Healthcare in Northern Ireland, 1921-73

Northern Ireland's modern health services have long been characterised by an unusually high degree of managerialism and centralised government authority. While Northern Ireland's overly centralised health system is a modern-day policy concern, there is little understanding of its long-term, historical development. This book focuses on the policies, politics and management of health care in Northern Ireland from 1921 to 1973. This period witnessed a complete transformation of Northern Ireland's health services, evolving from a highly fragmented system - characterised by differentiated providers and weak centralisation - to the most integrated and centrally managed of the United Kingdom's three NHS systems.

The volume examines the long-term trajectory of this change. At the core of this analysis is an exploration of the interest groups that were progenitors of change, or, conversely, strongly resisted reform. These included medical professionals, hospitals, medical voluntarism, local interests, central government, and political and religious groupings. Overall, a picture of involuntary change is depicted, in which conflict and tensions between the ruling Ulster Unionist Party and multiple stakeholders are posited as central to shaping Northern Ireland's health care. The book sheds new light on interwar Northern Irish health care, the coming of the welfare state and the relationship between health and politics. This includes nationalist disenchantment and the fragmentation of unionist health policy in the lead up to the Troubles. It identifies health policy as a divisive plank of the modernising, technocratic and managerialist policies of the Terence O'Neill administration in the 1960s. The book offers original insights into this key juncture in Northern Irish politics and history.

Donnacha Seán Lucey is a Research Manger at the College of Business and Law, University College Cork