ABSTRACT
Debates about twentieth-century medicine have been characterized above all by an increased preoccupation with the delivery of health care services. Underlying this preoccupation has been the fundamental assumption that personal health care delivered by a doctor to a patient, whether in the home or in a hospital, is a worthy endeavour that should be widely available. The focus of nineteenth-century health policy was pre-eminently environmental: all dirt was considered dangerous. By the end of the century, social investigators were convinced that physical well-being was a necessary prerequisite for further social progress. Responsibility for running ambulance services, home helps and old people’s homes became particularly time-consuming tasks. Within the specialty, debate centred on whether public health doctors should devote themselves more wholeheartedly to the work of medical administration. Central government and senior public health doctors were not convinced that a firm base could be built for public health that included clinical work.
