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The process whereby the 19th-century Canadian charity hospital for the sick poor was transformed into a centre for scientific health care for the whole community was well in hand by World War I. To fund this transition, and to cope with the subsequent unrelieved demand from all social classes for accessibility to hospitalization, hospitals instituted differentiated services, offering premium care and privacy to paying patients whose fees, in turn, sustained a more economical level of open ward maintenance for indigent patients. As the record of a 1912 public investigation into patient grievances and complaints against the Vancouver General Hospital reveals, the commodification of hospital-based health care reproduced in the hospital environment the social attitudes, controls, and structures of the wider community. This development appeared to contradict the hospital’s promise of undifferentiated, scientifically- mediated, medical efficiency and efficacy for all, and its reputation as a humane and caring institution. Notwithstanding the inquiry’s conclusion that these grievances were “evil reports” designed to appeal to “ignorant minds,” they reveal a patient population of already informed consumers ready, willing, and able to discriminate between the promise and the reality of hospital-centred health care for all.

“Evil Reports” for “Ignorant Minds”? Patient Experience and Public Confidence in the Emerging Modern Hospital: Vancouver General Hospital, 1912