What was life like before the NHS?

[Tatami]

The NHS turned 75 yesterday. It got me thinking about what was life like before the NHS. I'm most interested in the 1920s and 30s, when my Grandmothers would have been born. Would my Great-Grandmothers and their generation most likely have given birth at home, paid a midwife or just relied on the wisdom of a relative or friend? They weren't at all wealthy. Were working men given priority for any free or charitable care? Is there a good book or any records where I can find out more? Thank you.

You only have to look at some of the graves in old churchyards - multiple small children in the same family wiped out within a few weeks because of some disease like measles or diphtheria. A sobering education for anti-vaxxers.

That was of course down to no vaccines, not just no NHS. My DM born 1918 broke a leg at 11 but was lucky in that her family was better off than many and could afford doctor and hospital. OTOH my GGF who died at 94 in the 60s had a dodgy, badly set leg all his life, after breaking it as a child.

This! Personal responsibility!

Trigger warning, baby loss

My Mother was born in 1926, the last child born to her Mother was obviously very disabled when born so the midwife popped him under the bed without clearing his airways so he expired.

That's brutal to think the MW deliberately allowed the baby to die. However I can see a logic. Sad but true.

Lots of children are born with severe cerebral pausly who end up needing 24hr care, tube fed, never able to speak, stand or walk.

They are a huge drain on families. And the families end up having to fight for support to care for them.

Sometimes I do think that euthanasia should be legal and these children allowed to slip away. Along with Adults in the later stages of dementia.

I think some people of this thread are confusing the NHS with modern medicine. Even if there was a NHS pre 75 years ago many many people/children would have died as the modern drugs just weren’t available.

Along with reading The Citadel by AJ Cronin , you might want to research the role of Friendly Societies.
These, along with the Temperance movement and some employers , enrolled members for a small amount each week and provided medical care , some sickness and funeral benefits .
https://wellcomecollection.org/articles/Yj3JtBEAACEAirua#

It has to be said that probably the biggest improvements in pre NHS health care were the improvements in clean water , disposal of sewage, drainage of marsh lands , and the general movement in public health improvement that started in the 19th century that eg put standards down for bread and milk at a time when people died because of adulterated food.
The more humane approach to mental health problems , though it had a long way to go , also started to improve in the 19th century with visiting places like bedlam no longer seen as acceptable entertainment .
Pre war the problems of poor housing and tenements started to be recognised and addressed read South Riding by Winifred Holtby.

But in general many of the improvements in education and health were prompted by the Second World War evacuation of children from poorer to more affluent areas. The difference in height , health and educational achievement became personal experience to many.

I guess with call the midwife, to begin with the nuns were older, and nurses new. The NHS brought nurses to the nunnery. Before that nuns would have provided untrained midwifery care.

I remember watching a documentary on the beginning of the NHS some years ago - they had pictures of all these hernia belts and products that were thrown away after the NHS began, because people could finally have their hernias repaired rather than just using all these awful truss things to hold them in.

It seems to me that in the time between the end of WW2, when the NHS was set-up, until around the end of the 70s, society became more equal. Both here and in the States. There were council houses here, getting people out of slums. People were paid decently and housing was cheap and things like freezers and washing machines did away with a lot of work at home. People were paid well enough to live well. Education was free.
Since the early 80s we seem to be going backwards. People are paid less, it's almost impossible for a family to live on one salary now. Meanwhile the pay of executives has sky rocketed. The CEO of disastrous Thames Water was paid £1.6 million last year. There are no repercussions for failure.
I don't know what the answer is. We seem to be heading back to a time when the poor can't afford healthcare. NHS dentists are practically non-existent.

I think that is part of it.

75 years ago,
Antibiotics weren't invented so hospitals needed to be shit hot on cleanliness.

Surgery without modern anesthetic was still very dangerous

Cancer treatment and any sort of replacement bits (knees, hips hearts) were still a pipe dream.

Plastic surgery / reconstructive surgery wasn't a thing until after WW2 when surgeons started working on war veterans.

Generally 75 years ago.
People possibly had less food but better quality food,

People generally didn't have cars so walked more. More villages had Schools rather than children being bussed into towns.

Modern gadgets weren't a thing, heating the house involved getting a bucket of coal in from outside. The washing involved physically scrubbing and wrining it, and handing it up.
TV wasn't a thing, people walked to the local cinema, played music and sports because it was something to do in their limited free time
So more active and healthy lifestyles.

Poor people just didn’t go to doctors, unless they could afford the sixpence required to see a doctor as a “panel patient”.
My parents were born during and just after the First World War. Four of my mother’s seven siblings died in infancy. Labours took place at home attended by an untrained neighbour or older woman with experience of childbirth.
My father’s grandmother was an unqualified “midwife” who regularly suffocated newborn babies and told the mothers they were stillborn, if they looked obviously abnormal or were premature, and the mother was already struggling with six or more children in dire circumstances in the Tyneside slums.
My parents were so used to growing up without access to healthcare, they never called the doctor for their own children, (even though we were both born after the inauguration of the NHS) unless we had a legally notifiable infectious disease such as measles.

Plastic surgery has been around since at least 1600bc with reconstruction of noses.
Syphillis was probably the biggest early prompt for plastic surgery because of the damage it did to the face .
Wax was actually one of the first facial fillers and caused terrible problems in 19th century.
war has played its part but modern plastic surgery , could be argued , started in 1917 with the walking pedicle flap. It was a technique refined by Archibald McIndoe and Harold Gillies to help repair some of the terrible facial disfigurements.
Food quality was a problem for the poor , milk had been routinely adulterated with chalk and was unpasteurised , bread had been adulterated with chalk and other less savoury items. Botulism killed many , including possibly Antarctic explorers because of unsafe tinned foods.

There were possibly more babies born with deformities before the advent of scans etc

People often forget 12 & 20 week scans aren't for entertainment purposes they are medical appointments and some women do get told sort your baby isn't viable. Which results in a decision to terminate the pregnancy. It's something that just isn't really spoken about.

I'll stand corrected Harold Gillies was working on war veterans after first World War.
I couldn't have told you his name but hes the man I was thinking about 🙂

My siblings and I were born in the mid-late 1980s, on the continent. My mum had a grand total of 1 scan across all three pregnancies, because her sickness was so much worse second time round, so they wanted to rule out twins. So regular scans in pregnancy are relatively new. Incidentally, they freak my grandad (91) out so much he refuses to look at them😊

It explains so many random things in old literature - obsessions with changing damp shoes to ward off colds, 'delicate' invalids, children's books having endless adventures while in six week quarantines for measles, scarlet fever etc...

There were hospitals for the poor but they were grim. Also divided by illness, e.g. fever hospitals, TB sanatoriums (TB was absolutely rife in many areas, any references to people 'wasting away' were often to that, think of Beth in Little Women).

There are brilliant books about women nursing both in WW1 and WW2 - Monica Dickens wrote a brilliant one about being in a general (non-war) hospital as a trainee nurse in England in WW2: https://www.amazon.co.uk/One-Pair-Feet-Virago-Classics/dp/B09TWNWLLD/ref=sr_1_5?crid=1HYCX7QTI4NYA&keywords=monica+dickens&qid=1688728709&sprefix=monica+dickens%2Caps%2C87&sr=8-5

Our Spoons Came From Woolworths another good eye-opening read about a literate woman whose horrible husband deserted her and her children, two of them I think died:
https://www.amazon.co.uk/Our-Spoons-Came-Woolworths-Classics-ebook/dp/B00CXU7HVK/ref=sr_1_1?crid=2GU6QUY9WROMC&keywords=our+spoons+came+from+woolworths&qid=1688728761&s=audible&sprefix=our+spoons%2Caudible%2C72&sr=1-1-catcorr

It helps understand why older generations had so many things they just didn't talk about and were so stoic in many cases.

Also why for a very long time being a live-in servant was seen as desirable for many parents for their many, many children - it was a roof over the head, fairly decent and extremely reliable food, and likely a doctor being called by the master or mistress in case of extreme illness. As benefits and medicine improved, this was a less valuable bargain for ordinary working class people.

Working Class Wives by Margery Spring Rice is an eye-opening read, I wish it was on kindle.

Yes they are relatively new. I think the 12 week scan came in during the 80s, 20 week scan around 2000 but people do forget they are to give women choices.

Here’s the list of equipment my Nan had to take to have on hand for her first birth in 1928, and how much she had to pay (and when she finished paying for it) for the midwives.

Set in the 1960s when we had the NHS and not authentic as I was working in that part of London at the time in a healthcare setting.

Enforceddrysummer the later episode are set in the 1960, but there are much earlier series that are set in previous decades

My grandmothers delivered each others babies. No midwives involved. One baby lived a few hours and was put in a shoebox to be taken to the cemetery for burial in a communal grave. 1928. Two of her brothers were brain damaged during their births. Only one my maternal grandmother's four children was unharmed. My paternal grandmother had five children who were all born fit and well. One died at six of undiagnosed ruptured appendix and one at 23 of an untreated hernia. It was awful pre NHS and despite its shortcomings, it's far better than medicine a century ago.

Earliest episodes were 1950s, so after the NHS began.

And casualty 1900 series.

Another good series is the German equivalent to the above Charitè.

Not exactly pre-NHS but in the late 1800s Germany was a world-leader in medical advances.

My grandfather and his brother were born at home. The brother was born with a deformity in both feet but somehow his parents could afford to have them corrected with surgery - which took place on the kitchen table.

My gran caught scarlet fever as a child and was taken by horse drawn ambulance to the fever hospital in our small town.

Her father ran a business so relatively affluent.