By Leslie Hilliard 26.9.1952
Before 1948 local interest and popular support was directed almost entirely to the few large and many small voluntary hospitals. Little or no interest was shown in the municipal hospitals owing to their Poor’Law ancestry. It was usual for the medical profession and the public to react emotionally to the two types of hospital and give fulsome praise to the voluntaries and run down the others often without sufficient knowledge of what really went on in either type of establishment.
Today in the National Health Service a new dichotomy has been substituted for the old. In England and Wales the teaching hospitals are a semi-autonomous group which has inherited mantle and prestige of the former voluntaries while all the rest of the country’s hospitals, almost without exception, have been unified into a national service under the Regional Hospital Boards.
The grouping of hospitals of different sizes and functions .under Hospital Management Committees has had the effect of giving prestige to the large general hospital of the group. Nearly always this will be an ex-municipal hospital and the former voluntary hospitals with their relatively small number of bed’s take on a minor ancillary role. The bulk of the population needing hospital care will today receive it in the many units of the Hospital Management Committee groups. Those now attending teaching hospitals are, therefore, many fewer than those who formerly attended and therefore supported, the voluntary hospitals.
In the four years that the National Health Service has been in operation the effect on public opinion resulting from the above circumstances has already become apparent. The attitude of patients and their relatives to the former rate-aided hospitals is rapidly, if unconsciously, changing. The old distinctions have been abolished by Law, and the local hospital is becoming “the” hospital of the locality whether it was previously patronised or ignored by those who were not its patients. This would not have been possible without the recent physical improvement of the municipal hospitals by progressive local authorities and the even greater upgrading now made possible under the National Health Service.
Although local interest and support for hospitals varies greatly in different localities an increasing number of bodies of organised supporters calling themselves the Friends of X Hospital or a similar title have now developed. In general short-stay hospitals the members may be ex-patients their relatives or any local citizen who has become interested in the hospital. With Friends of Sanatoria, children’s long stay e.g. orthopaedic hospitals, and particularly mental and mental deficiency hospitals the majority of members are relatives of the patients, as they have the maximum interest in and incentive to improve the particular hospital.
The main function of these organisations is not primarily charity as in the old days when the hospital was directly supported by voluntary contributions. The activities of Hospital Friends are an indication of local interest and concern in the hospital and it is the development in the public of identification with its local hospital that will be our greatest safeguard when “economies”are directed to the lowering of hospital standards. The Friends of St. Leonards Hospital showed their strength when they prevented a step being taken by the G.N.C. which would have resulted in the closing of the hospital for lack of nurses.
Organisations of hospital friends can learn about the standard of care and the needs of their hospital. Some of these needs can be met out of their own collected funds but the Friends’ most useful function is to make known the need, to focus attention on it and to stimulate those responsible to meet it.