Health > Quarterly bulletin of the Health Organisation > Volume 3

RECENT TENDENCIES IN THE DEVELOPMENT
OF GENERAL HOSPITALS IN ENGLAND1
by
Dr. Melville D. MACKENZIE,
Member of the Health Section of the League of Nations Secretariat.
Part I.
ADMINISTRATION.
One of the most remarkable social changes that has taken place
in England in recent years is that in connection with the hospitals.
In order fully to understand this change, it is necessary to sketch
very briefly the method on which the hospital system in England
has developed. In the Middle Ages, the sick and poor were looked
after only by the monasteries. With the dissolution of the monas¬
teries in the reign of Henry VIII, a large amount of the provision
for the sick and destitute disappeared and consequently, in the
reign of Elizabeth, we find the first Poor Law giving power to Local
Authorities to provide relief for poverty and sickness. The work
under various Poor Law Acts steadily increased and eventually
included the care, not only of a large number of acute sick, but of
the great majority of chronic cases of illness. The next development
was the formatmn of the voluntary hospitals, mostly in the 17th
1 The present report is based on a study of the hospital development in
England only. Unfortunately, time did not allow of a visit to Scotland, where
the hospital administration is distinct from that of England. The difference
in the hospital administration in Scotland and the fact that this country did
considerable pioneer work in connection with hospital development is sufficient
to warrant a separate study.
In connection with the preparation of this report, the writer wishes to
express his thanks for the assistance of the Ministry of Health and the London
County Council. He wishes to acknowledge in particular the valuable help of
Dr. Macewen and Dr. McIntosh, of the Ministry of Health, of Sir Frederick
Menzies, of the London County Council, of Dr. Frazer, Medical Officer of
Health of Liverpool, and Dr. Newsholme, Medical Officer of Health of
Birmingham.