In need of care and attention – the 1940s

The need to care for each other has been a universal human need since the start of recorded time. It has found expression down the ages in the work of monasteries, medieval almshouses and the earliest hospitals that were essentially places of refuge, care and support. The Elizabethan and Victorian Poor Laws marked the beginnings of state intervention in response to the plight of the poor, the destitute and those unable to care for themselves. The motives for these measures were often more punitive than philanthropic, but they have left their mark, as we shall see.

To understand how we have ended up with our current system, the starting point for the modern history of social care should be the foundations of the post-war welfare state, when the social security element of the Poor Law was shifted to central government (social security as it was to be called later), and the ‘welfare’ element was given to new welfare departments within local authorities. This was a decisive moment that was to influence deeply the relationship between social care and its very big and dominant sibling, the NHS. Looking back to the origins of the modern welfare state also helps us to appreciate how much, and in many ways how little, has changed since then.

In the early months of 1948, a leaflet by the Ministry of Health plopped through the letterbox of every household in the land, proclaiming the launch of the new National Health Service on 5 July: