Henry Richard Jones
The grandfather of co-creator Ruth Jones played a key role in local healthcare in South Wales, both before and after the creation of the NHS
Gavin and Stacey
The mixed economy of care that existed before 1948 is illustrated by the career of Henry Richard Jones, grandfather of actor and writer Ruth Jones who appears in on 2 November. In 1926, Henry was appointed secretary of the Neath and District
Medical Aid Society, an organisation that provided GPs and other services to its members in South Wales. In the same year, he became a local representative on the hospital contributory scheme at the largest voluntary hospital in the region, the Swansea General Hospital and Eye Infirmary. From 1926, he served on the hospital’s Board of Management and various of its committees, dedicating more time to the development of health services. Henry lost his employment in 1948 when the NHS was founded, but took a position as secretary of the Rest Convalescent Home at Porthcawl on the South Wales coast. This was another important institution in the mixed economy of care in the region, and one that enabled thousands of men, women and children to enjoy a week or two by the seaside to recover from an operation or illness. in childbirth, and people with a variety of physical, mental and learning disabilities. Similar to other functions of the Poor Law, these infirmaries were transferred to local government in 1929 and these groups became the responsibility of county and borough councils.
Help For Paupers
These hospitals for the very poorest sections of the community complemented the other types of institutions already provided by local authorities, from isolation hospitals for those with infectious diseases to maternity hospitals, tuberculosis sanatoria, and mental-health institutions. Their size, physical state and effectiveness varied, depending on the resources and political will of individual local authorities.
Apart from such public hospitals, provision was also made voluntarily. Voluntary hospitals came to be established in large numbers from the 18th century onwards, and were a feature of all towns and cities across Britain by the early 20th century. They were funded by voluntary contributions and donations from wealthy elites, community fundraising and other sources of charitable income. They ranged from the oldest, largest and most prestigious hospitals in London to the small cottage hospitals that could be found right across the country.
Voluntary hospitals were intended for the respectable poor and working class, partly in order to prevent them from falling into destitution and becoming a burden on the Poor Law. They were not, however, intended for anyone who could provide for their own care; for those who had an infectious disease or mental illness; for pregnant women; or for certain other classes of sick people. As such, voluntary hospitals were initially intended for a relatively narrow section of the population, although this did broaden in the early 20th century as hospitals grew and provided more specialist care for certain illnesses and patient groups.
Our ancestors could gain
access to voluntary hospitals in a number of ways. In the 19th century, any individual wishing to be admitted to a voluntary hospital needed to obtain a letter of recommendation from one of the wealthy supporters of the hospital, who were given a number of such letters according to the amount of money that they had subscribed or donated. This, of course, granted a not inconsiderable amount of power over potential patients to the elites in any community, and access to the hospital could be approved or denied according to the personal feelings and whims of the wealthy benefactor concerned.
Payments To Hospitals
As hospitals diversified their funding methods, systems developed in the latter decades of the 19th century in which groups of workmen agreed to deductions from their wages and the payment of a sum of money to a hospital. These developed into more formal hospital contributory schemes by the early decades of the 20th century, and these continued to grow – there were 10 million or so subscribers by the 1940s.
However, hospital contributory
is a senior lecturer in the Department of History & Welsh History at Aberystwyth University. He appears on Ruth Jones’s episode schemes varied in the rights that they conferred. Admission was decided on the basis of medical judgement and the availability of beds, so the schemes were rarely run on an insurance principle by which subscribers gained an absolute right to hospital care. Such a right was confined to those better-off individuals who were able to afford the fees charged by most hospitals by the 1940s for use of their ‘paid beds’.
This, then, was the mixed economy of care that existed in Britain before the creation of the NHS in 1948. A person’s access to a GP and hospital medical services depended on a range of factors, most of which were outside their control. A person’s income and occupation, the location in which they lived, and their membership of different self-help and mutualist organisations all played a part. But so too did their age, their gender, their relationship to another individual, and the nature of the illness or injury they experienced. This also meant, of course, significant differences in the quality of care they received, the likelihood of recovery and cure, and the effects on their quality of life if they survived. a e
Llanberis, Caernarfon LL55 4TY w bit.ly/dinorwic
This museum offers insight into the medical care provided to a particular industrial community. a 183 Euston Road, London NW1 2BE t 020 7611 2222 w wellcomecollection.org Discover exhibitions, online resources and archives devoted to the history of medicine.
WEBSITES
w bit.ly/bbc-model-nhs
This article discusses the Great Western Medical Fund Society. w bit.ly/peoples-history-reform Learn more about healthcare before the creation of the NHS.