The mixed economy and the NHS across Morecambe Bay: voluntary, commercial, charitable and private medicine, 1948-79
pdf

Keywords

National Health Service
NHS
Morecambe Bay
mixed economy
voluntary sector
charitable organisations
private medicine
history of medicine
childbirth
adoption
unmarried mothers

Abstract

The third sector has been positioned as the key partner for successful integrated care at both system and national levels. Yet the NHS has always existed within a ‘mixed economy’ of healthcare; one with a ‘moving frontier’ between public, private and the third sectors. There has been continuity despite change and resilience within the local system against recurrent reform. This paper explores these continuities in Morecambe Bay from
1948 to 1979 covering voluntary, commercial, charitable, and private medicine across the historic tripartite division of the NHS. It demonstrates an enduring tension between bottom-up and top-down understanding of partnership between the NHS and other sectors mediated by place.

https://doi.org/10.48037/mbmj.v9i5.1424
pdf

References

Adebowale V. The voluntary sector: A game-changer in integrated care systems. Available from: https://www.nhsconfed.org/articles/voluntary-sector-game-changer-integrated-care-systems [accessed 13th April 2023].

Wheeler P, Edwards A, Halliday E, Lowther HJ. Achieving parity of esteem? The role of the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector within integrated care systems – a case study of Lancashire and South Cumbria VCFSE Alliance. Morecambe Bay Medical Journal. 2022;8(12):334-338. Available from: https://doi.org/10.48037/mbmj.v8i12.1343

Hewitt P. The Hewitt Review: An independent review of integrated care systems. 2023. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1148568/the-hewitt-review.pdf [accessed 4th April 2023]

Finlayson G. Citizen, state and social welfare in Britain, 1830-1990. Oxford: Clarendon Press; 1994.

Pater JE. The making of the National Health Service. London: King Edward’s Hospital Fund for London; 1981.

The National Archives. Roman Catholic hospitals and institutions: Minister of Health’s powers of disclaimer, 1946-49. MH 77/235.

The National Archives. Treatment of patients in institutions outside NHS: Contractual arrangements with RHBs, 1953-57. MH 123/318.

The National Archives. Contractual arrangements with private hospitals,1970-71. MH 166/443.

Roberts N. Cheadle Royal Hospital: A bicentenary history. Altrincham: Sherratt; 1967.

The National Archives. Treatment of patients in institutions outside NHS: Contractual arrangements with RHBs, 1958-60. MH 123/319.

Lancashire Archives. St Augustine Roman Catholic Church, letters and notices concerning the St John of God Hospital at Silverdale, 1957.RCPa 1/36.

Lancashire Archives. Lancaster Roman Catholic Diocese, correspondence concerning the Hospitaller Order of St John of God, 1962-67.RCLA/6/Box 14.

Lancashire Archives. North Lancashire and South Westmorland HMC, review of hospital services, 1968. HRL/1/14/9.

The National Archives. Newcastle RHB: Special Area Committee for Cumberland and North Westmorland, 1950-55. MH 88/11.

The National Archives. Contractual arrangements for hospitals: Arrangements with Newcastle RHB, 1971-72. MH 160/648.

Sheard S. Getting better, faster: Convalescence and length of stay in British and US hospitals. In: Sheard S, Abreu L (eds.) Hospital life: Theory and practice from the medieval to the modern. Oxford: Peter Lang; 2013: 299-330.

Pickstone JV. Production, community and consumption: The political economy of twentieth-century medicine. In: Cooter R, Pickstone JV (eds.) Companion to medicine in the twentieth century. London: Routledge;2003: 1-19.

Stewart J. The mixed economy of care in historical context. In: Powell M (ed.) Understanding the mixed economy of care. Bristol: Policy Press; 2019: 21-40.

Lambert M. Problems of practising public health in Westmorland: John A. Guy as County Medical Officer, 1946-70. Morecambe Bay Medical Journal. 2022;9(1): 14-17. Available from: https://doi.org/10.48037/mbmj.v9i1.1360

Lambert M. “Problem Families” and the post-war welfare state in the North-West of England, 1943-74 [PhD thesis]. Lancaster: Lancaster University; 2017.

The National Archives. Home Office, cruelty and neglect of children: matters arising in local authorities within Manchester region, 1953-56. MH 102/1984.

Keating J. A child for keeps: The history of adoption in England, 1918-45. Basingstoke: Palgrave Macmillan; 2009.

The National Archives. Ministry of Health, General Purposes Subcommittee, 1943-44, 1963-60. MH 55/1652.

Lambert M. Written evidence submitted to the Joint Parliamentary Committee on Human Rights Inquiry into the Right to Family Life: Adoption of children of unmarried women, 1949-1976. November 2021. Available from: https://committees.parliament.uk/writtenevidence/40260/pdf/ [accessed 13th April 2023].

Leathard A. The fight for family planning: The development of family planning services in Britain 1921-1974. London: Macmillan; 1980.

Cumbria Archive Service Carlisle. Westmorland County Council Health Department, family planning, 1958-67. WC/H/A1816/Box 8/1.

Bashford A. Epilogue: Where did eugenics go? In: Bashford A, Levine P. (eds.) The Oxford Handbook of the history of eugenics. Oxford: Oxford University Press; 2010: 538-558.

Rayner G. Lessons from America? Commercialisation and the growth of private medicine in Britain. Int J Health Serv. 1987;17(2):197-216. Available from: https://doi.org/10.2190/7HX5-HFDD-LEJT-CCGV

Ministry of Health (Hinchcliffe). Final report of the Committee on cost of prescribing. London: HMSO; 1959.

Ministry of Health (Sainsbury). Report of the Committee of Enquiry into the relationship of the pharmaceutical industry with the National Health Service. London: HMSO, 1967.

Slinn J. Price controls or control through prices? Regulating the cost and consumption of prescription pharmaceuticals in the UK, 1948-67. Business History. 2005;47(3):352-366. Available from: https://doi.org/10.1080/00076790500055970

Webster C. The health services since the war. Volume I: Problems of health Care. The National Health Service before 1957. London: HMSO; 1988.

Cumbria Archive Service Barrow. Barrow Executive Council Minutes, 1968-71. BTCAHA/1/26.

Cumbria Archive Service Kendal. Westmorland County Executive Council, reports on various services, 1961-73. WDPD/9/12.

Wilson NHF, Gelbier S. Dental witness seminars: Dentistry in the UK since 1948. Br Dent J 2016;220(3):133-142. Available from: https://doi.org/10.1038/sj.bdj.2016.96

Anderson S. Community pharmacists and tobacco in Great Britain: From selling cigarettes to smoking cessation services. Addiction 2007;102(5):704-712. Available from: https://doi.org/10.1111/j.1360-443.2007.01790.x

Anderson S. Community pharmacy and the rise of welfare in Great Britain 1900 to 1986. Pharm Hist (Lond) 2006;36(S2):10-17.

Mohan J, Gorsky M. Don’t look back? Voluntary and charitable finance of hospitals in Britain, past and present. London: Office of Health Economics and Association of Chartered Certified Accountants, 2001.

Mencher S. British private medical practice and the National Health Service. Pittsburgh, PA: University of Pittsburgh Press; 1968.

Lattimer M, Holly K, Kovats S. The gift of health: The NHS, charity and the mixed economy of healthcare. London: Directory of Social Change, 1996.

Lancashire Archives. Blackpool and Fylde Hospital Management Committee Medical Advisory Committee Minutes, 1948-67. HRBP/3/Acc. 7980/1.

Lancashire Archives. Victoria Hospital Blackpool, official opening of the Cardiac Investigation Unit, 1969. HRBP/1/Acc. 7084/305.

Griffith B, Iliffe S, Rayner G. Banking on sickness: commercial medicine in Britain and the USA. London: Lawrence and Wishart; 1987.

Williamson C. The quiet time? Pay-beds and private practice in the National Health Service, 1948-1970. Soc Hist Med. 2015;28(3):576-595. Available from: https://doi.org/10.1093/shm/hkv024