Over the last two decades, commissions and reports on institutional care across the western world have highlighted widespread physical, sexual, emotional and economic violence within caring systems, often targeted at society’s most vulnerable people, not least children, the disabled and the elderly. These have often come at significant cost not just to the individual, but the nation. As Maxwell has shown, national apologies, that require the nation to render itself shamed by such practices, and financial redress to victims, have impacted on political reputation, trust in state organisations, and finances. As each report is released and stories of suffering fill newspapers and are quantified for official redress, both scholars and the public have asked ‘how was this allowed to happen?’ At the same time, and particularly in the last few years as many countries have turned towards conservative fiscal policies, newspapers also highlight the wrongs of current systems.
In the UK, numerous reports have uncovered abuses within welfare systems, as people are sanctioned to meet targets, as welfare staff are encouraged to withhold information about services or grants to reduce demand, and through systematic rejection of first-try benefit applications to discourage service use. Often excused as ‘isolated incidents’ on investigation, such accounts are nonetheless increasingly widespread. They are accompanied by a measurable reduction in investment in welfare and health systems, that have required a significant withdrawal in services, and have been accompanied with policies of ‘making work pay’ that have required that benefits be brought in line, not with need, but with low working incomes. The impact of these policies and associated staff behaviour have been connected to increasing child and adult poverty, declining life expectancy, growing homelessness, and the rise in foodbank use.
Importantly, public commentators on this situation have described this situation as ‘cruel’. One headline saw a benefits advisor commenting ‘I get brownie points for cruelty’; another noted ‘Welfare reform is not only cruel but chaotic’. The system depicted in Ken Loach’s I Daniel Blake (2016), described by reviewers as a Kafka-esque nightmare, a ‘humiliating and spirit-sapping holding pattern of enforced uselessness’, and a ‘comprehensive [system of] neglect and indifference’, was confirmed by many as an accurate depiction. Whether or not this representation of the current welfare system is held to be true, such reporting raises significant questions about when and how systems designed to provide help and support move from care to abuse. A focus on ‘isolated incidents’ today can be compared to the blaming of ‘isolated perpetrators’ in historic cases of abuse, an account that is now held by scholars to ignore the important role of systems of welfare in enabling certain types of cruelty to happen.
As we think about how to manage contemporary systems to ensure that such cruelty does not become embedded in everyday practice, a focus on historic welfare systems can help us better appreciate why and how systems become sites of abuse. Notably, such scholarship increasingly draws our attention from finding perpetrators to highlighting how abuse is encouraged through particular political and social ideologies, through social and financial investment in welfare systems, and through the expectations that we place on front line workers in welfare systems. Such accounts are important to consider as a focus on cases of historical abuse highlights not just the terrible wrong done to individuals, but the significant social, economic and political costs to the state and nation.
The capacity of welfare systems to support individuals is shaped by cultural beliefs and political ideologies around the relationship between work, human nature, and welfare. Here late-eighteenth- and early-nineteenth-century Ireland provides a productive example. Ireland in this period was marked by significant levels of poverty amongst its lower orders, particularly those that worked in agriculture. The capacity to manage that poverty on an individual level was hindered by several economic downturns and harvest failure, that pushed people to starvation. As a nation without a poor law (welfare) system until 1838, the poor relied on charity, whether from individuals or institutions for relief. In the late eighteenth and early nineteenth century, the ‘state’ (usually local corporations) introduced more direct welfare, sometimes in the form of relief payments but more usually access to workhouses. After 1838 and until the crisis of the 1847 famine, relief payments were removed and all welfare recipients had to enter the workhouse. Accompanied by a growth in institutional charitable services, the success and ‘care’ of the system could vary enormously between areas and organisations. What it did not do is significantly reduce poverty levels in the population.
Indeed, it was important that the poverty levels of welfare recipients were not reduced by the workhouse system. Like current ‘make work pay’ policies, poverty relief measures were designed so that those in the workhouse or receiving charity elsewhere did not have a significantly higher standard of living than those who provided for themselves. This principle was determined based on the wage of an independent labourer, one of the poorest but also largest categories of worker. The problem for the system was that independent labourers earned so poorly that they barely managed a subsistence diet. Their living conditions were extremely poor; many slept on hay in darkened huts with little furnishings or personal property.
Those who managed the system believed that a generous welfare system would encourage people to claim benefits and so could potentially bankrupt those paying into the system. This encouraged an active policy of ‘cruelty’. Not only were benefit recipients given meagre food and poor living conditions, but families were routinely broken up, the sexes housed in different wings and prohibited from seeing each other. Welfare recipients were often ‘badged’ or given uniforms to mark their ‘shame’, and workhouse labour was designed to be particularly physically challenging.
It was a system underpinned by several interlocking beliefs about the Irish, the value of work and the economy. Hard work was viewed as a moral characteristic, something to be encouraged from childhood and promoted as ethical behaviour. Certain groups, notably the Irish poor but also the British lower orders and non-Europeans more generally, were viewed as lacking this moral characteristic and required it to be instilled by their social betters. Welfare systems that were not carefully designed to be ‘less eligible’ (i.e. a harsher experience than ‘normal; life for the working poor), were understood to indulge an innate laziness. Irish philanthropists, such as the Quaker Mary Leadbeater, and education facilities, like that ran by her father, promoted hard work as a disciplinary practice. Leadbeater’s writings for the poor encourage them to work constantly, putting children to work at home as soon as they could walk, placing them in paid labour (such as straw-plaiting and spinning) as very young children, and encouraging children to work around school. As adults, she recommended the poor take regular low-paid work over higher-paying more infrequent work. She understood that both were precarious existences but the former instilled good work practice.
This was accompanied by a laissez-faire economic policy that believed that low wages and long hours were crucial to an expanding economy. Thus, there was little concern with the wage levels of the poor, who instead were given capacious amounts of advice on how to live frugally, to save, and to accept their social position with grace. It was advice that, if well-meaning, misunderstood the fundamental challenges of poverty, where there was not enough room in budgets to live at a subsistence level, let alone save, and where a single bout of illness or an injury could wipe out a lifetime of meagre savings within days.
Such ideological positioning of work as a moral act, and the poor as failing in this key moral character, persisted as a feature of conservative and liberal thought well into the twentieth century. Whilst contemporary understandings of the nature of poverty, as well as a rethinking of the nature of work and leisure, have challenged a language of the morality of work, the legacies of these ideas continue to pop up in both popular culture and political policy-making. Complaints about ‘generations of unemployment’ and ‘cultures of worklessness’, that have little basis in any evidence, reflect the long-running impact of such ideas. Importantly, whether it is this belief or another, the way that we design and implement welfare systems is always shaped by our broader cultural beliefs. When we are driven not by the impact of our policies on service users, but social and political values, we risk the production of ‘cruel’ systems as in the Victorian era.
It is unsurprising that welfare systems work better when they are subject to considered investment. Such investments are not just financial, but reflect the priorities of a wider culture and their ongoing commitment to particular systems. An example of this can be found in the history of the nineteenth-century asylum. The asylum was designed as a humane response to previous practices. It focused on providing mental health treatment (ideally cures) through beautiful surroundings, bright light, air, and good food, as well as more directed medical treatments, such as water cures, medications, and similar. It was a form of ‘moral therapy’, designed to restore an orderly self through encouraging good conduct and orderly behaviours but with minimal physical interventions or restraint. An initial investment in the concept of the asylum produced well-built, attractive institutions, often surrounded by pleasant grounds for walking. The early asylums had small numbers of patients, who came for relatively short periods, moving back into society after recovery.
Over time, the number of ‘incurable’ patients increased in facilities that were not intended for long-term care (‘bed-blocking’, it might be described today). Demand also increased, particularly amongst the lower classes. Resources were stretched. As time went on, reflecting a lack of alternative services, they also became ‘dumping grounds’, as the historian Andrew Scull called them, for other vulnerable people – the ill, elderly, and disabled. Initial responses to this demand in some regions included the introduction of a two-tier system, where working-class people worked to run the institution (cooking, cleaning, laundry) as part of their treatment (something that could be justified due to the belief in the significance of work for this social group), whilst wealthier patients could pay more to avoid such labour. Eventually many asylums became significantly understaffed and managing patients required less freedom for individuals and greater ‘order,’ that in practice made them more like a penal regime. Uniforms were introduced for patients; daily life became increasingly regimented; treatments became rarer; and the quality of care reduced. In some institutions, patients experienced physical, sexual and emotional abuse.
A significant part of the failure of the asylum was an inability to scale up the service to deal with growing demand and a lack of resources to provide tailored care on the original model. Yet its breakdown also reflected changing attitudes towards the asylum from within the medical community and beyond. The growing number of ‘incurables’ cast doubts on a model that had been designed for short-term recovery. Psychiatry was also developing different types of treatments, and psychiatrists were moving into practice with largely middle-class individuals outside the institution, something that was more lucrative and held in higher professional esteem. By the twentieth century, in part because of the abuses of such institutions, people lost faith in institutional care as a model for ‘caring’ for people.
Medical treatment, as well as models of caring, have advanced significantly since the Victorian asylum; there are good reasons why it no longer has utility as a model for care. However, much of its failure was not simply about something innate to the asylum itself, but about social investments in its uses. A lack of financial investment to enable the system to run as imagined, as well as growing expectations that it be used for purposes beyond its remit, undermined its operation. Without a medical community to support it and demand that the original vision was realised, the institution became overwhelmed, producing not only a cruel system for caring, but a system that was vulnerable to exploitation by perpetrators of serious physical, sexual and emotional abuse. A parallel story can be told for many children’s institutions – often began as charities to help needy children, they became under-resourced sites of discipline and cruelty.
The important lesson here is that as long as people continue to be placed in or use systems of welfare, a failure of investment – whether financial or ‘emotional’ – produces a context where cruelty and abuse can be realised. Thus, we have a responsibility to continue investments into systems during their operation, or, if they do not work, to provide effective alternative solutions to the social need they are meant to address. The asylum case study (not unlike the Irish workhouse) is also an example of how resourced public services have to take the load for failures in societies and their support systems elsewhere, in ways that not only undermine their operation, but their capacity to provide a humane service.
Throughout history, welfare services have required considerable economic investment. Unsurprisingly, this has required those who run institutions of care for people also to keep a careful eye on their financial bottom line. More broadly, it has also required a monitoring of services to ensure value for money for the state and its taxpayers and to protect the interests of the service users. As has been seen recently in discussions of targets placed on staff providing welfare provision in the UK, such measuring systems can come to shape the nature and ethos of the service in damaging ways.
A relevant historical example of this is from the Australian laundry system in the late nineteenth and twentieth century. Young women were placed in youth homes and registered as delinquent for a wide range of reasons from petty criminal behaviour to perceived immorality (ranging from flirting with the opposite sex to premarital pregnancy), to having been neglected by parents. These homes, often run by religious organisations, were designed to ‘reform’ young (and occasionally older) women, preventing them from entering prostitution or other criminal pursuits. The main mechanism for ‘reform’ was through a moral discipline of work, which in many of these organisations revolved around a professional laundry service. Work was often unpaid or paid at very nominal sums, given to women on their release. The service, which catered to the general public, kept institutions financially afloat, and many became significant-sized businesses. They required women to work very long hours, in challenging conditions. Accidents, particularly burns, were not unusual. As businesses grew, other ‘reform’ efforts that ran alongside, such as education, became rarer.
The laundry became the driving focus of the institution. The women were cheap labour, and managing that machine became not just a means to an end, but shaped the logic and functioning of the care service. It is an example of how an economic imperative can come to adversely impact on care, by disrupting the purposes and functions of the service. It was also a process that significantly reduced the level of ‘care’ that such institutions provided, not only through a physical job that wore on the body but one reinforced with physical punishment, which came to include emotional and sexual abuse, and poor food and living conditions.
It is a case study that is suggestive of the ways that the core vision of an institution can be diverted through competing interests. In this instance, a financial need to support the service evolved to redirect the purpose and function of an institution, leading to significant cruelty to inmates. There are many less extreme examples of how targets designed to measure the efficacy of services come to direct the behaviour of staff towards specific goals to the loss of service provision or care elsewhere. In the English workhouse system, the tendering system for contracts encouraged suppliers to adulterate food and for workhouse masters to collude in the practice, as it ensured they came in within their budgets. Such examples are indicative of the importance of defining the core service, ethos and values of an organisation, and ensuring that they are maintained as a priority, when designing systems to measure and maintain themselves. They are highly suggestive that frontline staff working with service users should not have their interests diverted from the core values of an organisation. When such a diversion of vision emerges, the risks to service users is significant, leading to an abusive system and cruelty towards individuals.
There are significant variations between the institutional care described here for the nineteenth century and a contemporary welfare state that encourages users, as much as possible, to remain outside ‘the system’. The capacity for ‘the state’ to control every dimension of a person’s life today is significantly reduced; conversely, the ability of those in need to fall into service ‘gaps’ as they cannot access services or negotiate bureaucratic systems, is in some ways increased. Nonetheless, there are parallels in the operation of both systems that should give contemporary policymakers pause. Abusive care does not just emerge from individual perpetrators, from the institutional model, or even a lack of policies on staff-client relationships, but also from the wider values and beliefs that shape the production of welfare systems; from the financial and emotional investments that we place in institutions; and from the corruption or occlusion of institutional targets and goals.
Ensuring that the ‘cruel’ practices reported of current systems do not become systematic issues on the scale of previous institutional abuses therefore requires not just monitoring a few rogue individuals, but a clear goal about what our welfare systems should achieve. The needs and interests of service users should be placed at their heart, coupled with a significant social, cultural and political investment in ensuring that goal is achieved. All other goals and targets for welfare service providers, especially their frontline staff, should be secondary to that and carefully designed so as not to interfere with that end. With rising rates of poverty, homelessness and illness, welfare systems look to continue to hold a central role in society for the foreseeable future. It is imperative that the abusive practices of previous ‘caring’ regimes are left firmly in the past.
Crossman, V., Politics, Pauperism and Power in Late Nineteenth-Century Ireland (MUP, 2006)
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Garton, S., “Seeking Refuge: Why Asylum Facilities Might Still be Relevant for Mental Health Care Services Today”, Health & History, Vol.11, No.1, 2009, 25-45
Gill, A., Orphans of the Empire (Random House, 1997)
Gray, P., The Making of the Irish Poor Law, 1815-43 (MUP, 2009)
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Maxwell, K., “Settler-Humanitarianism: Healing the Indigenous Child Victim”, Comparative Studies in Society and History, Vol.59, No.4, 2017, 974-1007
Scull, A., ed., The Asylum as Utopia: W.A.F. Browne and the Mid-Nineteenth-Century Consolidation of Psychiatry (Routledge, 2013)
Scull, A., Museums of Madness: the Social Organization of Insanity in Nineteenth Century England (Allen Lane, 1979)
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