New Poor Law Medical Care in the Local Health Economy

The Poor Law Amendment Act (1834) failed to address sickness as a major reason for the increasing levels of pauperism and yet has been credited with setting the scene for the development of the National Health Service in 1948. This investigation analysing the poor law medical services of Birmingham and Wolverhampton demonstrates that the influence of the New Poor Law in their development was significant in the latter, but had little immediate effect in the former. However, in both towns the medical service played a crucial part in the control of infectious disease, particularly at times of local outbreaks or national epidemics. This role within the local community involved close collaboration with the relevant sanitary authority, in some cases with the provision of joint isolation facilities and policies. Overall, the poor law medical services in both locations were important elements in the lives of the poor even in the early days after the Act and comprised significant components of the medical landscape of each town. Although the medicalization of English workhouses was not a late nineteenth century phenomenon, they became the single most important institutional setting for the provision of medical care by the early twentieth century.