Healthcare in Ireland and Britain from 1850 Voluntary, regional and comparative perspectives Edited by Donnacha Seán Lucey and Virginia Crossman Healthcare in Ireland and Britain from 1850 Voluntary, regional and comparative perspectives Healthcare in Ireland and Britain from 1850 Voluntary, regional and comparative perspectives Edited by Donnacha Seán Lucey and Virginia Crossman LONDON INSTITUTE OF HISTORICAL RESEARCH Published by UNIVERSITY OF LONDON SCHOOL OF ADVANCED STUDY INSTITUTE OF HISTORICAL RESEARCH Senate House, Malet Street, London WC1E 7HU First published in print in 2014. This book is published under a Creative Commons Attribution- NonCommercial-NoDerivatives 4.0 International (CC BY- NCND 4.0) license. More information regarding CC licenses is available at https://creativecommons.org/licenses/ Available to download free at http://www.humanities-digital-library.org ISBN 978 1 909646 65 0 (PDF edition) ISBN 978 1 909646 02 5 (hardback edition) Contents Acknowledgements vii About the contributors ix Abbreviations xiii List of tables and figures xv Introduction 1 Donnacha Seán Lucey and Virginia Crossman I. Historiographical directions 1. ‘Voluntarism’ in English health and welfare: visions of history 31 Martin Gorsky 2. Healthcare systems in Britain and Ireland in the nineteenth and twentieth centuries: the national, international and sub-national contexts 61 John Stewart II. Voluntary hospital provision 3. Paying for health: comparative perspectives on patient payment and contributions for hospital provision in Ireland 81 Donnacha Seán Lucey and George Campbell Gosling 4. ‘Why have a Catholic Hospital at all?’ The Mater Infirmorum Hospital Belfast and the state, 1883–1972 101 Peter Martin 5. Cottage hospitals and communities in rural East Devon, 1919–39 117 Julia Neville III. Healthcare and the mixed economy 6. The mixed economy of care in the South Wales coalfield, c.1850–1950 141 Steven Thompson v Healthcare in Ireland and Britain from 1850 7. ‘… it would be preposterous to bring a Protestant here’: religion, provincial politics and district nurses in Ireland, 1890–1904 161 Ciara Breathnach 8. To ‘solve the darkest Social Problems of our time’: the Church of Scotland’s entry into the British matrix of health and welfare provision, c.1880–1914 181 Janet Greenlees IV. Public health, voluntarism and local government 9. Feverish activity: Dublin City Council and the smallpox outbreak of 1902–3 199 Ciarán Wallace 10. Influenza: the Irish Local Government Board’s last great crisis 217 Ida Milne 11. The roots of regionalism: municipal medicine from the Local Government Board to the Dawson Report 237 Sally Sheard vi Acknowledgements This collection of essays is based on two workshops held in Dublin. The first was held in 2011 in the Centre for Contemporary Irish History in Trinity College Dublin and the second in 2012 in the Centre for the History of Medicine, University College Dublin. We would like to thank these centres and institutions for holding these events. We would like to acknowledge the support of the Economic and Social Research Council, Oxford Brookes University and the Trinity Alumni Association for funding the Trinity workshop. We would also like to acknowledge the Irish Research Council and the Centre for the History of Medicine in Ireland for generously funding the University College Dublin workshop. D. S. Lucey would like to thank the Arts and Humanities Research Council for funding research in the introduction and in his chapter. Janet Greenlees would like to acknowledge the Wellcome Trust (Grant 095576) for funding the research for her chapter. vii About the contributors Dr. Ciara Breathnach is lecturer in history at the University of Limerick. She has published on Irish socio-economic, cultural and health histories. Author of The Congested Districts Board of Ireland, 1891–1923: Poverty and Development in the West of Ireland (Dublin, 2005) and editor/co-editor of six conference proceedings, she has published articles in Medical Humanities, Medical History, Irish Historical Studies, Immigrants and Minorities, History of Family: an International Quarterly, the Journal of Imperial and Commonwealth History, Historical Research and Social History. Professor Virginia Crossman is professor of modern Irish history at Oxford Brookes University. She has extensive expertise in Irish Poor Law history and was recently the principal investigator on the E.S.R.C. project ‘Welfare regimes under the Irish Poor Laws, 1850–1921’. She has published widely on the Poor Law and her most recent book is entitled Poverty and the Poor Law in Ireland, 1850–1914 (Liverpool, 2013). Dr. George Campbell Gosling works on the history of medicine and charity in modern Britain and beyond. He has held teaching and research positions at Oxford Brookes University, the University of Liverpool, King’s College London and the University of Warwick. His first monograph, exploring the limits of private healthcare in Britain before the N.H.S., will be published by Pickering and Chatto. Dr. Martin Gorsky is reader in the history of public health in the London School of Hygiene and Tropical Medicine. He has published extensively on voluntary hospitals, mutualism and healthcare, inter-war healthcare, and the N.H.S. in Britain, and on comparative health systems history. Dr. Janet Greenlees is a health historian and deputy director of the Centre for the Social History of Health and Healthcare, Glasgow Caledonian University. She has published extensively on British and American healthcare and has recently co-edited Western Maternity and Medicine, 1880–1990 (2013). Dr. Donnacha Seán Lucey is an A.H.R.C. research fellow in Queen’s University Belfast, and is writing a monograph on public health in twentieth-century Belfast. He has held research positions in Oxford Brookes University, Trinity College Dublin and University College Dublin. He has expertise in welfare and healthcare history and has published articles in English Historical Review, Irish Historical Studies and Medical History. ix Healthcare in Ireland and Britain from 1850 His second monograph, entitled The End of the Irish Poor Law? Welfare and Healthcare Reform in Revolutionary and Independent Ireland, will be published by Manchester University Press in 2015. Dr. Peter Martin received his Ph.D. in Trinity College Dublin and is a historian of twentieth-century Ireland. He has held teaching and research positions in Trinity College Dublin, University College Dublin and Queen’s University Belfast. He is the author of Censorship in the Two Irelands, 1922– 39 (Dublin, 2006) and several articles and essays on censorship, the Irish aristocracy and the history of health policy in Northern Ireland. He is a civil servant in the Northern Ireland Department of Social Development. Dr. Ida Milne is currently an Irish Research Council ELEVATE fellow based in Queen’s University Belfast and National University of Ireland, Maynooth and her principal research interest is in the effect of epidemic disease on societies. She was awarded a Ph.D. from Trinity College Dublin in 2011 for her work on social, political, economic and medical aspects of the 1918–19 influenza epidemic in Ireland. Her latest research is on the changing landscape of childhood illness in twentieth-century Ireland. Dr. Julia Neville is an honorary research fellow at the University of Exeter. Her Ph.D., completed in 2010, explored variations in local government hospital provision in the nineteen-thirties, and she has published on social change in the inter-war period in Southern History , Medical History and Women’s History Review. Dr. Sally Sheard is a reader in the history of medicine in the University of Liverpool. She has researched and published extensively on the history of public health and on the development of twentieth-century British health and social welfare policies. Some of her publications include The Passionate Economist: how Brian Abel-Smith Shaped Global Health and Social Welfare (Bristol, 2013), (with Liam Donaldson) The Nation’s Doctor: the Role of the Chief Medical Officer, 1855–1998 (Oxford, 2005) and (co-edited with Martin Gorsky) Financing Medicine: the British Experience since 1750 (2006). Professor John Stewart is emeritus professor of health history and former director of the Centre for the Social History of Health and Healthcare at Glasgow Caledonian University. He has expertise in healthcare provision and social policy and regional and comparative healthcare histories. His recent publications include Child Guidance in Britain, 1918–55: the Dangerous Age of Childhood (2013) and (co-authored) Municipal Medicine in Interwar England and Wales (Oxford, 2011). x About the contributors Dr. Steven Thompson is a senior lecturer in Welsh and British history at Aberystwyth University, with expertise in the history of medicine and welfare provision. His publications include a monograph entitled Unemployment, Poverty and Health in Interwar South Wales (Cardiff, 2006) and a number of journal articles and chapter contributions. Dr. Ciarán Wallace is a postdoctoral researcher in the Centre for Contemporary Irish History in Trinity College Dublin, where his research focuses on modern Irish and urban history. He is a co-ordinator of the Dublin History Research Network and his publications include articles on local government, Dublin municipal politics and commemoration. xi Abbreviations A.G.M. Annual general meeting B.M.J. British Medical Journal B.M.H. Bureau of Military History D.C.C.A. Dublin City Council Archives D.C.D.A. Belfast, Down and Connor Diocesan Archives D.E.G. Devon and Exeter Gazette D.H.C. Devon Heritage Centre D.N.A. District Nursing Association D.S.A. Dublin Sanitary Association Econ. Hist. Rev. Economic History Review Eng. Hist. Rev. English Historical Review Irish Hist. Stud. Irish Historical Studies G.P. General practitioner L.G.B. Local Government Board L.M.A. London Metropolitan Archives M.E. Merthyr Express N.A.I. National Archives of Ireland N.A.V.L. National Anti-Vaccination League N.G.O. Non-governmental organization N.H.I. National Health Insurance N.H.S.