Health care systems in Britain and Ireland in the nineteenth and twentieth centuries: the international, national and sub-national contexts
This paper argues that it is, of course, understandable and legitimate to see the historical development of healthcare systems in Britain and Ireland as deriving from the policies, actions and particularities of individual nation states – indeed this is how welfare history is generally written. However, it is suggested that it is also important to note, first, the international context. This is for three reasons: the constraints on individual nation states imposed by supra-national bodies such as the European Union and the International Monetary Fund and even, in certain cases, by other nations; the notions of welfare regimes and welfare peripheries which suggest that individual nations nonetheless share commonalities of social policy practice and approach – so, for instance, Esping-Andersen famously clustered welfare states into social democratic, corporatist, and liberal regimes; and the significant role of policy transfer and learning whereby ideas and practices are consciously shared, adopted, and adapted across national boundaries.
Second, and somewhat by contrast, it is also clear that within individual nation states there have historically been sub-national/regional differences in policy formation, implementation, and outcome. This is most obviously the case in overtly federal political systems such as that of the United States but also occurs within purportedly ‘unitary’ states such as the United Kingdom. These arguments are illustrated and supported by recent developments in the historiography of welfare; and by specific welfare policies and practices in Britain and Ireland from the middle of the nineteenth to the middle of the twentieth centuries.
Professor John Stewart’s research interests range broadly across modern British history. His work has focused on the history of health care provision and social policy, with an associated emphasis on the history of child welfare. His research research topics have included: municipal medicine in inter-war England and Wales; child evacuation policies in wartime Scotland; and welfare provision in ‘peripheral’ areas of the United Kingdom and Europe.