London School of Hygiene & Tropical Medicine

Whether due to wartime bomb damage or decades of under-investment, the poor condition of inherited buildings was one of the earliest crises the British National Health Service (NHS) had to contend with. Yet for almost fourteen years, no central government policy came close to providing adequate support for the development of new facilities. Ed Devane’s project looks at how the planning and design of hospitals and health centres continued as a dynamic, locally rooted, and often contentious process, which is altogether symbolic of how the wider health service developed and acquired meaning.  

This talk will explore negotiations between planners and the public by focusing on attempts to reorganise London’s teaching hospital system in the post-war period. The 1944 Goodenough Committee on medical schools recognised education had become too focused on a narrow range of conditions unrepresentative of the general populations’ need. A long history of neglect by doctors caused many ordinary people to fear being turned away or taught upon in elite teaching hospitals.  

With many of these institutions concentrated in a small area of the capital, many hoped the NHS and a more consolidated welfare state would resolve problems of treatment experience, introducing more systematised provision and equalised resource allocation. Taking the relocation of Charing Cross Hospital from the Strand to Fulham as a case study, this talk will discuss that whilst many teaching institutions remained in London, their provision has notably changed.  

Institution-community relations can be used to understand this process, seen in tensions between boards and governors, regional hospital boards and metropolitan borough councils. It details how civic leaders and residents were prepared to accept the relocation of elite medical institutions on the condition they developed more community-based services and ward accommodation for chronic conditions. Testimony from oral history, memoirs, and newspapers are assembled to trace these debates and their effect on public attitudes. The talk argues new specialisms such as geriatrics were significant in improving ordinary people’s esteem and affection for metropolitan hospitals and the wider health services. While more recently, many teaching institutions including Charing Cross have faced proposed mergers, it is primarily due to the later addition of community-based services that campaign groups have resisted closure and called for the NHS to be defended. 

Speaker  

Ed DeVane is a PhD student in the Centre for the History of Medicine, University of Warwick. His project, Building the NHS: planning, publics and Britain's new state healthcare facilities, 1945 - 1974 is supervised by Professor Mathew Thomson and Professor Roberta Bivins and is supported by the Wellcome Trust.