The public-private interface of domiciliary medical care for the poor in Scotland, c. 1875-1911

Sutton, David A. (2009) The public-private interface of domiciliary medical care for the poor in Scotland, c. 1875-1911. PhD thesis, University of Glasgow.

Abstract

This thesis explores domiciliary medical care for the poor in Scotland. Domiciliary care is understood as medical care provided in the home by qualified medical practitioners, or medical students. The poor are understood as those simply unable to ‘pay the doctor’ for the services they received. Focus is upon service provision, and therefore this thesis is a study of the different medical agencies engaged in the visitation of patients, and of the diverse ways medical practitioners as agents of different medical services facilitated or administered treatment. The period under focus is from 1875 to the National Health Insurance Act, 1911. Particular focus falls on urban Scotland, and Glasgow and Edinburgh. The interface between public and private provision is understood as the distinction between services provided for paupers, the legal poor, and services provided for the remainder, also unable to pay, and described as occupying ‘the boundary line between self-support and parish help’. Three types of service provider are identified: the poor law, medical charity, and medical missions.

The thesis is divided into four main parts, buttressed by an introduction and conclusion.

Chapter One sets the parameters to study of domiciliary medical care for the poor by identifying a literature of home visitation, and by identifying pressing issues concerning treatment in the homes of the poor of Glasgow and Edinburgh, like physical structure and family.

Chapter Two is comprised of eight sections and looks at public provision in the form of the poor law medical services. Of particular interest are the local management, and the medical officers who provided the service. In turn focus is put upon the role of medical relief under the Poor Law (Scotland) Act, 1911; the structure of outdoor medical services in Glasgow and Edinburgh; the role of the local medical sub-committee of the parish board; and the parochial medical officers and their work. A prosopographical approach is taken to profile the parochial medical officers.

Chapter Three, comprising five sections and conclusion, looks at private provision by medical charity. At issue is the range of charity dispensaries that provided outdoor services to the poor. A prospectus identifying the range of services is provided; outdoor medical services in Edinburgh and Glasgow are detailed; the interconnection between charity dispensary, domiciliary medical care, and medical educational requirements – particularly in Edinburgh – is investigated; and new developments occurring at the start of the twentieth century in health services requiring home visits are outlined.

Chapter Four is comprised of nine main sections plus conclusion and looks at private provision by home medical missions. An overview of the literature of medical missions is provided, before focus falls, in turn, on medical missions in Edinburgh; medical missions in Glasgow; the medical work of medical missions; opportunities provided for women; how medical missions work was justified against criticisms; differences between providers; the response to provision from the Catholic immigrant community, and the work of the St Vincent de Paul Society.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Keywords: domiciliary medical care, medical visits, home visitation, poor law, parochial medical officers, district surgeons, district medical officers, medical care in Edinburgh, medical care in Glasgow, the poor of late-Victorian and Edwardian Scotland, medical charity, charity dispensaries, medical missions
• Subjects: R Medicine > R Medicine (General); H Social Sciences > HN Social history and conditions. Social problems. Social reform; D History General and Old World > DA Great Britain
• Colleges/Schools: College of Social Sciences > Adam Smith Business School > Economics
• Supervisor's Name: Dupree, Prof. Marguerite W.
• Date of Award: 2009
• Depositing User: Dr David A Sutton
• Unique ID: glathesis:2009-1234
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 22 Oct 2009
• Last Modified: 10 Dec 2012 13:36
• URI: https://theses.gla.ac.uk/id/eprint/1234