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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
The past, the present and the future
Alistair Leanord

policy. It also considers the ways in which migration and localism have become key concepts in policy development. Finally, this chapter ends with some reflections on the future of infection control, based on experience, evidence and developing technologies. Background The emergence of a national system of control is often reactive; a ‘call to arms’ that provides the first stage of a policy cycle. In this context, the inciting event was a significant salmonella outbreak in a Scottish hospital. 1 In response to this specific outbreak, the Scottish government

in Germs and governance
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.

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

argued that nursing practice, education and policy were established and consolidated in the metropole before being exported to the colonies by British nurses, and as a consequence, professional nursing developed independently in each of the colonial outposts. However, cases like that of ‘Nellie’ Gould illustrate that nursing practice was equally constituted on the peripheries, and that a complex network of nursing ideas existed within the British Empire, fuelled and enhanced by the mass migration of nurses between various colonial locations. Ellen Julia Gould (known as

in Colonial caring
Abstract only
Quarantine, immigration and the making of a Port Sanitary zone
Author: Krista Maglen

The English System is a history of port health and immigration at a critical moment of transformation at the end of the nineteenth and beginning of the twentieth century. It challenges generally held assumptions that quarantine policies delineated intransigent national borders, and argues instead that the British geo-body was defined as a more fluid construction. A combination of port sanitation and sanitary surveillance, known to contemporaries as the ‘English System,’ was gradually introduced as an alternative to obstructive quarantines at a time of growing international commerce. Yet at the same time escalating anti-alien anxieties sought to restrict the movement of migrants and transmigrants who arrived from the Continent in increasing numbers. With the abolition of quarantine in 1896 the importance of disease categories based on place, which had formed its foundation and which had been adapted for the new ‘English system,’ lessened. However, these categories had not collapsed but were merely transferred. This book examines this crucial transition showing how the classification of ‘foreign’ and ‘domestic’ disease was translated, after the abolition of quarantine and during the period of mass migration, to ’foreign’ and ‘domestic’ bodies – or the immigrant and the native population.

Editor: John Cunningham

This collection offers important new insights across a broad range of topics relating to medicine in Early Modern Ireland. Of particular note is the substantial attention devoted to the years before 1750, a period that has been relatively neglected in studies of Irish medicine. The book brings together an exciting selection of established scholars, such as Peter Elmer and Clodagh Tait, as well as a number of early career historians. Their work effectively situates Irish medicine in relation to long-term social and cultural change on the island, as well as to appropriate international contexts, encompassing Britain, Europe and the Atlantic World. The chapters also engage in various ways with important aspects of the historiography of medicine in the twenty-first century. Among the key subjects addressed by the contributors are Gaelic medicine, warfare, the impact of new medical ideas, migration, patterns of disease, midwifery and childbirth, book collecting, natural history, and urban medicine. A common thread running through the chapters is the focus on medical practitioners. The book accordingly enables significant new understanding of the character of medical practise in Early Modern Ireland. This collection will be of interest to academics and students of the history of Early Modern medicine. It also contains much that will be essential reading for historians of Ireland.

Katherine Foxhall

intangible elements of medical relationships. Put simply, if a surgeon could not gain the trust of those in his care, he did not have authority. If he did not have authority, it was more difficult to perform the experiments and procedures that brought recognition. Through threads such as these, Australian voyages bind together the histories of medicine, social power, colonialism, and migration across national borders and geographical space. Notes 1 John Hood, Australia and the East (London: John Murray

in Health, medicine, and the sea
Suriname under Dutch rule, 1750– 1950

Explaining how leprosy was considered in various historical settings by referring to categories of uncleanliness in antiquity, is problematic. The book historicizes how leprosy has been framed and addressed. It investigates the history of leprosy in Suriname, a plantation society where the vast majority of the population consisted of imported slaves from Africa. The relationship between the modern stigmatization and exclusion of people affected with leprosy, and the political tensions and racial fears originating in colonial slave society, exerting their influence until after the decolonization up to the present day. The book explores leprosy management on the black side of the medical market in the age of slavery as contrasted with the white side. The difference in perspectives on leprosy between African slaves and European masters contributed to the development of the 'Great Confinement' policies, and leprosy sufferers were sent to the Batavia leprosy asylum. Dutch debates about leprosy took place when the threat of a 'return' of leprosy to the Netherlands appeared to materialise. A symbiotic alliance for leprosy care that had formed between the colonial state and the Catholics earlier in the nineteenth century was renegotiated within the transforming landscape of Surinamese society to incorporate Protestants as well. By 1935, Dutch colonial medicine had dammed the growing danger of leprosy by using the modern policies of detection and treatment. Dutch doctors and public health officials tried to come to grips with the Afro-Surinamese belief in treef and its influence on the execution of public health policies.

Space, identity and power

This volume aims to disclose the political, social and cultural factors that influenced the sanitary measures against epidemics developed in the Mediterranean during the long nineteenth century. The contributions to the book provide new interdisciplinary insights to the booming field of ‘quarantine studies’ through a systematic use of the analytic categories of space, identity and power. The ultimate goal is to show the multidimensional nature of quarantine, the intimate links that sanitary administrations and institutions had with the territorial organization of states, international trade, the construction of national, colonial, religious and professional identities or the configuration of political regimes. The circum-Mediterranean geographical spread of the case studies contained in this volume illuminates the similarities and differences around and across this sea, on the southern and northern shores, in Arabic, Spanish, Portuguese, Greek, Italian, English and French-speaking domains. At the same time, it is highly interested in engaging in the global English-speaking community, offering a wide range of terms, sources, bibliography, interpretative tools and views produced and elaborated in various Mediterranean countries. The historical approach will be useful to recognize the secular tensions that still lie behind present-day issues such as the return of epidemics or the global flows of migrants and refugees.