The legacy of voluntarism: charitable funding in the early NHS

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Before 1948, approximately one-third of the United Kingdom (UK)’s hospital beds were located in voluntary hospitals, many of which continued to benefit from the funds generated by their historic endowments. When the National Health Service (NHS) was created, the vast majority of these hospitals were taken over by the State. This paper examines the neglected question of what happened to these endowments and the role which charity continued to play in the funding of NHS hospitals more generally. It makes an explicit attempt to examine the development of hospital services in each of the UK's constituent nations and shows how the treatment of endowments and the role of charity differed between them. It also highlights the continuing importance of arguments over the ‘boundaries’ between ‘essential’ and ‘non-essential’ forms of health service expenditure, and between the roles of the statutory and voluntary sectors more generally.

Original languageEnglish
Number of pages30
JournalEconomic History Review
Early online date28 Aug 2023
Publication statusE-pub ahead of print - 28 Aug 2023


  • health
  • hospitals
  • charity
  • United Kingdom
  • national health service
  • NHS


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