Bridging the voluntarist gap: hospitals and the local state in Middlesbrough, 1890-1950
Doyle, Barry M.
Voluntary hospitals -- England -- History Public health -- England -- History -- 1890-1950 Εθελοντικά νοσοκομεία -- Αγγλία -- Ιστορία Δημόσια υγεία -- Αγγλία -- Ιστορία -- 1890-1950
In the late nineteenth century towns across England acquired voluntary hospitals to treat accidents, emergencies and the acute sick. Funded by donations, subscriptions or contributions from workers, such institutions were highly selective in the patients they chose to treat, excluding the infectious, the chronically sick, the destitute, maternity cases, TB and VD and the mentally ill. As a result, it fell increasingly to the local state to provide cover for such cases as Parliament allowed and obliged poor law and local councils to build infirmaries, hospitals and asylums. The need for such institutions was particularly great in towns which had expanded rapidly during the nineteenth century, especially in heavy industrial areas with extensive health and environmental problems and a relatively small middle class. This paper will examine the development of the municipal hospital system in Middlesbrough, a new industrial town in the north east of England heavily dependent on iron and steel making. By the end of the nineteenth century the town had a population of around 90,000 and was served by two voluntary hospitals paid for largely by worker contributions, a poor law infirmary, two municipal fever hospitals and a mental hospital. Over the next forty years these municipal services were expanded by the Medical Officer of Health Charles Dingle and his successor so that by the time of the NHS there were five municipal hospitals with over 1000 beds. The paper will assess the extent to which these hospitals helped to meet the gap in provision left by the voluntary hospitals, the degree to which they were able to finance adequate services, especially in a period of severe economic crisis in the town, and the scale of cooperation with the voluntary sector to provide a full acute and chronic hospital service. It will show that Middlesbrough was able to deliver a very extensive hospital service, despite the economic climate and that this service was not generated to any great extent by the political power of the Labour party, though it may have owed something to the long standing incorporation of the labour movement in the radical politics of the town.
Paper presented at Seventh International Conference on Urban History: European City in Comparative Perspective, Panteion University, Athens - Piraeus, Greece, 27-30 October 2004, Session: The urban and local history of social policy (XIX-XX centuries)