Voluntary hospital

Voluntary hospitals were created from the eighteenth century in England. In America, Ireland, and Australia, voluntary hospitals were established later. They can be distinguished from municipal hospitals, which were publicly owned, and private hospitals, which were run commercially. They were initially financed by public subscription. A voluntary hospital may also be a charitable hospital.

United Kingdom

By the middle of the 18th century there were five in London: St Barts, Guy's, St Thomas', Westminster and St George's. They provided free medical care to those who could not afford it. They were "amongst the chief sources of the advancement of medical science".[1] They were the earliest teaching hospitals.

St Mary's Hospital, London was the last to be founded in England, in 1851.

The 1851 census recorded 7,619 patients in hospital in England and Wales. At that time those who could afford it were generally cared for in their own homes. In 1901 there were 39,184 hospital patients. Standards of care, and of nursing in particular had improved as formal training was established and staffing ratios improved. Nursing was almost entirely by women. Even in 1937 there were less than 100 male nurses employed in the voluntary hospitals. In 1900 there were about 11,000 nurses working in voluntary hospitals, some of whom were sent out to do domiciliary nursing. In 1937 there were more than 33,000, mostly actually in the hospitals. They worked longer hours for less pay than nurses in the municipal hospitals.

After the First World War the hospitals began to admit private paying patients and by 1921, 171 of the provincial hospitals had pay beds.[2]

Plaque on the wall of Manchester Royal Infirmary

Public collections, Hospital Saturday Funds and flag days to support the hospitals continued in the UK until the 1930s.

The voluntary hospitals of Manchester in 1929 were the Royal Infirmary, St Mary's Hospital, the Royal Eye Hospital, the Royal Children's Hospital, Ancoats Hospital, the Northern Hospital for Women and Children, the Ear Hospital, St John's Ear Hospital, the Hospital for Consumption, the Hospital for Diseases of the Skin, the Christie Cancer Pavilion, the Radium Institute, the Jewish Hospital, the Babies' Hospital and the Dental Hospital; the Salford voluntary hospitals were Salford Royal Hospital and Greengate Hospital.[3]

The King's Fund supported the voluntary hospitals in London.[4]

Ten of the largest and most influential former voluntary hospitals in England established the Shelford Group in 2011 to protect their common interests.

Australia

A similar business model applied to all general hospitals in New South Wales up to the 1950s. Despite the charitable structure, much of the capital and half of the operating losses were being funded by state government by 1913.[5]

Ireland

In Ireland the model is still in use.

References

Rivett, Geoffrey. "The Development of the London Hospital System, 1823 - 2015". NHS History. Retrieved 5 June 2017.
Abel-Smith, Brian (1960). A History of the Nursing Profession. London: Heinemann. p. 128.
The Book of Manchester and Salford written for the ninety-seventh annual meeting of the British Medical Association in July 1929. Manchester: George Falkner & Sons, 1929; pp. 7-8, 117-38 & 142-44
Webster, Charles (1988). The Health Services Since the War. London: HMSO. p. 26. ISBN 0116309423.
Cummins, C. (1976). "The administration of hospitals and charities". The History of Medical Administration in NSW. Online: Health Commission of NSW. pp. 137–140. Archived from the original (PDF) on 2 February 2016. Retrieved 31 October 2015 – via NSW Ministry of Health. It cannot be stressed too frequently that general hospitals developed as voluntary charities for the indigent poor, and survived essentially on the subscriber system, with irregular Government assistance, during the nineteenth century. .... If approved, and if finance was available, assistance for capital expenditure was provided by the Government, which also met the deficit between income and expenditure on a £1 for £1 basis.

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[1] Rivett, Geoffrey. "The Development of the London Hospital System, 1823 - 2015". NHS History. Retrieved 5 June 2017.

[2] Abel-Smith, Brian (1960). A History of the Nursing Profession. London: Heinemann. p. 128.

[3] The Book of Manchester and Salford written for the ninety-seventh annual meeting of the British Medical Association in July 1929. Manchester: George Falkner & Sons, 1929; pp. 7-8, 117-38 & 142-44

[4] Webster, Charles (1988). The Health Services Since the War. London: HMSO. p. 26. ISBN 0116309423.

[5] Cummins, C. (1976). "The administration of hospitals and charities". The History of Medical Administration in NSW. Online: Health Commission of NSW. pp. 137–140. Archived from the original (PDF) on 2 February 2016. Retrieved 31 October 2015 – via NSW Ministry of Health. It cannot be stressed too frequently that general hospitals developed as voluntary charities for the indigent poor, and survived essentially on the subscriber system, with irregular Government assistance, during the nineteenth century. .... If approved, and if finance was available, assistance for capital expenditure was provided by the Government, which also met the deficit between income and expenditure on a £1 for £1 basis.