3. What did private healthcare look like before the NHS?

About this Lecture

Lecture

In this module, we think about what private healthcare looked like before the NHS, focusing in particular on: (i) the difference between private healthcare today and what ‘private healthcare’ meant prior to 1948; (ii) the risks involved with setting up a private GP practice prior to the introduction of National Insurance in 1911; (iii) the clustering of GP surgeries in ‘commercially viable’ locations, e.g. Harley Street in London, seaside towns, etc.; (iv) the extent to which the National Insurance Act encouraged GPs to set up medical practices in poorer areas; (v) the nature and importance of mutual aid schemes, and their transformation into approved societies after 1911; (vi) the nature and reach of hospital contributory schemes; (vii) the nature and range of voluntary hospitals, including the sense in which they were ‘voluntary’; (viii) the types of medical cases taken by voluntary hospitals compared to the types taken by the public hospitals; and (ix) the extent to which the private healthcare epitomised the ‘mixed economy’ of healthcare provision prior to the NHS.

Course

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.

Lecturer

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.