At a time when governments are obsessed with cutting back the social network and encouraging private charities to fill the needs of the poor and the sick, Daniel Hickey provides a timely look at retrenchment strategies in local hospitals in Ancien Régime France. He explores two opposing campaigns to reform poor relief and aid to the sick: attempts by the French Crown to centralize social services by eliminating local institutions and initiatives taken by the local population to revitalize those same institutions.

During the sixteenth and seventeenth centuries the French Crown closed down thousands of local hospices, maladreries, and small hospitals that had been refuges for the sick and poor, supposedly acting in the name of efficiency, better management, and elimination of duplicate services. Its true motive, however, was to expropriate their revenues and holdings. Hickey shows how, in spite of government efforts, a countermovement emerged that to some degree foiled the Crown's attempts to suppress local hospitals. Charitable institutions, churchmen inspired by the new message of the Catholic Reformation, women's religious congregations, and community elites defied intervention measures, resisted proposed changes, and revitalized the very type of institution the Crown was trying to shut down. Hickey's conclusions are supported by a study of eight local hospitals, which allows him to measure the impact of Crown decisions on the day-to-day functioning of these local institutions.

Challenging the interpretations of Michel Foucault and other historians, Hickey throws new light on an important area of early modern French history.