Dr Kim Price from our School of Historical Studies has been investigating medical negligence under state medicine, particularly the pre-NHS (pre-1948) welfare system in the UK. In a recent research paper published in the Lancet, he suggests the government’s use of 'nudge' theory harks back to ideas on welfare and recession from the end of the nineteenth century.

Back then, the Conservatives instigated a policy to cut back welfare expenditure and lessen reliance on poor law out-relief. This included cutting medical extras and payments to lone mothers, widows, the elderly, the chronically sick, and people who were disabled or had mental illness.

The result, Dr Price believes, lowered the health of many families and increased the number of people who could no longer be supported at home.

Dr Price argues that, under current UK Coalition government proposals for GP consortia, and its potential conflicts of interest, the doctor-patient relationship is in peril of shifting too far in favour of doctors and undermining the trust of patients. This too harks back to 19th century Poor Law doctors who had to choose between their private and public patients, resulting in widespread neglect of the poor.

• University Press Release

• The crusade against out-relief: a nudge from history (doi: 10.1016/S0140-6736(08)61345-8)