The principle commonly known as "the Workhouse System"—the complete substitution of "indoor" for "outdoor" relief—was, as we have shown, no part of the recommendations of the 1834 Report for any but the able-bodied. It was, however, adopted by the strictest of the reformers of 1834-47, and again by those of 1871-85, as the only effective method of applying the Principle of Less Eligibility and of reducing pauperism. The workhouse, on this principle, was not to be regarded as a place of long-continued residence, still less as an institution for beneficial treatment, but primarily (if not exclusively) as a "test of destitution," that is, as a means of affording the actual necessities of existence under conditions so deterrent that the pauper would rather prefer to maintain himself independently than accept the relief so offered. This is still the policy of the Central Authority, but only for one class of paupers, the wayfarers or vagrants. As we have seen, there are, in 1907, alternative methods of relief for the other classes, preferred by the Central Authority. In the case of the aged, the Central Authority explicitly lays it down that the "deserving" applicants ought not even to be urged to enter the workhouse, and ought to be given outdoor relief adequate for their maintenance in their own homes. In the case of the able-bodied, the "respectable" applicant is to be referred to the distress committee, outside the Poor Law altogether; whilst in periods of unemployment the Central Authority permits the outdoor relief of the less respectable destitute men against a labour test. With regard to the sick and children, the very idea of a deterrent workhouse has disappeared, and the policy is to afford them "treatment" (including maintenance wherever required), either in their own homes, or in other people's homes, or in institutions, in the manner, and to the degree, calculated to promote their utmost efficiency.
B.—New Principles Unknown in 1834
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.