The Problem of Mental Deficiency: Eugenics, Democracy, and Social Policy in Britain, c. 1870-1959 (review)

Mathew Thomson. The Problem of Mental Deficiency: Eugenics, Democracy, and Social Policy in Britain, c. 1870-1959. Oxford Historical Monographs. Oxford: Clarendon Press, 1998. ix + 351 pp. $90.00.

This is a densely woven and argumentative book, which shakes the kaleidoscope of knowledge to present new contexts for some familiar events and ideologies. It is an account of the eugenics movement that gives more space to the context within which eugenics existed than to the movement itself.

Thomson sees British society in the first half of the twentieth century as growing increasingly liberal and democratic, and the eugenic point of view as failing to fit into that trend. The eugenists demanded the segregation or sterilization of all kinds of undesirables to prevent their multiplication, but their arguments did not get broad support in the case of inebriates, criminals, paupers, or the unemployed. They had little impact on British social policymaking in general. Why, then, did they succeed with the segregation of mental defectives?

Hugh Heclo and some others writing in the 1970s emphasized the Civil Service as the key policymaker, collectively puzzling on society's behalf to identify problems and deal with them within the parameters nominally provided by the political process--a kind of scholarly Yes, Minister. ¹ Heclo puts the state at the center of the process; his work has provided a background against which students of political decision-making have tested their ideas and proposed their modifications and alternatives. Thomson--who actually does not mention Heclo--spreads the responsibility more widely. He approaches his problem by looking at the formation of social policy as a "complex, multilevel, and interactive process" (p. 3), digging down through its layers from the legislature to the Civil Service to the professional groups involved, the case workers, the families, and the subjects themselves. His three core chapters are expansions of his paper "Sterilization, Segregation and Community Care," which appeared in History of Psychiatry in 1992. ² To these he has added investigations of the parliamentary politics of mental deficiency, and the history of the rise and fall of the Board of Control created by the Mental Deficiency Act of 1913 and subsumed in the National Health Service Act of 1948 and the welfare state of which the health service formed a major part. The state emerges from this investigation rather de-reified, as a fluid process of many-sided negotiation between legislators and government departments, local and central authorities, official and nonofficial, statutory and voluntary bodies, professional associations and pressure groups and individuals.

Thomson's thesis is that though segregation succeeded in 1913, the sterilization campaign mounted by the Eugenics Society in the thirties failed because it came up against fundamental ideas about individual rights and the social responsibilities of citizenship in an increasingly democratic Britain. Because the mentally defective lacked a citizen's responsibility and therefore needed protection rather than freedom, it seemed reasonable and progressive to provide them with permanent care by segregating them, but not to wound them by sterilization. Thus segregation could attract the support of progressives where sterilization was more questionable, though both could be seen as possible ways of dealing with the problem of those who could not carry out the rights and duties of citizens. In the policymaking network, the eugenists as a pressure group could supply only a small part of the input; the rest pulled in a different direction.

Thomson's conclusions coincide with those of Desmond King and Randall Hansen, writing in 1999, ³ who suggest that the Departmental Committee on Sterilisation (Brock Committee) of 1933, which was indeed full of eugenists, produced a report advocating a program that was shown by their evidence to have little public approval. Sterilization as a solution to the problem of mental deficiency was not supported by the experts, by...