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Yes / Emergency Department demand continues to rise in almost all high-income countries, including those with universal coverage and a strong primary care network. Many of these countries have been experimenting with innovative methods to stem demand for acute care, while at the same time providing much needed services that can prevent Emergency Department attendance and later hospital admissions. A large proportion of patients comprise of those with minor illnesses that could potentially be seen by a health care provider in a primary care setting. The increasing number of visits to Emergency Departments not only causes delay in urgent care provision but also increases the overall cost. In the UK, the National Health Service (NHS) has made a number of efforts to strengthen primary healthcare services to increase accessibility to healthcare as well as address patients’ needs by introducing new urgent care services. In this review, we describe efforts that have been ongoing in the UK and France for over a decade as well as specific programs to target the rising needs of emergency care in both England and France. Like many such programs, there have been successes, failures and unintended consequences. Thus, the urgent care system of other high-income countries can learn from these experiments.

This thesis examines Irish and Jewish mothers' experience of maternity provision and infant care services in East London in the years 1870-1939. As newcomers these immigrants not only had to cope with poverty but also the barriers of language and different cultural customs. Leaving their family and kinship networks behind them, Irish and Jewish mothers had to find new sources of support when incapacitated through pregnancy or childbirth. Living in one of the poorest areas of London and unfamiliar with the local medical and welfare services, these immigrants might be expected to have suffered very poor health. On closer examination, however, Irish and Jewish immigrants appear to have had remarkably low rates of infant and maternal mortality. Despite the difficulties they faced as newcomers, Irish and Jewish mothers had certain advantages over the local population in East London. They were not only able to rely on the prolific and diverse services already present in East London, but could also call upon their own communal organisations. This provision offered a wide range of care and was a vital support to the newcomers. After examining the social and economic background to Irish and Jewish emigration and settlement the thesis examines what impact this had on their health patterns, particularly infant and maternal mortality. The following chapters explore what forms of support were available to married Irish and Jewish mothers through their own family and local neighbourhood and communal agencies. Chapter five concerns the unmarried mother and what provision was made specifically for her. The care offered by the host society to immigrant mothers and their infants is explored in chapters 6 to 8. Institutions covered by these chapters include voluntary hospitals, Poor Law infirmaries, and charitable organisations such as district nursing associations and medical missions. The thesis examines not only the services available to Irish and Jewish mothers, but also the attitudes of health professionals and philanthropists towards immigrants and how these affected the accessibility and acceptability of maternity and infant welfare services to Irish and East European Jewish mothers.