For a Healthy London – election leaflet March 1931

The Socialist Medical Association had a strong presence on the London County Council in the 1930’s. This election leaflet was published by the Party, but obviously written by members of the SMA who were standing in the 1931 municipal elections.

For a Healthy London


Healthy London  nurse with children
The face of municipal socialism

A Municipal Hospitals Policy that will Lessen Suffering and Disease


” Far from our hospitals being, as they once were, the envy of other nations, the great majority are years behind the times, and lack of funds compels the hospitals of our metropolis to carry on their work in the heart of London with an equipment and in surroundings which would not be tolerated in a small provincial town in Sweden.”

The  above words in which a famous surgeon of the London Hospital referred to the Voluntary Hospitals of London appeared in the Lancet of August 3, 1929.   It will be acknowledged that the condition of affairs disclosed by this statement ought to give rise to serious consideration on the part of the L.C.C., which is the Central Public Health Authority of the metropolis.

It will be news to many people to learn that, if we include tuberculosis, infectious fevers, and mental disease,there are in the hospitals controlled by the London County Council more than four times as many beds for sick people as there are in the Voluntary Hospitals.

The Voluntary Hospitals of London have had an interesting and romantic history. Most of them were long ago founded and endowed by charitably minded folk for the benefit of the “sick poor,” and until a comparatively few years ago no one was asked to pay anything for treatment in them. Before the war these hospitals managed to keep going with some difficulty by means of their endowments and voluntary subscriptions, but during the post-war period there has been an interminable struggle to provide sufficient beds and to make ends meet. The main causes of this struggle have been the ever-increasing complexity, and therefore costliness, of medical treatment.


All kinds of devices have been adopted by the Boards of Management of the Voluntary Hospitals to acquire the necessary funds—flag days, street collections, draws, lotteries and ballots, patients’ payments, workmen’s contributions, grants from ths State and others. Such are their financial straits that some of the hospitals have had to turn their public wards, originally intended under the Royal Charters for the “sick poor,” into paying wards so that money could be made in them to help keep the hospital going. There were 1,154 “paying” beds, as they are called, in the Voluntary Hospitals of London in 1929, and their number is increasing. As an illustration of the way in which these Hospitals are losing their charitable character it may be mentioned that, in 1929, 49 per cent, of the income of King’s College Hospital was derived from patients’ contributions. The increasing difficulty of collecting funds for the Voluntary Hospitals must eventually result in their complete municipalisation.

There are approximately 10,000 persons waiting for admission to the London Hospitals. This figure does not represent anything like the real need for beds; many doctors refrain from adding the names of their patients to the waiting lists as there is no chance of their admission.


To make up for the shortage of beds in the Voluntary Hospitals, some of the Poor Law infirmaries have, in the past, been provided with full equipment for modern methods of treatment, including the services of visiting specialists. In others the equipment and personnel are much less complete. In accordance with the terms of the Local Government Act, 1929, all these hospitals, containing about 29,000 beds for acute and chronic patients, have now been taken over by the L.C.C. What will be made of them depends mainly on the way in which the electors of London vote at this L.C.C. election.

There should be an adequate resident medical staff at each hospital. There should be visiting physicians and surgeons responsible for the treatment of the patients in the general wards and special departments. Efficient pathological and research laboratories must be provided.

Attached to each hospital efficient out-patient departments are also essential where patients can be attended to promptly and not kept waiting many hours, and where they will be treated as human beings.

The hospitals must be provided with an efficient nursing and domestic staff. Each hospital should be utilised as a training centre for nurses. The nursing service must be thoroughly overhauled, adequate remuneration given, and working hours reduced.

Will an L.C.C. controlled by a majority of Municipal Reformers, who are themselves not usually forced to use these institutions, ever carry out such a policy? Their watchword is ”keep down the rates,” and the health of the citizens of London is a much less important matter to them.


One of the first things that a Labour Council would do would be to dissociate completely the hospitals and hospital treatment from the Poor Law. Patients would be admitted because they are citizens of London and in need of treatment. They would be admitted on the certificate of their own doctor and not through the Relieving Officer.

The Labour Party’s policy is not only to make the Municipal Hospitals of London the best in the world, but ultimately to make them free to all, rich and poor alike. Unfortunately, this is not yet possible, as the Local Government Act, 1929, makes it obligatory for the Council to assess the full cost of maintenance and treatment to all suffering from non-infectious diseases. Consumption, as is well known, is a chronic and infectious disease, and sufferers have to be careful not to work too hard or become overtired for a long time after their apparent cure. Moreover, the members of the family of a consumptive, if they have been exposed to infection, as is usually the case, are not in a position to stand privation. It is a cruel thing, therefore, to charge any part of the cost of treatment to a consumptive or his family as the present Municipal Reform L.C.C. is doing, although there is no legal obligation to make such charge.

Where, under the present law, a charge must be made, the unpleasant task can be carried out in very different ways. The assessment is at present made by the Public Assistance Committee, and the money is collected with the help of the machinery of the Poor Law. So long as the assessment and collection must be carried out, the Labour Party policy is to do this through the medium of the Public Health administration without inquisition and without inflicting hardship.


It has been freely stated that it is the intention of the present Municipal Reform majority of the L.C.C. to provide “paying wards” or single rooms for paying patients in the Municipal Hospitals of London. This is utterly and entirely bad and must be resisted at all costs.

Nothing but the very best is good enough for the citizens of London. To permit “superior” accommodation, diet or amenities being given for payment implies that the ordinary services are not the best. Besides, where two types of service are permitted—a superior and an inferior—two types of treatment are almost certain to follow, and all the objectionable features of the Poor Law will be repeated in our Municipal Hospitals for those who cannot afford to be treated as private cases. The Labour Party desires for all patients in the Municipal Hospitals not only the best that medical science can give, but every reasonable comfort as well, and special attention would be paid to ensure that everything possible is done to make the patients happy while they are in hospital.

It is the object of the Labour Party to develop the Municipal Hospitals of London as the Medical Centres of the districts in which they are situated. As far as geographical considerations permit, it will associate with these hospitals tuberculosis and venereal disease work as well as the treatment of school children and early mental disease. Further, it would encourage the home treatment of the sick poor being undertaken from these hospitals.


The Labour Party believes that the health of the nation is of so great importance that it is unsafe to leave it to private charity. Accordingly it would like to see a unified inclusive Municipal Hospital service provided for all citizens of London within reasonable reach of their homes.

Does the above policy appeal to you as reasonable, wise, humane and in the public interest?

Only the Labour Party can be trusted to carry it out !


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