'To regulate and confirm inequality'? A regional history of geriatric hospitals under the English National Health Service, c. 1948-c. 1975


Gorsky, M; (2013) 'To regulate and confirm inequality'? A regional history of geriatric hospitals under the English National Health Service, c. 1948-c. 1975. Ageing and society, 33. pp. 598-625. ISSN 0144-686X DOI: https://doi.org/10.1017/S0144686X12000098

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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.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Centre for History in Public Health
Web of Science ID: 316918100003
URI: http://researchonline.lshtm.ac.uk/id/eprint/856626

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