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Julian M. Simpson

150 5 From ‘pairs of hands’ to family doctors The professional options of South Asian doctors who decided to stay in Britain were limited, notably as a result of racism and heterophobia. Discrimination operated both in hospital medicine, resulting in migrant doctors being directed towards general practice, and within general practice itself resulting in outsiders being at a disadvantage when it came to obtaining posts in the more desirable areas. The presence of South Asian doctors in general practice in industrial and inner-​city areas is nevertheless partly

in Migrant architects of the NHS
Julian M. Simpson

93 3 The empire of the mind and medical migration It is important, in order to understand how the NHS and British general practice were able to draw on the labour of South Asian doctors, to appreciate, as was shown in the previous chapter, how British immigration and medical registration policies remained defined by imperial legacies for much of this period. It is also crucial to appreciate that these legacies continued to shape medicine in the Indian subcontinent and the thought processes of doctors—​as is apparent in their oral history interviews and in

in Migrant architects of the NHS
Julian M. Simpson

movement of doctors.3 In this chapter, I  argue that seeing the development of the NHS through the prism of empire and its legacies is key to understanding how it came to be so reliant on migrant South Asian doctors. This reflection draws on the work of historians who have argued that closer attention should be paid to the ways in which Britain’s imperial past have shaped its present. It also builds on the insights of post-​colonial theorists who argue that the impact of imperialism is an essential dimension of the modern world that cannot be ignored.4 Adopting such an

in Migrant architects of the NHS
Julian M. Simpson

124 4 Discrimination and the development of general practice The presence of migrant South Asian doctors in the British healthcare system can be linked to the existence of a post-​imperial recruitment system in post-​war Britain and the lingering effects of the empire of the mind in South Asia. Their movement into general practice, however, requires to be understood in a different way. This chapter and Chapter 5 will show how a discriminatory professional environment limited these doctors’ options and how their responses to this context contributed to defining

in Migrant architects of the NHS
Howard Chiang

categories that structure our thought, pattern our arguments and proofs, and certify our standards for explanation.”5 Their 4 Howard Chiang work on the construction and transformation of concepts of evidence, scientific objectivity, and personhood has fundamentally reoriented the terrain of the history and philosophy of science and medicine, proving to be an indispensable source of inspiration for a new generation of scholars. Despite this, however, scholars of East Asian science and medicine have not had the chance to come together and direct similarly inspired

in Historical epistemology and the making of modern Chinese medicine
Acupuncture and the techno-politics of bodyscape
Wen-Hua Kuo

Learn the rules like a pro, so you can break them like an artist. (Attributed to Pablo Picasso) Introduction: global acupuncture and bodies on treatment Acupuncture is an essential part of East Asian medicine. A peculiar way of diagnosing and treating people via meridians inside their bodies punctuated by regulatory points, it is a simple yet sophisticated art of healing that has been used

in Global health and the new world order
Patient work in colonial mental hospitals in South Asia, c. 1818–1948
Waltraud Ernst

5 ‘Useful both to the patients as well as to the State’: Patient work in colonial mental hospitals in South Asia, c. 1818–1948 Waltraud Ernst This chapter focuses on the organisation of patient work in the mental institutions established by the British for both Europeans and Indians in South Asia. It explores the changing and plural meanings of work in relation to prevalent medical ideas and practices in different institutional settings in British-held territories from the early nineteenth to the middle of the twentieth centuries. Different aspects of work will

in Work, psychiatry and society, c. 1750–2015
Claire Beaudevin, Jean-Paul Gaudillière, Christoph Gradmann, Anne M. Lovell, and Laurent Pordié

insecticides for malaria). During this first period, drugs and clinical care played a role that was secondary to prevention strategies, which mobilized vaccines as well as social control techniques in the fight against infectious diseases. These programmes appeared critical to the reconstruction of post-war Europe as well as for the stabilization of African and Asian colonies (Staples, 2006 ). This landscape started to shift in the 1960s, partly as a result of two major changes: on the one hand, the new socio-political climate, associated with the Cold

in Global health and the new world order
Daktar Binodbihari Ray Kabiraj and the metaphorics of the nineteenth-century Ayurvedic body
Projit Bihari Mukharji

among the most salient features of these changes’. 3 Both modernity and modernisation are thus made synonymous with ‘western societies’. A place like South Asia, though intimately connected to the developments in Britain and thus equally implicated in the dynamics of urbanisation, industrialisation, and the spread of market capitalism (though in different ways and at distinct rates), is yet expunged from the ambit of nineteenth-century modernity. In the same year that L. S. Jacyna wrote the above lines, William Bynum

in Progress and pathology
South Asian doctors and the reinvention of British general practice (1940s– 1980s)

The NHS is traditionally viewed as a typically British institution; a symbol of national identity. It has however always been dependent on a migrant workforce whose role has until recently received little attention from historians. Migrant Architects draws on 45 oral history interviews (40 with South Asian GPs who worked through this period) and extensive archival research to offer a radical reappraisal of how the National Health Service was made.

This book is the first history of the first generation of South Asian doctors who became GPs in the National Health Service. Their story is key to understanding the post-war history of British general practice and therefore the development of a British healthcare system where GPs play essential roles in controlling access to hospitals and providing care in community settings.

Imperial legacies, professional discrimination and an exodus of British-trained doctors combined to direct a large proportion of migrant doctors towards work as GPs in industrial areas. In some parts of Britain they made up more than half of the GP workforce. This book documents the structural dependency of British general practice on South Asian doctors. It also focuses on the agency of migrant practitioners and their transformative roles in British society and medicine.