ABSTRACT
This chapter considers the development of specialist hospital services, especially those emerging between the wars, such as mental health outpatient services. It addresses two case studies which illuminate the influence of local economic, social and political factors in the shaping of orthopaedic and maternity services. The chapter also shows that while the development of new specialities was limited and not particularly novel, in the key areas of maternity and orthopaedics Leeds and Sheffield developed as important regional centres under the influence of both local need and national policy. The first half of the twentieth century saw a huge growth in the use of hospital services and their extension to almost every social and demographic group. The 1917 maternity and child welfare act gave a prominent role to local authorities in the management of childbirth, but the pattern of antenatal services owed much to existing delivery, especially in the voluntary sector.
