ABSTRACT
This chapters describes developments in health care provision before the NHS was established on 5 July 1948. The expansion of philanthropic and mutual aid voluntary associations in the nineteenth century played a key role in the development of health care. The historical role of voluntary associations also provided evidence of the limitations of a reliance on altruism and mutual aid as the means of providing health care. The Liberal welfare reforms represented a particularly intense period of changes in social policy and health care in particular. The first new commitment of the war-time government was to establish a comprehensive hospital service after the war. The post-war social policy reforms had a very significant impact on the role of local government in health care. The most significant change following the Beveridge Report was the exclusion of Friendly Societies from any administrative responsibilities within the National Health Service and the nationalisation of the voluntary hospitals.
