Doyle examines the role of local and national politics on hospitals. Ultimately, Doyle argues that social and economic diversity created a number of models for future health care which rested on a combination of voluntary and municipal provision.
"Drawing comparative patterns and conclusions from a case study of two cities, no matter how detailed, is always going to be problematic. To counter this, Doyle exhibits a thorough knowledge of the secondary literature to place his two cities in a broader context. He offers, too, some excellent data on hospital admissions and finances, and interesting thoughts on such side issues as the role and social function of almoners, and the impact of the motor car on hospitals." - Nick Hayes, Nottingham Trent University