Healing the sick poor: social policy and disability in Norwich 1550-1640.

In the history of social policy in Britain, state medicine is not seen as the natural state of affairs. Rather, it seems that medical services have been provided by the state in the twentieth century only after a process of painful evolution in the nineteenth, which even now is not complete. Only the inexorable effects of industrialization were able to force upon policy-makers an awareness of the social and economic cost of ill health and early death. Before this point of crisis, health care was primarily delivered by voluntary agencies. Medical poor relief began to be organized on a parochial basis in the eighteenth century, but this remained a meagre and makeshift version of what was evolving on the voluntary level. The workings of private philanthropy continued to be the main support of the less fortunate members of society. This perspective has been supported by assumptions about the growth of medicine as a profession. Medical historians, although increasingly aware of the sophistication of public medical provision on the continent, incline to the view that medical poor relief began in England towards the end of the seventeenth century because they also assume that the medical profession was insufficiently developed before this date. If the poor were treated at all previously, it was by barbers and old women. It is assumed that authorities of the earlier period either had no faith in the effectiveness of medical practitioners, a view which leads inevitably to anachronism, or that they considered them too few or too expensive to have any relevance to the poor.' This set of assumptions could be attacked in a number of different ways. It has been remarked that, with respect to the early modern period, attitudes to social policy are better known than their application.2 An intensive study of the scattered