The Legacy of Voluntarism: Charitable Funding in the Early Nhs

Bernard Harris, University of Strathclyde

This paper examines a key aspect of the relationship between charity and the establishment of the UK’s National Health Service(s) in 1948: the distribution of endowment income and the future of charitable fundraising for public health care. Before1948, the UK possessed a patchwork of different types of hospital: unreformed Poor Law hospitals, municipal hospitals and voluntary hospitals. However, this patchwork came under increasing pressure during the 1930s and early-1940s, culminating in the passage of the three National Health Service Acts between 1946 and 1948. One of the most important issues confronting reformers was the status and financing of the voluntary hospitals. The majority of these institutions had been established as charitable institutions and they continued to derive significant proportions of their income from endowments and other charitable sources. However, the Minister of Health for England and Wales, Aneurin Bevan, described the hospitals’ continued reliance on charitable funding as ‘repugnant to a civilised community’ (House of Commons Debates, 30/4/1946). The establishment of the NHS(s) therefore had two major implications for the role of charity within the health care system. In the first place, it raised fundamental questions about the status of the charitable funds which many hospitals had already amassed. Second, if it was also accepted that charity should not have a significant role to play in the provision of core health services, what role should it play? What role did the Government foresee for ‘voluntarism’ within the health service(s) once the new arrangements came into force? This paper seeks to answer these questions by summarising the changes introduced by the new legislation, exploring their impact on the distribution of endowment income and then looking more broadly at the growth and expenditure of non-tax income within the NHS before 1974.

No extended abstract or paper available

 Presented in Session 90. Public Health and Population Health