This article explores the local mixed economy of healthcare in two of England’s largest cities – Leeds and Sheffield – between the late Edwardian period and the outbreak of the Second World War. It examines the level of service provision across the period to identify areas of strength and weakness and considers the extent to which these were determined by local political priorities. It examines indicators of success, such as falling death and infant mortality rates, increased access to treatment in hospitals and clinics and improved outcomes for those treated. Finally, it assesses the degree to which the mixed economy was able to develop a coordinated approach despite limited and ineffective central state direction. In particular, it looks at how local authorities and voluntary providers worked together in areas like Infant and Child Welfare, Maternity provision and general acute treatment to build the healthy city. Overall it suggests that this mixed economy, operating within a policy environment shaped by local urban cultures and needs, was able to deliver extensive health care improvements which belie the conventional pessimistic assessments of the period.

本文探讨了爱德华七世晚期和第二次世界大战爆发之间英国两个最大城市利兹和谢菲尔德的当地混合医疗保健经济。它检查了整个时期的服务提供水平，以确定优势和劣势领域，并考虑了这些领域在多大程度上取决于当地的政治优先事项。它检查了成功的指标，例如死亡率和婴儿死亡率下降、在医院和诊所获得治疗的机会增加以及接受治疗者的结果得到改善。最后，它评估了混合经济在中央国家指导有限且无效的情况下能够发展协调方法的程度。特别是，它着眼于地方当局和志愿提供者如何在婴儿和儿童福利等领域合作，生育保障和一般急性病治疗建设健康城市。总体而言，这表明这种混合经济在由当地城市文化和需求塑造的政策环境中运作，能够带来广泛的医疗保健改善，这与该时期传统的悲观评估不符。