patiently talks him – and us, if we need to know –
through the procedures for getting onto a doctor’s list and
obtaining an NHS card. His cluster of comic-relief scenes add up to
something very reminiscent of the short films of wartime in which
the instructional pill is sugared by humour, for instance those of
Richard Massingham – right down to the payoff where he breaks
an ankle and
Nursing older people in British hospitals, 1945–80
A poverty of leadership: Nursing
older people in British hospitals,
In February 2013, Robert Francis QC published the report of the public inquiry into the poor care, target-driven culture and patient neglect at the Mid-Staffordshire NHS Trust in the midlands of England.
Key to the findings and crucial for the recommendations were that
there was poor leadership and that the Trust Board had as its raison
d’être cost-saving and the meeting of government targets, rather than
successful patient outcomes. Francis wrote:
As a result
pay policy on the public sector and to abolish low pay for public
service workers. According to Fisher, the earnings of public sector workers
had declined between 1975 and 1978. Weekly earnings of male ancillary
workers in the National Health Service (NHS) had fallen from 84 per cent
Sun, 23 January 1979.
Daily Mail, 22 January 1979.
Socialist Worker, 20 January 1979.
Socialist Worker, 27 January 1979.
Daily Mirror, 23 January 1979, p. 1. Despite the appalling January weather that affected
sport, Arsenal defeated third division Sheffield
Pregnancy and childbirth: antenatal care,
birth and postnatal care
he introduction of the NHS in 194 gave rise to a renewed interest
in maternal and, to an even greater extent, child health. Women
and children were perhaps the NHS’s greatest beneficiaries as they
had gained least from the pre-war insurance schemes. However there was
never any clear and universally agreed upon idea of what form maternity
care should take. Policies were continually being modified in response to
changing medical opinions and technological developments. Initially the
SENs were also known as
‘subordinate’ nurses.107 Four former SENs were interviewed as part
of this study, three of whom are also, interestingly, homosexual; their
testimony is explored later in the chapter.
Mental health and the National Health Service
The UK was spiritually and economically drained by the two world
wars, and the creation of a National Health Service (NHS) in July
1948, free at the point of entry to every citizen, represented the ultimate act of national altruism.108 However, the inclusion of mental
health services into the NHS was by no means a
which further complicated the role of mothers. The introduction of the
contraceptive pill to Britain in 191 made contraception easier to obtain,
easier to use and more reliable. The National Health Service (NHS) Family
Planning Act of 197 allowed doctors to give family planning advice and
to prescribe free contraceptives, though initially only to married women.
The Abortion Act of the same year allowed the termination of pregnancy
if two independent medical practitioners agreed that continuance would
cause physical or mental risk to the health
.6 and the
Conservatives by 16.0 (Quinn et al ., 2011 :
It is clear that the Liberal Democrats did contribute to
the ideological watering down of the plans that the Conservatives had
within their manifesto. The main policy win for the Liberal Democrats
can be said to be in the area of public services, as on jobs and
welfare, the NHS, schools, pensions and the elderly
Healing with water provides a medical and social history of English spas and hydropathic centres from 1840 to 1960. It argues that demand for treatment rather than leisure drove the development of a number of inland resorts which became renowned for expertise and facilities for hydropathy and spa treatment. Water was used in varied therapeutic approaches by both orthodox and unorthodox practitioners. It explores ideas about water’s healing potential, the importance placed on a healthy regimen and how treatment became associated with new institutions and a specialist workforce. Water cures attracted sustained support from patients suffering from a variety of complaints, some of which were associated by contemporaries with the effects of industrialisation and modernisation. The importance of broader public and private cultures of health is considered, in particular how health and social reform movements influenced the views of patients and practitioners. The relationship between the medical application of water and its use for leisure and hygienic purposes is also investigated. The study brings new perspectives to the historiography of resort development, which has focused on the seaside and leisure, exploring how health and healing influenced society and economy in specialist watering places. These aspects were actively marketed to the public. A range of medical and non-medical actors were influential in shaping facilities and environment at resorts, including local authorities, charities and private businesses. The study assesses why the NHS funded spa treatment in 1948 but support was later withdrawn, comparing this with trends in France and Germany.
This book examines the payment systems operating in British hospitals before the National Health Service (NHS). An overview of the British situation is given, locating the hospitals within both the domestic social and political context, before taking a wider international view. The book sets up the city of Bristol as a case study to explore the operation and meaning of hospital payments on the ground. The foundation of Bristol's historic wealth, and consequent philanthropic dynamism, was trade. The historic prominence of philanthropic associations in Bristol was acknowledged in a Ministry of Health report on the city in the 1930s. The distinctions in payment served to reinforce the differential class relations at the core of philanthropy. The act of payment heightens and diminishes the significance of 1948 as a watershed in the history of British healthcare. The book places the hospitals firmly within the local networks of care, charity and public services, shaped by the economics and politics of a wealthy southern city. It reflects the distinction drawn between and separation of working-class and middle-class patients as a defining characteristic of the system that emerged over the early twentieth century. The rhetorical and political strategies adopted by advocates of private provision were based on the premise that middle-class patients needed to be brought in to a revised notion of the sick poor. The book examines why the voluntary sector and wider mixed economies of healthcare, welfare and public services should be so well developed in Bristol.
Through a study of diabetes care in post-war Britain, this book is the first historical monograph to explore the emergence of managed medicine within the National Health Service. Much of the extant literature has cast the development of systems for structuring and reviewing clinical care as either a political imposition in pursuit of cost control or a professional reaction to state pressure. By contrast, Managing Diabetes, Managing Medicine argues that managerial medicine was a co-constructed venture between profession and state. Despite possessing diverse motives – and though clearly influenced by post-war Britain’s rapid political, technological, economic, and cultural changes – general practitioners (GPs), hospital specialists, national professional and patient bodies, a range of British government agencies, and influential international organisations were all integral to the creation of managerial systems in Britain. By focusing on changes within the management of a single disease at the forefront of broader developments, this book ties together innovations across varied sites at different scales of change, from the very local programmes of single towns to the debates of specialists and professional leaders in international fora. Drawing on a broad range of archival materials, published journals, and medical textbooks, as well as newspapers and oral histories, Managing Diabetes, Managing Medicine not only develops fresh insights into the history of managed healthcare, but also contributes to histories of the NHS, medical professionalism, and post-war government more broadly.