Race, Rations, and Revenue: The Unequal Cost of Medical Care in the Colonial Hospitals of Calcutta, 1849–1891

Between 1849 and 1891, Calcutta’s colonial hospitals provided European and Indian patients with unequal levels of provision. This paper examines how racial classification shaped the cost of hospital care, how these differences were funded, and why they varied between institutions. Drawing on hospital regulations, financial accounts, medical reports and mortality records, it compares institutions serving different patient groups, including the Presidency General Hospital, the Medical College Hospital and Howrah General Hospital. An 1849 regulation prescribed a daily diet charge of four annas for European patients and one anna for native patients. By 1891, European diets still cost considerably more, although the difference varied between hospitals. Europeans accounted for only about 3 per cent of patients treated that year, while public funds supplied approximately 88 per cent of hospital receipts. The paper argues that racial discrimination extended beyond admission and the segregation of wards to the resources allocated to patients within the same hospital system. Differences in institutional purpose, organisation and funding help explain why the cost gap was not uniform. Evidence on hospital conditions and mortality also cautions against treating expenditure as a direct measure of the quality of care. By tracing the relationship between race, rations and revenue, this paper shows how colonial hospitals maintained unequal provision within a system that relied predominantly on public funding. It extends the history of Calcutta’s hospitals beyond 1860 and demonstrates the importance of examining not only who received medical care, but also the terms on which it was provided.