Voluntary organizations and the provision of health services in England and France, 1917–29

Abstract

ABSTRACT As the First World War came to an end, governments in the UK and France began the process of planning for reconstruction. In both cases health services emerged as key features of the post-war settlement with ambitious new Ministries of Health proposed to coordinate and deliver essential services. Public health infrastructure was at the heart of these plans, with the physical and social conditions that caused disease to be the focus of state activity. But there was also a need to take on key causes of mortality and improve the institutional infrastructure necessary to challenge old and new threats to life. Yet neither the funding nor political will existed to overhaul service provision in these areas. As a result, in both countries it was necessary for voluntary organizations to fill many of the gaps in provision expected or promised by the new state commitment to health care. To meet these tests a number of interested parties – the Rockefeller Foundation, the Red Cross, the Croix-Rouge Française, the Order of St John, voluntary hospitals and local charities – extended their work. Their contributions underpinned an extensive mixed economy of provision that ensured the reconstruction of health services in a way that met at least some of the promises of government. This article focuses on three key areas of voluntary involvement in health in post-war Britain and France: maternity and child welfare services; hospital services, especially tuberculosis provision; and accident response, in particular ambulance services. It argues that while local and national governments focused on improving health through environmental transformations, the voluntary sector stepped in to extend personal services aimed at saving individual lives, curing those suffering from specific diseases and preventing deaths through better education and care.