Ageing and Society
- Ageing and Society / Volume 33 / Issue 04 / May 2013, pp 598-625
- Copyright © Cambridge University Press 2012
- DOI: http://dx.doi.org/10.1017/S0144686X12000098 (About DOI), Published online: 21 March 2012
Articles
‘To regulate and confirm inequality’? A regional history of geriatric hospitals under the English National Health Service, c.1948–c.1975
MARTIN GORSKY
Centre for History in Public Health, London School of Hygiene and Tropical Medicine, UK.
ABSTRACT
The post-war history of hospital care for older people in Britain in the first phase of its National Health Service (NHS) emphasises a detrimental Poor Law legacy. This article presents a regional study, based on the South West of England, of the processes by which Victorian workhouses became the basis of geriatric hospital provision under the NHS. Its premise is that legislative and medical developments provided opportunities for local actors to discard the ‘legacy’, and their limited success in doing so requires explanation. Theoretical perspectives from the literature are introduced including political economy approaches; historical sociology of the medical profession; and path dependence. Analysis of resource allocation decisions shows a persistent tendency to disadvantage these institutions by comparison with acute care hospitals and services for mothers and children, although new ideas about geriatric medicine had some impact locally. Quantitative and qualitative data are used to examine policies towards organisation, staffing and infrastructural improvements, suggesting early momentum was not maintained. Explanations lie partly with national financial constraints and partly with the regional administrative arrangements following the NHS settlement which perpetuated existing divisions between agencies.
(Accepted February 08 2012)
(Online publication March 21 2012)
KEY WORDS
- geriatric hospital;
- Poor Law;
- history;
- National Health Service
Correspondence
Address for correspondence: Martin Gorsky, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15–17 Tavistock Place, London WCIH 95H, UK E-mail: martin.gorsky@lshtm.ac.uk
