The mixed economy of care in the South Wales Coalfield, c.1850-1950


Dr Steven Thompson (Aberystwyth University)


The mixed economy of care in the South Wales Coalfield, c.1850-1950


Healthcare systems, regional and comparative perspectives in Britain and Ireland, 1850-1960, a conference convened by DrSean Lucey, at CHOMI, 8-9 June 2012



Crowd gathering at the pit head of the Senghenydd Colliery in October 1913. Public Domain

The mixed economy of care is an idea that many historians have utilised as a means to conceptualise the welfare system of any country. It has been used to demonstrate the existence of and interaction between different providers of welfare and medical services, and has served as a useful reminder that the state was not the only nor indeed the main provider of welfare in the past. In the work that has utilised this concept, historians and other writers have emphasised the ways in which the mixed economy of care varied, both over time and between different states, but they have failed to give sufficient attention to the numerous and fascinating ways in which the mixed economy of care varied between different regions within states.

This paper adopts a regional perspective and outlines the particular developments and influences that led to the distinctive mixed economy of care that characterised the South Wales Coalfield from the mid-nineteenth century to the midtwentieth century. The region had some of the lowest levels of Poor Law institutional and voluntary hospital provision in the whole of Britain, and was marked by a relative absence of philanthropic and paternalistic resources and services. In the place of these providers, it was the labour movement that attempted to fill the gap and offered a range of welfare, health-care and medical services through a variety of self-help and mutualist organisations or, at least by the early twentieth century, through the influence it attempted to wield through Labour Party councillors on local authorities in the region.

Such factors led to a mixed economy of care that was very different in character and scope than that for other regions of Britain during the period and one in which a labourist perspective determined that the earning capacities of male workers were to be prioritised over the needs of other sections of the community. In addition, this distinctive mixed economy of care left the region as one of the most poorly provided for regions in the whole of Britain by the mid-twentieth century, though one that did, in various ways, influence the post-war reorganisation of welfare and medical services under the Labour governments of 1945-51. In these various ways, the paper emphasises the particularities of coalfield regions in terms of medical and welfare provision, the distinctiveness of south Wales relative to other coalfields, and the highly differentiated nature of the mixed economy of care across Britain during the century or so before the creation of the welfare state.

Steven Thompson


Dr Steven Thompson, Aberystwyth University

Dr Steven Thompson BA, Ph.D (Wales) is a historian of the modern period with specific interest in the history of Wales and Britain in the nineteenth and twentieth centuries. His research interests include the history of medicine, the provision of welfare, and labour history. His current research is focused on the mixed economy of medical and welfare provision in south Wales from c.1780 to 1950. He also has research interests in the history of carnival, music and musical culture in Wales, and the history of sport.

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