• "Open the other eye": Payment, civic duty and hospital contributory schemes in Bristol, c.1927-1948

      Gosling, GC; Centre for Health, Medicine and Society: Past and Present, School of Arts and Humanities, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, UK. gcgosling@brookes.ac.uk (Cambridge University Press (CUP), 2010-10-01)
      On the appointed day of 5 July 1948, the National Health Service (NHS) came into existence in Britain. What existed before had been a complex and constantly evolving mixed economy of healthcare, within which hospital services were provided by a combination of public and voluntary sectors. The public sector accounted for the majority of hospital beds and dominated treatment of the chronic and aged sick. However, it is the voluntary hospitals that have often been seen as at the heart of this system because of their historic foundations—many having been established as charitable institutions in the eighteenth and nineteenth centuries—as well as their perceived clinical superiority. In fact, the move towards a national health service, which ultimately nationalized the hospitals, gave great credence to an approach Daniel Fox has described as “hierarchical regionalism”. This placed such institutions as leading specialist and teaching centres at the top of a hierarchy of regional service providers, and in doing so reinforced this view of the primacy of the voluntary hospitals