Conservatives think "Dickensian" is a Term of Approbation

Via supergee, oursin's account of British health care before NHS.

Because at least until 1929, and in some areas until 1948, to get free medical care you needed: either to be provably below a certain poverty line, in which case you were eligible under the Poor Law (which was a huge stigma - cf people putting away money they could ill afford to avoid being buried 'on the parish'), or, if you needed hospital treatment, you had to get a letter of recommendation to a voluntary (i.e. funded by charitable subscription) hospital to say that you were a deserving candidate for treatment and care (I have among my papers a photocopy of a printed letter form of a leading maternity hospital, late 1930s, to be issued only to married women and unmarried women pregnant for the first time only - and some maternity hospitals, I suspect, did not even make that concession).

There's good musing there about the 'deserving/undeserving' and why it shouldn't really matter. (Talk to the hand about the Puritan heritage.)