Depth and diversity in parochial healthcare: Northamptonshire 1750–1830

Abstract

Notwithstanding interesting recent work, the nature of parochial healthcare under the Old Poor Law, particularly in its later years, remains very much under-researched. This article considers a sample of Northamptonshire parishes in order to investigate attitudes towards health care on the part of poor law officials between the mid-i8th and early 19th centuries. It will be shown that long-term sickness could be matched by a long-term commitment to paying for diverse and innovative care for the sick poor. Parochial authorities drew on a range of formal and informal medical practitioners to improve the lot of the sick poor, as well as employing a considerable variety of nurses from amongst the wider pauper population. The article represents the first attempt to conduct a systematic study of parochial records for any county.Recent research on the nature of doctor-patient relationships, the i8th-and 19th-century rise of the medical marketplace (Digby 1994) and the nature and language of professionalization (Porter and Porter 1989) has taken our understanding of the interaction between medicine and society to new heights. It is clear that while marked regional differences existed in access to doctors (as measured by practitioner to patient ratios) being treated by doctors was a much more familiar part of the medical landscape by the early 19th century than it had been a century earlier. It is equally clear that, while doctors (surgeons and physicians) and to some extent apothecaries had made great strides in establishing a professional structure and veneer, the rise of the quack, the continuing longevity of certain types of alternative practitioner and the evolution of 'new' trades such as the druggist and chemist, led to an ever increasing depth of 'healthcare by the early 19th century. Such historiographical developments are important, but we might also note that medical historians have tended to concentrate on the activities of doctors treating those at the higher end of the social scale, where competition and cash encouraged the emergence of proto-professionals operating in a medical marketplace.The experiences of the poor (defined here as those in receipt of poor relief), their relationships with doctors, and the nature of their medical treatment, has received rather less attention. Thus while Cherry, Sturdy, Loudon and others have generated important research on the rise of institutional provision for the poor, marginal and working classes, the operation of the parochial healthcare system funded by the Old Poor Law (1601-1834) has yet to receive systematic attention. It is clear that communities up and down

Review of periodical literature published in 2006

“…Brown, who offers a case study of a false imprisonment scandal at York Lunatic Asylum during 1813–15, which is seen in the context of wider asylum reform and as a product of conflicting sets of views about administration and accountability. Meanwhile, Smith, in a study of Northampton, argues that the asylum might be seen properly as an integral part of the poor law insofar as it discriminated between the deserving and undeserving poor and Stringer looks at how Northamptonshire parish authorities coped more generally with demands for health care between 1750 and 1830.…”