Victorian and Edwardian cottage hospitals, compared to infirmaries and workhouse institutions, have been neglected by social historians. Yet, they provided an infrastructure dedicated to localism and healthcare for the aged under the new National Health Service (NHS) after World War Two. This article focuses on two renowned Midlands cottage hospitals built in mid-Northamptonshire at Pitsford. In their patient case-histories we can engage with: dignity standards, medical regime, ward designs, staffing levels, budget provisions, and patient voices. These popular institutions had a well-deserved reputation for delivering high-quality geriatric medicine from 1948 to 1978. Human vignettes detailing the physical indignities of ageing nonetheless proliferate in the records. The longevity of these basic issues was to prove to be a recurring tension in NHS financial planning. Budget models lacked enough funds for aged patients to receive ‘stable’ bedside care. Instead, NHS accountants allocated resources to ensure the future ‘sustainability’ of the system itself. A new paradigm highlights the inherent financial contradictions and empty political promises that those needing geriatric care often experienced, and still do. Throughout, the rediscovered cottage hospital records contain important historical lessons for the present impasse about how to define, deliver and secure dignity for elderly patients in today’s NHS.

中文翻译：

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“让我摆脱这种侮辱！”：英格兰中部的山寨医院、地方主义和 NHS 医疗保健，1948-1978

与医务室和济贫院相比，维多利亚时代和爱德华时代的乡村医院被社会历史学家忽视了。然而，他们在第二次世界大战后在新的国家卫生服务 (NHS) 下提供了一个致力于地方主义和老年人医疗保健的基础设施。本文重点介绍在北安普敦郡中部皮茨福德建造的两家著名的米德兰乡村医院。在他们的患者病历中，我们可以参与：尊严标准、医疗制度、病房设计、人员配备水平、预算规定和患者的声音。从 1948 年到 1978 年，这些受欢迎的机构因提供高质量的老年医学而享有当之无愧的声誉。尽管如此，详细记录衰老带来的身体侮辱的人类小插曲仍然在记录中激增。这些基本问题的持久性被证明是 NHS 财务规划中反复出现的紧张局势。预算模型缺乏足够的资金让老年患者获得“稳定”的床边护理。相反，NHS 会计师分配资源以确保系统本身的未来“可持续性”。一种新的范式凸显了那些需要老年护理的人经常经历的内在财务矛盾和空洞的政治承诺，现在仍然如此。自始至终，重新发现的山寨医院记录都包含了重要的历史教训，可以解决目前关于如何在当今 NHS 中定义、提供和确保老年患者尊严的僵局。NHS 会计师分配资源以确保系统本身的未来“可持续性”。一种新的范式凸显了那些需要老年护理的人经常经历的内在财务矛盾和空洞的政治承诺，现在仍然如此。自始至终，重新发现的山寨医院记录都包含了重要的历史教训，可以解决目前关于如何在当今 NHS 中定义、提供和确保老年患者尊严的僵局。NHS 会计师分配资源以确保系统本身的未来“可持续性”。一种新的范式凸显了那些需要老年护理的人经常经历的内在财务矛盾和空洞的政治承诺，现在仍然如此。自始至终，重新发现的山寨医院记录都包含了重要的历史教训，可以解决目前关于如何在当今 NHS 中定义、提供和确保老年患者尊严的僵局。