It is perhaps difficult for contemporary readers to appreciate that at the time of Titmuss’s earliest writings, the term ‘welfare state’ was not in common parlance, social policy did not exist as an academic subject, and the idea of using fiscal instruments for social ends was anathema to most politicians and commentators. The concerns Titmuss explores in the four extracts which form this part of the book reflect the newness of ‘the welfare state’ as a concept: scoping and defining what constitutes a welfare state, addressing arguments for and against state control of welfare provision, and puzzling over its rapid development in Britain. There is a refreshing urgency and immediacy about the arguments; although some would not be out of place in the debates of today, it is important to bear in mind that in many cases they found their first expression in Titmuss’s lectures and articles.

In ‘The welfare state: Images and realities’, originally presented at the University of California in 1962, Titmuss traces the history of the term ‘welfare state’, noting that it came into common use in Britain only in the 1950s – several years after the Beveridge report, the foundation of the National Health Service (NHS) and the passing of the National Assistance Act. The confusion over its meaning was such that Titmuss avoids it where possible, preferring to use the term ‘social services’. In the United States, ‘welfare state’ was a term of abuse; former President Hoover described it in 1949 as “a disguise for the totalitarian state”. This difference in meaning and emphasis can be seen reflected in the use of language today: ‘welfare’ in the US refers to social assistance and carries connotations of dependency, while the ‘welfare state’ in Britain encompasses universal services with much higher degrees of public support, such as the NHS. Thus the main American parties competed at the polls in 2000 on the basis of who would cut more through welfare reform, while in Britain the competition the following year focused on who could maintain high levels of spending on health and education (albeit, for the Conservative and Labour parties, without raising taxes).