Gosling, George Campbell (2007) The patient contract in Bristol’s voluntary hospitals, c.1918-1929. University of Sussex Journal of Contemporary History, Volume 11 . pp. 1-16.

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Abstract

The years following the end of the First World War were a time of great change, not least in the
field of healthcare. Rising costs and demand ensured that traditional philanthropic sources of
income became increasingly insufficient. This necessitated the emergence of new patterns of
funding in Britain’s voluntary hospitals with a greater place for contributory schemes, direct
patient payments and arrangements with the public sector. One aspect of such change was that
the largely passive role, in which charitable provision had traditionally held the patient, was
called into question. This article places this specific issue within context of the various
ideological conceptions of healthcare, each defining the role of the patient in a different way.
These are briefly outlined before the local case study of Bristol - and the Bristol Royal Infirmary
(hereafter the Infirmary) in particular - is used to consider the impact that changes in voluntary
hospital funding had on the role in which the patient was cast (here termed the ‘patient contract’).
Although there were major changes in funding, most notably the introduction of a patient
payment scheme in 1921, the patient contract remained in essence philanthropic. This was the
result of a clear ideological commitment, most obviously on the part of the Faculty, to the
treatment of the sick poor.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Arts > History
Library of Congress Subject Headings (LCSH):	Voluntary hospitals -- England -- Bristol -- History --19th century, Charities -- England -- Bristol , Patient compliance, Hospitals -- Rates -- England -- Bristol , Hospitals -- England -- Bristol -- Finance
Journal or Publication Title:	University of Sussex Journal of Contemporary History
Publisher:	University of Sussex * Graduate Research Centre in the Humanities
Official Date:	2007
Dates:	Date Event 2007 Published
Volume:	Volume 11
Page Range:	pp. 1-16
Status:	Peer Reviewed
Publication Status:	Published
Funder:	Wellcome Trust (London, England)
Related URLs:	Publisher

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