During the nineteenth century there was a shift away from a paternalistic form of welfare towards professionally administered and insurance-financed systems. The question arises to what extent the legacy of Christian humanitarianism and mercantilist concern with population numbers contained in earlier concepts of bienfaisance1 and of the Wohlfahrtsstaat were reformulated in a more modern guise rather than rejected.2 The financial bases of welfare expanded with industrialization, although there was no simple correlation between industrial growth and new forms of medical care on a socialized basis.3 Democratic expectations of benefits according to need rather than on a charitable and discretionary basis meant that charity and the stigmatization of poverty were intertwined. Yet schemes for reform mooted during the 1880s and 1890s retained a place for voluntary agencies, which have survived in most welfare systems. Charity was modernized. Separate facilities were held to be necessary for the sick and for the poor; the incurable were separated from the infectious. Special measures and institutional arrangements were made for such groups as children, unmarried mothers and the aged.