"For a healthy London": the Socialist Medical Association and the London County Council in the 1930s.

London's hospitals are never far from the news, recently for often depressing reasons. The inter-war period, however, saw expansion and development in the capital's municipal hospital service. Between 1921 and 1937 expenditure on centralized health services such as hospitals rose by a factor of nearly twenty, so that by the latter date London accounted, Lee suggests, "for almost a quarter of national expenditure on centralised health care". This confinned the capital's primacy "as the major national centre of hospital medicine". In so expanding, London was almost certainly advantaged in that the economic depressions of the period hit the city relatively lightly. This was in contrast to other areas, for example the Manchester region, where, as Pickstone points out, development of the hospital services was constrained by the collapse of the cotton industry and the general depression of the 1930s.1 London also had some of the most prestigious voluntary hospitals. These were independent institutions, reliant for their income on donations and subscriptions, and included such famous teaching hospitals as St Thomas's. There were significant differences between municipal and voluntary hospitals, however, not least in that the former bore the brunt of care for the long term and chronic sick. And as Esther Rickards, a Labour member of the London County Council (LCC), commented in 1938, municipal general hospitals provided over 22,000 beds for London's people. The voluntary hospitals, on the other hand, provided 15,000 "but only 9,000 of these are available for the inhabitants of London, the remainder being occupied by patients from outside the county". An official post-war LCC publication made a similar point, adding that this situation prevailed despite the presence of "twelve teaching hospitals and many other well-known voluntary hospitals". Sir George Newman, former Chief Medical Officer to the Ministry of Health, summed the situation up in 1939 by describing the LCC as the "greatest Local