Relation to Poor Law Administration
[The] contempt for medical science infuluenced Chadwick's treatment of the Poor Law medical service, and the resentment the doctors felt against him lowered still more his estimate of their usefulness. Under the old Poor Law the parish officers had entered into a general contract with the doctors for the care of the sick poor. The New Poor Law confined the contract only to 'sick paupers', and limited it only to 'a person licensed to practice as a medical man', a qualification which it was ledt to the Guardian to determine. The change was not of itself injurious to doctors. The limitation from 'sick poor' to 'sick paupers' hardly affected them since their private parients among the poor were so few in numbers. What injured their position was the parsimonious policy the Board deliberatily continued, under Chadwick's pressure, until 1842 when Chadwick was jettisoned. Although, in the Second Annual Report, Chadwick equivocally sought to throw the responsibility for this policy on the Guardians, it really was the Board's own policy, and it secretly directed its Assistant Commissioners to recommend larger medical areas, so that fewer doctors would be needed and there would be greater competition between them. Where the older men redused to agree to the new terms, younger men were encouraged to settle in the countryside. Chadwick and the Assistant Commissioners did their best to place the contracts by public advertisement for the lowest tender [F 158].

He charged the medical officers with abusing their powers and prescribing joints and wines and hams to the poor upon their list. His view was that although the doctors prescribed little but comfort to the soul they had an incentive to treat as many cases as possible, and so made paupers of otherwise independent labourers [F 159].