This collection of essays admirably sets out to focus not on the organizations that provided charitable aid but on the people who consumed that aid and, in some cases, on ways the poor were able to provide mutual aid. The editors stress that by concentrating on the relationships between aid providers and recipients, they hope to avoid a paternalistic approach by restoring a sense of the recipients’ agency within the process of requesting and receiving charitable assistance. The goal of recovering voices of the poor is both significant and difficult, and while some of the essays in the collection succeeded, others resulted in familiar historiographical patterns of describing the institutions that dealt with the poor without managing to animate the poor themselves.

Of the twelve essays in the collection (excluding the introduction), among the strongest are those by Stuart Hogarth and Andrea Tanner. Hogarth's “Joseph Townend and the Manchester Infirmary: A Plebeian Patient in the Industrial Revolution” begins with an excellent summary of the historiography of the rise of the modern hospital, noting the general acceptance by many of a Foucauldian world in which doctors wielded power and patients were simply cogs in the medical machine. The case of Joseph Townend allows Hogarth to question this orthodox view. Townend came to the Manchester Infirmary through the influence of his employer, seeking treatment for a recent wrist injury. However, once admitted, Townend was able to negotiate to become an inpatient at the infirmary, and he was able to convince the medical staff to also treat a longer-term injury, the result of a childhood accident. This injury had resulted in scar tissue binding his arm to his torso; the condition would require a delicate surgery that doctors seemed reluctant to undertake without Townend's own conviction that he wanted the procedure carried out. Hogarth concludes, “The people in these institutions broke and bent the rules as much as the rules broke and bent the people” (109). Tanner's contribution, “Choice and the Children's Hospital: Great Ormond Street Hospital Patients and Their Families, 1855–1900,” works with a database of patients and additional evidence drawn from casebooks to examine the relationship between the hospital and the parents of its young patients. Like Hogarth, Tanner concludes that the recipients of Great Ormond Street's charity were far more active on their own and their children's behalves than orthodox views on the power structures within medicine and charity might suggest. As Tanner points out, as a voluntary hospital, Great Ormond Street could not force parents to bring their children in for treatment; the very choice to appeal to the hospital was an important one, involving a willingness to possibly be separated from a child, a willingness to adhere to the institution's strict rules, and the effort to present the child (and themselves) in clean clothing when applying for treatment. Tanner is particularly interested in the cases of parents who, after going to such lengths to get their children admitted, then removed their children from care before treatment was complete. She explores many possible reasons, including unhappiness over being separated from the child, needing the child to return to work, and concluding that no further benefit could be gained from treatment. Interestingly, most often the decision to remove a child from care was reached, or at least expressed, by the father.

Other essays within the collection do not succeed as well in challenging existing historiography or finding the voices of charity recipients. For example, Anne C. Shepherd's essay, “Mental Health Care and Charity for the Middling Sort: Holloway Sanatorium, 1885–1900,” while an interesting look at the creation of this institution, does not seem a good fit for this collection. Despite the fact that Holloway was set up as a charity, the essay does not really get to the experiences of the patients but instead goes into detail on the architectural design of the facility and the ways that elegant buildings and entertainment programs were meant to set middle-class patients at ease. Evidence as to whether these designs succeeded in making the patients feel at home is lacking here. Barry Doyle's essay, “Power and Accountability in the Voluntary Hospitals of Middlesbrough, 1900–1948,” also struggles to meet the goal of discussing patients rather than institutions. While Doyle sets out to examine where the money to support these institutions was coming from and to show the role played by working-class contributors, the essay is largely still about institutions rather than people—in this case, the local Labour Party became one of the institutions with influence and was even able to impose its will on the medical authorities within the hospitals, but that still does not tell us much about how working-class citizens perceived and made use of the hospitals in Middlesbrough.

The essays in this collection are all strong works of historical research. However, some do not achieve the aims set out by the editors in their introduction, and some do not seem to fit with the collection at all. The goal is worthy, and those authors who achieved it within these pages are to be congratulated.