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Healthcare in London
Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.
==Early history==
The earliest state hospitals in the UK were set up in London under the management of the Metropolitan Asylums Board which was established by the Metropolitan Poor Act 1867. They supplemented the pattern of voluntary hospitals which had developed, in the case of St Bartholomew's Hospital since 1123. Florence Nightingale campaigned to establish accommodation in infirmaries for the sick separate from that provided by workhouses. She had formulated her schemes for immediate application to London because it was obvious that sweeping reforms could not be absorbed at once throughout the country.
Sanatorium benefit was a particular feature of the National Insurance Act 1911. The Metropolitan Asylums Board had established some 8,500 isolation beds and it was agreed that these beds could be used to meet the obligations of the London County Council. The Board was eventually dissolved in March 1930 as a result of the Local Government Act 1929 and its 24,000 beds transferred to the Council. The Local Government Act permitted, but did not compel, local authorities to take over Poor Law institutions, and to bring some measure of order into an expanded municipal hospital system. This opportunity was exploited by the LCC, which by 1936 had become a stronghold for members of the Socialist Medical Association. Somerville Hastings, President of the SMA, was chairman of the LCC’s hospital committee. "The LCC constituted a crucible for experiment, a state within the medical state" which informed the Ministry of Health during the evolution of its thinking on a comprehensive health service. The expansion of health services by the LCC resulted in the maternal death rate per thousand births falling dramatically, from 7.2 in 1932 to 2.49 in 1937 and London under Labour going from well above to below the national average.
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