New approaches to the history of health and welfare

The problem of how to afford social welfare perplexes modern liberal democratic states as they confront the twenty-first century. As demographic changes have turned the population pyramid upside down in postindustrial societies, so the price of providing pensions and services for the longer-living chronic sick has risen beyond all expectations. Add to this the social security bill for periods of high unemployment produced by economic volatility, and you have an ever-expanding debit for what Victorians called “dependency.” Economic and political liberalism promises greater freedom for individuals living in affluent societies, so the contradiction between reducing personal taxation and meeting the costs of caring has led governments in Europe, North America, and the Antipodes to seek new formulas for the welfare state. Apart from questions of social justice and the rights of citizenship, postmodern societies cannot afford to ignore the welfare needs of the vulnerable and the dispossessed. The potential for civil disorder caused by disaffected unemployed youth is only one consideration. The ever-greater voting power of the retired equally preoccupies policymakers who need to be elected to power in modern democracies. In analyzing the recent British general election, pundits have suggested that by accusing the Tory government of secretly planning to scrap state pensions, Labour gave an additional thrust toward their landslide win.

Revising the welfare state has become a priority of democratic governments in the 1990s. In the United States, the second Clinton administration is promising to “end welfare as we know it” by the year 2000. ¹ In Britain, the recently elected New Labour government is putting a complete revision of the welfare state at the top of its agenda. In continental Europe, the governments of France, Germany, and Scandinavia have been looking at new experiments in pension-provision in economically reviving societies such as Chile. New approaches to the historical analysis of welfare, therefore, could not come at a more appropriate moment. Recent historiography of welfarism has addressed new questions such as the relationship between state provision, voluntary philanthropy, and mutual aid. ² A fresh sociological perspective has recently inquired into who precisely have been the main consumers and providers of welfare, and whether it constituted wages for what had previously been unpaid work. ³ While modern historians have identified the hundred years between 1850 and 1950 as the period that witnessed the emergence of the “classic welfare state,” early-modern and “postmodern” historians have been exploring a much longer chronology of care in the community.

The volume of essays edited by Anne Digby and John Stewart makes an excellent contribution to these debates. The title of the volume suggests that the main focus of the book is on gender, but the essays do much more than simply discuss divisions of labor and consumption between men and women; rather, they make other social groups such as children and the elderly central subjects of analysis, while continuing to keep the politics of gender within their sights. Digby and Stewart’s joint “Introduction” is an incisive survey of the recent historical sociology of welfarism. They argue that a “gendered analysis” of the “classic welfare state” has provoked a new conception of what constitutes welfare, who it was aimed at, and who actually received it, along with who contributed most to providing, managing, and administering it. Such a view, Digby and Stewart maintain, highlights the need for paying attention to female agency in both the provision and receipt of welfare, which is one theme that is persistently explored throughout the volume. In doing so the essays not only dissect the welfare state in terms of the politics of the family but also examine how...