Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T07:14:31.887Z Has data issue: false hasContentIssue false
  • English
  • Français

The Northern Ireland government and the welfare state, 1942–8: the case of health provision*

Published online by Cambridge University Press:  20 July 2015

John Privilege
John Privilege*
Affiliation:
Ulster University
*
Centre for the History of Medicine in Ireland, Ulster University, [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Northern Ireland, the United Kingdom’s only self-governing region, recorded year-on- year the worst statistics on health and poverty. However, it was far from certain that the Unionist government in Belfast would enact the kind of sweeping post-war reform that occurred in England and Wales. The raft of legislation governing health and social care introduced in 1948 was, therefore, the product of conditions and circumstances peculiar to Northern Ireland. The government in Belfast needed to overcome the conservative instincts of Ulster Unionism as well as suspicions regarding Clement Attlee’s Labour administration. Although the process was somewhat blighted by sectarianism, the government of Sir Basil Brooke enacted what amounted to a revolution in health and social care provision.

Type
Research Article
Information
Irish Historical Studies , Volume 39 , Issue 155 , May 2015 , pp. 439 - 459
Copyright
© Irish Historical Studies Publications Ltd 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

With thanks to Professor Greta Jones for her invaluable suggestions on an earlier draft.

References

1 Webster, Charles, The health services since the war (2 vols, London, 1988), i, 27Google Scholar.

2 Stewart, John, ‘The national health service in Scotland, 1947–74: Scottish or British?’ in Historical Research, lxxvi, no. 193 (Aug. 2003), pp 389–410CrossRefGoogle Scholar.

3 Ditch, John, Social policy in Northern Ireland between 1939–1950 (Aldershot, 1988), p. 99Google Scholar.

4 The Ulster Unionist Party lost six seats and six per cent of the vote: Walker, Graham, A history of the Ulster Unionist Party: protest, pragmatism and pessimism (Manchester, 2004), p. 100Google Scholar.

5 Buckland, Patrick, A history of Northern Ireland (London, 1987), p. 76Google Scholar.

6 Johnson, D. S., ‘The Northern Ireland economy, 1914–39’ in Liam Kennedy and Philip Olleranshaw (eds), An economic history of Ulster (Manchester, 1985), p. 210Google Scholar.

7 For a discussion of Northern Ireland’s financial difficulties see Walker, , History of the Ulster Unionist Party, pp 55–56Google Scholar.

8 Report of the parliamentary select committee on health 1944, N. I., HC601 (Belfast, 1944), p. 48.

9 Two notable discussions on healthcare in Ireland and Northern Ireland in the 1930s and 1940s can be found in McCormick, Leanne, Regulating sexuality: women in twentieth century Ireland (Manchester, 2009)CrossRefGoogle Scholar and Jones, Greta, ‘Captain of all these men of death’: the history of tuberculosis in nineteenth and twentieth century Ireland (New York, 2001)Google ScholarPubMed.

10 For a vivid account of general practice in Northern Ireland see Deeny, James, To cure and to care: memoirs of a Chief Medical Officer (Dublin, 1989)Google Scholar, chapter 1.

11 Martin, Peter, ‘Ending the pauper taint: medical benefit and welfare reform in Northern Ireland’ in Virginia Crossman and Peter Gray (eds), Poverty and welfare in Ireland, 1838–1948 (Dublin, 2011), p. 227Google Scholar.

12 Hansard N. I., (Commons), i, xxv, 3153–4 (15 Dec. 1942).

13 Martin, , ‘Ending the pauper taint’, p. 230Google Scholar.

14 Socialist Medical Association, Health in Belfast (P.R.O.N.I, D2162/J/31).

15 Hansard N. I. (Commons), i. xxv, 2901 (28 Oct. 1942).

16 Hansard N. I., (Commons), i, xxv, 3153–4 (15 Dec. 1942).

17 Hansard N. I. (Commons), i. xxv, 3111–2 (15 Dec. 1942).

18 Carson to Spender, Wilfrid Spender’s diary, 22 Dec. 1942 (P.R.O.N.I. D715/20).

19 Spender to Carson, Wilfrid Spender’s diary, 30 Dec. 1942 (P.R.O.N.I., D715/20).

20 Hansard 5, cclxxxvi, 2001–2002 (18 Feb. 1943).

21 Ibid., i, xxvi, 32 (9 Mar. 1943).

22 Wilfrid Spender thought the Beveridge proposals could be made practicable once financial considerations, like employee contributions, were resolved. He did view Andrews’s reluctance to commit the government to immediate implementation as ‘sound’. Wilfrid Spender’s diary, 15 Feb. 1943 (P.R.O.N.I., D715/21).

23 The government’s failure to ‘put Northern Ireland on a proper war footing’ and continuing industrial unrest also played a part. Walker, , History of the Ulster Unionist Party, pp 89–91Google Scholar.

24 Spender’s diary, 28 Apr. 1943 (P.R.O.N.I., D715/21). Spender noted the mounting criticism being heaped on R. Dawson Bates in particular.

25 Brian Barton describes Northern Ireland under Andrews as being ‘appallingly underprepared’ for events like the Belfast Blitz. There was high unemployment and widespread industrial unrest while preparations for reconstruction were confused. Barton, Brian, Brookeborough: the making of a prime minister (Belfast, 1988), pp 197–207Google Scholar.

26 Hansard N. I. (Commons), i, xxvi, 464–6 (11 May 1943).

27 Spender’s diary, 9 Jan. 1943 (P.R.O.N.I., D715/21).

28 Ibid., 26 Mar. 1943.

29 Report of the parliamentary select committee on health 1944, N. I., HC601 (Belfast, 1944), p. 50.

30 Spender’s diary, 14 Mar. 1944 (P.R.O.N.I., D175/24).

31 Members of the cabinet and the Unionist Party opposed Midgley’s appointment, despite him taking the Unionist whip. Spender’s diary, 23 Mar. 1944 (P.R.O.N.I., D715/24). See also Walker, , History of the Ulster Unionist Party, p. 97Google Scholar.

32 Ditch, , Social policy in Northern Ireland, p. 90Google Scholar.

33 Keir, D. Lindsay, The Beveridge report (Belfast, 1943)Google Scholar. Keir also chaired the rather ineffectual Planning Advisory Board which was tasked by Andrews with framing the government’s priorities for post-war reconstruction. Barton, , Brookeborough, p. 207Google Scholar.

34 Wilfrid Spender’s diary, 10 Mar. 1943 (P.R.O.N.I., D715/21).

35 Basil Brooke’s diary, 18 Jun. 1946 (P.R.O.N.I, D3003/D/37). The select committee had recommended the creation of county health schemes, including medical officers of health, along the same lines as England. Report of the parliamentary select committee on health 1944, N. I., HC601 (Belfast, 1944), p. 49.

36 Brooke’s diary, 28 Oct. 1948 (P.R.O.N.I., D3004/D/38).

37 That is not to say that Unionist M.P.s consistently opposed reform of healthcare: see Ditch, , Social policy in Northern Ireland, pp 119–122Google Scholar.

38 Belfast Telegraph, 15 Nov. 1947

39 Cabinet conclusions, 11 Mar. 1946 (P.R.O.N.I, CAB 9/65/C/1).

40 Cabinet conclusions, 21 Mar. 1946 (P.R.O.N.I, CAB 4/661/8). The Home Office was ostensibly the ‘main channel of inter-state relations’ between the Northern Ireland government and British government in London. Bew, Paul, Gribbon, Peter and Patterson, Henry, The state in Northern Ireland, 1921–72: political forces and social classes (Manchester 1979), p. 177Google Scholar.

41 Hansard 5 (Commons), cdxxxvii, 1467–550 (13 June 1947).

42 Belfast Telegraph, 30 Apr. 1947.

43 Hansard 5 (Commons), cdxxxvii, 1476 (13 June 1947).

44 Brooke’s diary, 13 June 1947 (P.R.O.N.I., D3004/D/38).

45 Belfast Telegraph, 25 Jan. 1946.

46 Ibid., 30 Mar. 1946.

47 Ulster Unionist Council, 6 Feb. 1947 (P.R.O.N.I. FIN/30/A/B/24).

48 Ibid. The U.U.C. conference was held on 5 and 6 Feb. 1948.

49 Brooke’s diary, 14 Oct. 1946, 4 Mar. and 20 Oct. 1947 (P.R.O.N.I., D3004/D/37, D3004/D/38).

50 Ulster Unionist Council, 14 Nov. 1947 (P.R.O.N.I., PM/5/31/5).

51 Webster, , The health services since the war, p. 110Google Scholar.

52 Socialist Medical Association, Health service or panel? 292/847/ 3, Warwick Digital Archive, http://contentdm.Warwick.ac.uk.

53 ‘The Act and the profession’, The Lancet, ccli, no. 6491 (24 Jan. 1948), p. 154.

54 Strain, R.W.M, ‘Address to the Ulster Medical Society’, 9 Feb. 1967 in Ulster Medical Journal, xxxvi (Summer, 1967), p. 30Google Scholar.

55 Grant’s memorandum to the cabinet, 13 Sept. 1946 (P.R.O.N.I, CAB 9/65/C/1).

56 Ibid., Grant’s memorandum to the cabinet, 7 Mar. 1947.

57 Cabinet conclusions, 12 Mar. 1947 (P.R.O.N.I, CAB 4/705/7).

58 British Medical Journal, issue 4481 (23 Nov. 1946), p. 413.

59 Report of the parliamentary select committee on health 1944, N. I., HC601 (Belfast, 1944), p. 62.

60 Belfast Telegraph, 16 Jan. 1946.

61 Ibid., 30 Mar. 1946.

62 Ibid., 21 Jan. 1947.

63 Bevan would allow the pay-bed system to continue in England and Wales as a concession to hospital consultants: Carrier, John and Kendall, Ian, Health and the National Health Service (London, 1998), pp 77–78Google Scholar.

64 Grant’s memorandum to the cabinet, 10 Jun. 1947 (P.R.O.N.I., CAB 4/720/6).

65 Cabinet conclusions, 26 Jun. 1947 (P.R.O.N.I., CAB 9/C/65/1).

66 Ibid., 30 Jun. 1947.

67 The Lancet, ccl, no. 6471 (6 Sept. 1947), pp 360–1.

68 Brooke’s diary, 18 Jun. 1947 and summary for the year (P.R.O.N.I., D3004/D/38).

69 Founded in 1928, the executive committee of the Association had elected members for Ireland, Scotland, London and the Provinces. Allen first took on the role of Ireland’s representative in 1943. ‘Proceedings of the fifteenth annual general meeting of the British Paediatric Association’ in Archive of diseases in childhood, xviii (1943), p. 154. Following partition, medical graduates in the Irish Free State and the United Kingdom retained reciprocal rights of registration. Jones, ‘Captain of all these men of death’, p. 135.

70 Grant’s memorandum to the cabinet, 10 June 1947 and Draft Health bill, no. 140, 28 June 1947 (P.R.O.N.I., CAB 4/720/6).

71 Allen to Gransden, 16 Oct. 1947 (P.R.O.N.I., CAB 9/C/65/1). On 5 October 1947, a meeting of hospital consultants had declared the Health bill ‘not in the interests of the health of the people’ in its current form. Irish News, 6 Oct. 1947.

72 Allen to Gransden, 22 Oct. 1947 (P.R.O.N.I., CAB 9/C/65/1).

73 Lady Londonderry to Grant, 4 Apr. 1947 (P.R.O.N.I., CAB 9/C/65/6).

74 Ibid., Grant to Lady Londonderry, 23 Apr. 1947.

75 Ibid., Grant to Brooke, 22 Aug. 1947.

76 Hansard N.I. (Commons), xxxi, 1463, 24 Sept. 1947.

77 Ibid., 2965, 26 Nov. 1947.

78 Sinclair to Brooke, 20 Oct. 1947 (P.R.O.N.I., CAB 9/C/65/1).

79 Ibid., McClure to Brooke, 20 Oct. 1947.

80 Ibid., McWilliam to Freer, 21 Oct. 1947.

81 Ibid., 22 Oct. 1947.

82 Farmar, Tony, Patients, potions and physicians: a social history of medicine in Ireland (Dublin, 2004), pp 170–171Google Scholar.

83 Grant’s memorandum to the cabinet, 10 Jun. 1947 (P.R.O.N.I., CAB 4/720/6).

84 Brooke’s diary, 25 Sept. 1947 (P.R.O.N.I., D3004/D/38).

85 For a flavour of the clerical debate, see Lucey, Cornelius, ‘Beveridge and Éire’ in Studies, xxxii (Mar. 1943), pp 31–44Google Scholar and McKevitt, Peter, ‘The Beveridge Plan reviewed’ in Irish Ecclesiastical Record, 5th series, lxi (Mar. 1943), pp 145–150Google Scholar.

86 Catholic Herald, 27 Oct. 1944. A personal account of the movement for health and social care reform in the Irish Free State can be found in Deeny, , To cure and to care, pp 150–179Google Scholar.

87 In his Lenten pastoral for 1946, the bishop of Down and Connor, Daniel Mageean, declared that the modern state was in danger of becoming ‘an octopus, extending its tentacles into every department of human life’, Irish News, 4 Mar. 1946.

88 Lynn, Brendan, Holding the line: the Nationalist Party in Northern Ireland, 1945–72 (Aldershot, 1997), p. 70Google Scholar. Suspicion persisted in spite of the fact that capital grants were increased to voluntary schools. Walker, , History of the Ulster Unionist Party, p. 110Google Scholar.

89 Irish News, 5 Jan. 1946.

90 Grant’s memorandum to the cabinet, 10 Jun. 1947 (P.R.O.N.I., CAB 4/720/6).

91 Cabinet conclusions, 17 Jul. 1947 (P.R.O.N.I., CAB 9/C/65/1).

92 Ibid., Hollis to Gage, 26 Sept. 1947.

93 Hansard N. I. (Commons), i, xxxi, 1470–2, 24 Sept. 1947.

94 Ibid., 1512.

95 Ibid., 1766, 9 Oct. 1947.

96 Freer to McWilliam, 16 Oct. 1947 (P.R.O.N.I., CAB 9/C/65/1).

97 Ibid., Porter to Brooke, 11 Nov. 1947.

98 Brooke’s diary, 3 and 10 Oct. 1946 (P.R.O.N.I, D3004/D/37).

99 Lynn, , Holding the line, p. 72Google Scholar.

100 Hansard N.I. (Commons), i, xxxi, 2982–3, 26 Nov. 1947.

101 Belfast Newsletter, 2 Jan. 1948.

102 Irish News, 9 Feb. 1948.

103 Ibid., 19 Nov. 1948. Similar provisions for the preservation of the religious character of voluntary hospitals were enacted in Scotland. See Brooke to Gage, 21 Oct. 1947 (P.R.O.N.I., CAB 9/C/65/1). These avoided the kind of acrimony witnessed in Belfast: see Douglas Hyde’s article on the Mater in the Catholic Herald, 21 May 1954.

104 The Lancet, cclii, no. 6529 (16 Oct. 1948), p. 633.

105 British Medical Journal, issue 4547 (28 Feb. 1948), p. 423.

106 Belfast Newsletter, 6 Mar. 1948.

107 Ibid., 10 Apr. 1948.

108 Hansard N. I. (Commons), i, xxxi, 2741, 19 Nov. 1947.

109 Belfast Newsletter, 16 Apr. 1948.

110 Belfast Telegraph, 5 Jul. 1948.

111 Belfast Newsletter, 26 May 1948.

112 Belfast Telegraph, 5 July 1948.

113 Progress report: A factual review of the period 1945–9 under the Unionist government, 1949 (P.R.O.N.I., D344/3).

114 Ditch, , Social policy in Northern Ireland, p. 118Google Scholar.

115 Grant’s memorandum to the Cabinet, 30 Jun. 1947 (P.R.O.N.I., CAB 9/C/65/1/).