Social History of Medicine Advance Access published online on March 5, 2008
Social History of Medicine, doi:10.1093/shm/hkm118
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‘The Excellent Example of the Working Class’: Medical Welfare, Contributory Funding and the North Staffordshire Infirmary from 1815
* History in the School of Humanities, Keele University, Keele, Staffordshire ST5 5BG, UK.E-mail: a.e.tomkins{at}his.keele.ac.uk
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Abstract |
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Summary Contributory funding schemes for hospitals typically emerged in the late nineteenth century, but the North Staffordshire Infirmary was probably the first hospital to obtain workers' contributions (dubbed ‘establishment’ funds) on a mass scale. The early years of the hospital's finances were characterised by crisis and instability but the establishment income became central to both its survival and its identity. Nonetheless, this gave rise to an anomalous relationship between working-class patients, who obtained admission as a matter of right, and wealthier subscribers, who continued to regard them as objects of charity. This tension was maintained for 90 years before workers secured representation on the hospital governing body. It may explain why the funding model was not promoted more widely at the time and why the hospital's pioneering experiment has been neglected.
Keywords: medicine; welfare; relief; contributory funding; charity; infirmaries