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
The empire of the mind and
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
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.
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
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
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
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.
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.
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.
John Hood, Australia and the East (London: John Murray
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.
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.