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Dr. COSTAS G. DIKEOS Assistant Professor Dep. of Social Administration Democritus University of Thrace Komotini GREECE. cdikeos@socadm.duth.gr ++30.25310.

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HOW OLD IS BIG SOCIETY? HOW NEW IS SMALL GOVERNMENT? Charities and Health and Social Care Provision in 19th Century Greece and UK. A comparative historical approach mirroring today.
Introduction. The paper wishes to investigate and challenge the assumption that the notion of Big Society and Small Government is a new idea. To achieve this it will approach health and social care provision through charities and philanthropy (voluntary hospitals, charitable hospitals, hospitals created by benevolent benefactors, friendly societies etc) vis--vis the absence of state intervention in Greece and the UK during the mid and late 19th century. In both states over that era most hospitals and other such institutions were set via these paths (however for different reasons as we will present). It will juxtapose current political ideology (with references to Thatcherisms rolling back the state) as presented in the Conservative Party manifesto for the May 2010 election alongside other contemporary texts promoting state activity (or rather inactivity) on the one hand, and ideologies of the past on the other. In this pursuit the investigates history of hospitals and welfare institutions in the UK, in parity with Greece. The paper consists of four parts: the first presents the big society doctrine and compares it with other aspects of the Conservative Party ideology and policy implementation, notably Thatcherism; the second examines the development of social policy measures and institutions in Victorian Britain and looks for similarities with contemporary times; the third turns to the Greek nineteenth century which despite the timely parallel has no state or social structure parallel with Britain, but presents us

with a state welfare absence parallel for different reasons; and the fourth compares the four cases and offers some conclusions.

(a) Big Society, Small Government and Rolling Back the State. This first part will present the idea of big society and small government as presented in the 2010 Conservative Party Manifesto and other similar documents, and investigate it with references to Thatcherisms idea of rolling back the state. Great ideas aiming towards political innovation have usually been condemned as political slogans and catchphrases, whilst the reverse may also happen: a political slogan be elevated to the level of a great and pioneering political idea opening new paths and horizons for a country or indeed the world. History is abound with sayings such as lebensraum, ein volk, ein reich, ein fuhrer, toil, sweat and tears, iron curtain, ich bin ein Berliner, the question is not what your country does for you, but what do you do for your country, you have never had it so good, the lady is not for turning, , its time for change etc. Therefore, we could easily dismiss the idea about a Big Society as a breed of the second species. However, as Rodney Barker (2011: 54) remarks [r]hetoric is never just rhetoric and the big society should not be dismissed as meaningless phrase mongering, due to its relation with pluralism. Additionally, the interest raised about Big Society (google gives on 24/05/11- about 168,000,000 entries, with only 5,570,000 for big society Cameron, plus articles in academic journals, to say nothing of our conference) is such that the term has to be discussed more both in scope and depth. Last but not least, it should be borne in mind that big society is a political term with political aims, results and repercussions that has to be examined in relation to both earlier terms or slogans, and contemporary arguments and approaches within current political discourse and developments. Though the idea has been with us for about six years now, as Mr. Cameron himself has said in July 2010 Its an idea I spoke about when I ran for the leadership of the Conservative party, when I was elected, throughout all the years in opposition, during the election campaign and when I stood on the steps of Downing Street (http://www.conservatives.com/News/Speeches/2010/07/David_Cameron_Our_Big_S ociety_Agenda.aspx, visited 23/05/11), the term remains somehow hazy. This is rejected by its founder who claims that it is not vague but it doesn't follow some grand plan or central design and it stands on three pillars: decetralisation, opening up

services, volunteering, involvement is social and/or charitable actions, and philanthropy; spanning at a wide spectrum of activities from local parks and post offices, to community schools, mutuals and co-operatives (even by public sector employees who will form them as to deliver the service they provide becoming self employed, (http://www.guardian.co.uk/commentisfree/2011/feb/12/david-cameronvisited 23/05/11,

big-society-good,

www.cabinetoffice.gov.uk/sites/default/files/resources/building_big_society_o.pdf/ published18/5/2010, visited 23/05/11). It is in this context that Barker (2011) claims that in government the term is understood rather as lots of small societies, than really a big one, and relates idea and term with pluralism and many different roles an individual may take and/or pursue. Taking these into account, and though not wishing to cause offence or to upset the British Prime-Minister, I have to state that at least in my view the term remains obscure. Moreover, it lacks theoretical clarity upon its very foundations and premises as Mr Cameron himself proudly admitted in his Liverpool speech when presenting Big Society as a great idea that [y]ou can call it liberalism. You can call it empowerment. You can call it freedom. You can call it responsibility. I call it the Big Society. The Big Society is about a huge culture changewhere people, in their everyday lives, in their homes, in their neighbourhoods, in their workplace (http://www.conservatives.com/News/Speeches/2010/07/David_Cameron_Our_Big_S ociety_Agenda.aspx, visited 23/05/11). Additionally, the Conservative Manifesto for the 2010 election mentions that through the Big Society the UK will get a family friendly society with more responsibility, empowerment etc., while this idea includes redistribution of power and the passing to a new post bureaucratic age and its spirit via state retrenchment (but not exactly in the old Thatcherite idea of rolling back the state), alongside the ideological stance that society exists but is not the same as the state (The Conservative Manifesto 2010,

http://www.conservatives.com/News/Speeches/2009/11/David_Cameron_The_Big_S ociety.aspx). The question to be addressed now on is whether big society is a new idea [something that Mr. Cameron himself admits does not entirely happen

(http://www.guardian.co.uk/commentisfree/2011/feb/12/david-cameron-big-societygood, visited 23/05/11)], and if not what is its relation with other older ideas such as rolling back the state. To achieve this the paper will furthr explore three trends. The

first relates to con-current issues and ideological stances alongside a presentation of the recent political past in the UK (namely Thatcherism), and the other two to a more remote past that is an investigation of welfare services through benelovence in Britain and Greece during the mid and late 19th century.

Big Society, Current Developments, and the Thatcher Legacy. Any political idea and policy proposal has to be examined in context of time and in context of other developments, alongside other proposals coming from the same source. Moreover, political parties aiming at Parliamentary majorities and party leaders aspiring for the post of Prime-Minister are compelled to present voters a broad however coherent and cohisive set of ideas to be implemented, usually in the form of a Party Manifesto. So it should not take us by surprise that Big Soceity is one of the subchapters of the Conservative Manifesto 2010 Invitation to Join the Government of Britain. The Manifesto itself consists of five main chapters (change economy, society, politics, protect environment, promote national interest), whilst the big society idea is one of the five subchapters (others deal with the NHS, families, education etc) in the Change Society chapter. What should be borne in mind is that the big society idea exists in an overall manifesto of neo-liberal ideology concentating upon macroeconomic stability and debt, and aiming to eliminate the bulk of structural deficit over a Parliament [. and to achieve this the CP will] cut wasteful government spending (p. 7). There are various references in the Manifesto about cost reduction (with the promise that it will not cause deterioration of services) in the public sector, reducing welfare dependency, increasing family control of their lives, along the need to improve productivity in the public sector, reduce and simplify (business) taxation, and making the UK a more enterprise friendly place, but for inter and multi national large and small domestic firms. Overall savings can reach 12 billion pounds (Manifesto p. 9), while regulation will be also reduced or repealed (p.20). These in conjunction with our main subject big society can lead according to Mr. Cameron to better services and more social values (not his term). In his own words I want to extend and deepen the argument I made in my party conference speech this year, that the size, scope and role of government in Britain has reached a point where it is now inhibiting, not advancing the progressive aims of reducing poverty, fighting inequality, and increasing general well-being []Yes, there are specific instances where the very act of rolling back the state will serve to roll forward

society, for example when organisations that have been dependent on the state are asked to go outside government for funding, and thereby improve their record of engaging with the public and society. But I believe that in general, a simplistic retrenchment of the state which assumes that better alternatives to state action will just spring to life unbidden is wrong. Instead we need a thoughtful re-imagination of the role, as well as the size, of the state.

(http://www.conservatives.com/News/Speeches/2009/11/David_Cameron_The_Big_S ociety.aspx). Regardless of his own opinion the question about the relation between Cameron and Thatcherism and big society and rolling back the state remains unanswered. Commenting (political or other) has to be based upon both intentions and actions, which moreover have to be seen within wider political frameworks such as globalisation (Taylor-Gooby 2011), and in context with other intentions, ideas and actions on the one hand, and with each other on the other hand. So, views on Big Society have to be seen close with other ones on more traditional premises such as family (which plays key part in big society both foramtion and pursuits as we have seen), law and order and immigration, subjects that show important influence by the Thatcher ideas, that are related with a conception of a smaller state due to scepticism against a large one. However, this scepticism had to be expressed in a more palatable way as not to discourage the electorate. This trend goes alongside (pre-election) promisses of pursuing economic stability and not tax cuts, and an attempt to move towards a more centrist position abandoning Thatherite free markets (Evans, 2010). It could be claimed that it was juxtaposition with reality and pressing problems caused by the previous governement that lead the coalition governement in not implementing some of its promises, but rather pursuing cuts and restructuring in public spending, tax increases and the aim to eliminate public deficit in four years.These were pursued through policy implementation not following same lines alongside some European partnetrs neo-Keynesian policies as P. Taylor-Gooby and G. Stoker (2011) point out. It should be emphasised that commentators agree that it is not only expenditure cuts that take place, but an overall restructuring of services from state to other entities (NGOs, social enterprises, forms of national citizen service, small-local private companies etc) while key argument is individual responsibility and self-dependence, that roll the frontiers of society forward and of state backward, that challenge solidaritys foundations and states role to a miniscule compared to the golden years of welfare, and reminicent rather of a US settlement (Barker, R. 2011; Taylor-Gooby

P. , 2011; Taylor-Gooby P. & Stoker G, 2011; Mycock A. & Tonge J., 2011). Therefore the relation between Big Society and Small State on the one hand and Freedom of the Individual and Rolling Back the State on the other, personified via the Cameron Thatcher relation (Evans, 2010; Mycock and Tonge, 2011) remains unanswered. To pursue this line the paper will turn to an retro-examination of policies in the Thatcher era. One of the central questions regarding Thatcherism, was (and in our case somehow still is) whether the Thatcher administration expanded or rolled back the state, an issue related to the New Right Ideology and the Conservative Party 1979 onwards (till 2005??) rhetoric of rolling back the state. It should be noted that though rolling back the state can be seen as a catch-phrase of slogan, it is based upon a wider political theoretical argument about freedom, liberty and dangers of serfdom as set by New Right theorists such as Hayek, Friedman, Buchanan, and their confrontation to bureaucratic Keynesian social planning and expenditure. For the New Right, liberty as a value is supreme to any other and the source of all other values in human life. Its utility is that it offers the best opportunities to the individual in society. This freedom is both economic and political, and political freedom is this cause of the economic one. As King (1987) observes, political freedom remains unfulfilled if not accompanied by economic freedom. For the libertarians liberty has a negative concept as the absence of coercion or intervention such as regulation, planning and taxation. It is worth noting at this point that Mr. Camerons description of Big Society, alongside other stances within the Manifesto does not exactly distance itself from such an approach, even when he uses negatively the term big government (instead of rolling back the state) in the Manifesto. The question when expressed like this fails to address the very issues of what do we mean by state (or government for that matter) and what do we mean by more (or less). Thatcherism was characterized by a transformation of the functions of the Keynesian, social democratic, and corporatist, and decentralised and local state that was the dominant form of administration by both Labour and Conservative governments between 1945 and 1979, and an increase in the deregulation of the markets and in privatisation of the economy. On the other hand though, intervention of the state in the pursuit of control of the money float in the economy, consolidation and security of order, and achievement of uniformity (including ideological uniformity) has increased. As Andrew Gamble claims in his Free Economy... the

great contradiction of Thatcherism is that in the circumstances of modern capitalism it is very difficult for the state to withdraw either economically or politically. Despite the anti-statist rhetoric the Thatcher Governments have proved remarkably interventionist and derigiste. The state has had to considerably strengthen in order that the Thatcher Governments can press ahead with freeing the economy.. Additionally, he mentions that the Thatcher governments taxed and spent as much as their predecessors (Gamble 1988 p. 351). According to A. Gamble the main tasks of the Thatcher governments were to a) restore the health of economic and social life, b) restore incentives, c) strengthen Parliament (in comparison to corporatism) and the rule of law, d) support the family and e) strengthen the British defense. And Gamble suggests that the first two involve the creation of a free economy, while the rest three others require a strong state (ibid. p. 121). This implies a change in the functions of the state, whereas we should always remember that functions of the state are mostly undertaken by governments either big or small, and that the underpinning ideas of the Thatcher and Cameron governments are strikingly similar. All these policy changes assisted post 1979 in rolling back the state and in the creation of a smaller (or less) state according to the New Right rhetoric. Though we would be inclined to agree that there have been changes in the scope of the state policies, we want to mention that what is less is the Keynesian, Social Democratic and Corporatist state and not the state itself, since the British state remained rigid and interventionist in other functions and areas. Trying to form an answer to the question of less state (?) we have examined the increase of centralisation, secrecy, and rigidity of the state during Thatcherism. At this point it is worth reminding of the changes in the allocation of public funds leading to a more strong state in the form of increased expenditure for defense (National Income and Expenditure, HMSO various years), and law and order, or in other words expenditure is not lower than this of the Butskellite state, but was directed to other sectors, alongside a monetarist control of the economy. Additionally, the needs of implementing this monetarist theory and achieving cuts in expenditure created political problems between centre and periphery. Despite the anti-statist rhetoric, the Conservatives are the party that believes that their main task is to uphold the authority of the state, and they are not willing to compromise on this authority (Gamble 1988, p.170). The Thatcher governments were quite consistent and in-line with the implementation of the New

Right libertarian political theory and traditional Tory ideology. They tried to roll back the state and to free the individual from bureaucracy. Additionally they enhanced the functions of the state that provide the distinction and security of private property, as Buchanan (1986) asks for. However, there are a number of paradoxes and contradictions in this process of implementation. The state in order to be rolled back in some areas (or sectors) has had to be expanded in others. These policies were matched with the inherited conservatism of the right wing of the Tories who advocated traditional values and family life. Thus, we did not have just more (or less) state, but different state during Thatcherism neither there was smaller government, but rather a redirected activities government, something that we see in the Cameron discourse and policy implementation too. Therefore Evans (2010) is right to seek and find similarities and influences between the Thatcher and the Cameron discourses through the encapsulation of concepts like individual responsibility, and less government action. As he claims (2010, p. 340): Cameron has made clear that the next Conservative government would complete the work of the last and, in doing so, would be guided by its own set of Victorian values. To investigate this we will turn to a presentation of nineteenth century welfare provision (mainly health care) in the United Kingdom and Greece. (b) Victorian Britain and Social Care: a Cradle of Big Society? To see how old or new the big society doctrine is we turn to an exploration of health and social care provision in 19th century Britain with references to ideologies of the period. Though it can be claimed that the very foundations of a lessaiz faire approach can be traced to Adam Smith and his response to mercantilism, this (response) can be read two ways since Smith was in favour of some state action as to facilitate production and mainly commerce, to say nothing of his common sense, with Thomas Payne standing on a different side and arguing in favour of a welfare society (Vic George, 2010, Derek Fraser 2003), we will focus on work and ideology of the mid and late nineteenth century. It was in this context that state intervention had to be minimal as society was understood as a collection of individuals, and Victorianism encapsulated the ideas of hard work, self help and reliance, respectability etc (Fraser 2003). This ideology caused creation and expansion of friendly societies, mutual help societies and charities or a combination of them as to offer another solution from the

workhouses, one of them being the Charity Organisation Society of 1869, or Ladies Societies in various industrial cities looking after health and hygiene of the worse off, that were first set in 1862, alongside other bodies such as the Salvation Army (which had to do with morals too), Barnardos with the central state remaining remote and overall supervising and assisting philanthropy, but as far as government action is under question concentrating on balance budgeting, and supporting the Empire internationally. This commenced been challenged in the late nineteenth century with an overall expansion of state intervention, increase of personnel and expenses in a framework of reduced trust to the invisible hand. As for health care in particular further to the limited facilities set in paper (but rarely really provided) by the Poor Law 1834 within the workhouses, hospitals were being set and run either by the voluntary sector or by local government at the municipal level (Fraser, 2003; Greener, 2009; Davie Smith, et al, 2001; Dikeos 2010), as the pioneering work of Brian Abel-Smith on The Hospitals has shown. Alongside reference to these minimal provisions as far as health care is under question, we should refer to the relation between medical technology (in the broadest sense) and intervention, turning our focus on vaccinations. Knowledge concerning vaccination commenced circa 1796, the vaccination board was set in 1808, vaccinations became free in 1840, and obligatory in 1853. This is compatible with a liberal ideology requiring minimal state intervention as vaccination protects not only the vaccinated but the social milieu his is in too. It should be at any rate remembered that state intervention during the nineteenth century in the UK was limited to partial regulation of child (and in a lesser extend female) labour, minimal assistance to education (some funding to schools of the Church of England, but with very low percentages of elementary school completion, mostly under Liberal governments whilst the changes were going hand in hand with other broader ones such as widening of suffrage, Trade Union recognition etc. Most of these changes (in welfare) were ideologically based upon philanthropy (usually Christian), and a sense of obligation to protect children on the one hand, but a sense of personal responsibility and obligation for work for adults on the other (Dikeos, 2010). Returning to health care, and in an attempt to relate big society and nineteenth century health care provision, the paper will once more return to the classic work of AbelSmith on the hospitals. In Abel-Smiths own words (B. Abel-Smith, 1964: 3): [t]he main care of the sick poor came inevitably from within the family circle. A folklore or

quasi-medical knowledge was handed down from mother to daughter and no doubt advice of neighbours, friends and priests was taken if not always used. The patient was made as comfortable as the love and care of the family could make him. Illness was not regarded as a circumstance that required much positive action. All that could be done was to ask God to remove the affliction in his own mysterious way. Most hospitals at the very beginning (this is prior to the 19 th century) were established upon religious foundations and often via clergy activity and had an unclear role in caring for the poor or the ill, or the poor who fell ill but had some hope of recovery and also not spreading infection, whereas the wealthy were treated at home. This lasted (due to lack of medical knowledge aw we today understand it too) till mid nineteenth century. It was during the period, that lay members of local elites (or occasionally the Royal family or nobles) set voluntary hospitals to which they contributed small amounts of money as subscriptions, so their protges or beneficiaries (who paid very little or nothing) could have access through such benevolence (Abel-Smith, 1964). In a nutshell, state action in welfare during the mid and late nineteenth century was minimal, whereas needs were either not met, or covered through personal philanthropy, mutual assistance, friendly societies etc., an overall settlement based upon liberal approaches to self-responsibility and self-dependence, coupled by a sense of rather communal than social solidarity, concepts reminiscent of the big society and the relaunching of a set of Victorian values as we saw earlier in Evanss (2010) work. A question that comes to fore is whether Britain was sole in abstaining from social intervention during that era. The paper will turn on Greece as it presents a rather different state of affairs that period. Social problems are widespread as in the UK (but of a different nature), whereas the country is devastated after the war for independence and does nor control any colonial resources.

(c) Different Structures, Similar Policy Results; State, Society and Welfare in Nineteenth Century Greece. To examine whether Big Society is in conflict with Big Government and requires rather a Small Government we turn to an exploration of health and social care provision in Greece during the first years of independence. State intervention in welfare cannot be expected to exist prior to state (and perhaps indeed modern state) itself. It is therefore obvious that the absence of state may leave

ample space for communities (or what in current terminology could be called Big Society) to act. This is the case of pre-revolution, pre-independence Greece. Social and political life in the Ottoman Empire was organised around religious-linguistic and cultural groups or millets. Each millet had a pyramid like structure and was further divided to local communities. Therefore a village or town might have consisted of more than one communities in it each one belonging to a different millet. The central Ottoman state governed by the Sublime Porte was rather detached from welfare activities others than these of zakat, sandaka, and the institutions of imaret and vakouf, which are predominantly forms of benevolent philanthropy based upon the Holy Koran. It was left upon the communities of the millets to look after the needs of people. Communities (in an agricultural society either of serfs, or of petty proprietors) had a multifold task ranging from tax collection, to grievance representation; from water sources or fountains regulation and cleaning, to firefighting; from minor infrastructure works and cemeteries, to securing a local priest; and /or from notary and registry services, to solving local judicial disputes etc. In some cases undertaking forms of welfare provision (finding and paying for a doctor, or a teacher, collecting and giving money to somebody in need etc) was within the communitys realm. It has to be stressed that the range and quality of services varies and differed from community to community and within time. Also it has to be clear that in some cases (moreover the most notable and successful) there was a combination of locality, wider locality and profession that was the basis of solidarity. Successful cases of welfare (offering good education and health services, food assistance to the needy or even to all in cases of famine-, some form of monetary support) were few as the cases of Ampellakia (village in Thessaly that dealt with cloth dying and commerce), Mastichocoria (mastic resin villages in the isle of Chios) and Mademochoria (cast iron producing villages), or some communes in the Black Sea show. These as mentioned were a combination of local group of a millet and collectives or co-operatives usually having the form of closed shop with strong internal links (Anastasopoulos, 2010; Karouzou, 2010; Seitanidou, 2010). It is worth mentioning that similar cases, either of societies or of benefactors occur (for Greek millet populations) in areas of the Ottoman Empire after Greek independence, but before annexation of these regions to the Greek state. It should be noted that when Greece got independent, first this related to about one fourth of todays territory, and second most of the Peloponnese was still under the

occupation of Imbrahim Pasha, whereas the few areas that remained free were under the rule of local war-lords with central power remaining just nominal. The borders of the state were not clearly drawn; there was no bureaucracy; no judiciary; no police; no central bank, whereas there was public debt! The population is estimated at approximately 500-600,000, whilst Greek economy prior to the revolution was based primarily upon agriculture and secondarily upon commerce and commercial navy. To add disaster to plight about 40,000 fig-trees and 60,000 olive-trees had been uprooted by the Turko-Egyptian army, whereas the key town or Tripolis had been severely canon-bombarded and burnt with only a few houses remaining intact. Widespread devastation and poverty lead inhabitants either to the only safe town (Nafplion, then having a population of approximately 30,000) or to the hiding as other segments of the population -often armed former fighters- had find refuge from poverty to turning to bandits ransacking the countryside, or to pirates looting the seas. Furhtermore as to add illness to injury a plague epidemic spread out in the summer of 1828 affecting most of the mainland and the isles of Hydra and Poros. Twenty-five years later, in 1853-55 a cholera epidemic spread out through Athens causing panic to all population alongside a considerable number of deaths exceeding 3,000 in a population of less than 50,000. During most of the long nineteenth century Greece was in a rather poor and precarious condition. In the meantime, pressing priorities covered a wide range from international recognition and consolidation, to drawing of borders, and from securing food supplies production to building basic infrastructure, or from creating bureaucracy, judiciary and police to setting a bank and dealing with debt! In other words it was not a matter of rolling back the state or confronting a big government, but contrary of creating a state and consolidating if not government, at least governance as Kapodistrias assassination proved. As a brief reference to Greek economy of the post-struggle period, it has to be noted that the majority of wealthy and economically active Greeks (mostly involved in commerce and/or shipping) that could form a bourgeoisie lived out-with the borders of the state, usually in parts of the Ottoman Empire (Constantinoupolis, Smyrna, Alexandria), and the Austrian (Vienna, Danube, Galati) and Russian Empires (Odessa) concentrating their activities there. Some had managed to accumulate wealth that was surpassing this of the Greek state itself.

In this framework social assistance, social aid and social policy were if not neglected at least not set as priorities. Despite this, Greece tried early on to adopt measures of social provision. Among the first pursuits was the care of the victims of the war for Independence either these who were left crippled after fights, or those who were widowed or orphaned. This effort can be attributed both as a benevolent amelioration of plight, and a thanking gesture of acknowledging heroic contributions of individuals to the nation, and included a form of money assistance or pension that was given to members of the Phalanx, which was composed by former fighters, though not all since some of them fell victims of political reprisals of the era. The first medical institution to be set was the the Municipal Hospital in the prosperous cycladic isle of Syros established short before Independence in 1827 (in paper circa 1825), partly created and staffed by wealthy escapees of the Chios disaster, and some from other places, mostly Aegean islands. The esteem of the initiators and first staff was such, that a number of them, hovering between nobility and bourgeoisie and having benevolent feelings, got involved with the royal palace later on. The bequest of the S. Proios assisted the hospital in 1887, and this I. Vardakas much later in 1938 lead to naming the hospital as the Vardakion and Proion, whereas many other benefactors has contributed in the past for certain buildings, infrastructure, or even day to day functioning etc. (Leivadaras 2009). Shortly after, the Military Hospital (which was anyway accessible to civilians too) of Nafplion was set in a comfortable and well-ventilated site of the town probably by rebuilding (through giving some employment to the destitute too) the old Venetian hospital of Accagioli. This hospital initially had 42 beds one chief doctor, a pharmacist and auxiliary staff, whereas in a later stage 16 more beds were added. Most Greek hospitals established in this period have a similar story as for example the Elpis (Hope) municipal hospital of Athens. It was established in 1836 after the donation of King Ludwig of Bavaria father of King Otto of Greece- to the municipality of Athens. Various other smaller donations were added to the initial, including land by Baron K. Bellios and funds by member of Greek nobility Mavrokordatos. The hospital which was also used for medical teaching after 1837 by the University of Athens, offered free treatment to well over 5,000 patients per annum coming from all over Greece. The Athens Ophthalmic Hospital was created by donations of wealthy Greeks of the diaspora in 1854, and it was also used for medical teaching and training.

Wealthy industrialist Eleni Zanni establishes the Pireas hospital still bearing her name in 1875. Meanwhile, a number of hospitals were established in various towns (eg Agios Andreas at Patras, Manolopoulos after the name of the benefactor- in Pyrgos, the municipal hospital of Aegion, etc) usually through donations. Remaining in health care provision we return to the Capital that has grown in size during these years whilst has turned to a magnet too. Grand Duchess Olga of Russia got married to King George I in 1867 becoming Queen Olga of Greece. Her endowment to her new country was wide philanthropic activity alongside the money and effort to establish a new hospital in central Athens. Apart of the money she donated, she (at least namely) managed to collect more by other benefactors such as Dimitrios Theodoridis from Odessa, Andreas Syggros (industrialist, banker and owner of mines), the Empirikos family (shipping), Emmanouel Benakis (cotton merchant, who with Korialenios was involved in setting the Red Cross hospital too) and various others. The Church offered a large land area for the new Evangelismos hospital, which commenced treating patients on the 16 th April 1884 by admitting a ten-year old boy. The hospital initially had three wings and commenced operating with two clinics, a total of 48 beds, and a small number of doctors perhaps fewer than 10. It is worth noting that today the hospital has well over 900 beds, and about 770 doctors! It was built following the most up-to-date standards of the era concerning hygiene and capacity (ventilation shafts, space per bed, auxiliary rooms etc). Three years later one of the Evangelismos benefactors Tzortzis Dromokaitis gave most of his fortune for a psychiatric hospital the first in Greece, while one more such hospital the Aeginition was set by the fortune of professor of psychiatry in 1904, operating as a unit of the University of Athens, as well as next door Areteion (with a similar history) which is still a surgical hospital. Turning to international assistance the hospital of the Red Cross was established in 1877. It is worth noting that for the creation of most hospitals of the period we see involved the same if not persons at least family names belonging to the same milieu of wealthy philanthropic bourgeoisie and/or nobility, having concerns for the problems of their fellow citizens, but rather also an idea of self-reliance and self-responsibility for the undeserving poor who got in their circumstance due to laziness. We should not however assume that problems were covered. Health care remained concentrated in cities (mostly Athens), the number of doctors was small and people could hardly meet medical costs. Last but not least, as far as health policy in the very first stages is under consideration, vaccination

became obligatory as early as 1835 (though implementation was not easy) before than in other European states. (Kokkinakis, 2010; Korasidou, 2002; Liakos. 1993; Chatzidaki, 2005; Adamantidou and Vatzeli, 2009; Mastrogiannis, 1960). War for Independence and bad health conditions, including epidemics, caused deaths and low life expectancy, therefore a significant number of orphaned children. One of the first institutions was the Aegina Orphanage, set by the Greek state, which housed and catered for children whose parents were killed during the uprising, was one of the first institutions set by Kapodistrias. Though the orphanage had been designed to host up to 100 children, it had to put up with numbers approximating if not exceeding 500 but with a death rate of about 30%. Other orphanages had a history similar to hospitals. Orphanages were created by benefactors such as Chatzikostas, Babayiotos, Zannis (the hospital benefactor), and Chatzikyriakos. Some of these institutions initially catered for the children of the cholera epidemic victims of 1853, whereas they offered training and assistance in finding employment as apprentices. Additionally, local societies undertook philanthropic tasks covering through institutions needs of the destitute, particularly children and patients (Mastrogiannis, 1960; Kokkinakis, 2010; Polyzoidis, 2008). Overall, due a a number of reasons Greece could hardly establish and sustain the institutions needed through national moneys, not to mention that a significant segment of the budget was already going towards funding a public sector set either to support clientalistic relations between politicians and supporters (according to a critical approach), or to give some form of employment and offer destitution amelioration to the population through providing jobs (according to a more understanding approach). It becomes clear that the state had little to offer and assistance to the needy had to come predominantly through rather benevolent philanthropy than purposely scheduled social policy. As a response, foreign royal families (usually involved in forming the Greek royalty, such as eg the Russian Czars) contributed some of their wealth too in an effort to gain support and legitimacy, or just out of a Christian benevolence and ethical and moral motive of assistance. These were coupled by a Greek bourgeoisie and/or nobility who felt the responsibility of assisting deserving destitute. Thus the inability, lack of resources and different priorities of the Greek state and government(s) of 1830-1920 caused rather not a retreat or rolling back of state, but a rolling forward of philanthropy and benefaction through endowments, bequests, functions of friendly

societies etc. We are facing thus the gray area between philanthropy, compassion, benefaction, assistance and social policy, which in todays terms could call big society. Notable institutions in this case are the Athens Benevolent and Philanthropic Society, that set and run (till today) one of the major old-age sanctuaries-homes in Athens, catering for old and needy, its members been drafted among people related to the then Royal Court and bankers, merchants, industrialists, generals et al; and the Literature Society Parnassos, set up in mid 1860s to promote letters and training for the poor and destitute boys of Athens and having as members, trustees and/or benefactors members of the Royals, Presidents of the short lived second Greek Republic, prime-ministers, university professors, writes and poets etc. The school giving evening lessons as to offer opportunities to the working youth, was launched in 1872 in Athens and later on opened branches in other towns too

(http://www.lsparnas.gr/index.php?option=com_content&view=article&id=20&Itemi d=30&lang=el, http://www.lsparnas.gr/index.php?option=com_content&view=article&id=19&Itemid =29&lang=el, http://www.lsparnas.gr/index.php?option=com_content&view=article&id=71&Itemid =67&lang=el). However, it was not only in Athens that such societies, and/or fraternities were set. Other towns (in this case out-with Greek territory at the time), such as Thessaloniki, Kavala and Komotini had groups of people looking after both the local needy and national affairs (Polyzoidis, 2008). Greece of the nineteenth century (either as a state, or as Greek populations outside the borders of the Greek state) shows that it is not a matter of expanding or extending big society versus a big government or rolling back the state, that is the key factor for big society, It is absence of state action itself either due to a poor and incapable (or with different priorities) state, or even the absence of a state itself (either before independence or before annexation) that causes the need of filling the vacuum in the social services and social protection sectors. In a nutshell, in the Greek case, Small Government was the cause, of Big Society; and the latter was the result of the former, not a way out of the predicament of a Big Government.

(d) Comparison and Conclusions. The paper wished to investigate or even challenge the view that Big Society is a new doctrine. In the previous sections we have seen that though the wording might be new

(as a catch-phrase or slogan) the concept itself is not a distant departure from the Thatcher pursuit to roll back the state (or rather to roll back a form of regime the Keynesian social democratic and butskellite one, and roll forward a different kind or regime the new right one), not to mention in both cases the wish to reduce public spending for fiscal reasons. We also saw that this is compatible with Victorian ideas and values of self-dependence and self-reliance that dominate the Conservative Party ideology and both Lady Thatcher and Mr. Cameron have a party leader (S. Evans 2010). Moreover it is compatible with actions (not) taken by governments of the Victorian era, and activities undertaken by society that time (Abel-Smith, 1964; Fraser, 2003; Greener, 2010; Dikeos, 2010). Therefore the British case (current, recent past and distant past) presented us with evidence that Big Society is an old concept in a rather new wrapping, wishing to present some positive aspects more (R. Barker, 2011, with relation to pluralism) and mainly to hide withdrawal of state provision (P. Taylor-Gooby and G. Stoker, 2011). It has additionally presented cases, through Greek history, that corroborate an argument that (big) society takes action in the absence or inability of the state to cover the needy, or the entire population for that matter (Korasidou, 2002; Anastasopoulos, 2010; Karouzou, 2010; Seitanidou, 2010, Kokkinakis, 2010; Chatzaki, 2005; Adamantidou, Tr. and Vatzeli, K., 2009; Leivadaras, 2009). To recapitulate, though the Big Society doctrine may have some positive aspects in enhancing pluralism and strengthening some social entities and actors, in real terms it is an idea of state retrenchment or even withdrawal from welfare activities and a return to fiscal cuts, and individual (responsibility) ideology, without taking into account the fact that it may be rather the absence of state that requires Big Societys activities as the Greek nineteenth century case indicates, than the extended government that requires a Big Society as a reply as the UK Conservative Party argument is.

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Cameron, David (2011): Have no doubt, the big society is on its way in http://www.guardian.co.uk/commentisfree/2011/feb/12/david-cameron-big-societygood visited 23/05/11 Conservative Party Manifesto 2010 Invitation to Join the Government of Britain. Davey Smith G., Dorling D., Shaw M. (eds) : Poverty, inequality and health in Britain: 1800-2000 a reader Policy Press, Bristol. Evans S. (2010): Mothers Boy: David Cameron and Margaret Thatcher, The British Journal of Politics and International Relations Vol. 12 (3) pp325-343 Fraser D. (2003): The Evolution of the British Welfare State, Palgrave MacMillan, Houndmills. Gamble, A. (1988): The Free Economy and the Strong State MacMillan London George, V. (2010): Major Thinkers in Welfare, Policy Press, Bristol Greener, I. (2009): Healthcare in the UK: understanding continuity and change Policy Press, Bristol. Hayek, F. (1963): The Constitution of Liberty Routledge and Keegan Paul, London. Jessop, Ling, Bromley Bonnet : Thatcherism: a tale of two nations Polity Press (1988) Jessop, Ling, Bromley Bonnet : Popular Capitalism, Flexible Accoumulation and Left Strategy New Left Review Vol. 165 King, D. (1987): The New Right: politics, markets and citizenship, MacMillan, London National Income and Expenditure, HMSO London, various years Mycock A., & Tonge J.: A big Idea for the Big Soiety? The Advent of National Citizen Service, the Political Quarterly Vol. 82 No.1 , pp 56-66, January-March 2011. Taylor-Gooby P. (2011): Does Risk Society Erode Welfare State Solidarity? Policy & Politics vol 39 no 2 pp147-161 Taylor-Gooby P. & Stoker G.(2011): The Coalition Programme: A new vision for Britain or Politics as Usual? , the Political Quarterly Vol. 82 No.1 , pp 4-15 JanuaryMarch 2011. webpages www.cabinetoffice.gov.uk/sites/default/files/resources/building_big_society_o.pdf/ published18/5/2010, visited 23/05/11

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(webpages) http://www.lsparnas.gr/index.php?option=com_content&view=article&id=20&Itemid =30&lang=el, http://www.lsparnas.gr/index.php?option=com_content&view=article&id=19&Itemid =29&lang=el, http://www.lsparnas.gr/index.php?option=com_content&view=article&id=71&Itemid =67&lang=el