Madrid Hospitals and Welfare in the Context of the Hapsburg Empire

Over the last twenty-five years, the tendency of historians to see extreme distinctions between Catholic and Protestant health care provision has faded away, mainly thanks to the works of Brian Pullan on Venice and Jean-Pierre Gutton on Lyons. It has become generally accepted that Catholic areas pursued efficient and highly selective welfare policies, especially as regards the control of public begging, in order to achieve long-term social improvement by giving the poor both an education and opportunities to work.1 In order to centralize and co-ordinate the resources available, welfare services were improved by the creation of institutions under the auspices of the Church and lay authorities.2 Public begging was prohibited, and relief was limited to deserving local inhabitants and restricted to the period before they could be set to work, while the itinerant poor were given only the temporary assistance they required. It has also been generally assumed that Madrid was included among the towns where a programme of reform led by lay elites following the guidelines of the poor law tract De subventione pauperum (On Assistance to the Poor) by Juan Luis Vives (1526) prevailed from the second to the fourth decades of the sixteenth century. In accordance with this programme, hospitals for beggars and other “undeserving” poor were founded, supposedly reaching a peak in the seventeenth century. In the confines of such institutions, unworthy individuals could be punished if they resisted the obligation to work.3 However, measures for poor relief have primarily been studied in cities with a strong communal tradition and a sophisticated system of urban government. It is these studies, simplistically extrapolated to less well-researched cities like Madrid, that have provided the basis for the picture of the principal characteristics of the Catholic system of welfare.4 But what was the true situation in a villa—Madrid—which was essentially a creation of the early modern period, and which was designed by the Hapsburg dynasty to be the centre of government of the largest Catholic empire history has ever known? It is clear that both the history and character of Madrid (a small town that had become the capital and the home of the royal court in 1561) are very different from those of the republics, principalities and cities of Spain, Italy and France. The latter were endowed with municipal dynamism, strong manufacturing, trade and guild traditions, and possessed systems of relief that have attracted the attention of historians and have generally been regarded as pioneering. The aim of this paper is to summarize current research on poor relief in Madrid, including the policy towards the sick, between 1561 and 1700. After briefly reviewing the current state of research, two particular features will be focused on, the assistance given to the sick poor, and that which all other categories of poor people received. It will be argued that, in contrast with other Catholic areas, improvements in health care rather than the redemption and rehabilitation of beggars and vagrants were seen as a useful ideological and political resource for the dynasty up to 1700. In order to illustrate these two topics, three episodes will be examined. First is the plan for poor relief exemplified by the ordinances of the General Hospital of Madrid (1589). In theory, the hospital was the result of the unification of various existing institutions, a move undertaken only five years after Madrid had been declared the capital. Second, through sources such as visitation and account books, the history of this institution will then be traced from 1613 to 1677, reflecting how policies were carried out in practice. Finally, brief reference will also be made to the new project in 1673 for a shelter for beggars and the reasons for its “renewed” failure.