- Healthcare in Ireland and Britain from 1850: Voluntary, Regional and Comparative Perspectives ed. by Donnacha Seán Lucey and Virginia Crossman
This collection of essays, which derives from workshops in Dublin in 2011 and 2012, focuses on aspects of health care provision in the four countries that constituted the United Kingdom from 1801: England, Ireland, Scotland, and Wales. The volume is divided into four sections: historiographical directions; voluntary hospital provision; health care and the mixed economy; public health, voluntarism, and local government. The editors’ comprehensive introduction provides a useful historical and historiographical survey of health care systems and medical practice in Ireland from the early eighteenth century. They pay particular attention to the evolving network of voluntary hospitals, county infirmaries, fever hospitals, and dispensaries, and to the introduction of the Poor Law in 1838, with its twin welfare and medical components, which changed significantly during and after Ireland’s calamitous Great Famine of the mid- and late 1840s. In the course of their review, the editors introduce some of the volume’s key themes: the “mixed economy” of health and welfare services, voluntarism, localism, state intervention, and the tensions between central and local government in tending to the public health. [End Page 155]
The two substantial historiographical essays that constitute the volume’s opening section complement the editors’ introduction and contextualize the book as a whole. The first, by Martin Gorsky, is a wide-ranging analysis of voluntarism in relation to health and welfare in twentieth-century England, while John Stewart’s exploration of health care and welfare developments in nineteenth- and twentieth-century Britain and Ireland has a broader canvas. Stewart suggests that the nation-state perspective is too singular in any such analysis of health policy formation and implementation, and that local, regional, and international contexts need to be considered also.
Five of the volume’s remaining nine essays address Irish themes: patient fee payment and contribution schemes for hospital treatment north and south of the Irish border following the country’s partition in 1921; Belfast’s Mater Infirmorum Hospital, its religious ethos and identity from its establishment in 1883, and its relationship with the state; district nursing in the late nineteenth and early twentieth centuries, specifically the role of Queen Victoria’s Jubilee Institute for Nurses; a smallpox outbreak in Dublin in 1902–3 and the response of the local authority, the Dublin Municipal Council; and the 1918–19 influenza pandemic and the part played by the Local Government Board for Ireland in addressing the crisis. Two essays are devoted to regionalism in England: cottage hospitals in East Devon in the interwar period 1919–39; and the development of municipal or infectious disease isolation hospitals in the half century from 1870, with Liverpool’s experience offered as a case study. The remaining contributions have a Welsh and Scottish focus. One examines welfare and medical services in the South Wales coalfield from the mid-nineteenth century to the mid-twentieth, while religion is kernel to the volume’s final essay, the provision of institutional welfare in Scottish cities, particularly Glasgow, by the Established Church of Scotland in the decades leading up to the First World War. The focus is on social work—the provision of various types of accommodation for the disadvantaged—rather than health care, and as such the essay’s content bears only a tangential relationship to the volume’s title.
Religion, or more specifically denominationalism, one of the dynamic and divisive forces in Ireland’s history, surfaces in several of the Irish-themed essays, and features in some of the chapter titles: “Why Have a Catholic Hospital at All?” and “… It Would Be Preposterous to Bring a Protestant Here.” In Ireland, religion and politics were always historically intertwined, and politics in its various guises—influence, allegiances, and divisions—has a strong presence in a number of the analyses.
Initialisms in text and notes are resorted to excessively, a distracting and frustrating feature that...