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The legacy of the Poor Law: institutional care of the elderly in the West of England, c. 1930-1960
| The broad theme of this paper is the changing nature of public institutional care for poor and vulnerable adults in Britain between about 1930 and 1960, a period of major reform in state welfare which saw the establishment of the National Health Service (NHS). Its focus is the old Poor Law workhouses and infirmaries, which in the interwar period were rebranded as public assistance institutions. While some were transmuted into municipal general hospitals, others remained outside the remit of the public health administration, although they accommodated many people (mainly elderly) with mental or physical illness, alongside others deemed to be fit but ‘infirm’. When the NHS began some of these were transferred to become long-stay hospitals while others remained with social welfare departments as old peoples’ residential homes. But what is known about the standard of care, the level of resources they received, the nature of the patients / ‘inmates’, and their management by local politicians through this period of transition? The paper aims to answer these questions through a regional study based on three cities and two largely rural counties in the West of England. The method is partly quantitative, tracing resource allocation through local taxation data, and analysing patients through admission statistics, and partly qualitative, relying on administrative records and material in the medical press. The main conclusion is that despite the policy goal of breaking up the Poor Law, at local level traditional attitudes to the elderly poor lingered; while some progress was made in the major urban centres, the majority of such institutions remained deprived of financial support for capital expenditure and patient maintenance and this continued into the NHS era, when again the acute care hospitals won the battle over resources.
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