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Julian M. Simpson

60 2 Empire, migration and the NHS The establishment and development of the NHS in the post-​war period coincided with the dismantling of the British Empire. Colonial-​era language or parallels have been used at times to describe the relationship between the NHS and the migrant labour it has relied on.1 However, the development of the British healthcare system and the impact and legacy of the Empire are two closely linked phenomena that historians have rarely considered together.2 The same can be said of the history of post-​war migration to the UK and the

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
A European perspective
Burkhart Brückner

campaigns, like Léon Sandon (1823–72), Hersilie Rouy (1814–81) or Raymond Seillière (1845–1911), but no evidence is available of any self-advocacy association. 15 Although several other European countries had also passed lunacy laws between the 1830s and 1880s, non-specific administrative and civil law provisions or local regulations largely prevailed. In the German Empire of the late 1880s, numerous ex-patients, alongside several politicians, called for the creation of a uniform

in Patient voices in Britain, 1840–1948
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Dolto in the twenty-first century
Richard Bates

This concluding chapter tackles the question of Dolto’s twenty-first-century reputation and what France is to do with her legacy.

Considering various references to Dolto in intellectual and popular culture, it shows that after 2000, she was no longer seen as a unifying national expert, but rather as someone linked to a particular ideological outlook, whose ideas were a suitable subject for mockery. Efforts to continue her agenda by her daughter or the politician Edwige Antier, or by opponents of equal marriage legislation, demonstrate that Dolto’s thinking became a polarising rather than a unifying force.

The chapter also shows how, towards the end of her life in the 1980s, Dolto was disconcerted by an increased focus on the psychology of race and empire in France’s former colonies, and unable to adapt her ideas to this development.

As Dolto’s life recedes into history, it becomes easier to see her ideas as products of a particular set of historical circumstances, rather than – as she and her followers believed – timeless truths about the human condition. While there are good reasons for wishing to retain some of Dolto’s contribution, it is doubtful that the ongoing desire to celebrate the positive aspects of her interventions can withstand the increasing criticism of the problematic and outdated aspects of her ideas.

in Psychoanalysis and the family in twentieth-century France
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Doltomania
Richard Bates

. 14 Heavy (and heavily unionised) industries such as coal and steel were declining, as were the small proprietor businesses of the traditional middle class, while job opportunities grew in the salaried white-collar and service sectors. France had lost almost all of its remaining formal empire in the 1960s, and was periodically seized by fears of being swamped by non-white immigrants from former colonies, prompting the government to ban new immigration other than for purposes of family reunification. 15 France in

in Psychoanalysis and the family in twentieth-century France
Dolto, psychoanalysis and Catholicism from Occupation to Liberation
Richard Bates

The years between 1939 and 1953 were ones of enormous upheaval in France. Following the destructive and divisive experience of war, occupation and liberation, by the early 1950s the country was rapidly modernising its economy, while caught up in Cold War geopolitics and fighting to retain its empire. Women had become full citizens, a baby boom was under way and the defeat and moral debasement of the Vichy regime had left the extreme Right discredited. While the 1950s remained an age of social conservatism, signs

in Psychoanalysis and the family in twentieth-century France
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Françoise breaks free?
Richard Bates

deviance, they valued art, classical learning and musical ability highly. They were connected to France’s military and to the French Empire: one of Dolto’s uncles fought in the Tonkin campaign in Vietnam in 1884, while her eldest brother served in Marshal Lyautey’s colonial army in Morocco in the 1920s. The family sought to perpetuate its social and economic status by directing male children into the army and commerce, while requiring daughters to learn a mixture of marriageability-enhancing decorative and practical skills and

in Psychoanalysis and the family in twentieth-century France
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Confronting the legacies of empire, disability and the Victorians
Esme Cleall

, originally from Shropshire, tried to establish a ‘deaf colony’ in Canada using the 1872 Homestead Act, which directly dispossessed First Nations people to secure land. As the lives of these three individuals intersected with the workings of the British Empire, this gives us an opportunity to consider the intersection between disability and colonialism more broadly. Scholars of disability have often used the language of colonialism to evoke the exclusion, discrimination and subjugation of disabled people by society. In 1977 T. Szasz used the expression

in Disability and the Victorians
Disease, conflict and nursing in the British Empire, 1880–1914
Angharad Fletcher

2 Imperial sisters in Hong Kong: disease, conflict and nursing in the British Empire, 1880–1914 Angharad Fletcher British nurses, much like those enlisted in the colonial or military services, frequently circulated within the Empire as a professional necessity, often in response to the development of perceived crisis in the form of conflicts or disease outbreaks, prompting reciprocally shaping encounters between individuals within the various colonial outposts. More traditional approaches to the history of nursing are enclavist in the sense that they have

in Colonial caring
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.