Health costs of social injustice

BMJ 1994; 309 doi: 10.1136/bmj.309.6963.1177 (Published 5 November 1994)
Cite this as: BMJ 1994;309:1177

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  1. M Bartley

    The benefits of increasing technological power for the mass of the population, in terms of higher living standards, greater freedom, and better health, have never been automatic. Reforming energy and social innovation have always been necessary for people to reap the full benefit of economic and scientific advances. The significance of last month's report by the Commission on Social Justice needs to be understood within this history of reform.1,2

    One hundred and sixty years ago the Poor Law Amendment Act of 1834 established the “workhouse rule,” according to which unemployed people were obliged to enter prison-like workhouses to become eligible for “relief.” The act was intended to cut the cost of “poor relief” and to create what we would now call a labour market. In this market people (or at least their ability to work) would be treated as commodities to be bought and sold by the owners of the great new factories, which were changing the face of Britain.3 A low price for labour aided profits, and when demand fell in recessions this price could be cut even further. When not needed workers did not have to be paid at all. Debates took place on how little low paid …

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