According to Joseph McAleer,
After the Second World War, the NHS [National Health Service] inspired a new kind of popular novel that was [...] supportive and sympathetic to the emerging health care system. [...] the new 'Doctor-Nurse' novels first published by Mills & Boon in the 1950s [...] reinforced a positive view of the NHS among middle- and working-class readers. [...] the almost fanatical endorsement of the medical profession is striking. The message sent, and met with approval by adoring readers, was this: nurses are heroic and selfless; doctors are larger than life; the delivery system works; and hospitals are places of romance as well as healing. The NHS could not have asked for a better endorsement. (174)
By contrast, here's a short passage from a US-set romance from 1994, whose hero is a recreational therapist:
"Private insurance companies aren't willing to spend money entertaining people, as they call it." Matt's lips curled derisively. "They'll cover physical therapy costs, but most baulk at recreational therapy."
"I find that hard to believe."
"It's true, though. If medical insurance companies subsidized places like mine, there'd be hundreds of them across the country. Unfortunately, there aren't, and only the well-off can afford the few that do exist. I try to take on as many needy cases as I can, but that's not a huge lot," he admitted. "I have to pay my therapists' salaries and feed the animals, and I can't do that without charging."
"What a shame!"
"It certainly is. The United States is one of the wealthiest nations in the world, but we have no comprehensive national health plan. It's a crime that people have to pay so dearly for medical treatment. To make matters worse, the more medical problems you have, the less likely you'll find an insurance company willing to underwrite you. [...] I'm involved with a group that's been lobbying Congress for a national health care system. So far there's been a lot of talk about legislation, but not much else." (Duquette, 29-30)
I haven't yet seen any comparison between medical romances from the US, UK, Australia, etc but I think one could be very interesting given how different their medical systems are. The descriptions of some of US author Adeline McElfresh's medical romances, for example, are intriguing: in Doctor for Blue Hollow (1971)
The rundown clinic at Blue Hollow was a far cry from big, modern Bayley Memorial Hospital where Ann Tyler once worked. But for the lovely young surgeon, this tiny Kentucky mining town seemed a perfect refuge from the memory of a handsome doctor who betrayed her love.
Waiting for Ann was the challenge of protecting the health of the miners and their families, even though this meant battling the owners over safety in the mines.
It sounds as though the novel deals with inequalities in healthcare provision and also with the ways in which the interests of big business can conflict with the health needs of their workers and their communities. Another of her novels, New Nurse at Dorn Memorial, features a heroine, Celeste Weller, who
had never walked away from a challenge, and her new career at Dorm Memorial Hospital would prove to be the greatest challenge yet. Not only was she the first nurse to break the racial barrier at conservative Dorn, but through the bigotry of one of its influential patients, she was transferred from the Surgery Department, her first love. From there she was thrust into the hectic schedule of double shifts in Emergency and the clinic purposely designed to force her to resign.
Celeste knew a bigger city might give her a better opportunity for acceptance on her own merit, but she was determined that her small hometown would have to make room for her. And she had allies on the staff. But more than that, Celeste was the best nurse Dorn had ever had.
As far as I can recall, the medical staff in the UK-set romances I've met have been pretty much exclusively white, which doesn't seem very accurate given that
Once the NHS was up and running in 1948, demand for health service labour increased rapidly, not only for basic care but also for new techniques and technologies such as radiology and blood labs. At a time of overall labour shortages in the British economy, health service workers from abroad were vital, with recruits from the Caribbean and the Indian subcontinent especially prominent. [...]
The overall scale of recruitment from abroad is striking. By 1960, between 30 and 40 per cent of all junior doctors in the NHS were from India, Pakistan, Bangladesh and Sri Lanka. “The Health Service would have collapsed” said eminent doctor Lord Cohen of Birkenhead, if it had not been for this “enormous influx”. [...]
Around 30 per cent of doctors and 40 per cent of nurses in today’s NHS were born outside the UK. Those proportions may yet rise as an ageing population limits the potential supply of British-born staff while adding to increased demand for health care. (Bowlby)
I do know that Anne Fraser's The Playboy Doctor's Surprise Proposal features a hero whose "parents are from India originally"; it's set in Australia.
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Bowlby, Chris, 2011. 'How Immigration Saved a British Institution', History Extra, 28 July 2011.
Duquette, Anne Marie, 1994. The Dinosaur Lady (Don Mills, Ontario: Harlequin).
Fraser, Anne, 2010. The Playboy Doctor's Surprise Proposal (Richmond, Surrey: Mills & Boon).
McAleer, Joseph, 2011. ‘Love, Romance, and the National Health Service’, Classes, Cultures, & Politics: Essays on British History for Ross McKibbin, ed. Clare V. J. Griffiths, James J. Nott, & William Whyte (Oxford: Oxford University Press), pp. 173-191.