on 20 October 2010
Anne Hardy presented herself with an enormous task when attempting to condense 140 years of British medical history into 234 pages. It is clear that from 1860, Britain saw wide-ranging developments in health and medicine and this is reflected in a vast historiography. Therefore, any attempt at a comprehensive overview would require a historian with advanced skills and sound judgement. Hardy attempted to plot the key events in British medical history from the 19th century through to the dawn of the twenty-first century in an uncomplicated and thematic fashion. A number of important points can be made on her work.
Hardy's work has a number of notable strengths. First of all, her chronological and thematic approach is beneficial to the reader. This chronological approach has the benefit of plotting the development of health and medicine throughout the period, which helps the reader to understand how our current form of medical care was created. The thematic breakdown makes big topics far more digestible. In terms of content, Hardy's analysis of civilian health during the Great War was outstanding, particularly charting civilian mortality from infectious disease, lack of healthcare provision and the 1918 influenza outbreak (Ch. 2). This fills gaps left by writers such as, Marwick and De Groot, whose works are considered outstanding in charting the civilian experience of the war. Hardy has made a good attempt at surveying health and medicine in the post-war period, which is not an easy task, due to the vast range of developments starting with the establishment of the National Health Service. However, this good work will always be overshadowed by the excellent work of Berridge on the same period. Hardy can also be praised for her mention of the changing attitudes towards the regulation of pharmaceuticals in the post-Thalidomide period, which was indeed a watershed in medical history (p. 166-8).
However, an important criticism refers to the starting point of 1860, which sometimes dilutes the importance of events. For example, public health in the late nineteenth century (pp. 29-39). Improvements from 1860 are addressed adequately but the starting point neglected the struggles of the early sanitary reformers when implementing public health reforms, without which, the later sanitary improvements may not have occurred in the recognised form. However, the starting point is also understandable, as the early nineteenth century saw many transformations, which would warrant a book in its own right. The value of this book would be enhanced by reading authoritative works on the earlier period. Further criticism can be applied to the imbalanced regional analysis of health. Scotland is particularly overlooked. According to the Index, Scotland is considered on three pages - two in the Introduction. Historians focussing on the Scottish experience of health and medicine throughout this period strive to mark this fundamental regional difference (For example, John Stewart). However, as this was a summary of a lengthy period this would be difficult to address within reasonable limits. At the same time, this clearly shows that a summary of health and medicine in Britain from 1860 may not be adequate because of the diversity of regional experiences.
Despite a few minor criticisms, Health and Medicine in Britain Since 1860 is a valuable contribution to the vast historiography surrounding health and medicine in Britain and a useful addition to the history of medicine as a whole. Hardy has provided a useful summary and reference text, which excites the reader's curiosity and encourages further reading on topics of interest. This book is particularly recommended for students studying health history and those with a general interest in Britain's medical past, as it provides key information in a very accessible and readable fashion.