Preliminary Programme

Wed 12 April
    08.30 - 10.30
    11.00 - 13.00
    14.00 - 16.00
    16.30 - 18.30

Thu 13 April
    08.30 - 10.30
    11.00 - 13.00
    14.00 - 16.00
    16.30 - 18.30

Fri 14 April
    08.30 - 10.30
    11.00 - 13.00
    14.00 - 16.00
    16.30 - 18.30

Sat 15 April
    08.30 - 10.30
    11.00 - 13.00
    14.00 - 16.00

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Friday 14 April 2023 16.30 - 18.30
R-12 HEA12 Public Health in History
E45
Network: Health and Environment Chair: Ian Miller
Organizers: - Discussants: -
Hayley Brown : The Expansion of Health Centres in the British NHS in the 1960s and 1970s
This paper investigates the rapid expansion of health centres within the British NHS in the 1960s and 1970s. At the core of the health centre concept was the idea that the various arms of primary healthcare should work together under one roof to provide curative and preventive individual and social ... (Show more)
This paper investigates the rapid expansion of health centres within the British NHS in the 1960s and 1970s. At the core of the health centre concept was the idea that the various arms of primary healthcare should work together under one roof to provide curative and preventive individual and social medicine. This paper will explore the changing meanings of the ‘health centre’ over the 1960s and 1970s and how these relate to the evolving role and conception of primary care more broadly, including in its relationship to secondary care.

Questions regarding the nature of primary care and how to better integrate the primary and secondary sectors have been habitually discussed in the NHS since its inception. Health centres were seen as one answer to these questions by providing a rounded approach to primary care and bridging the divide with secondary care. Health Centres were first advocated in the United Kingdom in the 1920 Dawson Report. A number were built in London boroughs by local councils in the 1930s including the Finsbury Health Centre as well as the privately developed Pioneer Centre in Peckham, and these centres have attracted the most attention from historians to date. Health Centres were initially conceived of as being a central part of the NHS, however few were built in its early years. This began changing in the mid-1960s and by 1978 over one in five general practitioners worked in a health centre. This period of health centre expansion covers both Labour and Conservative governments.

Much of the focus of NHS histories has been on hospitals and secondary care and the histories we do have of health centres have focused on the pre-NHS period and the early construction of centres under the NHS. This paper shifts the focus to the rapid growth of centres in the 1960s and 1970s, when most centres were established, and asks why this development took place at this point? On multiple occasions health centres were suggested as a solution to problems facing primary care such as providing healthcare in deprived areas and New Towns and encouraging the integration of different aspects of the health system. By examining NHS and Department of Health archives, this paper explores how health centres were viewed by health professionals, patients and policy makers and whether centres were thought to be achieving their goals. (Show less)

Matthijs Degraeve : Sanitary Governance of Private Housing in London, Paris and Brussels, 1850-1940
This paper will comparatively investigate the level and extent of government intervention in private sanitary conditions in London, Paris and Brussels between 1850 and 1940.
In the long nineteenth century, governments aimed to remedy the problems proceeding from the rise of the market economy, industrialisation and urbanisation (Egan 2001). A major ... (Show more)
This paper will comparatively investigate the level and extent of government intervention in private sanitary conditions in London, Paris and Brussels between 1850 and 1940.
In the long nineteenth century, governments aimed to remedy the problems proceeding from the rise of the market economy, industrialisation and urbanisation (Egan 2001). A major domain of public intervention coped with the inadequate sanitary conditions that threatened the health and well-being of urban dwellers (Melosi 2008). These measures consisted of commissioning public engineering infrastructure that sought to transport sufficient amounts of clear, potable water to the city and realise larger and more efficient sewage systems for the discharge of human and household wastewaters. Osborne (1996) and Joyce (2003) saw sewers as means of social direction and control built into the infrastructure of modern life that enabled governments to induce cleanliness.
While government intervention was imperative and feasible for the operation of water supply and sewage systems, its involvement was less straightforward with regard to the actual indoor installation and use of these utilities. In the nineteenth and twentieth centuries, the urban sanitary market was characterised by trends of privatisation and individualisation. Since the connection of public utilities to sanitary appliances within the house was a vital precondition for the government’s sanitary measures to take effect on the urban hygienic conditions, authorities equally aspired to interfere in the private domain of domestic sanitary installations. Through strict building codes and water supply regulations, for example, the construction of indoor water-closets and their connection to public systems of water supply and sewerage became increasingly regulated (Galavan 2021).
This paper will comparatively investigate the level and extent of government intervention in private sanitary conditions in London, Paris and Brussels between 1850 and 1940. As they needed the same resources of drinking water and sewage, comparing these cities shows how similar conditions of deteriorating urban environments triggered similar or different responses in the level of sanitary governance. It allows to assess whether these cities were representative for broader processes or whether they were primarily determined by their own urban and national contexts.
The research questions that underpin the analysis relate to (i) how regulation came about, (ii) the areas in which the government intervened, (iii) the reasons and motives behind the issued decrees, and (iv) how regulation was imposed and enforced. The comparative research is conducted through a combination of archival research and an extensive literature study. Archival sources that give insight in sanitary regulation can be found in national and city archives, depending on the level of decision-making, and comprise local building codes and regulations of public water supply. To trace the motives behind these regulations, the reports of parliamentary discussions, city councils and advice on the sanitary conditions in the city formulated by public officials will be elucidating. Confronting the findings for London, Paris and Brussels allows to highlight and explain differences in the extent to which governments were able to intervene in and regulate a domain that became increasingly privatised during the nineteenth and twentieth centuries. (Show less)

Mat Savelli, Aneeqa Aslam & Erika Dyck : Marketing the (Post)Colonial Mindset: Transnational Advertising Campaigns across the Global South, 1948 – 2000
Scholars studying colonialism have long argued that colonialism was a psychological project as much as a political one. By the late 1950s, practitioners such as Frantz Fanon and Octave Mannoni were alerting people to colonialism’s psychological aspects, noting that colonial systems depended upon the colonized coming to understand themselves ... (Show more)
Scholars studying colonialism have long argued that colonialism was a psychological project as much as a political one. By the late 1950s, practitioners such as Frantz Fanon and Octave Mannoni were alerting people to colonialism’s psychological aspects, noting that colonial systems depended upon the colonized coming to understand themselves as inferior to the colonizer. Historians, meanwhile, have discussed the ways that institutions such as residential schools and psychiatric hospitals were sites through which colonial authorities sought to enact mental transformations of colonized people, refashioning indigenous psychologies along “modern” lines.

The end of direct colonialism, however, did not necessarily spell the end of these practices. For instance, critically minded psychologists and psychiatrists (such as Suman Fernando and Derek Summerfield) have noted that the psy-disciplines continue efforts to remake the mental lives of people in the Global South in the neocolonial period. This paper explores another component of neocolonial efforts to reshape indigenous psychologies in the post-independence period, concentrating on the actions of transnational economic actors. Drawing upon several case studies – West Africa, the Maghreb, and South Asia - it uses semiotic and qualitative content analyses to explore how corporate actors within several industries (pharmaceutical, alcohol, tobacco, and caffeine) attempted to remake indigenous psychologies in the post-independence period. To do so, we argue, these industries both borrowed older strategies from colonial regimes (such as positioning colonial subjects as psychologically inferior), and developed new forms of messaging, such as the notion that the modification of psychological states was a marker of modernity. Through an analysis of historical advertisements for substances such as coffee, beer, cigarettes, and psychopharmaceuticals, we argue that the efforts to reshape the mental lives of individuals in the Global South continued well into the neocolonial period. (Show less)

Maria Sjöberg, Helene Castenbrandt & Anders Ottosson : From Private Concern to Public Care, c. 1750-1900, or how Healthcare became Female
After WWII, several countries, including Sweden, introduced universal healthcare, mainly organised by the government, and financed through tax revenue. At the end of the 18th century, the situation was almost the opposite. In Sweden most healthcare was managed privately. This would change dramatically during the 19th century. However, little is ... (Show more)
After WWII, several countries, including Sweden, introduced universal healthcare, mainly organised by the government, and financed through tax revenue. At the end of the 18th century, the situation was almost the opposite. In Sweden most healthcare was managed privately. This would change dramatically during the 19th century. However, little is known about how this large transition from private to public care. British research indicates that for long there was a “mixed economy of welfare” where governmental agents and interests intersected and collided with private care providers. On the contrary, in Swedish research, state-initiated healthcare institutions have been seen as strategically phases towards a publicly organised and financed healthcare apparatus where physicians played the main part. Thus, significant changes within the expanding healthcare infrastructure are overlooked, particularly the healthcare provided by women. Hence, within the framework of a “mixed economy of welfare” this project will study the emergence of public healthcare institutions in connection with the clinical activities conducted both by female and male healthcare providers, inside as well as outside private and governmental institutions. The overall approach of the study is concretized in three case studies where the provincial doctors, the hospitals and the spas clarify the tension and complexity between private and public and how this changed. In this paper I will concentrate on the hospitals. In the 18th century the healthcare at the hospitals were conducted by male public employed physicians while both male and female entrepreneurs kept the hospital running. The paper deals with how and in what way this organisation changed during the course of the 19th century. (Show less)

Janet Weston : Morality and Public Health Law in Mid-twentieth Century England
Public health, meaning the collective organized efforts of society to prevent disease, prolong life, and promote health, employs distinctive methods of surveillance, compulsion, coercion, and wide-ranging state intervention. Often controversial, these can prompt heated debates about responsibilities, rights, risks, the balance of different interests and needs, and the goals of ... (Show more)
Public health, meaning the collective organized efforts of society to prevent disease, prolong life, and promote health, employs distinctive methods of surveillance, compulsion, coercion, and wide-ranging state intervention. Often controversial, these can prompt heated debates about responsibilities, rights, risks, the balance of different interests and needs, and the goals of public health itself. In response to these debates, and the perceived failure of medical ethics to look beyond individual patient rights and the doctor-patient encounter, the field of ‘public health ethics’ began to coalesce in the UK in the 2000s.

This relatively recent rise in prominence of a field of academic enquiry and professional practice risks implying that attention to the ethical dimensions of public health is itself new. But, of course, disagreements about public health interventions, drawing on claims about morality, justice, or fairness, have long been present. These range from overt references to what is morally right, as in the case of “venereal disease” legislation in the first half of the twentieth century, to justifications for Covid-19 controls that assume a particular version of (un)fairness or (in)justice. These claims, and the actions or inactions that they enable, establish and maintain implicit and explicit moral frameworks that have shaped the possibilities and priorities of public health.

Introducing preliminary findings from a new project examining morality and public health law from 1920-2020, this paper will focus on a selection of mid-twentieth century public health laws in England, and the presence or absence of moral claims to justify them. Covering laws that tackled childhood nutrition, pollution, road safety, and and mental illness, it explores how and why the morality of public health law has changed, over time and in relation to different publics, problems, and politics. (Show less)



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