ABSTRACT
T he creation of the National Health Service (NHS) and the merger with the Maudsley marked a turning point in Bethlem's history. However, continuities remained. Bethlem kept its endowments and management ethos, while the merger mirrored the previous connection with Bridewell (see Chapter 5). Where much has been written, not least by contemporaries, about how Bethlem was supposedly administered before I 8 I5, no attention has been paid to the twentieth century. New research on the economic history of healthcare has started to address how institutional healthcare was managed and financed, but gaps remain. Apart from several institutional histories, twentieth-century mental hospitals have been neglected in favour of accounts of legislative change or therapeutic advance.! Research has ignored their administration and finance. In terms of Bethlem's management, the period between I900 and the formation of the Special Health Authority (SHA) in I982 was one of continuity and change, of internal development and external pressure, of prosperity and financial anxiety.
