© 1992 by Society for the Social History of Medicine
Articles |
Beyond National Health Insurance. The Voluntary Hospitals and Hospital Contributory Schemes: A REGIONAL STUDY.1
*School of Economic and Social Studies, University of East Anglia Norwich NR4 7TJ
SUMMARY In the context of developments in health care arrangements over the late nineteenth and twentieth centuries, change in the voluntary hospitals is not normally regarded as a major theme. Yet in their relations with each other, with external authorities, and in patterns of funding the hospitals were subjected to change. In particular, the growth of hospital contributory schemes enabled renewed hospital expansion to occur and established a quasi-insurance basis to hospital activity in place of the earlier, largely philanthropic approach. The schemes also involved additional market mechanisms and promoted reorganization, including a degree of co-ordination of hospital services, felt at the local level before the growth of policy making bodies on a national scale and largely independent of central or local government. Focusing upon East Anglia but including other examples, the article examines the growth of hospital collections, the emergence of contributory schemes and their consequences for popular access to hospital facilities. A ‘grass roots’ approach is adopted, using annual reports of several hospitals and contributory schemes and local Insurance Committee minutes. It appears that the size and impact of the schemes in East Anglia has been understated, though this may not be typical of the situation nationally. The local evidence is also examined in the light of other recent research on the themes of popular participation, employer interest and social control aspects in health care provision at hospital levels.
Keywords: central government; hospital contributory schemes; hospital finance; local government; national health insurance; popular medical provision; voluntary hospitals
1 I am grateful to the Study Leave Committee of the UEA Norwich for allowing me the opportunity to concentrate on research into hospitals and other health provision in East Anglia.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Gorsky and J. Mohan London's Voluntary Hospitals in the Interwar Period: Growth, Transformation, or Crisis? Nonprofit and Voluntary Sector Quarterly, June 1, 2001; 30(2): 247 - 275. [Abstract] [PDF]
|
|