title: [Vaud regional hospitals from private philanthropy of the to state-province administration (19th-20th century)].
abstract: In the canton of Vaud (Switzerland), hospitals were originally created within a local philanthropic framework which aimed as much at healing as at controlling the working classes. The practice of medicine was still not very effective, and the generosity of a few well-known people was enough at that time to ensure the viability of small infirmaries, run by deaconesses with just one or two doctors working part-time. Towards the end of the 19th century progress in medicine, particularly in surgery, and the beginning of a greatly improved technical environment following the introduction of X-rays, threatened the operation of these infirmaries. It became necessary to build new hospitals, to engage trained personnel in large numbers, to professionalize the management and to re-examine the organisation of these larger and more complex hospitals in order to meet the increasing demand for hospital treatment. This change of scale put an intolerable strain on the philanthropic framework and eventually led to the increasing intervention of public authorities. In the canton of Vaud after 1945 there was a widespread network of regional hospitals, which were heavily dependent on government funding. From being the principal supporter of a hospital network which had arisen from locally-based groups of infirmaries, the state intervened at the end of the 1970s with the aim of rationalizing the system.
authors.affiliation: Institut universitaire romand d'histoire de la médecine et de la santé, Chemin des Falaises 1, CH-1005 Lausanne. pydonze@hotmail.com
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Donzé
mesh_terms: D005653:Fund Raising / Q000266:history*; D049672:History, 19th Century; D049673:History, 20th Century; D006767:Hospitals, District / Q000266:history*; D006779:Hospitals, Public / Q000266:history*; D016519:Hospitals, Religious / Q000266:history*; D006801:Humans; D013557:Switzerland