London's voluntary hospitals in the interwar period: growth, transformation, or crisis?

The establishment of the British National Health Service in 1948 was a watershed for the nonprofit sector, as the voluntary hospitals were taken into public ownership. This article surveys the voluntary hospitals of London in the last two peacetime decades of their existence. Although this was a period of significant expansion for the hospitals, there were also difficulties looming. City-wide data and records of individual institutions are used to explore the risk of deficit, the hospitals’ asset base, the demand for expenditure, and the changing basis of income. The analysis confirms and augments earlier discussion of gathering financial hardship. Finally, the growth of the municipal hospital service is detailed. The London County Council’s enthusiastic development of publicly funded institutions added to the problems of the voluntary sector. Public/nonprofit partnership remained underdeveloped, voluntary fundraising was undermined, and principled opposition was articulated by council members.