UCC SONM 25 Year Book

UCC / School of Nursing and Midwifery

The Developing Health Services

The development of the health services is of critical importance to nursing. The training of nurses and midwives began in hospitals and hospitals continue to provide clinical placements for students. By the early 19 th century hospitals began their development when the epidemics of infectious diseases forced the government and voluntary agencies to provide for the sick poor. There was no central authority established for the health services until 1838 when the Poor Law Act established Workhouses which quickly became infirmaries for the sick poor. These grew in importance as seen in relation to St. Finbarr’s Hospital in Cork. Medicine, health services and nursing and midwifery developed within them. “Nursing” in the Workhouse was conducted by the sick paupers or by religious sisters who were trained elsewhere. As the years progressed to 1919 “trained nurses” were recruited and a hierarchical structure began to emerge with Matrons appointed who were either trained by the religious orders in Ireland or in the UK in a system influenced by the philosophy of Florence Nightingale (Nightingale, 1950). The Health Services developed and saw major growth in the period from 1950-1994. Medicine advanced and the demand for hospital care grew. In 1947 the Department of Health was established. The net effects of the Health Acts of 1947 and 1953 were that the County Councils were given powers as Health Authorities to administer the health services which existed side by side with the Voluntary Hospitals. In each County a general hospital existed, and one or more district hospitals and a county home provided for the chronically ill. The 1960’s saw a need for reform. Infectious diseases became less of a problem, and new care problems emerged such as heart diseases, cancers and morbidities associated with ageing and accidents. In this period general and specialist services began to develop with consultant medical staff appointed and relationships with universities deepened. The Health Act (1970) led to the establishment of Health Boards with officers accountable to the Department of Health (DoH) for general hospital services, community and specialised services. The Boards, comprised of membership from political parties and professionals, managed the services until 2005.

9