Through a study of diabetes care in post-war Britain, this book is the first historical monograph to explore the emergence of managed medicine within the National Health Service. Much of the extant literature has cast the development of systems for structuring and reviewing clinical care as either a political imposition in pursuit of cost control or a professional reaction to state pressure. By contrast, Managing Diabetes, Managing Medicine argues that managerial medicine was a co-constructed venture between profession and state. Despite possessing diverse motives – and though clearly influenced by post-war Britain’s rapid political, technological, economic, and cultural changes – general practitioners (GPs), hospital specialists, national professional and patient bodies, a range of British government agencies, and influential international organisations were all integral to the creation of managerial systems in Britain. By focusing on changes within the management of a single disease at the forefront of broader developments, this book ties together innovations across varied sites at different scales of change, from the very local programmes of single towns to the debates of specialists and professional leaders in international fora. Drawing on a broad range of archival materials, published journals, and medical textbooks, as well as newspapers and oral histories, Managing Diabetes, Managing Medicine not only develops fresh insights into the history of managed healthcare, but also contributes to histories of the NHS, medical professionalism, and post-war government more broadly.
This book explains the current fascination with autism by linking it to a longer history of childhood development. Drawing from a staggering array of primary sources, it traces autism back to its origins in the early twentieth century and explains why the idea of autism has always been controversial and why it experienced a 'metamorphosis' in the 1960s and 1970s. The book locates changes in psychological theory in Britain in relation to larger shifts in the political and social organisation of schools, hospitals, families and childcare. It explores how government entities have dealt with the psychological category of autism. The book looks in detail at a unique children's 'psychotic clinic' set up in London at the Maudsley Hospital in the 1950s. It investigates the crisis of government that developed regarding the number of 'psychotic' children who were entering the public domain when large long-stay institutions closed. The book focuses on how changes in the organisation of education and social services for all children in 1970 gave further support to the concept of autism that was being developed in London's Social Psychiatry Research Unit. It also explores how new techniques were developed to measure 'social impairment' in children in light of the Seebohm reforms of 1968 and other legal changes of the early 1970s. Finally, the book argues that epidemiological research on autism in the 1960s and 1970s pioneered at London's Institute of Psychiatry has come to define global attempts to analyse and understand what, exactly, autism is.
Concepts of ‘balance’ have been central to modern politics, medicine and society.
Yet, while many health, environmental and social challenges are discussed
globally in terms of imbalances in biological, social and ecological systems,
strategies for addressing modern excesses and deficiencies have focused almost
exclusively on the agency of the individual. Balancing the Self explores the
diverse ways in which balanced and unbalanced selfhoods have been subject to
construction, intervention and challenge across the long twentieth century.
Through original chapters on subjects as varied as obesity control, fatigue and
the regulation of work, and the physiology of exploration in extreme conditions,
the volume analyses how concepts of balance and rhetorics of empowerment and
responsibility have historically been used for a variety of purposes, by a
diversity of political and social agencies. Historicising present-day concerns,
as well as uncovering the previously hidden interests of the past, this volume’s
wide-ranging discussions of health governance, subjectivity and balance will be
of interest to historians of medicine, sociologists, social policy analysts, and
social and political historians alike.
Vaccinating Britain investigates the relationship between the British public and vaccination policy since 1945. It is the first book to examine British vaccination policy across the post-war period and covers a range of vaccines, providing valuable context and insight for those interested in historical or present-day public health policy debates. Drawing on government documents, newspapers, internet archives and medical texts it shows how the modern vaccination system became established and how the public played a key role in its formation. British parents came to accept vaccination as a safe, effective and cost-efficient preventative measure. But occasional crises showed that faith in the system was tied to contemporary concerns about the medical profession, the power of the state and attitudes to individual vaccines. Thus, at times the British public demanded more comprehensive vaccination coverage from the welfare state; at others they eschewed specific vaccines that they thought were dangerous or unnecessary. Moreover, they did not always act uniformly, with “the public” capable of expressing contradictory demands that were often at odds with official policy. This case study of Britain’s vaccination system provides insight into the relationship between the British public and the welfare state, as well as contributing to the historiography of public health and medicine.
This collaborative volume explores changing perceptions of health and disease in
the context of the burgeoning global modernities of the long nineteenth century.
During this period, popular and medical understandings of the mind and body were
challenged, modified, and reframed by the politics and structures of ‘modern
life’, understood in industrial, social, commercial, and technological terms.
Bringing together work by leading international scholars, this volume
demonstrates how a multiplicity of medical practices were organised around new
and evolving definitions of the modern self. The study offers varying and
culturally specific definitions of what constituted medical modernity for
practitioners around the world in this period. Chapters examine the ways in
which cancer, suicide, and social degeneration were seen as products of the
stresses and strains of ‘new’ ways of living in the nineteenth century, and
explore the legal, institutional, and intellectual changes that contributed to
both positive and negative understandings of modern medical practice. The volume
traces the ways in which physiological and psychological problems were being
constituted in relation to each other, and to their social contexts, and offers
new ways of contextualising the problems of modernity facing us in the
Women’s medicine explores the key role played by British female doctors in the
production and circulation of contraceptive knowledge and the handling of sexual
disorders between the 1920s and 1970s at the transnational level, taking France
as a point of comparison. This study follows the path of a set of women doctors
as they made their way through the predominantly male-dominated medical
landscape in establishing birth control and family planning as legitimate fields
of medicine. This journey encompasses their practical engagement with birth
control and later family planning clinics in Britain, their participation in the
development of the international movement of birth control and family planning
and their influence on French doctors. Drawing on a wide range of archived and
published medical materials, this study sheds light on the strategies British
female doctors used, and the alliances they made, to put forward their medical
agenda and position themselves as experts and leaders in birth control and
family planning research and practice.