the case is even clearer. If power is to be given to any Authority to separate a child from its parents, and to deprive the latter of its custody and care, public opinion emphatically demands that this power should be conferred and exercised solely for the good of the child, and with a view to its best possible nurture and training.
It is plain that this is best secured by freeing the child from all association with pauperism and entrusting its care to the Authority which deals, apart from any stigma of pauperism, with other children in a normal way, and which specialises on their proper training.
Finally, in the case of able-bodied and able-minded men and women in health, whose distress arises merely from their being without wage-earning employment—whatever may be the cause of such unemployment—it will, we think, be wholly impracticable to obtain, for a Destitution Authority, any powers of compulsory segregation. To compel, by law, able-bodied men and women to become paupers against their will; to force upon them a degrading status with the stigma of pauperism, when they do not even apply for public assistance; to compel them to come into an institution of the Destitution Authority, when they ask only to be let alone, must, we think, in the absence of any judicial conviction of a specific offence against the law, be dismissed as politically out of the question. It may be that some such restriction of personal liberty is essential to the effective curative treatment of particular individuals, whose unemployment proceeds from their own personal defects. But no power of compulsory segregation can be justified except in respect of individuals in which this personal defectiveness has been definitely ascertained and judicially certified. The Destitution Authority, having no means of ascertaining whether or not situations are available, and no opportunity of experimenting upon the personal willingness of its patients to accept and retain wage-earning employment, can never sift out the voluntary from the involuntary unemployed. Moreover, even if the Destitution Authority possessed the machinery for searching out the men who really needed reformatory treatment, but who did not apply for relief, and if it had some infallible method of recognising which of them were involuntarily idle, and which of them were unemployed through their own defects of character, it would still be impossible to justify the grant of compulsory powers of segregation, except to an Authority which was both authorised and qualified to improve—not to pauperise and degrade—the persons, unconvicted of any crime, whom it thus forcibly deprived of their freedom.
We come to quite a different kind of compulsion when no one is forced to become a pauper against his will, but those who have voluntarily entered a Poor Law Institution may be, under certain circumstances, detained against their will, either for their own advantage, or as a disciplinary measure. In such a case Parliament has already shown itself willing to grant certain minor powers of detention. But there is, as all Poor Law administrators know, a practical difficulty in enforcing any such detention at any time or in any way that is unpleasant to the common run of patients, even when it is sought only to exercise the power for the patient's own good. Experience shows that, if those who need the shelter of the institution, or the care which it affords, believe that they will be liable to be detained against their will, many of them simply will not come in to be treated; and, least of all, if the liability to compulsory detention is combined with the stigma and the degradation of pauperism. Thus, compulsory detention is a natural and defective adjunct of a "deterrent" Poor Law, because it scares people off; but it is a fatal obstacle to the operations of a Poor Law which is intended to be curative and restorative. The very patients to whom the "order for continuous treatment" would be most appropriate and most useful will refuse to come in. Without the will, the power, or the machinery for "searching out" cases (other than those who apply for relief), which no Poor Law Authority can ever have, or the power to compel them to come in, irrespective of their pecuniary resources or their own consent, which no Poor Law Authority is ever likely to be granted, any policy of compulsory detention of those already in the Poor Law Institutions becomes, on any policy of curative and restorative treatment, simply suicidal. Those for whom the curative and restorative treatment is especially designed do not present themselves.
(iii.)The Principle of Universal Provision and a Destitution Authority
When we come to the third of the "Principles of 1907," that of Universal Provision, we see at once that this is inherently inconsistent with the very nature of a Destitution Authority. It is of the essence of a Destitution Authoritywhatever its functions and whatever its designation, that it should confine its ministrations to a particular section of the community, namely those who are destitute. But with regard to one subject after another, such as primary education or sanitation, or the ordinary matters of municipal government, the community has come to the conclusion that it is in the public interest that these services should be rendered to all who need or claim them, whatever their affluence. Thus, whenever it is decided to apply the Principle of Universal Provision to any public service, either free of any charge or upon payment of a stated price or contribution, this public service necessarily falls to some Public Authority other than that administering the Poor Law. And the further consequence arises that at once we get, in respect of that particular service, an overlapping of functions and duplication of work. The Destitution Authority is bound to provide everything requisite (including the service in question) for its destitute clients. The other Public Authority is bound to supply the service in question to all who need it (including those who are destitute). This overlapping and duplication has, as we have elsewhere indicated, already gone very far. The Local Education Authorities are now providing for children, irrespective of their affluence, not only primary, secondary, and university education, but also, in many tens of thousands of cases, medical inspection and treatment, meals at school, and even complete board, lodging, and clothing. The Local Health Authorities are now providing for the sick, irrespective of their affluence, not only sanitary inspection and control, but also medical diagnosis and treatment, nursing, and (in 700 municipal hospitals) even maintenance. The Local Lunacy Authorities are now providing for all grades of the mentally defective, irrespective of their affluence, not only control, but also ameliorative treatment and maintenance. The Local Pension Authorities are now providing for all persons over seventy who do not possess more than twelve shillings a week of income, irrespective of whether or not they are destitute, regular pensions from national funds. The Local Unemployment Authorities (the Distress Committees) are providing for all men who are unemployed, quite irrespective of their affluence, various costly services, part of which are now in process of being transferred to a NationalAuthority (the National Labour Exchange). It is not possible to stop this overlap and duplication by establishing, as the Majority Report vainly desiderates, in every district "one Authority and only one Authority" for all forms of public assistance, for this would be, as we see, to merge in the Poor Law all the services of Local Government, and to extend the "stigma of pauperism" to the entire community. Indeed, the adoption of the Principle of Universal Provision has already gone so far, and the services of the separate Public Authorities are already so all-embracing, that there is no section of the pauper host for which they do not nowadays provide. Destitute children are already being maintained by the Local Education Authorities, destitute sick by the Local Health Authorities, destitute mentally defective by the Local Lunacy Authorities, destitute aged by the Local Pension Authorities, and destitute able-bodied by the Local Unemployment Authorities—actually in greater numbers, in the aggregate, than those still under the Poor Law. There are no paupers who do not belong to one or other of these five sections. Hence the partial adoption by the community of this Principle of Universal Provision has rendered unnecessary the retention of any Destitution Authority. Its work is being done elsewhere.
We must remember that the Principle of Universal Provision in no way implies or involves, either the gratuitousness of the service or the charging of any uniform fee. The enforcement by the Local Health Authority of a National Minimum of sanitation and water-supply for each dwelling-house, does not mean that these things are necessarily provided by the Local Health Authority itself, or free of charge. Most of the service is ensured by an enforcement upon the owners and occupiers of dwelling-houses of the fulfilment of their personal obligations. The provision by the Local Education Authority of educational facilities for all who claimed them was long accompanied by a universal charging of fees, and is, above the primary grade, still usually made a matter of charge. The Local Lunacy Authorities insist on payment being made in respect of all their patients whose settlements they can trace, recovering the full cost (apart from the Government Grant) either from the patient's own estate, or from his relations, or from the Union to which he belongs. Hencewe see that the adoption of the Principle of Universal Provision does not imply or involve the gratuitousness of the service, or any diminution of the number or kinds of cases in which, under the present law and practice, payment is enforced on the individual or his relations. A transfer to the several Preventive Authorities (the Education Authority, the Health Authority, the Lunacy Authority, and the Unemployment Authority) of the various services now combined under the Board of Guardians, could, in fact, hardly fail to lead to a more systematic consideration and a far stricter enforcement of the duty of repaying the cost of the treatment than the present slipshod and logically inconsistent arrangements. What particular services should be charged for to the recipients as such, and which to the ratepayers as a whole; in what proportion the cost should be shared between the patient, the Local Authority, and the National Government; and at what rate and under what conditions any such charges should be recovered by legal process in particular cases, are all of them questions which should, in our view, be authoritatively determined by Parliament, in a clear and consistent code relating to Charge and Recovery of Cost.