Published online by Cambridge University Press: 06 July 2011
This paper examines the relatively neglected topic of municipal public health expenditure in the inter-war period, and emphasizes two neglected dimensions: the political and the geographical. After justifying the importance of the topic and the approach and giving some details of municipal public health provision, a quantitative analysis of expenditure in the urban county boroughs is presented. In general, the analysis tends to argue against conventional wisdom in stressing the political dimension instead of the economic dimension in explaining the pattern of expenditure, giving a positive answer to the question posed in the title.
1 Pickstone, J., Medicine and Industrial Society (Manchester, 1985), 2Google Scholar.
2 Lee, R., ‘Uneven zenith: towards a geography of the high period of municipal medicine in England and Wales’, Journal of Historical Geography, 14 (1988), 271CrossRefGoogle ScholarPubMed.
3 Hicks, J.R. and Hicks, U.K., Standards of Local Expenditure (Cambridge, 1943)Google Scholar.
4 Mark-Lawson, J., Savage, M. and Warde, A., ‘Gender and local politics: struggles over welfare policies 1918-1939’, in Murgatroyd, L. et al. (eds) Localities, Class and Gender (London, 1985), 198Google Scholar.
5 Thomson, M., ‘Social policy and the management of the problem of mental deficiency in inter-war London’, London Journal, 18 (1993), 129fn.Google Scholar
6 Lee, ‘Uneven zenith’, 260.
7 Digby, A., British Welfare Policy (London, 1989), 49Google Scholar.
8 Webster, C., Problems of Health Care. The Health Services since the War, vol. 1 (London, 1988), 12Google Scholar.
9 Higgins, J., The Business of Medicine (Basingstoke, 1988), 10CrossRefGoogle Scholar.
10 Wilson, N., Public Health Services (London, 1938), 150Google Scholar.
11 Fraser, D., The Evolution of the British Welfare State (London, 1984), 207CrossRefGoogle Scholar.
12 Mr Marshall (Labour, Sheffield Brightside), Hansard, House of Commons, 15 February 1945, col. 459.
13 Webster, Problems of Health Care, 8.
14 Stevenson, J., British Society 1914-45 (Harmondsworth, 1984), 307Google Scholar.
15 Lee, ‘Uneven zenith’.
16 Pickstone, , Medicine and Industrial Society; Rivett, G., The Development of the London Hospital System 1823-1982 (London, 1986)Google Scholar.
17 Preston, B.T., ‘Rich town, poor town: the distribution of rate-borne spending levels in the Edwardian city system’, Transactions of the Institute of British Geographers, 10 (1985)CrossRefGoogle Scholar.
18 Ward, S.V., The Geography oflnterwar Britain (London, 1988)Google Scholar.
19 Lee, ‘Uneven zenith’, 267.
20 Calculated from the 1931 Census and the Ministry of Health/Nuffield Provincial Hospitals Trust Hospital Surveys. For an overview, see Powell, M.A., ‘Hospital provision before the National Health Service: a geographical study of the 1945 Hospital Surveys’, Social History of Medicine, 5 (1992), 483–504CrossRefGoogle ScholarPubMed.
21 Lee, ‘Uneven zenith’, 265.
22 Local Government Financial Statistics (annual). Extracted from years 1929-30 and 1936-37.
23 Ibid. (1936-37).
24 Ibid. (1930-31 and 1936-37).
25 Ibid.
26 M.A. Powell, ‘An expanding service: municipal acute medicine in the 1930s’, Twentieth Century British History (forthcoming, 1996).
27 Boaden, N.T., Urban Poliocy Making (Cambridge, 1971), xiiiGoogle Scholar.
28 Webster, Problems of Health Care, 8.
29 Abel-Smith, B., The NHS: The First Thirty Years (London, 1978), 4Google Scholar.
30 Walters, V., Class Inequality and Health Care (London, 1980), 55Google Scholar.
31 Preston, ‘Rich town, poor town’.
32 Crowther, M.A., Social Poliocy in Britain 1914-1939 (Basingstoke, 1988), 38CrossRefGoogle Scholar.
33 Webster, C., ‘Health, wealth and welfare during the depression’, Past and Present, 109 (1985), 228CrossRefGoogle Scholar.
34 J. Mohan, ‘Back to the future’, Radical Community Medicine (1988), 4.
35 Whitehead, M., National Health Success (London, 1988), 21Google Scholar (my emphasis).
36 Chester, D.N., Central and Local Government (London, 1951)Google Scholar.
37 Robson, W.A., The Development of Local Government (London, 1931)Google Scholar.
38 Ibid., 301-2.
39 Robson, W.A., ‘The outlook’, in Laski, H., Jennings, W.I. and Robson, W.A. (eds), A Century of Municipal Progress 1835-1935 (London, 1935), 458Google Scholar.
40 Howard, E., ‘Joint authorities’, in Wilson, C.H. (ed.), Essays in Local Government (Oxford, 1948)Google Scholar.
41 Ministry of Health, A National Health Service, Cmnd 6502 (London, 1944), 15Google Scholar.
42 Hansard, House of Commons, 30 April 1946, cols 48-9.
43 Hansard, House of Commons, 1 May 1946, col. 211.
44 Abel-Smith, B., The Hospitals 1800-1948 (London, 1964), 383Google Scholar.
45 Sharpe, L.J. and Newton, K., Does Politics Matter? (Oxford, 1984)Google Scholar.
46 Laski et al., A Century of Municipal Progress.
47 Cole, G.D.H., A History of the Labour Party from 1914 (London, 1948), 454Google Scholar.
48 Wilson, Public Health Services, 173.
49 Local Government News, 7 (November 1930), 80.
50 Cook, C., The Age of Alignment (London, 1975), 79CrossRefGoogle Scholar.
51 Webster, ‘Health, wealth and welfare’, 209.
52 Stevenson, British Society 1914-45, 310.
53 Phillpott, H.R.S., Where Labour Rules (London, 1934)Google Scholar; Cole, Labour Party, ch. 1.
54 Savage, M., The Dynamics of Working-Class Politics. The Labour Movement in Preston 1880-1940 (Cambridge, 1987)Google Scholar; Mark-Lawson et al., ‘Gender and local polities’.
55 Savage, Dynamics, 36-7.
56 Mark-Lawson et al., ‘Gender and local polities’.
57 SirGodber, G., ‘The Domesday Book of British hospitals’, Bulletin of the Society for the Social History of Medicine, 32 (1983), 10Google ScholarPubMed.
58 Wilson, Public Health Services, 169-70.
59 Pickstone, Medicine and Industrial Society, 275; Webster, ‘Health, wealth and welfare’, 223-4.
60 Wilson, Public Health Services, 170-1.
61 Williams, B., ‘The idea of equality’, in Laslett, P. and Runciman, W.G. (eds), Philosophy, Politics and Society (Oxford, 1962), 121Google Scholar.
62 Chester, Central and Local Government.
63 Webster, Problems of Health Care, 8.
64 Crowther, Social Policy, 158.
65 Powell, M.A., ‘A tale of two cities: a critical evaluation of the geographical provision of health care before the NHS’, Public Administration, 70 (1992)CrossRefGoogle Scholar.
66 Powell, M.A., ‘Hospital provision before the NHS: territorial justice or inverse care law?’, Journal of Social Policy, 21 (1992)CrossRefGoogle Scholar.
67 Powell, ‘Expanding service’.
68 Phillpott, Where Labour Rules.
69 Titmuss, R.M., Poverty and Population (London, 1938), 77, 82Google Scholar.