There's several episodes of Downton Abbey where the family do the servants fairly substantial favours (like paying for medical care and such like). Are there many/any cases of aristocrats doing that sort of thing reality, a century or more ago?

I've got some insights into this as before changing careers I worked as an Archivist and worked on the landed estate records of some families in Ireland. These Estates would be similar to Downton and owned either by English landlords or their descendants. One of the estates that I worked on was the Lismore Castle Estate papers and this estate was owned by the Dukes of Devonshire. It would be of a very similar standing to Downton. Other estates would have been on a slightly smaller scale.

To answer the question directly - it really depended on the Landlords and estates themselves. Some estates would have had a tradition of being more generous to their tenants and workers. Estates that existed side by side could have had a very different method in dealing with workers benefits. The Lismore Castle Estate in Co. Waterford was bordered by the estates of the Kiely-Ussher family in Ballysaggart More, Co. Waterford, and the treatment of workers was vastly different between the two estates.

I have looked over and worked on all the documents of the Lismore Castle Estate from 1820 - 1940 and their record keeping was impeccable and gives local historians an amazing insight into the working of a large landed estate.

The Lismore Castle Estate was always very generous, not just to its own workforce but also to the wider community of Lismore town and surrounding countryside owned by the Estate. In the records of the Lismore Castle Estate, which can only be viewed in person at the moment but there is a descriptive list available online it has a Petty Cash book which shows multiple entries that were for payments for staff medical expenses, travel expenses, clothing and schooling allowance for children. Another payment that was available to the wider community was a Burial Allowance, the Lismore Castle Estate would give a grant donation to families who lived on or worked for the Estate to bury their dead if they were unable to afford the cost of a casket. Other employees got direct benefits in relation to their jobs; Fisheries workers were allowed bring home a fish each on a Friday. They were also given a Whiskey Allowance for the months of November, December, January and February. These workers worked in the rivers and salmon hatcheries of the estate all year round and were given an extra supplement in their wages for the winter months to buy an extra bottle of whiskey to combat the cold conditions. There was a great relationship that existed then between the Lismore Castle and the local workforce and community which would resemble that of Downton Abbey. The Estate was well respected and thanked for the employment and aid it gave the local community. So much so that there was very little upheaval and no attacks during Irelands War of Independence, 1919-1921, and the Estate is still owned by the English Dukes of Devonshire to this day and continue to have a strong relationship with the local community.

To contrast this with the Kiely-Ussher Estate then which existed only a couple of miles away. Workers and local farmers were treated horrifically under the Kiely-Usshers and there was a great deal of resentment. Rents were very high and unfair which resulted in mass evictions during the time of the Irish Land Wars in the late 19th century. Workers received very low pay and no benefits which resulted in a high turn-over in staff - very different to Lismore which had many generations of the one family work for the estate. The family were so reviled that the house was burned to the ground during the Irish Civil War.

The records of the Irish landed estates are fascinating and give a great insight into the workings of estates like Downton. I have to admit though, the amount of stuff that is fictionalised in the show is quite high and some stuff could be elaborated on more as there is such fascinating stories that could be used.

Most records are only available to view in Ireland in their original hand-written state but there is a growing number which are being digitised. For the Lismore Castle records, which are one of the most indepth that I have ever worked on, you should check out http://www.waterfordcouncil.ie/en/Resident/Archives/Explore,Collections/Lismore,Estate,Papers/

And for a complete listing in the National Library of Ireland visit http://www.nli.ie/en/udlist/manuscripts-collections.aspx?article=c85c048d-ae6a-4ad4-a107-f7e9df641287