Open-handed hospitality always creates mendicants. This is what the hospitals offer in the out-patient and casualty departments, and they have created a class of hospital mendicants. The cases are quickly dealt with, without Hospitals. inquiry and without regard to home conditions. The medical man in the hospital does not co-operate with any fellow-workers outside the hospital. Where his physic or advice ceases to operate his usefulness ceases. He regards no conditions of morality. In a large number of cases drink or vice is the cause of application, and the cure of the patient is dependent on moral conditions; but he returns home, drinks and may beat his wife, and then on another visit to the hospital he will again be physicked and so on. The man is not even referred to the poor-law infirmary for relief. Nor are conditions of home sanitation regarded. One cause of constant sickness is thus entirely overlooked, while drugs, otherwise unnecessary, are constantly given at the hospital. The hospitals are thus large isolated relief stations which are creating a new kind of pauperism. So far as the patients can pay—and many can do so—the general practitioners, to whom they would otherwise go, are deprived of their gains. Still worse is it when the hospital itself charges a fee in its out-patient department. The relief is then claimed even more absolutely as a right, and the general practitioners are still further injured. The doctors, as a medical staff, are not only medical men, but whether they recognize the fact or not, they are also almsgivers or almoners; what they give is relief. Yet few or none of them have ever been trained for that work, and consequently they do not realize how very advantageous, even for the cure of their own patients, would be a thorough treatment of each case both at the hospital and outside it. Nor can they understand how their methods at present protract sickness and promote habitual dependence. Were this side of their work studied by them in any way they would be the first, probably, to press upon the governors of their hospitals the necessity for a change. Unfortunately, at present the governors are themselves untrained, and to finance the hospital and to make it a good institution is their sole object. Hospitals, however, are, after all, only a part of the general administration of charity, though as they are now managed they have seldom any systematic connexion with that administration. Nor is there any co-ordination between the several hospitals and dispensaries. If one rightly refuses further treatment to certain applicants, they have only to wander to some other hospital, there to be admitted with little or no scrutiny. For usually out-patients and casualty patients are not even registered, nor can they be identified if they apply again. Practically they come and go at will. The definite limitation of cases, according to some standard of effectual work, association with general charity, trained almonership and inquiry, and a just regard for the interests of general practitioners, are stepping-stones to reform. In towns where medical charities are numerous a representative board would promote mutual help and organization.
Like the poor-law, endowed charities may be permanent institutions established to meet what should be passing and decreasing needs (cf. the arguments in The State and Charity, by T. Mackay). Administered as they usually Endowed charities. are in isolation—apart from the living voluntary charities of the generation, and consisting often of small trusts difficult to utilize satisfactorily, they tend to create a permanent demand which they meet by fixed quantities of relief. Also, as a rule, they make no systematic inquiries with a view to the verification of the statements of the applicants, for they have no staff for these purposes; nor have they the assistance of almoners or friendly visitors. Nor does the relief which they give form part of any plan of help in conjunction with other aid from without; nor is the administration subject to frequent inspection, as in the case of the poor-law. All these conditions have led to a want of progress in the actual administration of endowed charities, in regard to which it is often very difficult to prevent the exercise of an undue patronage. But there is no reason why these charities should not become a responsible part of the country’s administration, aiding it to reduce outdoor pauperism. It was never intended that the poor-law should extinguish the endowed charities, still less, as statistics now prove, that where endowments abound the rate of pauperism should be considerably above the average of the rest of the country. This shows that these charities often foster pauperism instead of preventing it. As a step to reform, the publication of an annual register of endowed charities in England and Wales is greatly needed. The consolidating schemes of the charity commissioners have done much good; still more may be done in some counties by extending to the county the benefits of the charities of well-endowed towns, as has been accomplished by the extension of the eleemosynary endowments of the city of London to the metropolitan police area. Nor, again, until quite lately, and that as yet only in a few schemes, has the principle been adopted that pensions or other relief should be given only in supplementation of the relief of relations, former employers and friends, and not in substitution of it. This, coupled with good methods of inquiry and supervision, has proved very beneficial. Hitherto, however, to a large extent, endowed charities, it must be admitted, have tended to weaken the family and to pauperize.
In many places funds are raised for the relief of school children by the supply of meals during the winter and spring; and an act has now been passed in England (1906) enabling the cost to be put upon the rates. Usually a very large number of children Relief to children at school. are said to be underfed, but inquiry shows that such statements may be taken as altogether excessive. They are sometimes based on information drawn from the children at school; or sometimes on general deductions; they are seldom founded on any systematic and competent inquiry at the homes. When this has been made, the numbers dwindle to very small proportions. Teachers of experience have noted the effect of the meals in weakening the independence of the family. While they are forthcoming women sometimes give up cooking meals at home, use their money for other things, and tell the child he can get his meal at school. Great temptations are put before a parent to neglect her family, and very much distress is due to this. The meals—just at a time when, owing to the age of her children, the mother’s care is most needed, and just in those families where the temptation is greatest, and where the family instinct should be strengthened—stimulate this neglect. Considered from the point of view of meeting by eleemosynary provision a normal economic demand for food, intervention can only have one result. The demand must continue to outstrip the supply, so long as there are resources available on the one side, and until on the other side the desire of the social class that is chiefly exposed to the temptations of dependence in relation to such relief has been satisfied. If the provision be made from the resources of local or general taxation the largeness of the fund available will allow practically of an unlimited expansion of the supply of food. If the provision be made from voluntary sources, in some measure limited therefore and less certain, this very fact will tend to circumscribe demand and limit the offer of relief. It is indeed the problem of poor-law relief in 1832 over again. The relief provided by local taxation practically unlimited will create a mass of constant claimants, with a kind of assumed right to aid based on the payment of rates; while voluntary relief, whatever its short-comings, will be less injurious because it is less amply endowed. In Paris the municipal subvention for meals rose from 545,900 francs in 1892 to 1,000,000 in 1904. Between 1894 and 1904 there was an increase of 9% in the school population; and an increase of 28% in the municipal grant. In that period the contributions from the local school funds (caisses des écoles) decreased 36%; while the voluntary contributions otherwise received were insignificant; and the payments for meals increased 2%.
The subject has been lately considered from a somewhat different standpoint (cf. the reports of the Scottish Royal Commission on Physical Education, 1903; of the Inter-departmental committees on Physical Deterioration, 1905, and on Medical Inspection and the Feeding of School Children, 1905; also the report of the special committee of the Charity Organization Society on “the assistance of school children,” 1893). After careful investigations medical officers especially have drawn attention to the low physical condition of children in schools in the poorer parts of large English towns, their low stature, their physical defects, the improper food supplied to them at home, their uncleanliness, and their want of decent bringing-up, and sometimes their want of food. Other inquiries have shown that, as women more usually become breadwinners their children receive less attention, and the home and its duties are neglected, while in the lowest sections of the poorer classes social irresponsibility reaches its maximum. Cheap but often quite improper food is provided, and infant mortality, which is largely preventable, remains as high as ever, though adult life is longer. This with a marked decrease in the birth-rate in recent years, has, it may be said, opened out a new field for charitable effort and social work. Science is at each revision of the problem making its task more definite. Actually the mere demand for meals stands for less; the reform of home conditions for more. So it was hoped that instead of making school meals a charge on taxation, as parliament has done, it would be content to leave it a voluntary charge, while the medical inspection of elementary Schools will be made universal; representative relief committees formed for schools or groups of schools; the cases of want or distress among the school children dealt with individually in connexion with their families, and, where necessary, day schools established on the lines of day industrial schools.
At a time of exceptional distress the following suggestions founded on much English experience may be of service (cf. Report of special committee of the Charity Organization Society on the best means of dealing with exceptional Exceptional distress. distress, 1886). Usually at such a time proposals are made to establish special funds, and to provide employment to men and women out of work. But it is best, if possible and as long as possible, to rely on existing agencies, and to strengthen them. Round them there are usually workers more or less trained. A new fund usually draws to it new people, many of whom may not have had any special experience at all. If a new fund is inevitable, it is best that it should make its grants to existing agencies after consultation with them. In any case, a clear policy should be adopted, and people should keep their heads. The exaggeration of feeling at a time of apprehended or actual distress is sometimes extraordinary, and the unwise action which it prompts is often a cause of continuing pauperism afterwards. Where there is public or poor-law relief the following plan may be adopted:—In any large town there are usually different recognized poor-law, charitable or other areas. The local people already at work in these areas should be formed into local committees. In each case a quick inquiry should be made, and the relieving officer communicated with, some central facts verified, and the home visited. Roughly, cases may be divided into three classes: the irresponsible casual labouring class, a middle class of men with decent homes, who have made no provision for the future, and are not members of either friendly society or trades union; and a third class, who have made some provision. These usually are affected last of all; at all hazards they should be kept from receiving public relief, and should be helped, as far as possible, privately and personally. If there are public works, the second class might be referred to them; if there are not, probably some should be left to the poor-law, some assisted in the same way as members of class three. Much would turn upon the family and the home. The first class should be left to the poor-law. If there is no poor-law system at work they should be put on public works. Working men of independent position, not the creatures of any political club, but such as are respected members of a friendly society, or are otherwise well qualified for the task, should be called into consultation. The relief should be settled according to the requirements of each case, but if the pressure is great, at first at least it may be necessary to make grants according to some generally sufficient scale. There should be as constant a revision of cases as time permits. Great care should be taken to stop the relief as soon as possible, and to do nothing to make it the stepping-stone to permanent dependence.
If employment be provided it should be work within the skill of all; it should be fairly remunerated, so that at least the scantiness of the pay may not be an excuse for neglect; and it should be paid for according to measured or piece work. The discipline should be strict, though due regard should be paid at first to those unaccustomed to digging or earthwork. In England and Wales the guardians have power to open labour yards. These, like charities which provide work, tend to attract and keep in employment a low class of labourer or workman, who finds it pays him to use the institution as a convenience. It is best, therefore, to avoid the opening of a labour yard if possible. If it is opened, the discipline should be very strict, and when there is laziness or insubordination, relief in the workhouse should at once be offered. The relief furnished to men employed in a labour yard, of which in England at least half has to be given ih kind, should, it has been said, be dealt out from day to day. This leads to the men giving up the work sooner than they otherwise would. They have less to spend.
In Great Britain a great change has taken place in regard to the provision of employment in connexion with the state. Since about 1890 there has been a feeling that men in distress from want of employment should not be dealt Unemployment. with by the poor-law. A circular letter issued by the Local Government Board in 1886, and subsequently in 1895, coincided with this feeling. It was addressed to town councils and other local authorities, asking them to provide work (1) which will not involve the stigma of pauperism, (2) which all can perform whatever may have been their previous avocations, and (3) which does not compete with that of other labourers at present in employment. This circular led to the vestries and subsequently the borough councils in many districts becoming partially recognized relief authorities for the unemployed, concurrently with the poor-law. Much confusion resulted. The local authorities had seldom any suitable organization for the investigation of applications. It was difficult to supply work on the terms required; and the work was often ill-done and costly. Also it was found that the same set of people would apply year after year, unskilled labourers usually out of work part of the winter, or men habitually “unemployed.” As on other occasions when public work was provided, very few of the applicants were found to be artisans, or members of trades unions or of friendly societies. In 1904 Mr Long, then president of the Local Government Board, proposed that local voluntary distress committees should be established in London consisting of poor-law guardians and town councillors and others, more or less supervised by a central committee and ultimately by the Local Government Board. This organization was set on foot and large sums were subscribed for its work. The report on the results of the movement was somewhat doubtful (Report, London Unemployed Fund, 1904-1905, p. 101, &c.), but in 1905 the Unemployed Workmen’s Act was passed, and in London and elsewhere distress committees like the voluntary committees of the previous year were established by statute. It was enacted that for establishment expenses, emigration and removal, labour exchanges, and the acquisition of land a halfpenny rate might be levied, but that the rate would not be available for the remuneration of men employed. For this purpose (1905-1906) a large charitable fund was raised. A training farm at Hollesley Bay was acquired, and it was hoped to train Londoners there to become fit for agricultural work. It is impossible to judge this experiment properly, on the evidence available up to 1908. But one or two points are important: (1) something very like the “right to labour” has been granted by the legislature; (2) this has been done apart from the conditions required by the poor-laws and orders of the Local Government Board on poor relief and without imposing disfranchisement on the men employed; (3) a labour rate has not been levied, but a rate has been levied in aid of the provision of employment; (4) if the line of development that the act suggests were to be followed (as the renewed Labour agitation in 1908-1909 made probable) it must tend to create a class of “unemployed,” unskilled labourers of varying grades of industry who may become the dependent and state-supported proletariat of modern urban life. Thus, unless the administration be extremely rigorous, once more will a kind of serfdom be established, to be, as some would say, taken over hereafter by the socialist state.
In some of the English colonies Homeric hospitality still prevails, but by degrees the station-house or some refuge is established in the towns as they grow more populous. Finally, some system of labour in exchange for relief Vagrancy. is evolved. At first this is voluntary, afterwards it is officially recognized, and finally it may become part of the system of public relief. As bad years come, these changes are made step by step. In England the vagrant or wayfarer is tolerated and discouraged, but not kept employed. He should be under greater pressure to maintain himself, it is thought. The provision made for him in different parts of the country is far from uniform, and now, usually, at least in the larger towns, after he has had a bath and food, he is admitted to a separate room or cell in a casual ward. Before he leaves he has to do a task of work, and, subject to the discretion of the master, he is detained two nights. This plan has reduced vagrancy, and if it were universally adopted clean accommodation would everywhere be provided for the vagrant without the attractions of a common or “associated” ward; and probably vagrancy would diminish still further. It seems almost needless to say that, in these circumstances at any rate, casual alms should not be given to vagrants. They know much better how to provide for themselves than the almsgiver imagines, for vagrancy is in the main a mode of life not the result of any casual difficulty. Vagrancy and criminality are also nearly allied. The magistrate, therefore, rather than the almsgiver, should usually interfere; and, as a rule, where the magistrates are strict, vagrancy in a county diminishes. An inter-departmental committee (1906) taking generally this line, reported in favour of vagrants being placed entirely under police control, and it recommended a system of wayfarers’ tickets for men on the roads who are not habitual vagrants, and the committal of men likely to become habitual vagrants to certified labour colonies for not less than six months. Still undoubtedly vagrancy has its economic side. In a bad year the number of tramps is increased by the addition of unskilled and irresponsible labourers, who are soonest discharged when work is slack. As a part-voluntary system under official recognition the German Arbeiter-colonien are of interest. This in a measure has led to the introduction of labour homes in England, the justification of which should be that they recruit the energy of the men who find their way to them, and enable them to earn a living which they could not do otherwise. In a small percentage of cases their result may be achieved. Charitable refuges or philanthropic common lodging-houses, usually established in districts where this class already congregate, only aggravate the difficulty. They give additional attractions to a vagrant and casual life, and make it more endurable. They also make a comfortable avoidance of the responsibilities of family life comparatively easy, and in so far as they do this they are clearly injurious to the community.
The English colonists of the New England states and Pennsylvania introduced the disciplinary religious and relief system of Protestantism and the Elizabethan poor-law. To the former reference has already been made. With an American conditions and methods. appreciation of the fact that the cause of distress is not usually poverty, but weakness of character and want of judgment, and that relief is in itself no remedy, those who have inherited the old Puritan traditions have, in the light of toleration and a larger social experience, organized the method of friendly visiting, the object of which is illustrated by the motto, “Not alms, but a friend.” To the friendship of charity is thus given a disciplinary force, capable of immense expansion and usefulness, if the friendship on the side of those who would help is sincere and guided by practical knowledge and sagacity, and if on the side of those in distress there is awakened a reciprocal regard and a willingness to change their way of life by degrees. Visiting by “districts” is set aside, for “friendliness” is not a quality easily diffused over a wide area. To be real it must be limited as time and ability allow. Consequently, a friendly visitor usually befriends but one or two, or in any case only a few, families. The friendly visitor is the outcome of the movement for “associated charities,” but in America charity organization societies have also adopted the term, and to a certain extent the method. Between the two movements there is the closest affinity. The registration of applicants for relief is much more complete in American cities than in England, where the plan meets with comparatively little support. At the office of the associated charities in Boston there is a central and practically a complete register of all the applications made to the public authority for poor relief, to the associated charities, and to many other voluntary bodies.
The Elizabethan poor-law system, with the machinery of overseers, poor-houses and out-door relief, is still maintained in New England, New York state and Pennsylvania, but with many modifications, especially in New York. A chief factor in these changes has been immigration. While the County or town remained the administrative area for local poor relief, the large number of immigrant and “unsettled” poor, and the business connected with their removal from the state, entailed the establishment of a secondary or state system of administration and aid, with special classes of institutions to which the counties or towns could send their poor, as, for instance, state reform schools, farms, almshouses, &c. For the oversight of these institutions, and often of prisons also and lunatic asylums, in many states there have been established state boards of “charity or corrections and charity.” The members of these boards are selected by the state for a term of years, and give their services honorarily. There are state boards in Massachusetts, New York, Pennsylvania, Ohio, Illinois, Minnesota, Michigan, Wisconsin, Iowa, Colorado, North Carolina and elsewhere. There is also a district board of charities in the district of Columbia. These boards publish most useful and detailed reports. Besides the state board there is sometimes also, as in New York, a State Charities Aid Association, whose members, in the counties in which they reside, have a legal right of entry to visit and inspect any public or charitable institution owned by the state, and any county and other poor-house. A large association of visitors accustomed to inspect and report on institutions has thus been created. Further, the counties and towns in New York state, for instance, and Massachusetts, and the almshouse districts in Pennsylvania, are under boards of supervision. Usually the overseers give out-door relief, and the pauperism of some areas is as high as that in some English unions, 3, 4 and 5%. On the whole population of the United States, however, and of individual states, consisting to a great extent of comparatively young and energetic immigrants, the pauperism is insignificant. In Massachusetts “it has been the general policy of the state to order the removal to the state almshouse of unsettled residents of the several cities and towns in need of temporary aid, thus avoiding some of the abuses incident to out-door relief.” In New York state, in the city of New York, including Brooklyn, the distribution of out-door relief by the department of charities is forbidden, except for purposes of transportation and for the adult blind. Most counties in the state have an almshouse, and the county superintendents and overseers of the poor “furnish necessary relief to such of the county poor as may require only temporary assistance, or are so disabled that they cannot be safely removed to the almshouse.” Public attention is in many cases being drawn to the inutility and injury of out-door relief.