Over the last year I have been revising the pages on this website that cover the hospitals in England. I am aware that some of the county pages have little more than a list of sites. Herefordshire was one that had very little information about any of the buildings, but it has now been revised with maps, brief histories and illustrations. This post gives a quick summary of the historic hospitals of Herefordshire and the present status of those buildings.
Hereford General was the first hospital in the modern sense to be established in the county. It was founded in 1776 and occupied adapted premises in Eign Street. Its success warranted a permanent structure for which a site was given by Lord Oxford (Edward Harley, the third Earl of Oxford and Mortimer, who was MP for Leominster and Droitwich). Building work began in 1781 to designs attributed to William Parker and was completed in 1783.
The original building survives at the heart of the site, comprising the central nine bays with advanced pedimented centre. It has been much extended and altered, upwards and outwards, including the entrance porch that was added in 1887 at the same time as the Victoria Wing. By the middle of the twentieth century the site was heavily built over, apart from the open ground immediately in front of the original range overlooking the River Wye. A good sense of way in which the hospital evolved can be gained from a short film made in 2002, as the hospital faced closure, which gives the viewer a guided tour both outside and in (see Hereford Focus on YouTube).
Hereford General remained the main acute hospital for the county throughout the nineteenth century and into the twentieth. The main alternative was Hereford Union Workhouse, which would have had some accommodation for sick paupers from when it was first built in 1836-7. New infirmary wings were built on the site in 1876 and in the early 1900s, but the main transformation came after the Local Government Act of 1929 which saw many former workhouses transformed into municipal hospitals. For Hereford this resulted in its development into the present Hereford County Hospital, initially with a new hospital range begun just before the Second World War. Shortly after the war broke a series of hutted ward blocks were built on the site as part of the Emergency Medical Scheme to provide for the anticipated large numbers of casualties.
Hereford also had a number of specialist hospitals. The Victoria Eye and Ear Hospital opened in 1889, a handsome Tudor style building designed by the local architect E. H. Lingen Barker. Hereford Town Council also provided for infectious diseases with hospitals at Tupsley while the wider county was served by a sanatorium for tuberculosis near Ameley in a converted house (Nieuport Sanatorium). Provision for maternity cases was increasing in the 1940s, as hospital births began to be more common than home births. The County Hospital had a maternity department that was being extended at the end of the war, and there was a small public maternity ward at the General as well as a few private beds. There were also a few maternity beds at all but Ledbury of the former workhouses, while for private paying patients there was a maternity home in Hereford with four beds.
There was also the county mental hospital, St Mary’s, at Burghill, first opened in 1871 and a ‘mentally deficiency’ institution at Holme Lacy House that opened in the 1930s. In the rest of the county there were a few workhouses, cottage hospitals and small rural isolation hospitals that were established in the nineteenth century.
Most of the pre-war hospitals in the Herefordshire are no longer in the NHS estate. Some have been demolished, others adapted to new uses. When the NHS came into being in 1948 the hospitals in Herefordshire came under the Birmingham Regional Hospital Board, which also covered Worcestershire, Warwickshire, Staffordshire and Shropshire. This administrative structure remained in place until the NHS reorganisation of 1974.
Initially the Regional Board was responsible for around 220 hospitals with a total of about 42,000 beds. These were grouped into management units based on function and geographical location. Herefordshire Hospital Management Committee oversaw eighteen hospitals. These were: the General and County Hospitals and the Victoria Eye Hospital in Hereford; St Mary’s Mental Hospital, Tupsley Hospital for infectious diseases and Tupsley Smallpox Hospital; Holme Lacy Hospital for ‘mental defectives’; the cottage hospitals at Ledbury, Leominster, Ross-on-Wye, and Kington; Stretton Sugwas Hospital, near Credenhill; Nieuport Sanatorium; the former workhouses at Ross-on-Wye (Dean Hill Hospital), Bromyard, Leominster (Old Priory Hospital),and Kington (Kingswood Hall). Leominster and Kington were owned by Hereford County Council but the NHS had rights to accommodation under the 1948 National Assistance Act. Nieuport Sanatorium closed in 1951 and the Tupsley smallpox hospital was used as a store. Another smallpox hospital near Bromyard was transferred to the NHS but not used, it was sold in 1952.
There are now four NHS hospitals in Herefordshire: Herefordshire County Hospital (the main complex built in 1999-2001, W. S. Atkins Healthcare, with other blocks from 1950s-80s and fragments of the 1830s workhouse), and three community hospitals at Leominster (1899, partly rebuilt 1991), Ross-on-Wye (1995-7 incorporating part of the former workhouse) and Bromyard (1989, Abbey Hanson Rowe Partnership). Mental Health services also operate two in-patient units in Hereford: the Stonebow Unit is on the County Hospital site and is a purpose-built facility erected in 1985 that was recently upgraded, and Oak House in Barton Road, a residential rehabilitation unit in a converted house.
Herefordshire in 1945 was still an essentially rural county with no large centres of population. The advent of the NHS was seen as an opportunity to rationalise services, including centralisation, continuing a process that had begun before the war. In order to inform the strategic planning of the hospital service, the Board drew on the Hospital Survey of the West Midlands Area published in 1945 by the Ministry of Health. The Survey did not cover the mental health service which was considered as an essentially separate service with its own legislative basis and at the time there were uncertainties about how it might be integrated within a broader national health service, or even if it should be included at all.
The future of cottage hospitals was particularly threatened by the wider policy for modernisation, centralisation and rationalisation. The Hospital Survey of 1945 noted that Ross-on-Wye cottage hospital had 16 beds, plus ‘a few beds in huts in the garden’, Leominster had 13 beds, Ledbury 12 and Kington just 10 beds. There had also been a cottage hospital at Bromyard, but financial difficulties had led to its closure during the First World War. The others lasted longer. Ross-on-Wye Cottage Hospital was replaced by the new community hospital built on the site of the old workhouse. It was demolished after closure in 1997 and replaced by retirement flats. The original Leominster Cottage Hospital partly survives, absorbed by the present community hospital. Its ward block was demolished to make way for the new hospital building which opened in 1991. Ledbury Cottage Hospital was converted to mixed residential and business use in 2009, having closed in 2002. The Victoria Cottage Hospital at Kington is now Kington Youth Hostel.
The Hospital Survey also noted that five former workhouses in Herefordshire had chronic sick wards: Leominster, Ross, Kington, Ledbury and Bromyard. Leominster workhouse, like Kington Cottage Hospital, has become a youth hostel (the workhouse had incorporated some fifteenth-century priory buildings). Ross-on-Wye union workhouse developed into Dean Hill Hospital for geriatrics and mental health unit, and had 157 beds by the mid-1960s. The workhouse buildings have partly been demolished to make way for the present community hospital. Kington and Ledbury Workhouses were not transferred to the NHS. Kington has been demolished and Ledbury partly demolished, but some of the workhouse ranges were converted into housing. Bromyard Workhouse has also been turned into flats, not with great sensitivity.
The largest hospital in the county was St Mary’s, built as the City and County Asylum. It closed in 1994 and in 1998 most of the hospital buildings were ‘stupidly demolished’ (according to the Pevsner Architectural Guide) to make way for a large housing development. The entrance building (St Mary’s House) remains along with sections of the ward wings which were converted to flats.
More information on Herefordshire’s hospitals can be found on the Herefordshire page. There is also more on the workhouses on the workhouses.org site. Archival records relating to the hospitals are mostly at Herefordshire Archive and Records Centre, and I would also recommend the Herefordshire Through Time website, which has a section on hospitals. Historic England Archive has the hospital reports and building files that were put together for the national survey of hospitals carried out in the early 1990s on which I worked (though not on Herefordshire). The files may contain photographs of buildings that were standing then but have since been demolished.