By Leslie Hilliard 26.9.1952

Before 1948 local interest and popular support was directed almost entirely to the few large and many small voluntary hospitals.   Little or no interest was shown in the municipal hospitals owing to their Poor’Law ancestry.   It was usual for the medical profession and the public to react emotionally to the two types of hospital and give fulsome praise to the voluntaries and run down the others often without sufficient knowledge of what really went on in either type of establishment.

Today in the National Health Service a new dichotomy has been substituted for the old. In England and Wales the teaching hospitals are a semi-autonomous group which has inherited mantle and prestige of the former voluntaries while all the rest of the country’s hospitals, almost without exception, have been unified into a national service under the Regional Hospital Boards.

The grouping of hospitals of different sizes and functions .under Hospital Management Committees has had the effect of giving prestige to the large general hospital of the group. Nearly always this will be an ex-municipal hospital and the former voluntary hospitals with their relatively small number of bed’s take on a minor ancillary role.   The bulk of the population needing hospital care will today receive it in the many units of the Hospital Management Committee groups.   Those now attending teaching hospitals are, therefore, many fewer than those who formerly attended and therefore supported, the voluntary hospitals.

In the four years that the National Health Service has been in operation the effect on public opinion resulting from the above circumstances has already become apparent.   The attitude of patients and their relatives to the former rate-aided hospitals is rapidly, if unconsciously, changing.   The old distinctions have been abolished  by Law,   and the local hospital  is becoming “the”  hospital of the locality  whether  it  was previously  patronised or  ignored  by  those  who  were  not   its patients.     This would not have been possible without the recent physical   improvement of the municipal hospitals by progressive local   authorities and the even greater upgrading now made possible under the National Health Service.

Although local  interest   and  support  for hospitals varies greatly  in different   localities an increasing number  of  bodies  of organised   supporters  calling themselves the  Friends of X Hospital or a  similar title  have  now developed.   In general short-stay hospitals the members may be ex-patients their relatives or any local citizen who has become   interested   in the hospital.  With Friends  of  Sanatoria,   children’s long stay e.g. orthopaedic hospitals, and particularly mental  and mental deficiency hospitals the majority  of members  are  relatives of the patients, as they have the maximum interest in and incentive  to   improve the particular hospital.

The main function of these organisations is not primarily charity as   in the old days when the hospital was directly supported by voluntary contributions. The activities of Hospital Friends are an  indication of  local   interest  and  concern in the hospital and it is the  development  in the public of  identification with  its local hospital  that  will  be   our  greatest   safeguard  when “economies”are directed to the lowering of hospital  standards.    The Friends of St. Leonards Hospital showed their strength when they prevented a step being taken by the G.N.C. which would have resulted in the closing of the hospital for lack of nurses.

Organisations of hospital friends can learn about the standard of care   and the   needs of their hospital.   Some of  these needs  can be met  out  of  their own collected funds but  the  Friends’  most useful function  is to make known the need,  to focus attention on it  and to   stimulate those responsible  to meet it.

By way of example mention may be made of the ‘Friends of the Fountain”, a hospital for 600 mentally defective children. In the past three years they have set up an active and well organised committee of parents, and have a membership of about 400.   They have collected money from their members to provide amenities for the   children.   But by interesting outside persons and bodies in the work of the Fountain Hospital they have already collected over £5,000. They have  presented  a £500  occupations hut  for patients, contributed £1,000 towards the  furnishing  of a holiday home  at Hastings for  which they had  campaigned and were the prime movers in obtaining the much used hospital coach.

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They contribute to the hospital’s monthly magazine and arrange socials for parents and entertainments for the children.  Their most valuable function has been to inform the public of the problems of mental deficiency by developing the National Association of Parents of Backward Children which has given guidance to many parents and organised lectures and radio and. television talks on the subject.

If Friends  of  Sanatoria were  developed  all  over the   country and became  as    active   in their   special  field  of  anti-Tuberculosis propaganda  it  would be  a great   step to  the achievement   of our stated aim  of  abolishing that  disease   in a  generations.

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