1. State Medicine and the National Health Service
Professor Mathew Thomson
Kill or Cure

2. Questions
What factors encouraged a rise of state medicine in the 20th century?
Why has state medicine encountered difficulties since the 1970s?
What accounts for the longevity and popular appeal of Britain’s National Health Service?

3. John Pickstone, ‘Production, Community and Consumption: The Political Economy of Twentieth-Century Medicine’ in Roger Cooter and John Pickstone (eds), Medicine in the Twentieth Century (2000), pp

4. What factors encouraged a rise of state medicine in the 20th century?

5. Was the state really absent from pre 20th century medicine?

6. Contagion, sanitary reform, local government and vital statistics

7. A national mental health service?

8. Poor law hospitals

9. The local Medical Officer of Health

10. Making the LCC into the largest hospital authority in the world

11. Keeping the state at arms length

12. Private asylums and convalescent homes

13. The doctor-patient relationship

14. Charity, class and the alternative to the state

15. Why does the state step in, and the alternatives fade?

16. National efficiency (productionism)

17. Communitarianism?

18. Self-interest?

19. The first compromise: the illness service

20. The second compromise: a mixed economy of healthcare?

21. Q2: Why has state medicine encountered difficulties since the 1970s?

22. Consumerism and Rights

23. Collapse of post-war socio-economic settlement

24. Critiques of the mid-century compromises

25. The shadow of the poor law

26. Q3: What accounts for the longevity and popular appeal of Britain’s National Health Service?
Consumerism
Communitarianism
Productionism

27. consumerism

28. communitarianism

29. productionism