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The hospital system

In 1948, before the launch of the National Health Service, "there were over 1,000 independent voluntary bodies providing hospitals, and an even greater number of separate local authorities with powers to provide hospitals of one kind or anotherLink opens in a new window".

The majority of general hospitals were independent 'voluntary hospitals'. The voluntary hospitals were originally built and maintained from charitable donations and provided care for the sick poor. By the early 20th century charity was no longer enough to fund a modern hospital service, and the voluntary hospitals increasingly relied for income on fee-paying patients, subscription schemes (i.e. if you paid a certain amount a week you were entitled to free treatment) and contributions from local authorities. The focus of the voluntary hospitals was on acute rather than chronic medical cases (i.e. it usually provided short term rather than long term care).

Hospital services were also provided by local or municipal authorities. At the start of the 20th century medical treatment could be obtained by those with limited incomes at workhouse infirmaries run by the Poor Law authorities. This system was abolished by the 1929 Local Government Act, which transferred the administration of workhouse infirmaries and fever hospitals to local authorities.

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