Epilogue
Pasts, present, futures
in Performing medicine
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The 1858 Medical Act was the signal achievement of medical reform. And yet even this proved to be a grave disappointment to many general and provincial practitioners, who continued to lack the representation and political authority they desired. Private practice, rather than public health and 'state medicine', continued to be the principal concern and source of income for most practitioners and 'quacks' continued to operate more or less unchecked by legislative interference. It is impossible to address the history of medical professionalism in England without an eye to the foundation of the National Health Service (NHS). While the British public may remain attached to the concept of the NHS, the stability of medical-professional expertise has also been undermined by changes in popular attitudes. The later nineteenth century saw an ever greater investment in scientific rationality and expert knowledge in the social and cultural configuration of medical identity and authority.

Performing medicine

Medical culture and identity in provincial England, c.1760–1850

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