At a time when payment is claiming a greater place than ever before within the NHS, this book provides the first in-depth investigation of the workings, scale and meaning of payment in British hospitals before the NHS. There were only three decades in British history when it was the norm for patients to pay the hospital; those between the end of the First World War and the establishment of the National Health Service in 1948. Payment played an important part in redefining rather than abandoning medical philanthropy, based on class divisions and the notion of financial contribution as a civic duty.

With new insights on the scope of private medicine and the workings of the means test in the hospital, as well as the civic, consumer and charitable meanings associated with paying the hospital, Gosling offers a fresh perspective on healthcare before the NHS and welfare before the welfare state.

Reviews

'.an important piece of historical investigation and interpretation and this particular volume adds further not only to our knowledge of healthcare in what is now understood to be a crucial era but also to that of voluntarism and the origins of modern social work.'
John Stewart, Glasgow Caledonian University, Social History

Introduction
1 Payment in the history of healthcare
2 Medicine and charity in Bristol
3 Payment and the sick poor
4 Middle-class medicine
5 Th e meaning of payment
Conclusion
Select bibliography
Index