Skip to content

Response to Review no. 453

I welcome this opportunity to respond to Meaghan Kowalsky’s balanced and thoughtful review of my book. Although my present post is in medical humanities, I am a historian whose research has focused on the social history of medicine. Therefore, I am acutely aware of the plethora of primary sources that are available for a monographic study of a particular aspect of disability. But that was not my purpose. Rather I set out to produce a broad-ranging analysis of physical and mental disability across 250 years that integrated perspectives from history and the social sciences. I am pleased that this has been achieved in a successful ‘overview of policies and programmes’ for disabled people, which locates them ‘within the context of general welfare’, ‘cogently brings together … studies from the fields of history, sociology and social policy’, and ‘provides a much needed foundation for the history of disability’.

Given this agenda, my strategy was to conduct a comprehensive review of the existing literature and turn to primary materials to fill the more glaring gaps. Mental illness and learning difficulty are comparatively well researched, and old age is better served than physical impairment. Consequently, I concentrated my archival work in this area. Of course, Hansard, the papers of chief medical officers, and reports of the Local Government Board are rich sources for the history of disability, but it was impossible for me to look at them for the host of policies relating to physical and mental impairments since 1750.

Geographical coverage is likewise an issue in a book that purports to deal with Britain as a whole. I attempted to flag up any variations in policy between England, Scotland, and Wales, and to pick examples from different areas of the country. Of necessity, my archival research was more selective. However, as well as using the British Library and the Wellcome Library for the History and Understanding of Medicine, I did examine the holdings of record offices and/or libraries in Derby, Nottingham, Exeter, Shrewsbury, Cardiff, Birmingham and Swansea. If the references to Swansea are excessive, perhaps they can be regarded as compensation for the neglect of Wales in general discussions of policy history.

Disability studies have tended to exclude elderly people and my effort to include them is not without problems. When, as Kowalsky herself concedes, workhouse records conflate the ‘aged and infirm’, it is difficult to see how historiography can entirely escape this categorisation and disaggregate the ‘disabled elderly’. Similarly, old age pensions are, by definition, confined to elderly claimants. By the late 1960s, however, approximately two-thirds of the impaired population was over the age of 65, making retirement pensions the principal means of financial support for a majority of disabled people. It was for this reason that I considered old age pensions worthy of discussion ‘as a welfare issue in their own right’.

I was surprised to be accused of leaving claims unsubstantiated but, for reasons of length, it was not always possible to include specific examples in the text. My bibliography, described as ‘extensive’, is titled a Select Bibliography and lists the secondary sources most directly relevant to disability. However, full details of all the sources – primary and secondary – are given in the notes to each chapter. It is true that although the book ‘boast[s] a great deal of oral testimony from disabled people themselves’, I did not undertake any new research in this field. With a project of this kind, it was not practicable to do so. Nonetheless, to represent the voices of disabled people, I did draw on a number of published oral testimonies, including Out of Sight: The Experience of Disability, 1900–1950 by Steve Humphries and Pamela Gordon – a splendid collection of oral histories that offers many insights into different aspects of disabled people’s lives. I hope that my book will ‘act as a springboard’ for other such studies in the history of disability.