Dissecting the marketplace: The development of healthcare provision in nineteenth-century Portsmouth
type: CreativeWork
description: A tri-partite system of healthcare provision prevailed in nineteenth-century England, with treatment available from a range of private, state and charitable providers. Each of these sectors has been studied in depth, but the relationship between them is poorly documented. Current thinking generally accords a leading position to the private sector. Conceptualised in economic terms, the so-called 'medical market' is regarded by historians as the central driver behind the overall development of healthcare provision and responsible for its rapid expansion in this period. Evidence at a national level reinforces this hypothesis. At a local level however, it remains untested. Aspects of the hypothesis are also under-developed. In particular, an understanding of how the market actually worked in practice is lacking. Through a comprehensive reconstruction of healthcare provision in nineteenth-century Portsmouth, this thesis systematically tests the generalisations that underpin the medical market hypothesis. Its findings challenge the simplistic market generally portrayed in the existing historiography. In addition a range of insights are offered into market operation. These include a thorough consideration of how patients engaged with the market; how the market responded to sudden upsurges in demand; and how the market interacted with state and charitable providers. Detailed analysis of Portsmouth Royal Dockyard's archives forms an important component of the thesis. As well as giving an in-depth picture of dockworkers' health, the records show the extent to which factors other than market forces influenced the way local healthcare developed. Rather than provoking a market response, it is discovered that the high levels of occupational ill health generated at this industrial complex led to a substantial enlargement in state healthcare provision. As a result the state sector constrained the growth of the medical market in parts of Portsmouth. Hence, while broadly supporting t…
abstract: A tri-partite system of healthcare provision prevailed in nineteenth-century England, with treatment available from a range of private, state and charitable providers. Each of these sectors has been studied in depth, but the relationship between them is poorly documented. Current thinking generally accords a leading position to the private sector. Conceptualised in economic terms, the so-called 'medical market' is regarded by historians as the central driver behind the overall development of healthcare provision and responsible for its rapid expansion in this period. Evidence at a national level reinforces this hypothesis. At a local level however, it remains untested. Aspects of the hypothesis are also under-developed. In particular, an understanding of how the market actually worked in practice is lacking. Through a comprehensive reconstruction of healthcare provision in nineteenth-century Portsmouth, this thesis systematically tests the generalisations that underpin the medical market hypothesis. Its findings challenge the simplistic market generally portrayed in the existing historiography. In addition a range of insights are offered into market operation. These include a thorough consideration of how patients engaged with the market; how the market responded to sudden upsurges in demand; and how the market interacted with state and charitable providers. Detailed analysis of Portsmouth Royal Dockyard's archives forms an important component of the thesis. As well as giving an in-depth picture of dockworkers' health, the records show the extent to which factors other than market forces influenced the way local healthcare developed. Rather than provoking a market response, it is discovered that the high levels of occupational ill health generated at this industrial complex led to a substantial enlargement in state healthcare provision. As a result the state sector constrained the growth of the medical market in parts of Portsmouth. Hence, while broadly supporting t…
author: Biddle, Richard
language: en
date published: 2009
date modified: 2026-07-24T03:43:59Z
provider: Oxford Brookes University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Oxford Brookes University

PropertyValue
property ID: DOI
value: 10.24384/9qwe-vq07