George Campbell Gosling
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in Payment and philanthropy in British healthcare, 1918–48


I wrote this book in the hope of answering a question my Nan asked me over a decade ago. By the time I went to Bangor in North Wales to study History, I had already learnt her origin story. This had less to do with her childhood in St Werbrughs, a working-class neighbourhood in Bristol, or marrying a respectable Methodist scout leader, and more to do with his sudden, untimely death in the days following Christmas in 1965 – leaving her with two teenage daughters. After this she quickly began wearing trousers, learnt to drive and trained as a teacher. When I met her a couple of decades later, she was an impressive woman – a gifted educator, inspiringly self-taught on a vast range of subjects from world religions to art history, and who gave a mean rendition of ‘Do Your Ears Hang Low?

When I returned from university and told her I was switching to joint honours with Social Policy, she asked me what that was. When I explained I was writing an essay on Lloyd George's introduction of health insurance as part of the National Insurance Act of 1911, her immediate response was to ask me a question. She told me of the ‘dispensary ticket’ system she remembered from her childhood. She recounted what was expected of her as a small child between the wars when her father was sick – walking from the east of Bristol to the city's north to go cap in hand to the vicar to get a ticket, then down into the city centre to the dispensary where the ticket could be cashed in for medicines, which then needed to be taken home. In total over six miles up and down some serious hills – a long journey for little legs. Why, she asked me, was this necessary? Why was there not a National Health Service so he could simply see a doctor?

In the time I've spent finding out and making sense of what I found, a great many people have been incredibly generous with their time and support. I would not have been studying History if not for my good friend Andrew Harman. The help of Steve King and John Stewart in setting up the research project was invaluable, and I am especially grateful to Glen O’Hara, Barry Doyle, Kate Bradley, Peter Grant, Roberta Bivins, Mathew Thomson and Pat Thane for their encouragement over the years. Despite common complaints about academia, I have always found my colleagues to be amazingly kind and giving people. The Voluntary Action History Society provided an especially useful intellectual home-from-home during my doctoral years. In the final stages, the Social History Society and my colleagues on the Cultural History of the NHS project at the University of Warwick have taken on this on this role. I am grateful to them all.

In conducting that research, the assistance of staff at numerous archives has been priceless. Amongst them, particular mention should go to the Bristol Record Office, the University of Bristol’s Special Collections, and the staff at BCWA Healthcare (now part of Simply Health) who allowed me to rummage through boxes of the uncatalogued archive. I am especially grateful to the Bristol Reference Library, not only for their support in my research, but also for allowing me to use a number of photographs of items in their collection as illustrations in these pages.

Undertaking this work would simply not have been possible without the support of the Wellcome Trust. In particular, this book is based on the doctoral thesis written from the research conducted with the backing of a doctoral studentship (ref. 083402) and has been made available as an open access e-book thanks to further funding. It is no exaggeration to say I would not be in academia today if I had not received the backing of the Wellcome Trust.

The book itself took an unusual route to end up with Manchester University Press, but it has been a pleasure to work with Emma Brennan and her team. The advice of series editor Keir Waddington and the anonymous readers has also been hugely beneficial. I would like to thank them all for their thoughtful comments, which have always been based on a good understanding of my hopes for the book.

I have also benefited from the support of some wonderful friends along the way. Special mention should go to Jennie Maggs, Stephen Soanes, Ceci Flinn, Clare Hickman and Richard Huzzey, for keeping me positive, grounded and laughing throughout. I'd also like to thank a father who taught me to question and a mother who taught me to care. Above all, the support of my wife Claire has helped me retain a sense of perspective and kept me smiling. Thank you.

Any errors are, of course, entirely my own.

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