Drawing on hospital reports, committee minutes and the local press, this article examines the changing landscape of urban civic culture and challenges the pessimistic accounts of charitable financial support for voluntary hospitals in inter-war England. Through case studies of hospitals in four of the largest cities in the country, it assesses the extent to which voluntary resources of time and money continued to underpin day-to-day institutional income, stimulate the development of the hospitals' estates and investments, and enable hospitals to cut costs through the receipt of gifts in kind. It argues that by broadening the bases of charitable income, hospitals were freed from their dependence on the wealthy thus ensuring their transformation to modern community resources for all.