ABSTRACT
The years between 1905 and the First World War saw a major expansion of state welfare provision in Britain, including the passage of the National Insurance Act in 1911 and the inception of the National Health Insurance (NHI) scheme two years later. 1 These developments took place against a backdrop of intense debate over the role and responsibilities of the state, prompted by growing concern at the problems of poverty and destitution, and by a widespread perception that nineteenth-century forms of state welfare based in the Poor Law were failing to meet the needs of a modern industrial society Medical issues loomed large in these debates. Politicians and social reformers expressed concern that high levels of ill health among the working-class population were undermining industrial and military fitness and efficiency, and were thus inimical to the national interest. Most agreed that the poor quality of medical care available to large sections of the working class – be it privately purchased or provided under the Poor Law – was at least partly to blame for such problems. Consequently, a variety of views were formulated on what action the state should take to ensure that the poor were given access to an adequate standard of health care.
