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Britain – Healthcare, c.1900-48

2. Was there free public healthcare before the NHS?

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About this Lecture


In this module, we think about the extent to which there were free public healthcare before the foundation of the NHS in 1948, focusing in particular on: (i) the introduction of National Insurance in 1911, how it worked, and its strength and weaknesses; (ii) the two types of public hospital that existed in the 1920 – infectious disease hospitals and Poor Law hospitals; (iii) the importance of the 1929 Local Government Act that allowed (but did not require) local authorities to take over Poor Law hospitals and turn them into General Hospitals for the whole community; and (iv) the extent healthcare provision varied in different parts of the country in this period.


In this course, Dr George Gosling (University of Wolverhampton) explores healthcare in Britain prior to the establishment of the NHS in 1948. In the first module, we think about when the NHS began, looking at the importance of the Second World War and Labour’s 1945 election victory. After that, we consider whether there was public healthcare in Britain before the NHS, before turning in the third module to think about what private healthcare looked like prior to 1948 – a mix of businesses operating for profit but also community and charitable initiatives. In the fourth module, we think about whether people had to pay for healthcare prior to the NHS, before turning in the fifth and final module to think about why the NHS was ‘only’ set up in 1948.


Dr George Gosling is a Senior Lecturer in History at the University of Wolverhampton. He specialises in modern British history, focusing in particular on the themes of medicine, charity and welfare to explore wider questions of gender, citizenship and consumerism. His most recent book, Payment and Philanthropy in British Healthcare, 1918-48 (2017), explored the complex meanings of payment in the pre-NHS hospital. It argues that, when patient payments became commonplace after the First World War, they neither empowered consumers as hoped nor crowded out the sick poor as feared, instead they found a surprisingly traditional accommodation with the long-established class-bound principles of philanthropy.

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APA style

Gosling, G. (2021, February 02). Britain – Healthcare, c.1900-48 - Was there free public healthcare before the NHS? [Video]. MASSOLIT.

MLA style

Gosling, G. "Britain – Healthcare, c.1900-48 – Was there free public healthcare before the NHS?." MASSOLIT, uploaded by MASSOLIT, 02 Feb 2021,