Urban hospitals before the NHS: finance, specialisation and integration in provincial England

Barry Doyle, University of Huddersfield

The pre-history of the NHS remains contentious. Initial social democratic interpretations emphasised the weak finances, poor coordination and barriers to specialist development inherent in the voluntary/municipal system. Barry Doyle's paper explores these topics through case studies of the interwar hospital systems of two of England’s largest cities, Leeds and Sheffield. He argues that provision in the big cities was financially sound, increasingly specialised and highly integrated. Moreover, these services were operating at a regional level, and met the needs of large populations. Indeed, the limitations on the system lay more in the narrow remit of council provision than on apparent jealous rivalries between voluntary providers.