There were only three decades in British history when it was the norm for patients to pay the hospital, those between the end of the First World War and the establishment of the National Health Service in 1948. At a time when payment is claiming a greater place than ever before within the NHS, this book uses a case study of the wealthy southern city of Bristol as the starting point for the first in-depth investigation of the workings, scale and meaning of payment in British hospitals before the NHS.
This seminar marks the publication of a new monograph, which questions what it meant to be asked to contribute financially to the hospital by the medical social worker, known then as the Lady Almoner, or to subscribe to a pseudo-insurance hospital contributory scheme. It challenges the false assumption that middle-class paying patients crowded out the sick poor. Hopes and fears, at the time and since, that this would have an empowering or democratising effect or that commercial medicine would bring about the end of medical charity, were all wide of the mark. In fact, payment and philanthropy found a surprisingly traditional accommodation, which ensured the rise of universal healthcare was mitigated and mediated by long-standing class distinctions while financial contribution became a new marker of good citizenship.
Payment & Philanthropy in British Healthcare, 1918-48 (Manchester University Press, 2017) explores these changing notions of citizenship, charity and money, as well as the hospital as a social institution within the community in early twentieth-century Britain. The seminar will also offer an opportunity to reflect on how engaging with questions of payment can enhance our understanding the voluntary sector, past and present.
George Campbell Gosling is Lecturer in History at the University of Wolverhampton. He has previously held teaching and research posts at the University of Warwick, King's College London, the University of Liverpool, City University London and Oxford Brookes University, where he received his PhD in 2011. His most recent publications are Payment and Philanthropy in British Healthcare, 1918-48 (MUP, 2017) and his chapter 'The Birth of the Pregnant Patient-Consumer? Payment, Paternalism and Maternity Hospitals in Early Twentieth-Century England' in Jennifer Evans and Ciara Meehan (eds), Perceptions of Pregnancy from the Seventeenth to the Twentieth Century (Palgrave Macmillan, 2017). His recent research posts were working with Professor Pat Thane on the history of the Child Poverty Action Group and Professors Roberta Bivins and Mathew Thomson on the cultural history of the NHS. He is a former trustee of the Voluntary Action History Society and currently Communications Officer for the Social History Society.
Voluntary Action History seminar series