in Managing diabetes, managing medicine


This book has been the product of a long journey, during which I have accrued more debts than I can acknowledge in such a short space. I can only hope that over time I have been a decent enough person and scholar to have expressed my gratitude to my creditors. There are, however, some thanks that I wish to express more formally here.

This monograph was made possible by the support of the Economic and Social Research Council (Grant Reference ES/H010912/1) and the Wellcome Trust (Grant Reference 100601/Z/12/Z). First and foremost, I would like to thank these institutions for their belief in my research and their generosity over the past six years. During this period, I have also benefited from the immense assistance of staff at several fantastic institutions, and I would like to express my thanks to librarians and archivists at The National Archives, the National Records of Scotland, the Royal College of General Practitioners Archives, and the Wellcome Library, as well as to Claire Keyte and members of the Centre for Medical History at the University of Exeter. The team at Manchester University Press have offered expert advice during the production of this monograph. Particular thanks are owed to my two anonymous reviewers, and to Emma Brennan, Tom Dark, Rob Byron, and Keir Waddington. Their input has greatly improved the text, and I am deeply appreciative of their perseverance and support in the presence of my incompetence.

The present work has been greatly enhanced by the permission to reproduce materials and images from a range of sources. A deep gratitude is owed to Routledge for their kind permission to reuse work from Martin D. Moore, ‘Reorganising chronic disease management: diabetes and bureaucratic technologies in post-war British general practice’, in M. Jackson (ed.), The Routledge History of Disease (London: Routledge, 2017), pp. 453–72. This chapter was central in forming ideas developed within this monograph and is cited throughout. My thanks also to the reviewers of this piece and its editor, Mark Jackson, for their comments. I am similarly grateful to The National Archives for allowing reproduction of a standard outpatient clinic form (Fig. 3.1) and components from a community co-operation booklet (Fig. 3.3), as well as to the Journal of the Royal College of General Practitioners (now the British Journal of General Practice) for permission to reproduce components from a structured record card for GP diabetes care (Fig. 3.2). I would also like to thank the researchers and proprietors of the Diabetes-Stories project for permitting me to use materials from their wonderful archive, and I am likewise greatly indebted to the many wonderful research participants who gave up their time and energies to allow me to interview them for this book. Their testimonies have been essential in opening-up new areas of investigation, and have helped me to rethink many of my prior conceptual assumptions and readings of archival and published material. I hope I have done them justice here.

My penultimate thanks must go to the colleagues whose insight and feedback have enriched the following pages. I am grateful to Emily Andrews for our discussions about the cultural and political value of data and management systems, and to Jane Hand for conversations about chronic disease and post-war British public health. Over the past three years, moreover, I have had the greatest support from friends and colleagues on the Wellcome Trust-funded ‘Balance’ project and at the University of Exeter. Thanks go to Fred Cooper, Ali Haggett, Nicos Kefalas, Ayesha Nathoo, and Rebecca Williams for their comments on material, advice on publication, and friendship during my move to a new institution. Special mentions must also go to Natasha Feiner for her comments on the whole manuscript, to Mark Jackson for his intellectual and moral support during the production of this monograph, to Roberta Bivins for her unwavering faith and helpful black marker pen, and to my new colleagues on the Waiting Times project – especially Lisa Baraitser and Laura Salisbury – for their patience and help in thinking about time and temporality in new ways. Finally, Harriet Palfreyman and Gareth Millward deserve special recognition for offering consistent feedback on copious drafts, and for reading and commenting on the whole manuscript on numerous occasions. I also owe them an inexpressible debt for their friendship during some challenging times. To all these fantastic people, I hope what follows goes some way to justifying your hard work and considerable investment. And of course, I apologise if my stupidity or stubbornness have led me to ignore some of your advice. All errors and inadequacies that remain are my own.

My final and greatest thanks, however, must – and will always – go to Lucy, without whom there would be nothing to publish. You have been a constant source of advice, love, laughter, and inspiration, and I am lucky enough to have had your support and forgiveness at all times, despite my frustrating inability to meet deadlines or be anywhere on time. This work is dedicated to you.

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Managing diabetes, managing medicine

Chronic disease and clinical bureaucracy in post-war Britain




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