The Ulleråker Hospitalum : A Case Study in the Wage Development of the Medical Sector 1890-1920

Abstract: This essay presents a case study about the development of income levels in the medical sector during Sweden´s period of modernization, 1890-1920, focusing specifically on the five wage groups which comprised the medical staff at Uppsala´s Ulleråker hospitalum (=mental asylum). This institution, though different in it´s stated mission from hospitals and the like, was similarily organized, and staffed with employees belonging to the same categories as regular hospital staff - they shared similar social backgrounds, education levels, work tasks and conditions. This was thanks to the centralized nature of the Swedish medical sector, which was governed mainly by the Medicinal Board, which in turn was influenced by the government on one side, and influential individuals, schools for medical education and employee organisations/unions on the other. The objective of the essay is to establish a timeline of the wage development, and to identify factors which influenced this development. Furthermore, it seeks to identify differences between genders, wherefore the male orderlies and female nursing aides are given special focus throughout. Although the hospitalum has been the subject of previous books, the financial records have never been used in research before. The essay begins with presenting a history of Swedish societal development - and the simultaneous development of the medical sector - before moving on to establish a timeline of the nominal wage data. Using methodology developed by previous historical wage development research, it then calculates the real wages with the help of a converted consumer price index. It also makes use of a separate, in-depth study to try and showcase differences between genders; primarily, it calculates the share of bonuses of total income and what the maximum earning capacity of the male and female staff was. The essay concludes that the wage development was influenced by multiple factors. Primarily, education level was a crucial factor for the employee in securing higher wages. Not only did it serve as basis for securing higher wages, it also came with the bonus of educational organisations oftentimes aiding their graduates in discussion with prospective employers. Secondarily, collective bargaining (and, from 1904, unions), along with influential members of the national doctor´s corp (who were realizant about the need for better work conditions in order to retain talented employees) allowed the staff to directly influence decisions in the Medicinal Board, and use the conditions at other medical institutions as motivation for implementing improvements. Additionally, larger societal trends also played a part. In particular, the real wages show clearly that the wage development to a great extent followed the trends in cost of living, and obviously the extreme influence of World war I also necessitated extreme adjustments - though, interestingly, these adjustments consisted more of increased bonus payouts that wage increses, perhaps due to bonuses being easier to lower or discontinue after the expensive times were over. In all, education appears to have been the most important factor in securing high wages - other research reveals some wage groups used professionalization to improve their work conditions, to the detriment of lower level wage groups. Since market forces had little impact on the medical sector, due to it not producing marketable goods and services or competing for workers, collective bargaining and larger societal developments became the main influences for less educated staff.