The Architecture of Isolation

May 2, 2020October 29, 2021 / Harriet Richardson / 2 Comments

Recently I wrote a short post on this topic for the Society of Architectural Historians of Great Britain for their website. This is a slightly revised and extended version of that piece.

*Interior view of NHS Nightingale, London. Photographed on 27 March 2020 by No.10 Reproduced under Creative Commons License CC BY-NC-ND 2.0*

The conversion of exhibition centres to temporary hospitals in our major cities mimics earlier measures to cope with hospitals overwhelmed by cases of infectious disease. Though nothing on quite that scale, as far as I am aware. The last major pandemic that occurred in Britain, the ‘flu that ran rife after the First World War, completely overwhelmed the systems in place to deal with infectious diseases which included a nationwide network of isolation hospitals. These hospitals had been built in response to a series of earlier epidemics, which had given rise to a sequence of Public Health Acts, variously aimed at improving environmental health, preventing the spread of disease, and containment when disease did occur.

*Old leper Hospital of St. Bartholomew, Oxford*. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Some of the earliest hospitals were provided for the purpose of isolating those with infectious diseases. Colonies for lepers were established on the outskirts of settlements from the late 11th century to the early 13th. When the Black Death arrived in England in 1348 land was set aside for cemeteries in which to bury plague victims. Later epidemics led to the establishment of Pest Houses – these were mostly isolated dwellings for those who could not be isolated in their own homes. By the 17th century these were commonly administered by the local parish, a nurse would be employed to occupy the house and care for patients sent there.

*The Bills of Mortality from 1664. Reproduced from Paul K. BibliOdyssey Bogspot*

In London, the course of the Great Plague was documented by those who lived through it, most notably Samuel Pepys and John Evelyn. Statistics which charted the rise and fall of epidemics began in the late 16th Century with the Bills of Mortality, printed and published weekly giving the numbers and causes of deaths. Isolation remained the main way of dealing with contagion.

*Aerial photograph of the Lazaretto Vecchio, from Chris 73 Reproduced under Creative Commons License CC BY-SA 3.0*

Ports were the vulnerable points for introducing infectious disease – and most had some form of quarantine station. Lazarettos, or Lazar house, close to a harbour or on an island were more often permanent and purpose built. The Venetians were perhaps the most efficient at setting up a network of lazarettos to protect their trade interests throughout their territories. The Lazzaretto Vecchio on Santa Maria di Nazareth, an island in the Venetian Lagoon, was established in the early 15th century for both plague victims and as a leper colony. These hospitals were maintained and continued to serve their original purpose for centuries.

*The Fortress of Clissa, from* Les bords de L’Adriatique et le Monténégro, *Charles Yriate 1878*

In 1757 when Robert Adam journeyed to Spalatro (modern day Split, then a Venetian territory) to explore and record the Roman antiquities of Dalmatia, he was initially put up at the governor’s residence in the lazaretto by the harbour. He recorded how traders bringing goods from Bosnia and the neighbouring parts of Turkey were escorted by soldiers from the Fortress of Clissa (now Klis) to Spalatro to prevent them from ‘Scattering or Mixing with the People’ until their goods had been purified in the magazines of the Lazaretto and the traders themselves spent time in quarantine there. [National Records of Scotland, Clerk of Penicuik Papers, GD18/4953.]

*Edward Jenner vaccinating patients against smallpox.* Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Although various remedies were experimented with to treat disease, medicine was first used successfully in the realm of prevention, with inoculation and vaccination against smallpox. Inoculation was introduced to England in the 1720s from Turkey, and vaccination discovered by Edward Jenner at the end of the century. Despite the success of the vaccine, public uptake was not sufficient to prevent further epidemics. The first purpose-built smallpox hospital in England was in Cold Bath Fields, Clerkenwell, built around 1753. At that time three such hospitals were in existence in London: one in Islington was for those convalescing from the disease, one in Shoreditch was for those who had smallpox although they had been inoculated, and so had a milder form of the disease, while that in Clerkenwell was for the severest cases – those who had never been inoculated.

*View of the Coldbath Fields smallpox hospital in 1823, by which time it had been replaced by a new hospital in St Pancras. The redundant hospital was subsequently used as a distillery.* Reproduced from the Survey of London, volume 47 original in Islington Local History Centre

As the onus on action was placed at local level, and legislation advised on measures that could be taken, rather than dictating what must be done, responses to epidemics varied across the country and often took too long to be truly effective. With inadequate existing hospital accommodation, outbreaks of smallpox and cholera saw houses, factories and barracks commandeered. In Aberdeen a disused match factory was turned into a temporary hospital by the City Corporation after an outbreak of smallpox in the early 1870s. In most cases once the outbreak subsided the temporary hospitals closed and any plans to build permanent isolation hospitals were abandoned. But at Aberdeen a permanent hospital was begun in 1874, designed by the City Architect, William Smith II, and unusually constructed of concrete. This was chosen on the principle that the wards could be hosed down and disinfected after use. Even the floors were of concrete. Later, timber floors and panelling were inserted to soften the rather prison-like interiors.

*View of one of the ward blocks at the City Hospital, as altered and enlarged to designs by John Rust in the 1890s* https://canmore.org.uk/file/image/1374923

*Detail of a plan of the City of Aberdeen from the Post Office Directory of 1879, showing the ‘Epidemic Hospital’ on the outskirts of the city.* Reproduced by permission of the National Library of Scotland

Until about the 1860s there was no consensus regarding ideal hospital design. Of the few purpose-built fever hospitals erected in the 18th and early 19th centuries, some had small wards arranged on either side of a corridor with the idea that smaller groups of patients limited the risk of cross-infection, others large open wards with twenty or more beds. The presence of such a hospital – often optimistically dubbed a ‘house of recovery’ – on one’s doorstep was understandably unpopular. When one was set up in a house off Gray’s Inn Lane the neighbours threatened legal action to have it closed. It decamped northwards, and eventually became the London Fever Hospital, designed by Charles Fowler and built in 1848-9 on Liverpool Road, Islington. Here a mix of small, large and back-to-back wards seems evidence of a lack of confidence in any one system.

*Coloured engraving of the main front of the London Fever Hospital*. Reproduced from the Wellcome Collection https://wellcomecollection.org/works/pspzgh6a

*Plan from* The Builder, 12 August 1848, p.391

General hospitals also took in infectious cases, sometimes against their own regulations, but needs must. The London Hospital and University College Hospital both set aside wards for contagious cases in the 1830s and 40s. Other hospitals built separate fever blocks, one of the largest was at the Royal Infirmary in Glasgow, built in 1828-9

*The west front of the Fever block, probably photographed around 1910. From the* *Wellcome Collection* *CC-BY-4.0*.

The Poor Law Amendment Act of 1834, and its counterparts in Ireland of 1838 and Scotland of 1845, not only saw a network of workhouse built across Britain but also of associated infirmaries and fever blocks. A small single-storey fever hospital was built as early as 1836 at Stow-on-the Wold workhouse in Gloucestershire.

The first cholera epidemic in Britain erupted in 1831 and claimed around 22,000 lives. Yet there was scant progress in providing hospitals for its victims. A Cholera Prevention Act of 1832 had little effect. The worst epidemic came in 1848-9, in which about 50,000 lost their lives in England and Wales. This was particularly devastating, coming just a decade after a smallpox epidemic that claimed the lives of around 42,000. Legislation continued to encourage the provision of isolation hospitals, but hospitals were expensive to build, and raising the money from local rates to pay for them as unpopular. In the midst of each succeeding epidemic local authorities accepted that available hospitals accommodation was disastrously inadequate, but had seldom gone farther than proposing to take action before the epidemic subsided and the initiative was lost. The cholera epidemic of 1866 for example prompted the erection of only a few hospitals although the provisions of the Sanitary Act of 1866 gave town councils and local boards of health the power to provide either temporary or permanent hospitals and justices of the peace the power to remove patients to them.

*Aerial photograph of the Brook Fever Hospital, Shooter’s Hill, London built by the Metropolitan Asylums Board and opened in 1896.* Wellcome Collection. Attribution 4.0 International (CC BY 4.0

In London the Metropolitan Poor Law Amendment Act of 1867 resulted, eventually, in a comprehensive network of fever hospitals around London, linked by an efficient horse-ambulance service. Public fear remained strong. The building of a large smallpox hospital in Hampstead was considerably delayed by local opposition. Most isolation hospitals were built well away from the denser urban areas, and floating hospitals served by river ambulance operated from wharves at Fulham, Blackwall and Rotherhithe.

Outside London, from the 1870s the construction of isolation hospitals was overseen by the Local Government Board, and following the 1875 Public Health Act loans were made available to build them. Low cost solutions widely adopted were the purchase of a tent that could be put up and used in emergencies, or the erection of temporary, pre-fabricated hospitals. Hospital huts of timber and corrugated iron were supplied by various companies: Humphreys of Knightsbridge; Boulton and Paul of Norwich; Speirs and Company of Glasgow being three of the largest and most enduring. The corrugated iron block near Hempsted, to the south-west of Gloucester, may have been supplied by Humphreys – Gloucester was listed as one of the places supplied by the firm. A smallpox epidemic in 1874-5 had raised talk of erecting a temporary iron hospital. An even worse epidemic struck the city in 1895-6. Dr Sidney Coupland prepared a lengthy report, attempting to assess why this epidemic had been so much worse than the previous one, and to what extent re-vaccination had contributed to its rather abrupt cessation. Some of his observations strike a chord today: ‘It is possible that the hope was entertained that by an attempt to isolate every case as it arose the epidemic might be checked, but this attempt only resulted in filling the hospital beyond its capacity and over-burdening a too-restricted staff.’

*Hempsted Smallpox Hospital, Gloucester, photographed by H.C.F. in 1896* Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Where permanent buildings were erected, they were usually based on standard plans drawn up by the Local Government Board and issued between 1876 and 1924 in a series of memoranda. The model plans adopted the pavilion principles of planning, validated by Florence Nightingale, with open wards, windows placed opposite each other to create cross-ventilation, and W.C.s placed away from the ward, separated from it by a cross-ventilated lobby at the very least. These were intentionally draughty places. Currents of air were drawn through the wards through open windows, ventilation grilles and ducts. Drainage too, became increasingly important to keep infected waste out of the water supply. The new isolation hospital for Hemel Hempstead, built in 1914-15 at Bennet’s End, is a typical example. It was designed by John Saxon Snell and Stanley M. Spoor and comprised two single-storey ward blocks, an observation block, a service building housing the laundry, with steam disinfector, mortuary, and ambulance garage, and an administration block with nurses’ accommodation. The wards were intended for the most prevalent diseases at that time, diphtheria and scarlet fever, with the observation block for the undiagnosed.

A ward block built at the Hemel Hempstead Infectious Diseases Hospital at Bennet’s End, based on the model plans issued by the Local Government Board. LGB model plan B, 1900 and 1902-21 versions. The Bennet’s End ward has elements of both. Ward block photographed in May 1992 as part of the RCHME Hospitals survey. © H. Richardson

*LGB model plans from Local Government Board* On the Provision of Isolation Hospital Accommodation by Local Authorities *August 1900, and reissued in 1902.*

Research interest in bacteriology from the late 19th century saw the rise of laboratories, in Glasgow a laboratory was set up to deal with the bacteriology of epidemics. This research helped the medical officers of health to control epidemics through isolation, supervision of carriers and contacts, tracing the source of infection and the pathways by which it spread. The present test, trace and track strategy has its roots in this late-Victorian public health policy. Then as now it was widely recognised as the most effective means of controlling epidemics. One historical method of interrupting the spread of disease was to provide a ‘reception house’ to take families who had been in contact with infected persons, such as that opened on Baird Street in Glasgow in 1906.

*Baird Street Reception House, from the 1906 Medical Officer of Health for Glasgow’s Annual Report.*

*Ground and First-Floor plans of the Reception House.*

Progress in medical knowledge was reflected in hospital design. A better understanding of the transmission of diseases and the discovery of bacteria were factors behind the development of the cubicle isolation block. This first appeared in the early twentieth century. One was built at Walthamstow which consisted of rows of single rooms reached from an external veranda. This allowed patients suffering from different diseases, or who were yet to be diagnosed, to occupy one building. Glazed partitions between the rooms allowed nursing staff to supervise the patients, as well as allowing patients to see each other. By about 1940 almost every isolation hospital in the country had at least one cubicle block. At Twickenham the former South West Middlesex Hospital was originally built in 1898 to designs by W. J. Ancell comprising four ward blocks and the usual service buildings. Two cubicle isolation blocks were added in 1937 as part of a major extension of the hospital. Following the Local Government Act of 1929, provision for infectious diseases passed from the myriad of small local urban and rural sanitary authorities to county and borough councils, this also led to many of the smaller hospitals being replaced by larger more centralised hospitals.

*Cubicle isolation block built at the South West Middlesex Hospital, exterior.* Photographed in November 1991 © H. Richardson

*Cubicle isolation block interior* Photographed in November 1991 © H. Richardson

Wide-ranging public health measures to improve living conditions were the first effective weapons in lessening the impact of infectious diseases. Improved housing, sanitation, and street cleaning, regulation of lodging houses and factories, testing for food adulteration, were all vital preventive measures. Local Medical officers of health had a wide network of resources from laboratory research to morbidity and mortality statistics, to help them control epidemics through isolation, supervision of carriers and contacts, tracing the source of infection and the pathways by which it spread, and interrupting these by whatever means were available. Vaccines, inoculations, and effective treatments, for the most part, came after the Second World War. Since then we have been in a period of epidemiological transition, shifting from an age of receding pandemics and into an age of degenerative and so-called man-made diseases (those associated with lifestyle, such as heart disease, or lung cancer from smoking).

Infectious diseases were not wiped out, but could be treated within a general hospital. Post-war general hospital design included a higher proportion of single rooms in ward units to allow patients to be isolated for a variety of reasons, cross-infection being one of them. An experimental ward unit built at Hairmyres Hospital, East Kilbride, in the 1960s, was used to study ways of reducing cross-infection, but one of its findings was that human error remained a major culprit. Medical, nursing and domestic procedures could be one source, but also misuse of the engineering services. They found ventilation diffusors and exhaust grilles blocked up by the medical staff.

Photographs of the interior of NHS Nightingale show the huge open warehouse being fitted up with cubicles – here to facilitate laying on all the necessary services for each patient rather than isolating one from another. A dedicated hospital for infectious diseases is an old solution, but it is still a valid one, provided the infrastructure, the equipment and staffing are also in place – along with the necessary training in how to operate the appliances and services. As history shows, to tackle epidemics of infectious disease isolation hospitals need to be backed up by systems of quarantine, testing, tracing and tracking.

William Goldring and Asylums — The Gardens Trust

April 25, 2020 / Harriet Richardson / Leave a comment

This blog post on asylum landscape design was posted recently on the Gardens Trust site. I sympathise on the difficulties of researching the gardens and grounds of hospitals, it can be very difficult to find much information in the surviving documentary sources. Old maps provide evidence of how diverse and complex these designed landscapes were.

At the end of last year I wrote about the work of William Goldring, a prolific landscape and garden designer who died in 1919. Apart from his private commissions and work on public parks he was also involved in the design of landscapes that have been generally overlooked by garden and landscape historians: those of […]

via William Goldring and Asylums — The Gardens Trust

The Falkirk Ward

March 1, 2020February 26, 2023 / Harriet Richardson / Leave a comment

The Falkirk Ward was designed by the Department of Health for Scotland in the 1960s. It was an experimental ward, a prototype to be tested for its efficiency and flexibility. If successful, it was to be rolled out in the new district general hospitals planned to be built across Scotland as promised by the Hospital Plan of 1962. In the 1990s it was selected by DoCoMoMo as one of Scotland’s key 20th Century Modern architectural monuments. It was one of 60 post-war buildings which were deemed to be of particular significance in terms of their design or style.

*Looking towards the Falkirk Ward Unit from the south, photographed in 1991* © RCAHMS

The ward block was erected at the existing Falkirk and District Royal Infirmary. The Infirmary had been built in 1926-31 to replace an older cottage hospital and was officially opened by Prince George, later Duke of Kent, in January 1932. It had been designed in a sparse Neo‑Georgian style by the local architect, W. J. Gibson, with advice from Dr D. J. Mackintosh, Medical Superintendent of Glasgow’s Western Infirmary. Mackintosh was an inveterate giver of advice to hospital boards of management, and author of Construction Equipment and Management of a General Hospital published in 1916. The architect, William Gibson, had a family connection with the infirmary as his mother, Harriette Hicks Gibson, had been the main force behind the foundation of the original cottage hospital. His father, John Edward Gibson, was managing partner of the Camelon Ironworks in Falkirk.

Falkirk Royal Infirmary, *photographed by in 2008. These buildings were demolished some time after 2010. © Copyright John Lord*

Funds were raised to add a nurses’ home in the late 1930s and a competition held for the design, limited to architects practising in Scotland. First prize went to the firm of Rowand Anderson, Paul & Partners, Stuart R. Matthew came second and a local firm, T. M. Copland & Blakey were placed third by the assessor, C. G. Soutar. [AJ, 22 Dec 1938, p.1013.] The outbreak of the Second World War resulted in the plans being postponed and eventually abandoned, instead nine Emergency Medical Scheme huts were built on the site (a further two were added later).

O.S. 1:1250 Map, Surveyed in 1951, showing the 1920s-30s infirmary at the top/north side of the site, and the EMS hutted annexe to the south. Reproduced by permission of the National Library of Scotland.

Falkirk Infirmary was one of eleven institutions in Scotland selected by the Department of Health for hutted annexes to provide for the anticipated air-raid casualties. The eleven sites comprised four local authority hospitals (Robroyston, and Mearnskirk, in Glasgow; Hairmyres, Lanarkshire; and Ashludie, Dundee) four voluntary hospitals (Astley Ainslie, Edinburgh; Victoria Infirmary Auxiliary Hospital, Busby, Glasgow; Falkirk Royal Infirmary; and Stirling Royal Infirmary), and three mental hospitals (Gartloch, Glasgow; Bangour, Edinburgh; and Larbert). The huts, measuring around 144ft by 24ft, were each to contain 36 beds, and were to be built and maintained by the Office of Works. [The Lancet, 22 April 1939, p.943.]

*Extract from the OS Air Photo Mosaics, 1944-50. Reproduced by permission of the National Library of Scotland*

The executive architects of the Falkirk Ward who worked in conjunction with the Scottish Home and Health Department and Western Regional Hospital Board were Keppie Henderson and Partners. The design was drawn up by the Hospital Planning Group of the Scottish Home and Health Department, comprising two architects – John Ogilvie and Mr Bruce, Dr Hunter and Miss McNaught on the medical and work-study side, Mr Rendle for administrative expertise, and Mr. Wotherspoon, engineer. Plans were finalised in October 1962 and work began in the following year. The new unit was officially opened by Bruce Millan M.P., Under Secretary of State for Scotland, on 4 November 1966, although one of the wards was brought into use towards the end of 1965. Patients were moved into it from two overcrowded wards in the old hospital. One of the consultant surgeons, Mr R. G. Main, noted that the old hospital’s surgical unit (which the new block replaced) had 65 beds consisting of one male ward and one female ward, but they sometimes added in as many as ten extra beds in the middle of each ward in order to cope with the waiting list. He recalled how ‘A ward round could be likened to a stroll through Glasgow Central Station on Fair Saturday!’ [SHHD, Hospital Design in Use 4 The Falkirk Ward, Edinburgh, HMSO 1969, p.39.]

*The Falkirk Ward Unit, photographed in 1991* © RCAHMS

The Falkirk ward was developed in order to provide greater ‘privacy, amenity and better facilities for caring for patients and so set standards for National Health Service hospitals which might be generally acceptable for many years to come’. [The Hospital, Feb 1968, p.65.] It was an experiment in design incorporating several features which were being contemplated or proposed for new hospitals but had not yet been tried out in Britain. It was a complete departure from the standard Nightingale ward, and involved a move towards much smaller ward units. It was not considered viable to provide only single and double rooms which were by then current in American hospitals. This would have created too many operational and staffing difficulties and greatly increased the running costs. For these reasons a combination of four‑bed wards and single rooms was selected, with a ward floor of 60 beds, including twelve for intensive care.

*Falkirk Ward Unit, First-floor, reception* © RCAHMS

In addition to the experimental ward block, a two-storey service building was constructed as part of a general scheme of reconstruction at the infirmary. This addition provided kitchen, staff dining-room, pharmacy and central stores, and was also completed in 1965. In that year work began to design a new out-patients’ department. This, too, was designed by members of the Hospital Planning Committee of the Scottish Home and Health Department. The team in this instance comprised one of the few female architects employed by the NHS in Scotland in the 1960s, M. Justin Blanco White, Dr Hunter and Miss McNaught were the medical advisers and Mr Rendle the administrative adviser.

*Interior of the Falkirk Ward, with the nurses’ station on the left. Photographed in 1991. © RCAHMS*

The new out-patients’ department was intended to be a demonstration building embodying the principles behind the Department’s Planning Note (the guidelines which were to be followed throughout the country for new out-patient departments). It was part of the wider strategy of devising standard hospital departments. In the mid-1960s the Department thought that the advantages of standardisation of departments would be increased if a standardised system of building and the use of common structural components were adopted. The model plan of the Falkirk out-patients’ department was also designed to illustrate the recommendations for A&E departments, especially regarding standard rooms for both diagnosis and treatment of either new or returning patients ‘walking, in wheel chairs or on a trolley’. They were also trialling a short-stay ward and operating theatre shared between out-patients and A&E.

Design work on the out-patients’ department continued through 1966-9. In 1969, with the plans nearing completion, work began to clear the site for the new department. Construction began in 1970, and the department was completed in 1972, having cost £881,000. It was equipped and furnished ready for use the following year.

With the reorganisation of the National Health Service in 1974, the running of Falkirk and District Royal Infirmary passed from the Western Regional Hospitals Board to the newly established Forth Valley Health Board. One of the first schemes undertaken by the new Health Board was the upgrading of the war-time hospital huts, completed in 1976.

*Windsor Unit, built in 1984-6. Photographed in 2008. © Tom Sargent (cc-by-sa/2.0)*

The next major development took place in the 1980s with the addition of the Windsor Unit. This project was approved in 1979 and was intended to provide 176 maternity and geriatric beds. Work began in April 1984, on the scheme estimated to cost £8.7m and was scheduled for completion in 1986. The three storey block was very much of its time, the design made effective use of contrasting colours and materials, with the rich brown brick threaded with orange-red brick stripes. Despite being of relatively recent date, the unit had been decommissioned by October 2010, after the opening of Forth Valley Hospital, and was subsequently demolished.

Randolph Wemyss Memorial Hospital, Fife

November 30, 2019October 29, 2021 / Harriet Richardson / Leave a comment

*Randolph Wemyss Memorial Hospital, photographed in October 2019 © H. Richardson*

The cottage hospital at Buckhaven opened on 28 August 1909. It was designed by Alexander Tod of Kirkcaldy for Lady Eva Wemyss in memory of her husband, Randolph Gordon Erskine Wemyss, of Wemyss Castle. Randolph Wemyss had died in July 1908 aged just 50 after a long illness, but in his relatively short life he had made a considerable impact on the Wemyss estate, guided and inspired by his mother. He invested the profits from the coal mines on his land both to improve production – building a coaling dock at Methil, and a railway from there to Thornton – and also to improve the conditions of his tenants and workers. He was behind the development of the ‘New Town’ or ‘Garden Village’ of Denbeath, where he built over 200 cottage flats in 1904-5, and invested in the company that built a tramway from Kirkcaldy to Leven.

*OS Map, 25-inch, revised in 1913. The Wemyss Memorial Hospital is here dwarfed by Denbeath School to its north-west. Reproduced by permission of the National Library of Scotland.*

The housing built by Wemyss at Denbeath was remarkable in many ways. The design of the cottage flats was unusual. Arranged in terraces of two storeys, with one flat per floor, the L-shaped flats interlocked with their entrances alternately on the north and south sides. The upper-floor flats were accessed by external stairs. They were also unusually large, giving a larger square footage of floor area than was recommended by the 1919 Housing Act, and built on a low density at 10 houses per acre, yet the rents kept affordable. [see John Frew and David Adshead’s article, ‘”Model” Colliery Housing in Fife: Denbeath “Garden” Village 1904-8’ in Scottish Industrial History, X (1987) pp 45-59 for more on the housing.]

*Wellesley Road. Detail of the cottage flats in Denbeath, photographed by Jerzy Morkis in 2010, © CC BY-SA 2.0, reproduced from Geograph*

Designs for a cottage hospital to serve the new garden village may have been outlined around 1907 by Randolph Wemyss and Alexander Tod, the Wemyss Castle estate architect. However, they were seen through by Lady Eva Wemyss, with Tod, following her husband’s death. Lady Eva was Randolph’s second wife (he had been divorced from his first wife in 1898), and the daughter of William Henry Wellesley, 2nd Earl Cowley, a great nephew of the Duke of Wellington. Both Lady Eva and Alexander Tod were said to have visited ‘some of the principal hospitals in the country’ before settling on the design, which embodied the ‘best features found in all of them’. [Dundee Courier, 31 March 1909, p.6]

*Detail of ward wing, photographed in October 2019 © H. Richardson*

In March 1909 Lady Eva Wemyss laid the foundation stone, placing a sealed glass jar containing current coins and copies of the daily newspapers in a cavity on top of which the foundation stone was lowered into place. Building work proceeded rapidly, and at the end of August 1909 the hospital was officially opened by Lady Eva, the ceremony being presided over by Charles Carlow, the manager of the Fife Coal company. Carlow gifted the four-dial clock, which originally had Westminster chimes, and had the novel design of hands representing the miner’s pick and shovel.

*Detail of the central tower. The hands of the clock are in the shape of picks and shovels. Photographed in October 2019 © H. Richardson*

The plan is of the standard central administration block flanked by ward blocks favoured at the time but it is dressed up with baronial details. Described as picturesque in the contemporary accounts in the local newspapers, the building has undoubted charm. Originally the harling was yellow, or ochre coloured rather than white. There are circular stair turrets and corbelled bartizans at the angles of the wards. The somewhat eccentric entrance has a Doric portico fronting a circular tower, topped with a conical roof sporting the gabled clock faces.

*Detail of the entrance to the Randolph Wemyss Memorial Hospital, with the coat-of-arms of the Wemyss family carved in red sandstone in the pediment. Photographed in October 2019 © H. Richardson*

To the rear were the kitchen and laundry, with the ‘latest appliances for mechanical ironing of linen’, and at the east end of the site a small chapel and mortuary. Originally there were wrought-iron gates ‘of mediaeval design, with side railings of wrought iron’ – now long disappeared’

*Rear of the hospital, showing the kitchen, laundry and boiler house, photographed in October 2019 © H. Richardson*

The hospital was designed as a surgical hospital – accidents in the coal mines were not infrequent – and contained two main wards with six or seven beds in each, an emergency ward with two beds, operating theatre, X-ray room, doctor’s room, as well as accommodation for the matron and nurses and the usual stores and offices. Three ‘up-to-date’ bathrooms were installed, including, an ‘electric bath’. It was to be lit by electricity, and heated by hot-water pipes and open fires.

*Design for entrance hall floor, dated April 1909.* © RCAHMS

Some of the original plans have were deposited in the National Monuments Record of Scotland (now part of Historic Environment Scotland), including a design for the entrance hall floor. It features the Wemyss family crest of a swan at the centre.

*The Chapel and mortuary, photographed in October 2019 © H. Richardson*

The grounds were laid out and planted with flowers and shrubs by the head gardener of Wemyss Castle, Charles Simpson. Originally the front of the hospital looked directly out over the Forth, but housing has since been built opposite. Along with the view, the hospital has lost a few of its original features – weather vanes formerly topped the turrets, a swan in the centre, a working miner with lamp and tools and a ship and colliery winding engine on the side turrets. On the whole, though, the building is little altered, except internally largely the result of a sizeable addition to the west built in the 1960s as a geriatric unit added by the South East Regional Hospital Board in the face of a pressing need for additional beds for the elderly in Fife.

*Geriatric Unit, from the south, photographed in October 2019 © H. Richardson*

An extension of the hospital was first mooted late in 1954. At that stage it was hoped to add an out-patient and physiotherapy department. At much the same time the South East Regional Hospital Board had been considering its strategy for hospital provision for the ageing population, specifically in Fife. Early in 1955 sketch plans were drawn up, at this stage for a 44-bed unit with some physiotherapy and out-patient accommodation. Little progress having been made, in January 1957 the Regional Board appointed Dr Robert Rankine to develop and take charge of a hospital geriatric service for the county. He produced a report in April endorsing the proposals to expand the Randolph Wemyss hospital. At this stage, however, there was no prospect of funds being available for such a building before 1960. In February 1959 the Regional Board approved the acquisition of additional land to the west of the hospital for a new building and the construction of a 60-bed geriatric unit, with limited facilities for physiotherapy, at an estimated cost of £120,000. [Fife Archives, H/EF/1/10-11, East Fife Hospital Board of Management Minutes.]

*Geriatric Unit, from the west, photographed in October 2019 © H. Richardson*

The new unit was built in 1962-3 and officially opened early in 1964. The architect in charge was Iain D. Haig, one of the team in the Regional Board’s architects department headed by John Holt. Although in marked contrast to the original hospital, its stylish design and respectful distance from the older building ensures that each can be equally appreciated. (Personally, I think they are both very handsome – in different ways.) Rather like the slightly earlier Phase One buildings at the Victoria Hospital, Kirkcaldy, the geriatric unit blends modernism, in its construction and the concrete fins that form the building’s most distinctive feature, with elements of traditional Scottish vernacular building traditions, in the use of random-rubble stone as a facing on the ground storey.

*Geriatric Unit, showing the low link-building, photographed in October 2019 © H. Richardson*

The new range was designed with a reinforced concrete frame, aluminium sliding sash windows (since replaced), a central spine beam supporting floors and roof, and close-centred perimeter columns of precast concrete designed as projecting fins to create ‘sun baffles’ for the ward areas. Wards were on the upper two floors, designed on an adaptation of the Nuffield type with the bed bays on one side of a service corridor, and ancillary rooms, plus single-bed rooms, on the other.

*Geriatric Unit, view towards entrance on west front, photographed in October 2019 © H. Richardson*

Each of the two ward floors accommodated thirty patients arranged in two nursing units per floor of sixteen and fourteen beds, with four 6-bed bays, one 3-bed bay and three single rooms. Nurses stations were in the service corridor area placed centrally between the 6-bed bays and with the single rooms close by. Glazed screens divided the bed bays to maintain a clear view for the nursing staff. A day room was placed at the centre, between the two 6-bed bays, and a passageway ran along the south-west side beside the windows, fitted with a handrail to assist ambulant patients to exercise, out of the way of the main circulation corridor on the other side of the wards. Perhaps in an echo of the original entrance hall floor, there was a patterned vinyl-tile floor, supplied by Nairn’s of Kirkcaldy in the new wing. The original colour scheme throughout was grey and white, with accents of stronger colour. [The Hospital, May 1965, pp.229-30]

In 2008 the hospital was re-opened by Nicola Sturgeon after modernisation. It currently operates as a community hospital run by NHS Fife, with various out-patient clinics, and the geriatric unit (now the Wellesley Unit) providing in-patient palliative and continuing care.

Victoria Hospital, Fife

November 3, 2019November 1, 2021 / Harriet Richardson / 2 Comments

*Victoria Hospital, Kirkcaldy, photographed October 2019. Looking north towards the 1960s tower block with the new ward block to the right. © H. Richardson*

Victoria Hospital, Kirkcaldy, and Queen Margaret’s Hospital, Dunfermline, are the two main hospitals in Fife, serving the eastern and western halves of this large county. They both comprise buildings that mark significant periods in the history of post-war hospital architecture, and the Victoria has some of the earliest surviving NHS buildings in Scotland. The site is now dominated by a large, 500-bed ward block built in 2009-12 by Balfour Beatty to designs by Building Design Partnership.

The maternity wing of the new building. Colour and texture, as well as contrasting forms and asymmetry, break up and humanise the large bulk of the most recent development on the site. Photographed in 2019, © H. Richardson

As yet little studied, I have recently been looking into the development of the hospital during the 1950s and 60s, delving into the Department of Health for Scotland files, and the records of the East Fife Hospitals Board of Management. But the story begins long before the National Health Service, and at least one remnant survives of the earliest phase of this hospital.

*One of the original buildings of the Kirkcaldy Burgh fever hospital, dating from 1897 with some later additions and alterations.*

Although not the most architecturally exciting of buildings, at the heart of the modest brick-built building pictured above is an 1890s ward block, part of the original burgh fever hospital. This was built as a scarlet fever ward. There was a larger ward block to its west that was intended for typhoid patients in one half of the building, and diphtheria patients in the other. Between these two was an administration block which also housed some staff accommodation, and there was a laundry and disinfector, mortuary, and gate lodge on the site. Plans for the hospital had been drawn up by the Glasgow architects, Campbell Douglas & Morrison in 1897 to provide accommodation for 33 patients in all.

Screen Shot 2016-03-10 at 09.55.18 — This map shows the extent of the hospital just prior to the First World War, the surviving ward block is the rectangular building towards the right hand side of the group. Extract from the 2nd edition OS map, revised in 1913, reproduced by permission of the National Library of Scotland.

The fever hospital was extended in 1908, with a sanatorium pavilion for tuberculosis patients (on the site of the present hospice, and possibly partly incorporated in the present building). Further additions were made in 1930 with another sanatorium building and a cubicle isolation block. By the 1940s the hospital had 124 beds, but by then the buildings were not considered up to modern standards. In the run up to the establishment of the National Health Service the plan was to use nearby Cameron Hospital for infectious diseases, and to convert the Victoria into accommodation for the aged and infirm. Cameron Hospital had been considerably extended in the 1930s, its relatively modern buildings and large open site offered the potential to develop a new general hospital there.

*Aerial photograph of Cameron Hospital, Windygates, Fife, taken in 1954. © Crown Copyright: HES*

Difficulties over the acquisition of the additional land required adjacent to Cameron Hospital caused considerable delays. This, together with the time consuming bureaucracy of the new health service, followed by drastic cuts in central funding for new building, lead eventually to the abandonment of the Cameron Hospital scheme in about 1958. In the mean time, a new surgical ward block and other additions had been planned at the Victoria Hospital, with a view to addressing the serious shortage of beds across Fife generally. Work on this extension was nearing completion when the Cameron plan was given up, and the decision taken to build a second, larger block at Kirkcaldy. The 1950s extension therefore became known as phase one, the 1960s development phase two. The contrast in style and planning between these two phases indicates how post-war hospital architecture was developing apace at this time. Both phases are rare survivals of a key moment, demonstrating the evolution of modernist architecture as well as of hospital planning.

Phase I

Preliminary plans for a 100-bed surgical unit at the Victoria site were on the drawing board of the architects’ department of the South East Regional Hospital Board in 1953. By October 1954 they had been broadly approved by the Department of Health and had been submitted to the East Fife Hospitals Board of Management based at Kirkcaldy for their consideration. John Holt, the Regional Board’s chief architect, attended meetings with the local Board of Management to explain the rationale behind the designs.

*View of phases one and two from the south east, photographed in October 2019, © H. Richardson*

The footprint of the ward block adhered to pre-war pavilion planning in its arrangement, if not its internal layout, comprising a three-storey T-plan building divided into three ward wings with the main entrance hall and stair at their meeting point. A single storey range on the north side contained the main out-patients’ department, and another at north-west corner housed a chest clinic. The entire building is flat-roofed, steel framed, and faced in buff-coloured brick and glass curtain walling. The flat roof of the north-east wing had a solarium and roof garden, its reinforced concrete pergola remains a distinctive feature of the building. Roof terraces and solaria were more common in the interwar period, and even then roof gardens were a rare feature in a Scottish hospital.

*View of the north side of Phase I, with the ward tower of Phase II looming behind*

Inside, clinics, offices and the children’s ward were on the ground floor, wards and accommodation for medical staff on the first floor, and further wards and twin operating theatres on the second floor. According to Holt, ward planning was based ‘on the continental practice’ of having wards sited on one side of a central corridor and ancillary rooms on the other. This was known as the Rigs model (referring to the Rigs Hospital, Copenhagen), and was also the basis of the Nuffield Provincial Hospitals Trust’s widely publicised experimental ward built at Greenock in the early 50s.

Detail of the north-east wing, north elevation, the upper two floors treated with glass curtain walling comprising strips of windows over opaque blue glass panels, the cross walls creating a vertical accent carrying up from the pilotis. A tangle of ventilators and air-conditioning units are an inevitable modern addition, muddying the clean lines of the wing. Originally air-conditioning was only provided in the operating theatres. Photographed October 2019, © H. Richardson

Unusually, the operating theatres faced south. This met with surprise from the Board of Management committee, as it was traditional for theatres to be on the north side to benefit from even northern light. Holt explained that the trend was now against providing large theatre windows, rendering their position unimportant, and the theatres here would be air-conditioned, combatting heat from direct sunlight and providing effective bacteriological control.

When work on the surgical block was nearing completion in 1959, it was discovered that the ward doorways were too narrow to allow beds to be wheeled through easily. The standard hospital bed, without mattress, sheets and blankets, was 36 inches wide, and the new ward doorways were fractionally under 40 inches wide. Various suggestions were made for easing the beds through the doorways, but widening them was dismissed as too costly. Metal strips were proposed to be added to the door frames to protect the woodwork, narrower beds were rejected, but narrower mattresses would be used. The matter was also to be ‘kept in mind’ when plans were drawn up for the phase two ward block.

Nurses’ Home, Hayfield House

*Hayfield House, the nurses’ home, north and west elevations, photographed in October 2019, © H. Richardson.*

The nurses’ home, now Hayfield House, has some more overtly modernist features: its upper floors resting on slender pilotis, originally with an open space in the centre. It was constructed in a novel way, using a method that until that time was only used on tall silos. The concrete frame of the building was constructed from shuttered concrete made using continuously sliding forms operated by hydraulic jacks. The timber forms were constructed in situ on the first floor, and given a slight batter to ensure that they were self-clearing. Work was carried out continuously for four days, with 54 men on the day shift and 51 on the night shift. This experimental construction method was recommended by the consultant engineers, Blyth and Blyth, because of the ground conditions. The presence of historic mine workings favoured a concrete frame, being lighter than steel, particularly for a building of this height. Nevertheless, the modernist aesthetic was tempered by the warm tones of the brick facing, pale blue tiles and random-rubble stonework at the entrance.

*Entrance to Hayfield House, with section of rubble-stone wall facing to the right. Photographed in October 2019, © H. Richardson*

Phase II

In 1958 the Department of Health approved a second extension at the Victoria Hospital. Trial borings had to be made on the site once more, to check for underground mine workings, but as soon as the site was deemed suitable detailed planning was begun in the hopes that building work might start in 1961. The architect in charge of phase two was Eric Dalgleish Davidson, who had taken over from Walter Scott on phase one when Scott had left to set up in private practice late in 1957.

A model of phase two was made in 1962, and plans had been finalised by November that year. The annual report of the Scottish Home and Health Department recorded that the second extension to the Victoria was in progress at the end of the year. Officially opened in 1967, phase two is in marked contrast to phase one in style and scale: high rise rather than low rise, uncompromisingly modernist, and adopting a deeper, double-corridor ward plan.

*Architect’s model of Phase II, reproduced from the* Architectural Review, *June 1965* *where it was used in an advertisement for Stramax radiant heating and acoustic tiles.*

An eleven-storey tower sits atop a two-storey podium – in the matchbox-on-a-muffin manner, demonstrated clearly in the model pictured above. The extension housed twice the number of beds as phase one (240), three operating theatres, a new out-patients’ department, A&E, X-ray, sterile supply, physiotherapy and occupational therapy departments, as well as a conference hall, and libraries for patients and medical staff. Eight ward units, each with 30 beds, were located in the tower; the beds were mostly in four-bedded bays, supplemented by single rooms. Various labour-saving devices were introduced making the most of technical innovations.

*View of Phase II from the west. The section with the pitch-roof is the lecture theatre. Photographed in October 2019, © H. Richardson*

In addition to the main ward tower, some of the phase one buildings were extended to meet the demands of the large increase in patients and staff. The kitchen and dining-room building was one that had to be enlarged, but the Board of Management’s hopes for greatly expanded staff recreation facilities (including a swimming pool) proved too expensive.

This view shows a part of the staff kitchen and dining room block on the left – which overlooked the Den burn valley. The Nurses’ Home is behind in the middle distance. The stair tower on the left of the home was added following the tragic and fatal fire which broke out in the home in 1981. Photographed October 2019, © H. Richardson

With the shift from Cameron Hospital to the Victoria as the new general hospital for East Fife, the central laboratory which had been established at Cameron was now in the wrong place. A new laboratory was therefore included in the phase two scheme. Different in style again from either phase one or the ward tower, this distinctly industrial-looking building occupies the north-east corner of the site. The laboratory is square in plan, arranged around an internal courtyard.

*Victoria Hospital, Central Laboratory. Part of the Phase II extension 1962-7. Photographed in October 2019, © H. Richardson*

The phase two extension of the Victoria Hospital is particularly significant in Scottish hospital history because of the involvement of Eric Davidson in its design. Whilst it is difficult to ascribe a single designer to the phase two buildings, Davidson was the architect in charge. In 1960 he had been made Assistant Regional Architect to the South Eastern Regional Hospital Board and also Chairman of the Scottish Hospitals Study Group (1960-4). Following the re-organisation of the NHS in 1974 he became Assistant Director and Chief Architect of the Scottish Health Service Building Division (from 1974 until he retired in 1989). John Holt, likewise, is a key figure in the earlier decades of Scottish hospital design. As the chief architect to the Regional Board, he headed up a department that designed many remarkable buildings extending from hospitals in the Borders, across the Lothians and into Fife.

*The ward tower of the Victoria Hospital, photographed in 2011, with work underway on the new wing to the right.* © *Copyright John Taylor and licensed for reuse under creativecommons.org/licenses/by-sa/2.0*

In the more recent additions to the Victoria Hospital, major architects or architectural firms are also present, with Building Design Partnership for the newest development (completed 2012) and Zaha Hadid for the Maggie’s Centre (2006). Each phase, from the 1890s onwards, encapsulates in built form the ideas, hopes and aspirations of the different times in which they were designed.

*Victoria Hospital new wing, photographed in 2016. © Copyright John Taylor and licensed for reuse under this Creative Commons Licence*

The view above looks south across the double-curved front of the new wing, with its paired entrances sheltered by distinctive, up-turned, curved canopies. The nearer entrance leads to the out-patients’ department and main wards, the farther entrance to the maternity wing. Just visible on the right is the corner of the diminutive Maggie’s Centre.

*Zaha Hadid’s Maggie’s Centre, with the tower of phase II behind to the right. Photographed in October 2019, © H. Richardson*

Sources

National Records of Scotland, Department of Health files: Fife Archives, East Fife Hospitals Board of Management, Minutes; Plans, DG/K/5/121: Department of Health for Scotland, Scottish Hospitals Survey, Report on the South-Eastern Region, 1946: PP, Scottish Home and Health Department, Annual Report for 1967, p.76: The Hospital, Jan. 1960 p.67; December 1960, pp 995-1004; Jan. 1961, p.54; July 1961, p.474; May 1962, pp 303-4; March 1964, p.163; Sept 1967, p.353: AJ, 22 Nov 1956, pp 746-7: Urban Realm, 24 Aug 2012.

Two Highland Hospitals: Ross Memorial, Dingwall and Nicolson Mackenzie, Strathpeffer

September 29, 2019November 2, 2021 / Harriet Richardson / Leave a comment

Only a few miles apart, there are two small hospital buildings both designed by W. C. Joass. Both hospitals are particularly fine examples of Victorian cottage hospital architecture in Scotland, typical of the diminutive scale of the earliest hospitals of this type.

W. C. Joass was the father of one of the great London Scots architects J. J. Joass. William Cumming Joass was born in Inverness in 1833. He may perhaps have trained with Alexander Ross, as he was later taken into partnership by him and placed in charge of the Dingwall office. From 1865 Joass was practising on his own account there. Most of his work was in the Highlands, much of it domestic or farm buildings, but also quite a few churches, some schools – notably during the 1870s, and police stations in the late 1880s and 90s (four of these were on the island of Lewis). In the year that he became a partner of Alexander Ross the poorhouse on Skye was one of the projects in hand, but the first hospital that Joass designed was the Ross Memorial in Dingwall.

*Front elevation of the Ross Memorial Hospital, photographed in August 2019, © H. Richardson*

Still functioning today, this hospital opened in 1873 as a memorial to Dr William Ross who died in 1869. Joass was also the architect for additions to the hospital carried out around 1879. That year he was also engaged to design the Spa Pavilion at Strathpeffer, having earlier designed two hotels in the small Spa town, the the Strathpeffer and the Ben Wyvis.

The 1st edition OS map, surveyed soon after the hospital was built in 1873, shows the isolated position of the hospital, well east of the town centre. Reproduced by permission of the National Library of Scotland

The Ross Memorial treated both medical and surgical cases, and, if need arose, could accommodate infectious cases, due to the way in which it was designed with effective separation between the wards. Joass was advised by the local medical practitioner, Dr Bruce, as well as drawing on Florence Nightingale’s Notes on Hospitals. The medical and surgical sections were designed to function independently, minimising the risks of cross infection. Each comprised two small wards (with just two beds apiece), with their own kitchen, wash-room and WCs. The nurse’s room was placed between the wards, with inspection windows through which she could view the patients.

*Plan, elevations and sections of the Ross Memorial Hospital, reproduced from H. C. Burdett,* Cottage Hospitals: General, Fever, and Convalescent: Their Progress, Management and Work…, *London, 1880 p. 274*

Henry C. Burdett, the great social reformer and chronicler of hospital design in the late-nineteenth century, commended Joass’s plan in his book, Cottage Hospitals, published in 1880: ‘as, with the exception of the ventilation of the WCs, which should in all cases be entered by a lobby with cross ventilation, so that the escape of sewer gas into the passages may be avoided, we consider the arrangements very good indeed.’ Burdett’s description of the hospital suggests that in the short time since it opened it had adapted to suit local needs and was treating surgical and accident cases on one side of the building, and infectious diseases on the other.

*Old postcard of the Ross Memorial Hospital. © H. Richardson*

The Inverness Courier, reporting on the opening of the hospital, found no fault with the building: ‘everything about the hospital is so arranged as to prevent the absorption of any poisonous matter’. The floors were ‘saturated with solid paraffin’, and non-absorbent matting used. The main decorative element seems to have been a set of engravings given by Lady Walden to cheer the rooms. An unusual detail given in the newspaper regarded the operating table, made of pitch pine donated by the owner of one of Inverness’s sawmills, Mr Walker. The table was made by Mr Lewis Macdonald, carpenter, but intriguingly, the legs were turned ‘by an amateur’.

*OS 2nd edition of the 25-inch map, revised in 1904, shows the various additions to the hospital to this date. Reproduced by permission of the National Library of Scotland.*

The David Ross lodge, at the entrance to the hospital, was built in 1895-6 as a memorial to the Provost David Ross by the Wester Ross Farmers’ Club. In 1909 a new isolation hospital was built, with six wards, kitchens, nurses’ accommodation, bathrooms and ‘special pan cleaning apparatus’ (this may be the block to the west of the main building – later used as a nurses’ home). It also had a veranda for the open-air treatment of patients suffering from tuberculosis. Further additions were made in 1938 by the local architects Mackenzie and MacDonald and X-ray apparatus was installed, gifted by William Peterkin, a well-know shorthorn breeder. Peterkin later gave £3,000 to build and furnish a maternity home on the site. This gift was announced mid-December in 1944, and only a week later he died suddenly (though he was 87 years old). When the new wing was opened in July 1946 it was named the William Peterkin Maternity Home in his honour. The ‘home’ provided 16 beds, varying from one-bedded to four-bedded, and a labour room. During that year around 200 babies were born in the hospital – the only such facility in the county of Ross-shire.

*The large-scale OS map of 1964 shows the new out-patient department to the rear of the hospital. Reproduced by permission of the National Library of Scotland.*

Two years after the Maternity Home opened, the hospital passed to the Secretary of State for Scotland under the National Health Service. The change had not been welcomed by the Chairman of the managers, W. R. T. Middleton.

*Outpatients’ Department, photographed in August 2019 © H. Richardson*

Under the NHS a new out-patient department was built which opened in 1962. This was followed by new maternity and physiotherapy units in 1966. The design of the out-patient department was based on the standard plan devised within the Department of Health for Scotland, a copy of which was supplied in advance of publication to the Northern Regional Hospital Board. D. Polson Hall, the Architect to the Board, had to adapt the plan in order to provide additional space for orthodontics and eye specialities. Double-glazing was another modification, not unreasonably for a hospital in the Highlands. The standard plan was also applied to the out-patients’ departments at Raigmore Hospital, Inverness, and the Lawson Memorial Hospital, Golspie, built around the same time.

*View of the rear of the hospital, with the boiler house chimney to the right. Photographed in August 2019, © H. Richardson*

The maternity unit contained 16 beds and labour suites, and the physiotherapy unit included treatment rooms and a gymnasium. Building costs for the maternity and physiotherapy units were not overly high, coming in at £111,136, below the limit of the region’s ordinary building programme and thus not centrally funded. This included the boiler house, which had to be put in to cope with the demands for heating and hot-water in the enlarged hospital.

*Entrance to the back of the Out-Patients’ Department. Perhaps the original porch? Photographed in August 2019. © H. Richardson*

The second, and last, hospital that Joass designed was the Nicolson Mackenzie Memorial Hospital in Strathpeffer which first opened its doors in 1896. It was established as a mineral water hospital, a partly charitable and partly self-funding small enterprise to treat those of limited means seeking treatment for rheumatism and other joint pains.

*South front of the former Nicolson Mackenzie Hospital, photographed in August 2019 © H. Richardson*

Built on the slopes above Strahpeffer, the Nicolson Mackenzie blends in with the neighbouring villas of this surprising spa. It is a buff-coloured, harled building with a tall slim central block of two storeys flanked by single-storey ward blocks. At a public meeting in Strathpeffer in October 1891 the first committee was appointed for promoting a hospital scheme, and a site was gifted by the Earl of Cromartie (at the rear of Mr Lunn’s posting establishment). In 1894, the committee was offered £1,000 from Miss Morison Duncan, on behalf of her mother, Mrs Morison Duncan of Naughton House, Fife, if the hospital was named after her uncle, Dr Nicolson Colin MacKenzie, who had been born in Strathpeffer but had lost his life in rescuing his fellow passengers from the wreck of the Fairy Queen off the coast of Nova Scotia.

*East front and main entrance to the former hospital, photographed in August 2019 © H. Richardson, and below the same view in the mid-1970s, © Crown Copyright: HES (List C Survey)*

With this generous donation work was soon underway on the building, the foundation stone was laid in October 1895 by Miss Morrison Duncan herself. The local newspaper recorded the event, which took place on a fine, if chilly, day. The Mineral Water Home was heralded as a most beneficial institution at this fashionable resort that would greatly benefit the poorer class: ‘it will enable them to sojourn in search of rest and health without incurring anything like the expenditure they cannot at present avoid.’

*OS 2nd edition, 25-inch map, revised in 1904, reproduced by permission of the National Library of Scotland.*

The contractors who built the hospital were all from Dingwall or Strathpeffer: Mr Harrow, mason, and D. Ross, carpenter, both of Strathpeffer; R. Mackenzie & Son, plumber, D. Maclean, slater, and G. Mackay, plasterer, all of Dingwall. In August 1896 the building was completed and the opening ceremony performed by Lilian, Countess of Cromartie. Miss Morrison Duncan was there, along with the local dignitaries and visitors then staying at the Spa. A short notice of the opening appeared in the specialist journal The Hospital in September 1896 which described it as being a ‘pretty little building’. Its success was immediate, and the original provision of just ten beds soon raised to 12.

*The Nicolson Mackenzie photographed in the 1970s, when the harling was painted white. © Crown Copyright: HES (List C Survey)*

It was not the first hospital to be built in Strathpeffer, but there is a mystery surrounding the earlier hospital with just a few scraps of information having so far come to light. It is mentioned in the New Statistical Account for Scotland as having fifty beds – remarkably large for so small a place. It seems to have been established largely through the efforts of Captain James Edward Gordon, briefly M.P. for Dundalk. According to a later newspaper report, the hospital never opened, as Gordon did not appointed any trustees to run it, and the building was pulled down some twenty years after it had been built. This is not quite consistent with a report in the Inverness Courier of 8 August 1838 which mentions a hospital or dispensary at Strathpeffer, as a favourite project of Gordon’s, ‘the design of which is good’. At the time, Gordon was trying to divert funds from the Destitution in Shetland Fund to his Strathpeffer charity. There is also a notice which appeared in the Courier in August 1836, entitled ‘Strathpfeffer Infirmary’ about a bazaar that was to be held to raise money for this charitable institution ‘established for the relief of the destitute and suffering poor, who annually resort to the mineral waters from the surrounding counties.’ Perhaps the truth about this early hospital will emerge one day.

*View from the north-west, the rear of one of the former ward blocks is in the foreground to the right, photographed in August 2019 © H. Richardson*

Its successor survives, though no longer as a hospital. Its future was already under threat in the 1960s, when the rationalisation of services and development of Raigmore were in full swing. It held out until the early 1990s, and was subsequently converted to domestic use. Around that time the harling, which had been painted white, was repainted a buff colour. Renamed Mackenzie House, it became a guest-house, and more recently has been adapted for holiday rentals. I would like to thank the present owner who very kindly allowed me to take some photos of the former hospital.

Sources

Inverness Courier, 30 Oct 1873, p.7: H. C. Burdett, Cottage Hospitals, 1880: The Hospital, vol.58, no.7 July 1962, p.491: Ross-shire Journal, 21 October 1892, p.4: 25 October 1895, p.7; 28 August 1896, p.7: The Hospital, 19 sept 1896, p.406: Ross-shire Journal, 16 July 1897, p.7; 6 May 1910, p.7: The Scotsman, 13 Dec 1938, p.8: Aberdeen P&J, 15 Dec 1944, p.4: The Scotsman, 24 July 1946, p.3

Medical Officer for Health, Ross and Cromarty, Annual Reports1946 adn 1947

Annual Reports of the Department of Health for Scotland: Parliamentary Papers, Estimates Committee, Hospital Building in Great Britain, Minutues of Evidence, Session 1969-70

Inverness Courier, 24 August 1836, p.1, 8 August 1838 p.3: The New Statistical Account of Scotland. V.14 (Inverness, Ross, Cromarty) Edinburgh W. Blackwood and sons, 1845, p.250

see also the Ross-shire Journal 8 Sept 2018

Brooksby House, Largs. From Yachting Residence to Seaside Convalescent Home.

June 30, 2019November 4, 2021 / Harriet Richardson / 2 Comments

For many decades, Brooksby House was the convalescent home for Glasgow’s Victoria Infirmary. The Governors of the Infirmary purchased this substantial villa by the sea-front at Largs in 1896 and it opened the following year with accommodation for 24 patients.

*Postcard of Brooksby House, postmarked 1910. Reproduced by permission of H. Martin*

Convalescent Homes were a common aspect of health care for about a century. They first emerged in the mid-nineteenth century in an attempt to solve the problem of patients discharged from hospital who did not fully recuperate, either from having to return to work too soon, poor sanitary conditions in the home, or inadequate nourishment. In the late-eighteenth century some general hospitals began to provide convalescent wards and a few of the more enlightened workhouse infirmaries had convalescent wards around the mid-nineteenth century.

The former Metropolitan Convalescent Institution, later Ellesmere Hospital, Walton-on-Thames. Photographed in 1993 © H. Richardson. The hospital closed in 1989, and some time after 1998 was converted into private flats.

The first convalescent home in England seems to have been the Metropolitan Convalescent Institution. It grew from an ad hoc arrangement between Theodore Monro, a medical student at Barts Hospital in the City of London and his brother, a vicar in Harrow Weald, whereby patients discharged from the hospital were lodged with families in the Harrow Weald to recuperate. Monro wanted to provide an asylum in the country, where pure air, rest and nutritious diet would speed recovery. In 1842 a vacant workhouse in Carshalton provided a more formal home for the nascent institution, but a purpose-built home was erected in 1852-4 near Walton-on-Thames, designed by Joseph Clarke in a handsome Italianate style (later renamed Ellesmere Hospital).

Despite its success, and increasing awareness of the usefulness of convalescent homes, there was a lapse of some years before any more homes were built. This changed during the 1860s, with homes built in Bournemouth (the Herbert Memorial), Wimbledon (the Atkinson Morley), Whitley Bay (Prudhoe Memorial), and various other locations. The first in Scotland was established at Dunoon in 1869 (the Dunoon Homes).

*The Prudhoe Memorial Convalescent Home, Whitley Bay, reproduced from the Wellcome Collection, CC BY*

The earliest purpose-built homes were designed on hospital-like lines with large nightingale-style wards. Florence Nightingale herself commended a more domestic scale and appearance, and published an ideal plan in 1863 for a convalescent hospital arranged as three cottages, linked by covered ways.

*Florence Nightingale’s ideal convalescent home, plan and elevation, from* Notes on Hospitals, *London, 1863*

Like Brooksby House, many convalescent homes were established in converted houses. Brooksby was originally built around 1837-40 as a yachting residence for a Glasgow merchant, Matthew Perston. It is attributed to the architect David Hamilton, or his son James, under the partnership they formed of D & J Hamilton. Designed in a fashionable though restrained Italian Renaissance style, the main elevation faces west, towards the sea, with a verandah, now missing its canopy, in front of the central projecting three bays. The main entrance was on the south side, with a grand porch sheltering the doorway. The house had particularly fine interiors, with plaster ceilings, chimney-pieces and a painted armorial ceiling in the rooms on the ground floor.

*Brooksby House, photographed in June 2018 by Ian Rainey. © Copyright Ian Rainey and licensed for reuse under this Creative Commons Licence.*

Perston already had a house in Largs by 1836, when he was the owner of the Yacht ‘Wave’, though his address is not give as Brooksby in the newspapers until 1845. In 1839 he had won a challenge cup with Wave and he had been elected a steward of the Royal Northern Yacht Club by 1844. The Club’s Regatta was held in Largs in that year. In 1846 he was listed as a shareholder of the Glasgow, Largs and Milport Steam-boat Company, but his main business was the Bothwell Street Spinning Company, Glasgow. Perston was bankrupted in 1847, and had to put Brooksby House up for sale or to let. A buyer proved hard to find, and a sale of his wines, port, madeira, sherry etc along with much of his household furniture was held in June 1848. The following year, in October 1849, the house was advertised for sale again, at the reduced price of £3,700, despite having cost £10,000 to build. It was described as a splendid marine residence. It had three reception rooms, seven bedrooms, as well as a bathroom and hot and cold water.

*Extract from the 1st edition OS map, surveyed in 1855. Reproduced by permission of the National Library of Scotland*

By the 1850s Brooksby had become the home of Robert Graham, a Justice of the Peace for Ayrshire. Graham senior had died by the mid-1860s, but his daughter, Gertrude Schuyler Ramsay, wife of George Gilbert Ramsay, Professor of Humanity at the University of Glasgow, and his son, R. C. Graham and his wife, retained the house. In 1897 Brooksby was acquired by the Victoria Infirmary, Glasgow. The Grahams offered to sell for £4,000, but the Infirmary Governors did not wish to pay more than £3,500. After some haggling, they agreed to meet half way. The acquisition of a convalescent home fulfilled the wishes of the Infirmary’s benefactor, Robert Couper, who had left £40,000 in his will to establish both the infirmary and an associated convalescent home. It was hoped that the home would allow patients to be discharged earlier, and thus help to lessen the waiting list.

*Ceiling in one of the ground-floor rooms, photographed by RHCME in 2012*

Brooksby House was attractive because of its seaside location, easy distance from Glasgow, and because the service buildings to the rear, including coach-house and stables, could easily be rented out and provide an income without interfering with the amenity of the home. After a swift refurbishment, the home was formally opened on 26 June 1897 by Lady Watson, wife of the Chairman of the Board of Governors, Sir Henry Watson. Accommodation was provided for 24 patients, later raised to 30.

*Painted ceiling in ground-floor room of Brooksby House, photographed in 2012 by RCHME*

Under the National Health Service Brooksby initially remained under the same Board of Management as the Victoria Infirmary. Latterly it was mostly used to provide a fortnight’s holiday for long-stay psychiatric patients from Leverndale Hospital, Glasgow. In 1983 it was transferred to Ayrshire and Arran Health Board. It provided continuing care beds until around 2006 and since 2009, has been used as the North West Ayrshire Resource Centre by the NHS.

Sources:

The Scotsman, 8 Sept 1847, p.4: Glasgow Herald, 18 April 1845, p.2; 6 March 1846, p.4; 25 Feb 1848 p.3; 29 May 1848, p.3: Greenock Advertiser, 14 December 1852 p.2: Morning Advertiser, 11 Aug 1865, p.8: Largs & Millport Weekly, 3 July 1897: NHS, Greater Glasgow & Clyde Archives, Victoria Infirmary Annual Reports: S. D. Slater & D. A. Dow, The Victoria Infirmary of Glasgow 1890 -1990, 1990, pp.245-7.

The Hospitals on Islay

June 2, 2019November 4, 2021 / Harriet Richardson / 5 Comments

*Islay Hospital, Bowmore. View of the ward block and main entrance from the west. Photographed in May 2019, © H. Richardson*

There have been three hospitals on Islay: a poor law institution that provided medical care for paupers and in the early decades of the National Health Service became the island’s general hospital; an infectious diseases hospital, established in the 1890s, and provided with a permanent small building in 1904; and the present Islay Hospital built in 1963-6, pictured above.

Screen Shot 2016-03-03 at 21.23.29 — *Extract from the 1st-edition OS map, surveyed in 1878, reproduced by permission of the National Library of Scotland*

The earliest of these was the poorhouse, built in 1864-5 on the outskirts of Bowmore on land owned by Charles Morrison. The local Parochial Board decided to get their plans from an Edinburgh architect with experience in such buildings, J. C. Walker. As can been seen from the map above, the building comprised an H-shaped complex. The main north wing was of two storeys, the rest single-storey. (For a photograph of the poorhouse see the Islay History blogspot)

*Gartnatra Hospital, from an old photograph on display at the Columba Centre.*

To comply with the Public Health Acts the local authority had to provide accommodation for cases of infectious disease and so a fever hospital was established at Gartnatra, to the east of Bowmore. Although the building pictured above was built in 1904, there had been a hospital hereabouts since at least the mid-1890s. The local Medical Officer for Health, Dr Ross, reported on an outbreak of measles in 1895, the patient being removed to the hospital. However, as there was no nurse employed by the local authority to attend the hospital, the patient’s mother went to nurse her daughter. Dr Ross had no authority to confine the mother to the hospital, and she went in to the village on many occasions. In a short time the disease spread rapidly throughout Bowmore.

*The former fever hospital, now the Columba Centre. Photographed in May 2019, © H. Richardson*

The situation was finally remedied with the erection of a new building for which the plans were approved by the Local Government Board for Scotland in 1902. To cover the cost of construction a loan of £1,100 was secured from the Public Works Loan Board. The building is dated 1904, and the Local Government Board sanctioned it for occupation in February 1905. It was built by James MacFayden. The building survives, though the interior has been completely refurbished and a large extension built to the rear. It is now in use as a cultural centre. In the photograph below, the old hospital is the gabled block on the left, with the short bay attached (the former sanitary annexe). The rest has been added to form the new cultural centre and cafe.

*The former Gartnatra Hospital, viewed from the east. Photographed in May 2019, © H. Richardson*

With the establishment of the National Health Service in 1948 the administration of Gartnatra Hospital and the poorhouse, latterly known as Gortanvogie House, passed to the Campbeltown and District Hospitals Board of Management, under the Western Regional Hospital Board (WRHB). Under the terms of the National Health Service Act responsibility for the elderly remained with local authorities, so the presence of elderly as well as the sick at Gortanvogie posed problems. In the opinion of the Board of Management, although Gortanvogie left much to be desired, the conditions were probably better than most of the patients enjoyed at home.

Photograph taken in 1955 outside Gortanvogie Hospital. The Matron, Miss C. E. M. Morrison, is seated on the left, and behind her in uniform is the hospital sister, Agnes Watson Miligan. A colleague is pictured seated to the right, and a young patient standing behind. (Reproduced by kind permission of L. Tudball. © L. Tudball.)

Given the list of improvements that the Matron had requested, this makes for a depressing view of those conditions. She had asked, without success, for: electric light – the Hydro Electric Board’s supply reached the front door, but the building was not wired; hot water on the ground floor; a bathroom directly off each main ward on the ground floor; a linen cupboard; wooden or other suitable flooring instead of stone floors; a brick side screen with steel windows along the outside of a covered way between the front and back of the building to stop the inmates from passing through the staff dining-room; essential repairs to the structure of walls and ceilings, and re-slating a large part of the roof. Neglect of building maintenance during the war, common throughout Britain, had left many of the inner walls damp and rotten, with plaster having fallen from many of the ceilings.

*Extract from the 2nd-edition OS map, surveyed in 1897, reproduced by permission of the National Library of Scotland*

Gartnatra, on the other hand, was described as well-built with no serious trace of damp except in two W.C.s at the back on either side which were below a flat part of the roof where the rain water had forced a way in during stormy weather.

‘The site of Gartnatra is bleak and exposed to the prevailing westerly wind coming off the bay; there is nothing “cosy” about the building, but Matron remarked that the islanders are used to hearing the wind roar about their houses. Our visit was on a day of cold rain. A shelter belt of trees would obviously be desirable, but we were told that owing to the wind and the salt spray from the sea, there would be little chance of trees growing.’

*The former Gartnatra hospital, now the Columba Centre, viewed from the south-east. Photographed in May 2019, © H. Richardson*

When the question of modernising the hospital facilities was under discussion, a small team from the mainland visited Islay in May 1952 that included Mr Guthrie, the Regional Hospital Board Architect, Dr Guy, the Medical Officer of Health, and representatives of Argyllshire County Council. The Secretary of the Board of Management for Campbeltown & District Hospitals favoured an extension to Gartnatra but the local doctors argued for a new hospital on a more convenient and sheltered site. Funding was the main problem, but the Department of Health were conscious that spending money on upgrading inferior accommodation was not the best long-term policy.

Plans for extending Gartnatra were drawn up by the WRHB architects, only to be rejected by the Board of Management. With patient numbers dwindling to none, Gartnatra closed in April 1955. The following year the tide had turned towards using Gortanvogie as the hospital and turning Gartnatra over to the local authority as a home for the elderly, and in 1958 sketch plans were drawn up by the WRHB for a new hospital building on the Gortanvogie site. By May 1959 these plans seem to have evolved into something like their final form, encompassing the demolition of Gortanvogie and building in its place two separate buildings, a hospital and a home for the elderly. This was certainly the case by the following May, when some of the problems of shared staff and services were beginning to be discussed.

Islay Hospital, south-west corner of the main block, showing what was originally planned as the patients’ dining and sitting-room and on the left the end of the link corridor to the Eventide Home. © H. Richardson

By July 1960 detailed plans had been drawn up by the WRHB and submitted to the Department of Health. Forbes Murison, Chief Architect to the WHRB, had been building up a central staff of architects with some success, and did not want to have them sitting around doing nothing. The Islay job was one on which he was keen to let them cut their teeth. In 1960 Douglas Gordon McKellar Adam had joined as Principal Assistant, (he became Assistant Chief Architect in 1962).

*Islay Hospital, general view from the entrance looking along the south side of the ward block, photographed in May 2019 © H. Richardson*

In the hopes of gaining the necessary approbation from the Department of Health, the WRHB stressed that Gortanvogie was one of the few examples of an old poorhouse still used in the hospital service in the Western Region. It not only had 12 beds for the sick, but 8 for the old and infirm under the charge of the local authority. Despite the nature of its original purpose, the hospital had in recent times been fulfilling the functions of a cottage hospital by the admission of general and maternity patients. The fabric of the building was so poor as to make reconstruction unviable. Many of the floors were laid directly on the ground, and there was practically no sub-floor ventilation. The intention was to provide all the services of a general cottage hospital and make the island as independent of the air services as practicable. Argyll County Council wished to arrange for the provision of a 20-bedded Eventide Home as part of the scheme, and it was agreed that the one architect should design both, and that this should rest with the Regional Board’s architectural staff.

*The entrance front of the Eventide Home, photographed in May 2019, © H. Richardson*

The new hospital was also originally to provide 20 beds (an additional maternity bed was added later), as well as X-ray, casualty and treatment room, mortuary, boiler-house, kitchen etc, accommodation for the matron and six nurses – considered essential given the location on a ‘remote island’. From the start, the hospital was to be linked to the eventide home by a covered way, and the heating, hot water services and kitchen were to be shared. This raised the question of who should fund what. It also required authorisation from the Treasury as sharing facilities was not authorised by the National Health Service Act. Although combining a hospital with a home for the elderly went against government health policy, as well as introducing the complexity regarding shared funding, mixed institutions were thought to have a place in the more remote parts of the Scottish Islands and Highlands.

*Plan of Islay Hospital, based on original dated January 1962, in the National Records of Scotland. © H. Richardson*

At this point the estimated cost was £146,000. At the end of October the Department forwarded their comments on the plans. Within the Department of Health these were circulated to a team of advisers on the different elements of hospital design, function and administration, each of whom submitted comments, criticisms and suggested alterations. The list of criticisms was lengthy, ranging from concern over the position of the maternity unit below the staff residential quarters (as babies’ crying was liable to cause disturbance), to suggesting that the entrance to the visitors’ viewing room into the mortuary should be placed opposite the doctor’s room rather than in the main hall. Some rooms they thought too small, others too large.

*Islay Hospital. This block was designed as the maternity wing with staff accommodation on the upper floor © H. Richardson*

Treasury approval was granted in November 1960, and the following month the Department was able to give the Regional Board approval in principle to enable planning to proceed. In June 1961 the WRHB sent in revised plans, and raised the issue that the scheme would need to be carried out in two phases, the first phase being the provision of the hospital which could be done without demolishing the existing building, and the second phase being the eventide home following demolition. The revised plan for the eventide home had by then already been agreed to by the County Council, but one of the Department of Health’s architects, R. L. Hume (presumably Robert Leggat Hume, 1899-1980), also discussed the plan with the Regional Board, which seems to have resulted in further revisions.

*Islay Hospital, main entrance © H. Richardson*

Some of the criticisms revolved around room allocation, others around safety. The home was designed around a garden court with a pool in the centre – and so there were concerns that the old people might fall in. Hume discussed the plans with Mr Ellis (Kenneth Geoffrey Ellis), one of the Regional Board’s architects who confirmed that the points raised had been attended to, and that the pool was intended to be shallow with low shrubs or flowers planted around it to keep old people away from the edge. (The plans submitted to the Department were drawn by Ellis, and are dated January 1962.)

Islay Hospital, viewed from the south-east looking towards the maternity and staff quarters’ block. On the left is the rear of the entrance block, and the link range contained treatment rooms and the X-ray room. © H. Richardson

Although it had been hoped that building would start in the financial year 1961-2, the already complex bureaucracy was exacerbated by the apportionment of costs between the Department and the County Council. It was not until June 1962 that the Department sanctioned the preparation of final plans.

*Islay Hospital, from the north-east with the ward block in the centre and the eventide home to the right of the picture © H. Richardson*

Revised plans were submitted in April 1963, and circulated yet again to the Department’s professional advisers for comment. As comments trickled in they were relayed back to the Regional Board, but the Department was at pains to stress that they would not expect drastic alterations to the proposed layout at this stage. The main delaying factors were not difficult to identify: the amount of scrutiny that the project was given had led to ‘a good deal of adverse comment on the plans’; the architectural staff of the WRHB were under pressure to cope with the wider building programme; and the awareness of the shortage of capital funds had generated a reluctance to embark on a relatively expensive project for its size. Once the plans were agreed and the costing completed, work began towards the end of 1963.

*Islay Hospital, north side, with wards and kitchen block. © H. Richardson*

Caution over the estimates was well founded. Within the three years since the original probable costing of around £100,000, it had more than doubled to £236,816. The revised figure took into account the special prices that might be expected to be charged for building on Islay. But everyone involved was aware that costs might still creep up. The main difficulty was attracting a sufficient number of contractors even ‘reasonably interested’ in building on Islay, in order to avoided inflated prices.

*The north-east corner of the Eventide Home, with the link corridor between it and the hospital, photographed in May 2019 © H. Richardson*

The hospital was built first, then Gortanvogie House demolished and the home built on its site. In 1966 work on the hospital was completed. It had cost about £180,000, and provided 12 chronic sick beds, 6 beds for general medicine and 3 maternity beds.

Sources:

National Records of Scotland, HH101/1491: Dictionary of Scottish Architects

Brechin Infirmary and St Drostan’s House

May 13, 2019December 23, 2022 / Harriet Richardson / Leave a comment

*Prospect of Brechin (detail), by John Slezer from* Theatrum Scotiae, 1693. Reproduced by permission of the National Library of Scotland

On a gloriously sunny day in April, I visited Brechin, primarily to see the cathedral with its extraordinary round tower, but while there walked over to Infirmary Street to see what remains of a group of buildings that for so many years took care of the health and welfare of the city: the now-closed Brechin Infirmary, largely of the 1860s, a 1970s Health Centre, the former poorhouse (built in the 1870s) and the remnants of the former infectious diseases hospital (late 1890s). Tucked in behind is a post-war hospital block, added to the site in the early 1960s, and sheltered housing built in the 2000s. This group also lies conveniently between the railway station to the south, and the cemetery to the north.

*Extract from the second edition OS map, revised in 1901, reproduced by permission of the National Library of Scotland*

Brechin Infirmary opened as a general voluntary hospital in 1869, but the sick poor in the city had earlier been served by a dispensary, established in about 1824 following a bequest of £50 from a Mrs Speid of Ardovie. The dispensary supplied medicine and medical attendance to the poor for free, and by the mid-1840s was said to be in a prosperous state. But the new Poor Law had placed all sick paupers under superintendence of the local Parochial Board, which had appointed a surgeon to carry out that task. As a result, ‘only some six or eight patients remain upon the dispensary lists’.[1] Over the years the dispensary’s work diminished, until it closed altogether.

*Extract from the OS Town Plan of Brechin, 1852. The Poorhouse is on City Road near the corner with Damacre Road. Reproduced by permission of the National Library of Scotland*

The first poor law institution in Brechin was opened in 1853 in City Road, locally usually known either as the almshouse, poor’s house, or parochial lodging house. It was in a large converted tenement which the Board purchased for £300 in 1852 from a Mr Thomson, writer, of Montrose. A later report suggested that the building had originally been built as a cotton factory, but that when this business failed it was sold to Mr Thomas who converted it into a dwelling house. [2]

In July 1864 plans for a hospital were first made public, after the late James Don, Esquire, of Bearhill, bequeathed £1,000 for the purpose of establishing a hospital or infirmary and dispensary in Brechin on condition that a further £1,000 was raised within 18 months by the local community. Subscriptions to the cause quickly mounted to more than £3,000, including £100 from Sir Jamsetjee Jejeebhoy, 2nd Baronet, and his brother, the Hon. R. J. Jejeebhoy. (Perhaps they were approached by someone local, the Jejeebhoys wealth and generous philanthropy, and associations with Britain, were well known.) The Earl of Dalhousie (Fox Maule-Ramsay, the 11th Earl) offered the site – considered open healthy and with convenient access by three different roads – at an annual feu-duty of £4 per acre.

*Main front of Brechin Infirmary, photographed in April 2019 © H. Richardson*

The hospital was designed by William Fettis or Fetties, and construction was carried out by local builders and craftsmen: Mr Alexander Crabb, mason; Messrs W. Black & Sons, carpenter work; John Lindsay & Son, slaters; J. & J. Thomson, plasterers; and C. Middleton & Sons, plumbers. Their tenders for the work amounted to just over £1,500. [3]

*Photograph taken on a less sparkling day, back in the late 1980s © H. Richardson*

The foundation stone was laid with full Masonic honours in May 1867 when building work was already well underway, and the first storey all but completed. The infirmary building was described at the time as ‘of the plainest description, being wholly formed of rubble work’ apart from the front wall which was ashlar. The plainness of the building was to be alleviated by the garden in front, which was to be finely laid out as pleasure grounds studded with shrubs. A kitchen garden was destined for the rear half of the garden. [4]

*West elevation of the infirmary, with later day room in the foreground, photographed in April 2019 © H. Richardson*

In May 1869 the new infirmary was formally opened by the Earl of Dalhousie. The 1901 map shows the infirmary before it was enlarged in the 1920s, with its principal front facing west, and indicating that the garden had been laid out on that side. (The garden was later built over for the present health centre.) Four wards occupied the long north-south wing, two on each floor on either side of the central entrance and with up-to-date cross-ventilated W.C.s, suggesting an awareness of the relatively recent developments in pavilion-plan hospitals on the lines recommended by Florence Nightingale. Two wards were for accidents and two for fever patients.

*View of the infirmary looking west to the rear of the earliest part of the building. Photographed in April 2019 © H. Richardson*

A major renovation, alterations and additions were carried out in 1928-9, for which the architect was David Wishart Galloway. During the work the patients were moved out to Maulesden House. The cost was largely met by a donation of £10,650 from the trustees of the late Sir James Duncan of Kinnettles. Plans were submitted to the Dean of Guild Court in September 1928. It was at this time that the new main entrance was formed, set in the gabled bay, treated as a pediment with oculus and framed by giant pilasters. The new accommodation included four private wards. The contractors were: joiners, Messrs W. Black & Son, Ltd, Brechin; plumbers, Mr J. Davidson; plasterwork, Messrs Burness Montrose; mason, Mr Rennie Brechin; slater, Mr D. Scott, Brechin. In December 1929, following the death of the architect David Galloway in a motorcycle accident, the infirmary directors appointed Maclaren, Soutar & Salmond, who had taken over Galloway’s practice, to see through the reconstruction. [5]

*View of the rear and west of Brechin Infirmary, with the health centre to the right, photographed around 1988-9 ©* *H. Richardson*

On the vacant land to the east of the infirmary a new poorhouse was built in 1879-80 to designs by James Baxter, architect, Brechin, to accommodate about 80 paupers, 51 being transferred from the old building but the Parochial Board intended also to move most of those receiving outdoor relief into the poorhouse.

*South elevation of St Drostan’s House, the former Brechin poorhouse. Photographed in April 2019 © H. Richardson*

It is in a similarly plain style to the infirmary, although the Brechin Advertiser was curiously impressed with its appearance, describing it as a ‘magnificent building’ that was an ornament and a credit to the town. The article continued:

Poor-houses have too frequently been poor in every sense of the term – poor in architecture, poor in conveniences, poor in comfort. It will be seen, however, … that the new Poor-house of Brechin possesses not only the external appearance, but all the internal appliances of a modern mansion-house. [6]

*Another photograph from that gloomy day in the 1980s, of the former poorhouse next to Brechin Infirmary ©* *H. Richardsn*

According to the same article, the architect’s plan for the poorhouse had been commended for its simplicity of design and conveniences and comfort in its internal arrangements. These comprised a room on either side of the entrance door for the Matron, and beyond these separate stairs to the upper floor. A corridor ran the length of the building on both floors. On the ground floor, on the north side of the central corridor, were two large sick rooms and two sitting rooms, and on the south side a spacious dining hall. Store rooms and bathrooms were placed at either end, a large kitchens was at the east end of the dining room. On the upper floor were the sleeping wards, and here the corridor had a glazed partition half way along separating the males from the females.

*Rear view of St Drostan’s House, looking west, behind is the eastern end of Brechin Infirmary. Photographed in April 2019 © H. Richardson*

The out buildings included a probationary ward, washing-houses, ash pits, and coal cellars. Once the new poorhouse had been completed and the inmates moved from the old building in City Road, the latter was put up for sale. It was bought by Mr J. L. Gordon, the Town Clerk, for £541, on behalf of the Town Council, with the intention of converting it into a model lodging house. [7]

*Block to the rear of St Drostan’s House, one of the original out-buildings. Photographed in April 2019 © H. Richardson*

A further report in the Brechin Advertiser following the opening of the new poorhouse, continued the enthusiastic spirit of the previous account, noting the ‘tasteful and imposing appearance’ of the main frontage, and approving of the introduction of mullioned windows to relieve the ‘baldness that might otherwise have characterise the house’. The garden had been laid out under the superintendence of Mr Annandale of the nearby Den Nursery, and the contractors were listed as: Mr J. Cribb, mason; Messrs Black & Son, joiners; Mr Masson, plasterer; Messrs Kinnear & Son, plumbers; Mr W. Bruce, painter; and Mr J. Davidson, slater – all of Brechin. [8]

South front of the former poorhouse or Parochial Lodging House, with the mullioned windows on the upper floor in the gabled bays. The bay windows on the ground floor are post-war additions. When new sheltered housing was built to the rear in the early 2000s the former poorhouse was converted to offices, but is currently empty. Photographed in April 2019 © H. Richardson

The next development of the medical services in Brechin was the establishment of an isolation hospital in the 1890s. Infectious cases, or ‘fever patients’ had up until then been cared for in the infirmary, but in times of epidemic there was insufficient accommodation there. In February 1893 an outbreak of smallpox at the Forfar and Brechin Railway huts at a time when the fever ward in the infirmary was already full prompted the Police Commission in Brechin – responsible for public health – to meet with the directors of the Infirmary to consider providing either a permanent or temporary hospital for infectious diseases. In 1895 the Brechin Police Commissioners joined forces with the District Committee and were on the search for a site. They discussed commissioning plans and estimates for a new hospital. The site must have been acquired by the end of August 1897 when an advertisement was placed in the Dundee Evening Telegraph for ‘Bricklayers (a Few Good) wanted. Apply New Hospital, Brechin’. [9]

*Detail from the 25-inch OS map revised in 1922, showing the infectious diseases hospital to the north-west of the Infirmary. Reproduced by permission of the National Library of Scotland*

The plans were drawn up by T. Martin Cappon, architect, Dundee. A caretaker was appointed in 1898, the building work probably completed by then. The hospital comprised three detached blocks, probably the administrative building, which would also have contained some staff accommodation, and two ward blocks.

*Probably a block from the former isolation hospital, to the rear of Brechin Infirmary, photographed in April 2019 © H. Richardson*

Another building on its own to the north (pictured above and below), may have been the service block containing disinfecting chambers, with boilers and disinfectors, wash-house, mortuary and stores. Thomas Martin Cappon went on to design the Forfar County Hospital in 1899. [10]

*Surviving building from the former infectious diseases hospital. Photographed in April 2019 © H. Richardson*

Post-War Changes

By 1940 the infectious diseases hospital had been converted into accommodation for the aged and infirm, but by 1950 it had been closed. The Eastern Regional Hospital Board recommended retaining the buildings for accommodation for nurses and for storage, releasing a hut at the infirmary which might be used for 30 chronic sick patients. [11]

Extract from the 1:1,250 OS map revised in 1965. This shows the 1920s extension to the infirmary, and the large post-war addition pictured below. Reproduced by permission of the National Library of Scotland

At the infirmary itself the largest addition since the 1920s was made in 1958-60, when the large wing to the north was added. A bequest of nearly £14,000 from Mrs Agnes Pederson, a Brechin woman in America, was used to provide new kitchen premises, out-patients’ and physiotherapy departments, alterations to staff quarters and a day room for geriatric patients between the new accommodation blocks. [12]

*A spliced photo showing the south-east front of the post-war hospital extension. Photographed in April 2019 © H. Richardson*

The health centre was built in about 1971, and was the first to be built in Angus.[13]

See also RCAHMS, National Monuments Record of Scotland, drawings collection, for the infectious diseases hospital and www.workhouses.org for St Drostan’s House.

Montrose, Arbroath and Brechin Review; and Forfar and Kincardineshire advertiser, 13 Feb 1846, p.5
Brechin Advertiser, 14 Sept 1852, p.2: 2 March 1880, p.2
Dundee Courier, 23 Aug 1864, p.4; 12 Dec 1865, p.4; 19 Dec 1866, p.4: Dundee Advertiser, 29 Dec 1864, p.3
Montrose, Arbroath and Brechin review; and Forfar and Kincardineshire advertiser, 19 April 1867, p.4: Dundee Courier, 6 May 1867, p.4
Brechin Advertiser, 5 June 1928, p.5: Aberdeen Press & Journal, 20 Sept 1928, p.5: Dundee Courier, 10 Oct 1928, p.5; 11 Dec 1929, p.6: Dundee Evening Telegraph, 11 Dec 1929, p.10
Brechin Advertiser, 2 March 1880, p.2
Brechin Advertiser, 16 March 1880, p.2
Brechin Advertiser, 16 March 1880, p.3
Dundee Courier, 1 Feb 1893, p.3: Aberdeen Press & Journal, 12 April 1893, p.5; 19 Aug 1896, p.6: Dundee Advertiser, 10 April 1895, p.2; 23 Oct 1896, p.2: Dundee Evening Telegraph, 25 Aug 1897, p.3
Dundee Courier, 6 July 1897, p.3; 4 Oct 1899, p.4: Peterhead Sentinel and General Advertiser for Buchan District, 28 Aug 1898, p.4
Dundee Courier, 26 Jan 1950, p.4
Brechin Advertiser, 2 Dec 1958, p.5
Aberdeen P&J, 16 Feb 1971, p.31

The Western Isles Hospital, Stornoway, and its forebears

March 3, 2019November 5, 2021 / Harriet Richardson / Leave a comment

Memorial stained-glass panel in the Western Isles Hospital, depicting the Lewis Hospital on the right and the County Hospital to the left, both closed when the new general hospital opened. © H. Richardson

The Outer Hebrides are served by one general hospital in Stornoway on the Island of Lewis – the Western Isles Hospital. It was designed and built by the Common Services Agency and opened to patients in 1992. The hospital was designed to replace two much older hospitals: the Lewis Hospital and the County Hospital.

*The Western Isles Hospital, photographed in January 2019, © H. Richardson*

The County Hospital had been built by the Red Cross during the First World War as the Lewis Sanatorium, and after the war was transferred to the local authority. The Lewis Hospital was built in 1893-6 on Goathill Road. Before the advent of the National Health Service, there was also Mossend Fever Hospital, built by Stornoway Town Council in 1876, which contained 12 beds, and the Lewis Combination Poorhouse, opened in 1897, which took in sick paupers and manageable cases of the mentally infirm.

*Memorial plaques from the Lewis Hospital preserved in the present hospital. © H. Richardson*

In 1904 the Lewis Hospital also contained twelve beds, but its capacity was increased to twenty when the building was enlarged in 1912. A consultant surgeon was appointed in 1924, partly funded by the Scottish Board of Health under the Highlands and Islands Medical Service. A further grant from the Board helped to fund an extension to the hospital that opened in 1928. At the time, this was heralded as the first step in the realisation of a perfect hospital service for the Outer Hebrides as envisaged by the Dewar Commission of 1912, which first outlined the Highlands and Islands Medical Service. Seen by many as a precursor of the National Health Service itself, the Service extended state-funding of health care beyond the responsibilities for the care of the destitute sick, the mentally ill and the control of infectious diseases.

*Part of the former County Hospital, photographed in September 1993, reproduced by permission of Kathryn Morrison © K. Morrison*

The works done in the 1920s included improvements to the water and electricity supplies, the installation of central heating to replace peat and coal fires, X-ray plant, a new operating theatre, light treatment – including artificial sunlight treatment – enlarged kitchens and improvements to staff accommodation.

With a population of over 32,000 on Lewis and Harris, scattered over a wide area, the difficulties of communications and the different way of life of the people presented the singular circumstances necessitating state intervention. According to the reporter for The Scotsman:

‘Until the advent of the motor car, medical practice in these parts was on a very limited scale, and to this day the superstitious practices of former generations still linger in the hereditary healers and village bone-setters. Until quite recent days the idea of an hospital universally held was that of a place where people went only to die. As a result, the mere suggestion of hospital treatment was opposed with the same vigour that city patients resist the poorhouse.’ [1]

This may have been true, but the annual report of the hospital back in 1899 painted a rather different picture; 70 patients had been treated during the past year, of whom only three died. The yearly number of admittances was increasing, most being from the island, but 18 patients were ‘strangers … whose home residence extended from Reikjavik, in Iceland, to Sidmouth, on the Devonshire coast’. Nearly all of these were fishermen or sailors. In 1923 fewer than 100 cases were admitted to hospital, but in the following year, after the appointment of the consultant surgeon, 375 patients were treated and 350 operations performed.

*The former Lewis Hospital, photographed in September 1993, reproduced by permission of Kathryn Morrison © K. Morrison*

In 1964 the Secretary of State for Scotland appointed a committee to review the general medical services in the Highlands and Islands. Under the NHS the areas formerly covered by the Highlands and Islands Medical Scheme were now administered by three separate regional hospital boards: the North Eastern, based on Aberdeen, took care of Orkney and Shetland; the Western, based in Glasgow, oversaw the counties of Argyll and Bute; and the Northern, centred on Inverness, took care of everywhere else. The Regional Hospital Boards appointed boards of management to run groups of hospitals (or, in some cases, individual hospitals). The Lews and Harris board of management was responsible for the Lewis and County Hospitals in Stornoway.

*The County Hospital, from the 1:1,250 OS Map revised in 1964. Reproduced by permission of the National Library of Scotland*

Then, as now, one of the biggest challenges to the health service was providing for the elderly, and one of the inherent flaws of the NHS was (and still is) the division of responsibility between the NHS and local authorities. In 1966 the Chairman of the Northern Regional Hospital Board commented on ‘the nebulous boundary’ between the two, noting that where responsibility is shared between two types of authority ‘each of whom would have no difficulty in finding good alternative uses for any resources currently required for care of the elderly, there is a natural inclination for each to feel that the other ought to carry more of the burden’. [2]

*The Lewis Hospital as extended, from the 1:1,250 OS Map revised in 1964. Reproduced by permission of the National Library of Scotland*

Between 1948 and 1960 around £100,000 was spent on additions to the Lewis Hospital. In 1950 work had begun on a new maternity unit, nursing staff quarters and an out-patient department. In the mid-1960s Lewis Hospital had 83 beds, 46 for general surgery, 24 for general medicine and 13 for maternity cases. the County Hospital had 89 beds, 50 for the chronic sick, 35 for respiratory tuberculosis and four for infectious diseases.

Following the re-orgnisation of the NHS in 1974 which abolished the old regions and introduced a larger number of new area health boards, the islands of Harris and Lewis were managed by the Western Isles Health Board. In 1978 the Board outlined the need for a new district general hospital, on the site of the Lewis Hospital, but recognising that this was likely to be a long-term goal, it proposed that in the mean time a new operating theatre should be built. The Common Services Agency (CSA) had by then already drawn up a development plan for the Lewis Hospital, but the medical staff in Lewis criticised some of its elements: the theatre was not on the same level as the main surgical ward, the out-patient department was too small, and generally the plans left no room for further expansion. The Aberdeen Press & Journal reported that the CSA apologised for the plans, explaining they were only basic block plans aimed at demonstrating that it was possible to add the required facilities to the existing site, incurring as little interference to the ongoing work of the hospital as possible. The CSA ‘were not proud of the plans but were open to suggestions’. [3]

By May 1980 the Health Board had drawn up a list of their requirements for the new hospital, suggesting at least 280 beds be provided, comprising 30 medical beds – including provision for infectious diseases and intensive nursing; 48 surgical beds, including 8 for orthopaedic cases, 10 gynaecological beds, 8 for children plus four cots, two for the staff sick bay, 14 maternity, 90 geriatric beds and 30 beds for acute psychiatric patients.

The inclusion of beds for psychiatric patients reflected current NHS policy and the terms of the Mental Health (Scotland) Act of 1960 (and the Mental Health Act of 1959 covering England and Wales), . The new network of district general hospitals were to cater for general medical, surgical and psychiatric patients. This policy had evolved from a recognition that the existing mental hospitals did not provide the best environment for new cases. This was in part due to the institutional character of the large Victorian mental hospitals, but also the difficulties of attracting good mental health nursing staff, together with the stigma attached to mental illness in general and the old ‘lunatic asylums’ in particular. In the Western Isles the problems were exacerbated by the distance to the only psychiatric hospital serving the whole of the Highlands and Islands: Craig Dunain Hospital at Inverness. In 1979 more than 100 patients from the islands were in care at Craig Dunain. The new hospital in Stornoway was therefore to include a psychiatric unit, though links to Craig Dunain were to be retained given the number of specialist psychiatric fields.

*Main entrance of the Western Isles Hospital, photographed in January 2019 © H. Richardson*

Formal approval to build the new hospital complex was granted in 1986, and work was underway by 1991. It took two years to build and cost £32m. Although the first patients were admitted in September 1992, the official opening took place the following March, performed by Prince Charles (as Lord of the Isles). The Prince was welcomed to the hospital by the chairman of the Western Isles Health Board, Marie MacMillan, and was given a comprehensive tour of the facilties and chatted to staff and patients. He then unveiled a plaque in the main concourse area. [4]

References:

The Scotsman, 4 May 1928, p.8
Parliamentary Papers: Scottish Home and Health Department, General Medical Services in the Highlands and Islands, Report of a committee appointed by the secretary of State for Scotland, June 1967. Cmnd. 3257
Aberdeen Press & Journal, 24 May 1978, p.26
Slàinte, NHS Western Isles Staff Magazine, Winter 2012, p.4

Sources:

North Star and Farmers’ Chronicle, 23 Feb 1899, p.6: Dundee Courier, 3 Feb 1904, p.1:: Department of Health for Scotland, Annual Reports:Aberdeen Press & Journal, 21 Feb 1979, p.27; 16 May 1979: The Guardian, 15 Oct 1986, p.31: Nicola MacArthur, ‘The origins and development of the Lewis Hospitals’, Hektoen International, A journal of Medical Humanities, Spring 2017: NHS Eileanan Siar Western Isles 70 Years

Historic Hospitals

An Architectural Gazetteer

Author: Harriet Richardson

The Architecture of Isolation

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William Goldring and Asylums — The Gardens Trust

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The Falkirk Ward

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Randolph Wemyss Memorial Hospital, Fife

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Victoria Hospital, Fife

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Two Highland Hospitals: Ross Memorial, Dingwall and Nicolson Mackenzie, Strathpeffer

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Brooksby House, Largs. From Yachting Residence to Seaside Convalescent Home.

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The Hospitals on Islay

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Brechin Infirmary and St Drostan’s House

Post-War Changes

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The Western Isles Hospital, Stornoway, and its forebears

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Post-War Changes

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