Jameel Hampton. Disability and the Welfare State in Britain: Changes in Perception and Policy 1948-1979. Bristol: Policy Press, 2016. 272 pp. $110.00 (cloth), ISBN 978-1-4473-1642-8.
Reviewed by Pamela L. Dale (University of Exeter)
Published on H-Disability (March, 2017)
Commissioned by Iain C. Hutchison (University of Glasgow)
In recent years, the history of disability in Britain has finally become established as an important field for interdisciplinary research. I hope and expect that this interesting contribution from Jameel Hampton, which seeks to switch attention away from the provision of services for the disabled to the availability of cash benefits and their promise of greater personal autonomy and independence, will reach the wide and diverse audience it deserves and also stimulate much-needed further research. Following the best traditions of disability history, this book uses new sources and approaches both to highlight and to counter the historic marginalization of disabled people while addressing wider social, economic, and political issues. By doing so, Hampton questions long-cherished assumptions about the operation of the British welfare state in its heyday and thereby problematizes the future direction of welfare policies under conditions of financial austerity. Although the United Kingdom is the explicit focus of the study, Hampton reveals reciprocal international influences on policy and practice that will interest scholars and stakeholders concerned with other countries.
The aims of the book are ambitious, and to a large extent realized. The introductory chapter is not overly long, but helpfully outlines the key definitions, questions, and approaches that inform the rest of the book. In a very detailed and reflexive way, Hampton discusses some of the problems he personally encountered with his study, and these are highly relevant to the discipline as a whole. One of the themes that interest the author is the problem of definitions leading to historical as well as contemporary uncertainty over numbers and needs. His focus is on the “general classes” of disabled people, but alongside his persuasive case for recognizing the distinctiveness of this group (to paraphrase Hampton, disabled adults of working age not covered by schemes for the war wounded or industrial injuries or special arrangements for blind people, deaf people, the mentally ill, and people we would now understand to have learning disabilities), there is explicit acknowledgment that this is not the terminology that has been adopted by disabled people. Difficulties with language are shown to lead to problems quantifying who might fall into the category, and Hampton draws a useful distinction between the importance of individuals self-identifying as disabled people and the legal and medical terminology that cuts across, yet seeks to define, their experiences. Hampton is rightly critical of the marginalization of disabled people within policy discussions, and later historical analysis, relating to the welfare state, but explicitly worries about maintaining objectivity. I am not sure that complete neutrality is either desirable or possible when confronted with evidence of systematic discrimination against disabled people, but as a reader I appreciated the commitment to objectivity revealed by the careful assemblage of evidence, the thoughtful analysis taking into account multiple perspectives and competing interpretations, and the temperate use of language.
In chapter 2, Hampton develops his ideas about provision for disabled people before the welfare state. The references, usefully collected at the end of each chapter, are unusually detailed and extensive, perhaps reflecting the study’s origins in a thesis. There are plenty of interesting ideas here, but also some evidence of problems around selecting and ordering material that could potentially form a separate monograph. The chapter acknowledges a considerable debt to Anne Borsay’s seminal text Disability and Social Policy in Britain since 1750: A History of Exclusion (2005), but it also draws on a comprehensive survey of the literature exploring evolving welfare provision and the support available to various groups of disabled people at different times. Hampton usefully identifies a number of distinct eras while also highlighting important continuities. The narrative is both straightforward and engaging, making this a good introductory text, but specialists will notice some gaps. I was, for example, surprised to see no discussion of tuberculosis services, which raise many questions about controls as well as care, and issues about work within and outside of the home that are highly pertinent to the rest of Hampton’s book.
Chapters 3 to 6 consider welfare state era provision for disabled people. This is the core of the book and Hampton offers a wealth of detail. Hampton persuasively quotes from Peter Baldwin to make the case that it is in the detail of policymaking that the significant battles of the welfare state were really fought and that, without understanding the more detailed and technical points, larger conclusions about the treatment of disabled people cannot be substantiated. I think that readers will agree with him, and while not everyone will be fascinated by all the minutiae, the narrative is engaging and arranged to highlight topics of general interest.
One of the main arguments advanced by Hampton is that it took time for the welfare state to recognize the needs of disabled people and even then it took sustained effort by disability activists to make them a political priority. Personally, it was chapter 3 dealing with “promotional welfare, 1948-63” that really caught my interest because it so accurately captured the experiences of my great aunt Olga who developed a severe arthritic condition in her teens and lived most of her adult life in a local authority home before dying in 1969 at the tragically early age of fifty-two. She suffered terrible pain and indignities inflicted by both her condition and by the social and economic marginalization that accompanied it. Yet like so many disabled people at the time, she was, and was expected to be, grateful for the support she received and before her death found some fulfillment in disseminating newsletters and other materials circulated by disability groups.
Chapter 4 moves the chronology forward to 1964-69, but continues the theme of the “emergence” of disabled people. Here the focus is on the growing interest in disability issues shown by the major political parties, the Trades Union Congress, and the print and broadcast media. While Hampton makes the point that interest in disability did not simply start in 1964, there was a powerful coalescence of factors that served to push disability topics, including the importance of cash benefits, up the political agenda at this time. Hampton accords a key role to the Disablement Income Group (DIG) and studies its membership, tactics, and successes in detail. It is certainly surprising that this is the first major study of such an important organization, and this is a section of Hampton’s book that really should stimulate further research. The role, and also limitations, of the DIG are also considered in chapters 5 and 6, which concentrate on “legislation for disabled people, 1970-72” and the expectations raised and then dashed by the implementation of the Chronically Sick and Disabled Persons Act (1970).
For Hampton, timing is crucial and he sees it as a cruel irony that the welfare state finally recognized the needs of disabled people and found a vehicle, however ineffective, to better meet them at the very moment that economic crisis decreed that little if anything could be done. As latecomers to the welfare state, disabled people were particularly vulnerable to efforts to roll back entitlements on ideological as well as cost grounds. Hampton follows Peter Townsend by highlighting the failure of the state to “conceive a central philosophy or set of principles on how the welfare of disabled people should be addressed by the state,” even during a period when major political parties seemed in agreement over the need to do something (p. 208). Hampton then regards the rise of Thatcherism as deeply inimical to the cause of disabled people and, not unexpectedly, characterizes the end of the 1970s as the “final days” of the welfare state. The analysis here is interesting, but in chapters 7 and 8 he moves away from the detail of his case studies to a more polemic discussion. For me, this was something of a missed opportunity because debates about the place of disabled people in the welfare state did not end in 1979; they intensified and thus threw into sharper focus all the financial, practical, and ideological difficulties identified by Hampton for the earlier eras. It might have been better to combine and extend remarks in these final chapters, perhaps along the lines of Chris Pierson’s 1996 essay exploring the idea of a welfare state consensus, the way it broke down, and the emergence of a new consensus for the 1990s. The jump from the election of Margaret Thatcher (1925-2013) in 1979 to a very brief comment on the state of debate in 2016 is too big and misses much.
One of the strengths of Hampton’s book is its bringing to life the key personalities with pen pictures of the lives as well as policies of leading Labour and Conservative politicians. Hampton points to a deep concern with humanity that motivated those on the left and right of the debate. Members of Parliament on both sides of the House of Commons were clearly influenced by the DIG but, as Hampton so interestingly discusses, also drew on their personal and family experiences of disability and the emotive testimony of service-users that filled their constituency postbags. Many of their ideas were undeniably well intentioned and yet there were serious obstacles to developing effective policies. Hampton reveals how backbench MPs, perhaps not fully attuned to the developing economic crisis of the early 1970s, took more progressive stances than ministerial, ministry, and most especially treasury policies allowed. While unquantifiable and inevitably costly demands were a persistent concern, so too were ideological commitments to contributory versus non-contributory schemes and universal benefits versus selective ones, while older debates about the need to raise work incentives and differentiate between the deserving and undeserving poor never went away.
These themes continued to interplay in highly problematic ways for successive governments hoping to “do” something for the disabled (from both political calculation and more positive sentiments), while also restricting the overall welfare bill. Just as policy evolved in the late 1960s and 1970s, I think Hampton could have briefly traced continuity and change across the three Thatcher governments, which saw many changes of personnel in the key ministries especially at junior levels. John Major is certainly worthy of explicit consideration. His autobiography (The Autobiography ) confirms a life-long personal interest in disability issues and, before serving as chancellor of the Exchequer and prime minister, he had a brief period as a junior minister with special responsibilities for the disabled and a rather wary relationship with the disability lobby groups. Disability issues also form an important backdrop to the personal and political journey of Tony Blair. In opposition and in government, New Labour sought to engage the academic community in reimagining welfare in a way perhaps not seen since the early 1970s, although disabled people were arguably neither the main target nor main beneficiary of these policies. Nonetheless, interesting commentary is provided by Blair and Alastair Campbell, with the former revealing growing frustration with the disability lobby.
With the DIG so central to Hampton’s study, it is worth considering its activities in more detail. Hampton is one of several authors who highlight the inspiration, common purpose, and personnel shared between the DIG and other perhaps better-known pressure groups, such as the Child Poverty Action Group (CPAG) and Shelter. I think a slightly more reflexive and/or critical edge could have been added to the analysis by referencing more contemporary and historical critiques of these organizations. There are questions about their aims, importance, and legacy over many decades, but it is perhaps their prominence and ultimate powerlessness in the 1970s that attracts most attention. Some of the leading thinkers were brought together for a 1999 witness seminar discussing the Black Report and Peter Townsend’s (1928-2009) testimony is particularly interesting to read alongside Hampton’s book. Crucially the witness seminar identified civil service as well as ministerial hostility to their research and campaigns and this is a key theme in Hampton’s book.
In several sections of his book, Hampton discusses the ambiguous role played by Richard Crossman (1907-74) when he was secretary of state at the Department of Health and Social Security. On the one hand, Crossman was close to a number of advisers and academics who were leading lights in the DIG and the later Disability Alliance, but it was also true that disability was not one of his pet projects, and, at best, it struggled to compete for his attention among a range of health and welfare reforms. My personal work on Crossman’s distinctive personal contribution to the reform of long-stay hospitals had left me with a favorable impression. So, faced with Hampton’s more critical assessment, I went back to Crossman’s famous diaries and found that not only were Hampton’s sources correct but the diaries also additionally revealed an unexpected personal hostility to Jack Ashley (1922-2012), apparently based on a prejudicial view of his role as a campaigning Deaf MP. While Crossman died before volume 3 of his diary was finalized for publication, it is perhaps also worth noting a possible Freudian slip where the Disability Alliance is recorded as the Disability Allowance. There is certainly no doubt that disability politics presented a difficult challenge for the Labour Party in the 1970s and it is possible to extend Hampton’s analysis of this point. Dennis Healey (1917-2015), for example, was not unsympathetic to the needs of the disabled and disadvantaged, but feared that efforts to turn the Labour Party into a “Rainbow Coalition” of single-issue pressure groups inflicted electoral damage, and specific welfare measures alienated traditional supporters.
Others on the left feared that the DIG, CPAG, and Shelter were not radical enough. A 1974 book by Bill Jordan (Poor Parents: Social Policy and the “Cycle of Deprivation”), who identified himself as a social worker, lecturer, and associate member of a claimant’s union, covers similar topics to Hampton’s, but many of the conclusions reached are very different. Jordan expressed concern that elite figures in the national organizations were imposing their agenda on clients and voiced suspicion that politicians overtly favorable to disabled people intended to punish other groups of disadvantaged people by resurrecting the principles of the Poor Law and invoking the language of the deserving and undeserving poor. Yet Jordan and Hampton offer a very similar analysis of the territorial injustices of local government services and both highlight the reality that many claimant groups had to compete for inadequate resources. They also agree that the aims and operation of departments concerned with personal social services were opaque and for many clients (and staff) sub-optimal. From a contemporary as well as historical perspective, they both confirm that means testing was expensive and intrusive and that junior officials were allowed levels of discretion that perpetuated prejudicial attitudes and discriminatory practices. This is powerful stuff, but personally I think Hampton missed the opportunity to add more personal testimony to illustrate these points. He explicitly rules out oral histories as being beyond the scope of the study, but the documents consulted could certainly have provided colorful material.
It is my hope that this study will prove a starting point for further research, but future scholars need to be aware of some difficulties with it. Hampton starts and ends with the exclusion of disabled people from the welfare state, but although he makes a persuasive case, other studies have taken a different view. Mathew Thomson, for example, discusses the early enactment of the Disabled Persons Employment Act (1944) as one of a number of measures that were intended to be inclusive and progressive. Thomson argues that these measures had a profound impact on certain groups of disabled people over the next twenty years although his sophisticated analysis also points to the continuation of earlier models of service delivery and a failure to confront prejudicial attitudes toward service-users. Hampton, following Borsay, is far more critical of the conception and operation of major pieces of legislation. For Hampton, the privileging of work and reliance on contributory benefits made key planks of the welfare settlement into major obstacles to delivering improvements to the lives of many disabled people. For me, this is an important and correct conclusion, but readers need to be a bit careful as there are some inaccuracies in the supporting arguments. The overall significance is marginal, but I found parts of the small sections on housing unconvincing and checked the details with a housing professional who worked in the 1970s and 1980s. He had a very different recollection of what was going on. Small factual inaccuracies and different interpretations are, however, inevitable in a study of this complexity and never detract from its overall merit.
. Peter Baldwin, The Politics of Social Solidarity: Class Bases of the European Welfare State, 1875-1975 (Cambridge: Cambridge University Press, 1990), 1.
. Chris Pierson, “Social Policy,” in The Ideas That Shaped Post War Britain, ed. David Marquand and Anthony Seldon (London: Fontana, 1996), 139-164.
. Tony Blair, A Journey (London: Hutchinson, 2010), 122-123; and Alastair Campbell and Richard Stott, The Blair Years: Extracts from the Alastair Campbell Diaries (London: Arrow Books, 2008), 283-284.
. Virginia Berridge, ed., “Witness Seminar: The Black Report and The Health Divide,” in Poor Health: Social Inequality before and after the Black Report, ed. Virginia Berridge and Stuart Blume (London: Frank Cass, 2003), 131-171.
. Richard Crossman, The Diaries of a Cabinet Minister, vol. 3, Secretary of State for Social Services 1968-1970, ed. Janet Morgan (1977; repr., London: Book Club Associates, 1978), 139, 345n3.
. Denis Healey, The Time of My Life (London: Michael Joseph, 1989), 352, 448-449.
. Mathew Thomson, The Problem of Mental Deficiency: Eugenics, Democracy and Social Policy in Britain c.1870-1959 (Oxford: Clarendon Press, 1998), 270-296.
. Anne Borsay, Disability and Social Policy in Britain since 1750: A History of Exclusion (London: Palgrave Macmillan, 2005), 135.
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Pamela L. Dale. Review of Hampton, Jameel, Disability and the Welfare State in Britain: Changes in Perception and Policy 1948-1979.
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