The Medical Services of the New Poor Law in County Durham: 1834-1910

Abstract

This thesis analyses the development of New Poor Law medical services in three contrasting Durham unions from 1834 to 1914. The county makes an excellent choice to investigate these services because it experienced rapid population growth following mining and industrial expansion, which produced a disparate range of economies and communities. The thesis scrutinizes medical services in a large port town of Sunderland, the mining community of Chester-le-Street, and the vast and remote, rural Weardale. The research utilizes evidence from administrative records and surviving pauper documents in order to understand the challenges and experiences of those administering, delivering and receiving medical care. The research makes comparison with other unions across the country.

The thesis analyses the development of medical services in the Durham unions, and shows that the universal New Poor Law had constant exceptions in the provision of medical services in Durham’s unions. Despite the unions spending less on medical care than other parts of England the thesis does not conclude that a north-south divide accounts for this difference. Instead, it recommends investigation into the alternative medical services available in the county which may account for the differences. Analysis of several case studies reveals the range of difficulties faced by sick paupers, medical officers and nurses, including a bureaucratic system that created conflict, settlement laws that created obstacles for the sick poor and negative attitudes of the administrators towards those in need of care. The research argues that poor law nursing contributed to the development of nursing as a profession and deserves greater recognition by historians. The thesis also exposes the inefficient administrative processes that restricted the uptake of vaccination in the three unions and concludes that compulsion did not contribute to increased uptake of vaccination in the Durham unions.