Hospitals before the NHS
Prior to the 19th century, hospitals were built and operated by subscriptions, charitable and private funds and bequests. Large teaching hospitals, known as infirmaries, were set up in Edinburgh in 1729 and Aberdeen in 1739, with Glasgow founding a Town’s Hospital in 1733, later opening Glasgow Royal Infirmary in 1794. Other large towns similarly set up infirmaries, while smaller towns built cottage hospitals and fever hospitals intended to cope with the regular outbreaks of cholera, typhus and other infectious diseases. Although town councils often supported these initiatives, local authorities were not generally empowered to incur costs for hospitals.[1]
Local authority formal involvement in constructing and maintaining hospitals began when parochial boards were permitted to subscribe to hospitals under the Poor Law (Scotland) Act 1845.[2] The Public Health (Scotland) Act 1867 permitted local authorities (town councils, police commissioners or parochial boards) to provide hospitals whether by building them, alone or in combination with other local authorities, or contracting with existing hospitals. [3] Thereafter, the Local Government (Scotland) Act 1889, transferred these powers from parochial boards to county councils, enabling them to build fever hospitals.[4] The Public Health (Scotland) Act 1897 enabled local authorities to provide and maintain hospitals for people with infectious diseases and convalescent hospitals, again in combination with other local authorities if they wished. It also gave the Local Government Board for Scotland the authority to compel provision of these hospitals.[5]
The Local Government (Scotland) Act 1929 empowered county councils and the town councils of large burghs to provide ordinary general hospital accommodation in addition to their existing statutory duties to provide for the treatment of infectious diseases, tuberculosis and the sick poor.[6] For this purpose, local authorities were authorised to submit schemes for the reorganisation and extension of hospital facilities in their areas to the Department of Health for Scotland.
The hospitals were transferred to the National Health Service in 1948 and therefore local authority responsibilities for operating hospitals ceased.[7]
Records of cottage hospitals, fever hospitals and other local authority or private and charitable hospitals may be found in local authority archives services. Local authority minutes and financial records can also make reference to these hospitals. Records of hospitals which transferred into the NHS in 1948 generally have been deposited in health services archives. National Records of Scotland holds files on local authority health services (reference code HH61) and other health matters.
Compiler: Elspeth Reid (2021)
Related Knowledge Base entries
Hospitals and local health provision under the NHS
Bibliography
Evans, A. A. L., ‘Health’ in Source book and history of administrative law in Scotland ed. by M. R. McLarty (Hodge, 1956), pp. 130-47
Levitt, Ian, ‘Boy Clerks and Scottish Health Administration, 1867-1956’ in Medicine, Law and Public Policy in Scotland ed by Mark Freemen, Eleanor Gordon and Krista Maglen (Dundee University Press, 2011), pp. 161-79
McCallum, John, “Nurseries of the Poore”: Hospitals and Almshouses in Early Modern Scotland’ Journal of Social History, 48:2 (2014), pp. 427-49
McLachlan, Gordon (ed.), Improving the Common Weal: Aspects of Scottish health services 1900-1984 (Edinburgh University Press for the Nuffield Provincial Hospitals Trust, 1987)
Stewart, John, ‘The provision and control of medical relief. Urban Scotland in the late nineteenth century’ in Medicine, Law and Public Policy in Scotland ed by Mark Freemen, Eleanor Gordon and Krista Maglen, (Dundee University Press, 2011), pp. 10-26
References
[1] Improving the Common Weal: Aspects of Scottish Health Services 1900-1984 ed. by Gordon McLachlan, (Edinburgh University Press for the Nuffield Provincial Hospitals Trust, 1987), pp.21-23, 213-18.
[2] Poor Law (Scotland) Act 1845 (8 & 9 Vict. c.83) ss.66-67.
[3] Public Health (Scotland) Act 1867 (30 & 31 Vict. c.101) s.39.
[4] Local Government (Scotland) Act 1889 (52 & 53 Vict. c.50) s.17.
[5] Public Health (Scotland) Act 1897 (60 & 61 Vict. c.38) s.66.
[6] Local Government (Scotland) Act, 1929 (19 & 20 Geo. V c.25) s.27.
[7] National Health Service (Scotland) Act 1947 (10 & 11 Geo. VI c.27).