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.

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
Angelica Michelis

This article engages with the discourse of food and eating especially as related to the representation of the abject eating-disordered body. I will be particularly interested in the gothic representation of the anorexic and bulimic body in samples of medical advice literature and NHS websites and how they reinforce popular myths about anorexia by imagining the eating disordered body as a fixed object of abjection. Focusing on the use of gothic devices, tropes and narrative structure, these imaginations will be read against alternative representations of anorexic/bulimic bodies in autobiographical illness narratives, fictional accounts and a psychoanalytical case history in order to explore how gothic discourses can help opening up new understandings and conceptions of illness, healing and corporeality in the dialogue between medical staff and patients.

Gothic Studies
Open Access (free)
Planned Obsolescence of Medical Humanitarian Missions: An Interview with Tony Redmond, Professor and Practitioner of International Emergency Medicine and Co-founder of HCRI and UK-Med

difficulty is the answer; I am sure some people do, but it is really difficult, whereas if you can move more freely between humanitarian and general medical practice, I think you would also more readily apply in humanitarian settings the technological innovations that are already there. TRM: That is what UK-Med tries to do, right, taking people working for the NHS who are trained in care as we deliver it in this part of the world and take that overseas

Journal of Humanitarian Affairs
British hospital contributory schemes in the twentieth century

This book presents a comprehensive account of a major innovation in hospital funding before the NHS. The voluntary hospitals, which provided the bulk of Britain’s acute hospital services, diversified their financial base by establishing hospital contributory schemes. Through these, working people subscribed small, regular amounts to their local hospitals, in return for which they were eligible for free hospital care. The book evaluates the extent to which the schemes were successful in achieving comprehensive coverage of the population, funding hospital services, and broadening opportunities for participation in the governance of health care and for the expression of consumer views. It then explores why the option of funding the post-war NHS through mass contribution was rejected, and traces the transformation of the surviving schemes into health cash plans. This is a substantial investigation into the attractions and limitations of mutualism in health care. It is relevant to debates about organisational innovations in the delivery of welfare services.

Margaret Brazier and Emma Cave

Francis QC’s Report of the Mid Staffordshire NHS FT Public Inquiry 2013 (the Francis Report) lamented the lack of effective reaction to the persistently appalling standards of care: In the end, the truth was uncovered in part by attention being paid to the true implications of its mortality rates, but mainly because of the persistent complaints made by a very determined group of patients and those close to them. This group wanted to know why they and their loved ones had been failed so badly. 3 But, as we shall see, the NHS complaints procedure has come

in Medicine, patients and the law (sixth edition)
Margaret Brazier and Emma Cave

for 2014/15 offers little by way of evidence. The reduction in the cost of claims to the NHS may be welcomed. Patients denied a civil remedy may look elsewhere even to the criminal process for redress, 5 and we must question how far limitations on access to funding for those who cannot self-fund a claim meet the needs of justice and accountability. 6 We begin this chapter by offering an overview of the litigation process. Then we consider claims that lawsuits against doctors are damaging medicine. The spectre of the malpractice crisis is often invoked but

in Medicine, patients and the law (sixth edition)
Martin Gorsky, John Mohan, and Tim Willis

have lacked a conventional commercial instinct, given their idiosyncratic origins, structure and ethos, and the survivors have retained many features of their predecessors. They are non-profit organisations and, unlike private insurers, they have neither challenged the principle of a collective risk pool embodied in the NHS nor attempted to offer a superior alternative. The surviving schemes are distinguished by: their commitment to charitable activity and their support for the NHS; their reliance on voluntary participation in fundraising and governance; and their

in Mutualism and health care
Margaret Brazier and Emma Cave

combination, the two reports revealed: a culture of fear in which staff did not feel able to report concerns; a culture of secrecy in which the trust board shut itself off from what was happening in its hospital and ignored its patients; and a culture of bullying, which prevented people from doing their jobs properly. 4 The third – the ‘Francis Inquiry’– in which over 250 witnesses and over a million pages of documentary material were considered, investigated why the NHS system failed to detect these problems earlier. 5 Constant NHS reorganisation, regulatory gaps and

in Medicine, patients and the law (sixth edition)
Reorientation under the National Health Service
Martin Gorsky, John Mohan, and Tim Willis

Chapter 9 ‘Where the shoe pinches’: reorientation under the National Health Service In an address to the schemes at their 1948 conference, a few months after the creation of the NHS, Aneurin Bevan advised the schemes that, in the changed circumstances, they should ‘Watch to see where the shoe pinches first because it is where the shoe pinches, and if the nation cannot do it, there your voluntary services will be required’.1 This quote has entered the folklore of the contributory scheme movement. This chapter considers the response of the schemes to the

in Mutualism and health care