A.J. Cronin- the Citadel

AJ Cronin and The Citadel: how a “middlebrow” novel contributed to the foundation of the NHS

Seamus O’Mahony

Consultant Physician/Gastroenterologist

Cork University Hospital

Wilton

Cork

Ireland

Seamus.omahony@hse.ie

Tel: 00353214922378

Fax: 003534346494

Introduction

AJ Cronin (1896-1981), an author little known to those below the age of fifty, was arguably the most successful novelist writing in English in the 1930s. His best known novel, The Citadel, was published in 19371. The book paints an unflattering portrait of British medicine in the inter-war years. It is widely thought that the book influenced the result of the 1945 general election in Britain, and the subsequent establishment of the National Health Service (NHS) by the Labour government in 19482. The Citadel anticipates such phenomena as evidence-based medicine and continuing medical education. This paper examines the influence of the novel and argues that although Cronin’s novel did significantly influence public opinion in Britain in favour of socialized medicine, the novel was never intended as propaganda for a state-controlled national health service. On the contrary, Cronin was against state control. Analysis of the novel is informed by recent biographical revelations about Cronin, and the blurring of the margin between fact and fiction in Cronin’s life and work is examined.

Brief Biography of Cronin

Cronin was born in Cardross, Scotland in 1896. His father was of Irish descent and Catholic; his mother’s family was Protestant. Cronin’s father died when he was 7, forcing Cronin and his mother to move in with her parents. Cronin excelled academically and at sports, and won a Carnegie Foundation Scholarship to study medicine at Glasgow University, where he graduated in 1919. He subsequently worked as a GP in South Wales, moving then to London, where he established a successful private practice. In his mid-30s, he experienced some form of crisis – ascribed to peptic ulcer in...