The long spell of good weather lately has not been very conducive to research and writing indoors. I have made some progress, and have have begun revising the Suffolk page and did a bit of spring cleaning on the Aberdeenshire page. As always, any contributions of recent snaps, historic photos or drawings that could be added to the site would be very gratefully received.
Lots of public buildings have foundations stones; these stones were usually laid by a local dignitary, marking the commencement of work. Usually they are inscribed with the name of the person laying the stone, the date, and often the names of the architect and builder. Recently I was sent photographs of Letchworth Hospital, including the one above ofthe foundation stone for the new wing built in 1921. It was the first time I had ever come across a foundation stone laid by the local May Queen. It also seemed unusual that the May Queen in question was not identified. I thought that I would easily find details in the local newspapers on the British Newspaper Archive, but have so far failed to turn up anything on the new wing or the May Queen. With a bit more digging, I found that the website Herts Memories lists all the May Queens from 1906 to 1966. The May Queen for 1920 was Edith Fox, later Mrs Stark, and I assume she was still in post in January 1921 when the foundation stone ceremony took place, before she was succeeded by Mary Cook (later Mrs Pound).
Letchworth Hospital was established in a converted house at the beginning of the First world War. Plans had been drawn up before the war for a purpose-built hospital to designs by Barry Parker, of Barry Parker & Raymond Unwin based in Letchworth. Fundraising had been proceeding in 1913, but the amount raised fell far short of the £6,000 target by July 1914 when war was declared. War-time conditions made the need for a local hospital even greater, as beds in the London hospitals, where people from Letchworth had gone for surgery, were reserved for the military, and the nearest cottage hospital at Hitchin could not be relied on to have free beds for patients from Letchworth.
A number of Letchworth homeowners came forward to offer up temporary accommodation. The hospital committee accepted an offer from Mr and Mrs Cockerell to take Pixmore House on lease for one year. At that time, many people believed that the war would not last long, so a year’s lease seemed adequate. Letchworth Temporary Hospital opened in October 1914. By March 1917, having extended the lease, the hospital’s board of management decided it should drop ‘Temporary’ from the hospital’s name. After the War a new fundraising scheme was launched to build a ‘peace memorial wing’. This was the extension for which the May Queen laid the foundation stone on 9 January 1921. Work was completed by November 1922. As well as not naming the May Queen, the stone did not record the names of the architect or builder, so as yet I am stumped. The plans may well have been provided by Barry Parker, who continued his association with the hospital into the 1930s. He was also the architect of Royston Hospital, about 12 miles north-east of Letchworth, built in 1920-4 to replace the earlier cottage hospital there.
Over the last month or so I have been revising the Cumbria page. While doing some research to fill in gaps for one or two of the hospitals I was delighted to find that the cottage hospital at Cockermouth had been designed by one of the leading Arts & Crafts architects of the early twentieth century, Sir Guy Dawber. It was a relatively small commission.
Delight turned to dismay when I discovered that the building had been demolished relatively recently. It was damaged by the terrible floods that occurred in 2009, and a new hospital built further south. Part of the site has been redeveloped with retirement apartments (called Lancaster Court). The Guy Dawber hospital had been built in 1915, and by the late 1930s had 14 beds and two cots for children.
A highlight for me this month was a trip to Margate on the Kent coast. Apart from the delights of Dreamland, the Walpole Hotel, the Margate Bookshop and many other attractions, it was an opportunity to catch up on developments at the former Sea Bathing Hospital site.
The hospital closed in the 1990s when services transferred to Thanet District General. After a decade of standing empty planning permission was granted to convert the historic core into luxury apartments, and since then much of the former hospital has been adapted into housing.
New apartment blocks have been built in sympathy with the 1880s additions to the hospital, and some high-end town houses built facing the sea. For more on the history of the site there’s a separate post here: Margate’s Sea Bathing Hospital
Over the last year I have been revising the pages on this website that cover the hospitals in England. I am aware that some of the county pages have little more than a list of sites. Herefordshire was one that had very little information about any of the buildings, but it has now been revised with maps, brief histories and illustrations. This post gives a quick summary of the historic hospitals of Herefordshire and the present status of those buildings.
Hereford General Hospital from the Annual Report for 1927, from the Wellcome Collection
Hereford General was the first hospital in the modern sense to be established in the county. It was founded in 1776 and occupied adapted premises in Eign Street. Its success warranted a permanent structure for which a site was given by Lord Oxford (Edward Harley, the third Earl of Oxford and Mortimer, who was MP for Leominster and Droitwich). Building work began in 1781 to designs attributed to William Parker and was completed in 1783.
The original building survives at the heart of the site, comprising the central nine bays with advanced pedimented centre. It has been much extended and altered, upwards and outwards, including the entrance porch that was added in 1887 at the same time as the Victoria Wing. By the middle of the twentieth century the site was heavily built over, apart from the open ground immediately in front of the original range overlooking the River Wye. A good sense of way in which the hospital evolved can be gained from a short film made in 2002, as the hospital faced closure, which gives the viewer a guided tour both outside and in (see Hereford Focus on YouTube).
Victoria Ward, Hereford General Hospital, from the Annual Report for 1928, from the Wellcome Collection
Hereford General remained the main acute hospital for the county throughout the nineteenth century and into the twentieth. The main alternative was Hereford Union Workhouse, which would have had some accommodation for sick paupers from when it was first built in 1836-7. New infirmary wings were built on the site in 1876 and in the early 1900s, but the main transformation came after the Local Government Act of 1929 which saw many former workhouses transformed into municipal hospitals. For Hereford this resulted in its development into the present Hereford County Hospital, initially with a new hospital range begun just before the Second World War. Shortly after the war broke a series of hutted ward blocks were built on the site as part of the Emergency Medical Scheme to provide for the anticipated large numbers of casualties.
Hereford also had a number of specialist hospitals. The Victoria Eye and Ear Hospital opened in 1889, a handsome Tudor style building designed by the local architect E. H. Lingen Barker. Hereford Town Council also provided for infectious diseases with hospitals at Tupsley while the wider county was served by a sanatorium for tuberculosis near Ameley in a converted house (Nieuport Sanatorium). Provision for maternity cases was increasing in the 1940s, as hospital births began to be more common than home births. The County Hospital had a maternity department that was being extended at the end of the war, and there was a small public maternity ward at the General as well as a few private beds. There were also a few maternity beds at all but Ledbury of the former workhouses, while for private paying patients there was a maternity home in Hereford with four beds.
There was also the county mental hospital, St Mary’s, at Burghill, first opened in 1871 and a ‘mentally deficiency’ institution at Holme Lacy House that opened in the 1930s. In the rest of the county there were a few workhouses, cottage hospitals and small rural isolation hospitals that were established in the nineteenth century.
Most of the pre-war hospitals in the Herefordshire are no longer in the NHS estate. Some have been demolished, others adapted to new uses. When the NHS came into being in 1948 the hospitals in Herefordshire came under the Birmingham Regional Hospital Board, which also covered Worcestershire, Warwickshire, Staffordshire and Shropshire. This administrative structure remained in place until the NHS reorganisation of 1974.
Postcard of the former St Mary’s Hospital, probably from around 1900-10, when it was still known as ‘the asylum’.
Initially the Regional Board was responsible for around 220 hospitals with a total of about 42,000 beds. These were grouped into management units based on function and geographical location. Herefordshire Hospital Management Committee oversaw eighteen hospitals. These were: the General and County Hospitals and the Victoria Eye Hospital in Hereford; St Mary’s Mental Hospital, Tupsley Hospital for infectious diseases and Tupsley Smallpox Hospital; Holme Lacy Hospital for ‘mental defectives’; the cottage hospitals at Ledbury, Leominster, Ross-on-Wye, and Kington; Stretton Sugwas Hospital, near Credenhill; Nieuport Sanatorium; the former workhouses at Ross-on-Wye (Dean Hill Hospital), Bromyard, Leominster (Old Priory Hospital),and Kington (Kingswood Hall). Leominster and Kington were owned by Hereford County Council but the NHS had rights to accommodation under the 1948 National Assistance Act. Nieuport Sanatorium closed in 1951 and the Tupsley smallpox hospital was used as a store. Another smallpox hospital near Bromyard was transferred to the NHS but not used, it was sold in 1952.
There are now four NHS hospitals in Herefordshire: Herefordshire County Hospital (the main complex built in 1999-2001, W. S. Atkins Healthcare, with other blocks from 1950s-80s and fragments of the 1830s workhouse), and three community hospitals at Leominster (1899, partly rebuilt 1991), Ross-on-Wye (1995-7 incorporating part of the former workhouse) and Bromyard (1989, Abbey Hanson Rowe Partnership). Mental Health services also operate two in-patient units in Hereford: the Stonebow Unit is on the County Hospital site and is a purpose-built facility erected in 1985 that was recently upgraded, and Oak House in Barton Road, a residential rehabilitation unit in a converted house.
Herefordshire in 1945 was still an essentially rural county with no large centres of population. The advent of the NHS was seen as an opportunity to rationalise services, including centralisation, continuing a process that had begun before the war. In order to inform the strategic planning of the hospital service, the Board drew on the Hospital Survey of the West Midlands Area published in 1945 by the Ministry of Health. The Survey did not cover the mental health service which was considered as an essentially separate service with its own legislative basis and at the time there were uncertainties about how it might be integrated within a broader national health service, or even if it should be included at all.
The future of cottage hospitals was particularly threatened by the wider policy for modernisation, centralisation and rationalisation. The Hospital Survey of 1945 noted that Ross-on-Wye cottage hospital had 16 beds, plus ‘a few beds in huts in the garden’, Leominster had 13 beds, Ledbury 12 and Kington just 10 beds. There had also been a cottage hospital at Bromyard, but financial difficulties had led to its closure during the First World War. The others lasted longer. Ross-on-Wye Cottage Hospital was replaced by the new community hospital built on the site of the old workhouse. It was demolished after closure in 1997 and replaced by retirement flats. The original Leominster Cottage Hospital partly survives, absorbed by the present community hospital. Its ward block was demolished to make way for the new hospital building which opened in 1991. Ledbury Cottage Hospital was converted to mixed residential and business use in 2009, having closed in 2002. The Victoria Cottage Hospital at Kington is now Kington Youth Hostel.
The Hospital Survey also noted that five former workhouses in Herefordshire had chronic sick wards: Leominster, Ross, Kington, Ledbury and Bromyard. Leominster workhouse, like Kington Cottage Hospital, has become a youth hostel (the workhouse had incorporated some fifteenth-century priory buildings). Ross-on-Wye union workhouse developed into Dean Hill Hospital for geriatrics and mental health unit, and had 157 beds by the mid-1960s. The workhouse buildings have partly been demolished to make way for the present community hospital. Kington and Ledbury Workhouses were not transferred to the NHS. Kington has been demolished and Ledbury partly demolished, but some of the workhouse ranges were converted into housing. Bromyard Workhouse has also been turned into flats, not with great sensitivity.
The largest hospital in the county was St Mary’s, built as the City and County Asylum. It closed in 1994 and in 1998 most of the hospital buildings were ‘stupidly demolished’ (according to the Pevsner Architectural Guide) to make way for a large housing development. The entrance building (St Mary’s House) remains along with sections of the ward wings which were converted to flats.
More information on Herefordshire’s hospitals can be found on the Herefordshire page. There is also more on the workhouses on the workhouses.org site. Archival records relating to the hospitals are mostly at Herefordshire Archive and Records Centre, and I would also recommend the Herefordshire Through Time website, which has a section on hospitals. Historic England Archive has the hospital reports and building files that were put together for the national survey of hospitals carried out in the early 1990s on which I worked (though not on Herefordshire). The files may contain photographs of buildings that were standing then but have since been demolished.
Hertfordshire was one of the counties covered by the London team of the national hospitals survey, carried out in the early 1990s by the Royal Commission on the Historic Monuments of England. The London team comprised myself and Colin Thom (now Director of the Survey of London). At that time we only investigated hospitals built prior to the inauguration of the NHS in 1948 – so major post-war hospitals, such as those at Welwyn and Stevenage, were excluded.
Fieldwork for the survey was carried out in 1991-3. There was not enough time to visit every single site, and some were considered in greater detail than others. The selection had as much to do with ease of access as it did with the historic significance of the buildings. This meant that some ‘important’ sites were either missed out or only briefly dealt with. I am puzzled now as to why some weren’t visited. In Hertfordshire we seem not to have managed to get to Welwyn, Royston or Hitchin, and also didn’t photograph Letchworth Hospital. The rest we visited on various dates between May 1992 and June 1993, while also covering the rest of the South East (Greater London, Essex, Kent, East and West Sussex, and Surrey) as well as Avon, Staffordshire, Shropshire and parts of the West Midlands, added late on to help out the York-based team. We covered a lot of ground, so perhaps I shouldn’t be too surprised that I’m struggling to remember visiting some of them.
For each site a building file was created, and these can be consulted in Historic England’s Archive based in Swindon. (The reference numbers for the files can be found on each of the county pages of the gazetteer after the name of the hospital following the grid reference.) These files vary in content, but generally have a report, photographs and maps.
Follow the link to the Hertfordshire page of this website for more details of individual sites.
What does Pevsner say?
The best known architectural guide to the buildings of Britain is the series begun by Nikolaus Pevsner after the Second World War. The Pevsner guides are generally the first place to look for information about the historic buildings throughout the UK. The original Pevsner guide to Hertfordshire was published in 1953, with an extensive revision published in 1977 (revised by Bridget Cherry). A further revised guide with new material edited by James Bettley was published by Yale University Press in 2019. I have relied heavily on this for updates to the condition of the various hospitals that we visited back in the 1990s. However, hospitals, especially former hospitals, are not easy to find in the guides and often receive only cursory mentions, if any at all. It is not a reflection of their historic significance as public buildings, but rather their relatively lowly architectural status, as they were seldom designed by ‘top’ architects, many are more interesting for their plans than their outward appearance, and where there have been many additions and alterations they can seem muddled and incoherent.
In its introductory overview, the guide notes that the first purpose-built hospitals appeared around the same time as the first workhouses built after the Poor Law Amendment Act of 1834. The West Herts Infirmary at Hemel Hempstead was built in 1831-2 followed swiftly by Hertford’s County Hospital in 1832-3 to designs by Thomas Smith. In 1840 Hitchin Infirmary was built designed by Thomas Bellamy. The last two have since been replaced, and only the core of their original buildings has been retained. Bellamy’s Hitchin Infirmary is now Bellamy House – the remainder of the site now occupied by a Waitrose supermarket. Hertford County Hospital has been replaced by a new building constructed alongside in 2003-4 (architects Murphy Phillips) leaving the old building rather marooned. West Herts is a typical multi-phase hospital, with much of its built heritage remaining in use, including the early Cheere House of 1831 and Coe and Robinson’s 1875-7 pavilion-plan infirmary (see photo above).
As well as general hospitals, there was a private asylum at Much Hadham established around 1803 (principally of architectural interest to the Guide because it occupied The Palace), and a crop of workhouses. Of the latter, there are partial survivals at Buntingford (1836-7 by W. T. Nash); St Albans (1836-7 by John Griffin); Ware (1839-40 by Brown & Henman) and more substantially at Watford (1836-7 by T. L. Evans) where the workhouse developed into the general hospital.
Architectural aerial perspective view of proposed asylum, Leavesden, from The Builder
During the Victorian and Edwardian eras Hertfordshire attracted children’s homes and mental hospitals, including the Metropolitan Asylums Board’s ‘Imbeciles’ Asylum’, later Leavesden Hospital, at Abbots Langley designed by John Giles & Biven and built in 1868-70. This asylum was the twin of Caterham Hospital which served the south of the Metropolitan area.
Of Leavesden Hospital only the former administration block, chapel and recreation hall have been retained, converted to the residential Leavesden Court – a gated development – with new housing built to the north and west on the site of the former ward pavilions and parkland to the east.
Setting aside children’s homes, the Guide also notes Holman & Goodrham’s TB sanatorium built for the National Children’s Home built in 1909-10 (survives as the King’s School); Rowland Plumbe’s Napsbury Hospital built in 1901-5 (partially demolished, parts converted to housing); and G. T. Hine’s Hill End Asylum of 1895-9 (largely demolished). The only ‘local hospitals’ during this period mentioned in the Pevsner Guide are the cottage hospital at Watford of 1885 designed by C. P. Ayres (still extant) and the Sisters Hospital at St Albans designed by Morton M. Glover of 1893 (later extensions demolished, original main buildings converted to housing).
In the 1920s Royston Hospital was built to designs by Barry Parker (still an NHS hospital, but much extended). Then in the 1930s the large new mental hospital at Shenley was built, designed by W. T. Curtis (mostly demolished), and ‘a rather utilitarian general hospital’ at Welwyn designed by H. G. Cherry (still an NHS hospital with a newer block built to the south).
There is no mention in the introduction of the post-war hospitals, and the Lister at Stevenage is quickly covered by two sentences that provide the date (1966-72), the architect (E. A. C. Maunder of the North West Metropolitan Regional Hospital Board) and summary of its appearance (A central Block of nine storeys, a symmetrical elevation with projecting balconies, surrounded by extensive lower buildings.) Before too long, I hope to produce a separate post on the Lister and the other post-war hospitals in Hertfordshire.
Hertfordshire Hospitals in the 2020s
Hospital services in the 21st Century have become significantly more complex since the early years of the NHS. The NHS currently has thirteen hospitals in the county (not including those that were formerly in Hertfordshire which now lie within Greater London – such as in Barnet). There have been at least 44 hospitals in Hertfordshire in the past, not including a few small local authority hospitals for infectious diseases. The decline in the number of hospitals reflects increasing centralisation of services and changing practices in medical care and treatment. Of the 44 that feature in the Hertfordshire gazetteer page, only five are still NHS hospitals; 15 have been converted to housing or other use, including partial demolition; and 24 have been either entirely or largely demolished. The scale of demolition is larger than even that figure suggests, as it includes some of the largest hospital complexes in the county.
It has been depressing to discover the extent of destruction of former hospital buildings, a great many of them only having been demolished in the last ten to twenty years. A great deal more should and could have been retained, particularly of the large former mental hospitals such as Shenley, Harperbury and Hill End.
Leavesden Hospital, as mentioned above, has largely been demolished to make way for housing. The hospital also had an annexe to the south. This had formerly been the St Pancras Schools, together with detached hospital and babies home. It had an Emergency Medical Scheme spider block built at the start of the Second World War on vacant ground behind the buildings which became Abbots Langley Hospital when transferred to the NHS in 1948. These emergency hutted buildings were intended to be temporary, and it is perhaps more surprising that they lasted into the 1990s than that few of them are left in the 2020s.
I have always had a few favourite hospitals – ones that were particularly attractive or interesting. In Hertfordshire, Shenley was one – at least in part because of its lovely grounds. The hospital was laid on the Porters Park estate, along with the mature landscape around the mansion house.
Porters Park has a complicated history having been substantially rebuilt or remodelled on more than one occasion. Its present appearance is largely due to the rebuilding of 1902 for C. F. Raphael by the architect C. F. Harold Cooper. The house and estate were transformed into Shenley Mental Hospital in the 1930s. The map below show the extent of the hospital in the 1950s. It was designed on a colony plan, whereby all the patients’ accommodation and treatment blocks were detached, and arranged in the manner of a village, with central service buildings and chapel.
Shenley Hospital on the OS map surveyed in the 1950s CC-BY (NLS)
The map below shows the modern housing development on the site. The existing buildings are shaded orange. The map is overlaid on the 1950s OS map above – and the grey shapes of the hospital blocks can just be seen behind. Only the PW – place of worship – and the small block to its south are from the hospital era.
Overlay map of Shenley showing the new housing development on the former hospital site. OS map of the 1950sand OS Opendata CC-BY (NLS)
Napsbury was another favourite – here too the landscape setting was particularly good, but the architect for this large asylum, Rowland Plumbe, was allowed to bring his characteristic style to the buildings, which were more decorative than Hine’s more pedestrian Hill End. The picturesque qualities of Napsbury no doubt made its adaptation appealing for the developers of the site, and it is now at the heart of Napsbury Park – a residential development near St Albans largely constructed between 2002 and 2008 (see blog post on Napsbury here).
If I had to name a top three of Hertfordshire hospitals, Napsbury would probably be at number one, with Shenley at number two. At number three I would put Bennett’s End – and I was particularly saddened to see that this one has been demolished. It was the perfect small local authority isolation hospital, built in accordance with the Local Government Board’s model plans.
Aerial perspective of Bennett’s End Hospital published in 1914, the hospital looked remarkably similar to this when we visited in the 1990s.
There were a few other losses that I am particularly saddened by. Potters Bar Hospital was a charming low-rise late 1930s Deco-ish building that has been replaced by a Tesco supermarket. A new Community Hospital was built on Barnet Road.
I was also shocked to find that I had missed Welwyn Garden City’s Queen Elizabeth II Hospital, demolished in 2017 after the new QEII was built on the adjacent site. The original QEII opened in 1963 and was one of the first new general hospitals to be completed by the NHS. There is a little more information on the Hertfordshire page.
Model of theWelwyn-Hatfield new hospital, published 1958 by the North-West Metropolitan Regional Hospital Board
It has been a sobering exercise, revisiting the survey of Hertfordshire’s hospitals. Far more has gone than I had anticipated. We knew at the time that the NHS was winding down the majority of the large former mental hospitals in England. There had also been an increase in hospital-building during the 1980s with many ‘nucleus’ district general hospitals being built. Together this contributed to a great many hospital closures and redundant buildings. Replacing the older pre-war hospitals had been an early ambition of the new NHS in 1948, but it has taken most of the second half of the twentieth century to come close to that ambition.
Tenbury Cottage Hospital, undated Valentine series postcard, c.1905
I recently acquired this postcard of the cottage hospital in Tenbury. It wasn’t a hospital that I was familiar with, and it seems to have missed out of the RCHME hospitals survey – perhaps because it lies on the border of two counties, Tenbury itself being in Worcestershire while the hospital lies over the river, and over the county boundary, in the Shropshire parish of Burford. Shropshire was one of the counties that I worked on, but this hospital slipped through the net. It’s a pity, not least because it is still an NHS hospital and the original section is a listed building.
Tenbury surveyed for the 25-inch OS map in 1883, the cottage hospital is at the top right, along the road from the Swan Hotel. The main village is south of the river, with Tenbury Union Workhouse the first building to the east of the Teme Bridge. Reproduced by permission of the National Library of Scotland, CC-BY (NLS)
The hospital was established in a converted house in 1869, and originally called St Mary’s Cottage Hospital. The early nineteenth century house was extended westwards around the turn of the century. The extension is probably the part shown on the postcard to the left, with veranda and balcony. In the 20th century the hospital expanded on its east side. It is currently (2024) a community hospital administered by Worcestershire Health and Care NHS Trust.
The cottage hospital at Tenbury from the 25-inch OS map surveyed in 1883. CC-BY (NLS)
The original building seems to have been listed because of its interest as a house. It was built around 1835 by Richard Titt, landlord of the Swan Hotel, who died in 1843, aged 86, having been the Swan’s landlord for over 40 years. However, it is also historically important as an early example of a cottage hospital in England, having opened on 1 September 1869. This was only ten years after the very first cottage hospital which opened in 1859: Cranleigh Cottage Hospital, Surrey. It is particularly rare to find a first-generation cottage hospital still using its original building.
The 1902 OS map shows the small western extension of the cottage hospital. CC-BY (NLS)
The hospital featured in Horace Swete’s Handy Book of Cottage Hospitals published in 1870. Swete described the hospital as a ‘small villa, with garden, coach-house and stable, altered for the purpose’. Patients contributed a small fee towards the cost of their care and treatment, charged at a weekly rate. Mrs Arabella Prescott served as the lady president of the establishment, and it was she who had purchased the house and footed the bill for fitting it up as a hospital, including the provision of linen, dressing-gowns and slippers for the use of the patients.
Cranleigh village hospital was the first of its kind, opening in 1859 and featured as the frontispiece of Horace Swete’s Handy Book of Cottage Hospitals published in 1870.
There was no connection to a mains sewer, so earth closets (or ‘earth commodes’ as Swete termed them), were used throughout the hospital. The floors were waxed and polished ‘with a view to greater cleanliness’, but Swete was critical of this, as it might make the floors slippery: ‘A poor fellow getting out on his crutches for the first time, would find considerable difficulty in walking upon it without falling’.
The hospital had a convalescent ward, and the coach-house was converted into a mortuary chamber, top-lit and fitted with a slate-topped table. The nurse in Swete’s time had formerly been a sister at Middlesborough Cottage Hospital. By 1910 the Tenbury cottage hospital had 9 beds, later extended to 12. An extension was built on the east side of the original house in 1912 named the Elizabeth Wing.
In 1915 the hospital featured in Henry C. Burdett’s How to Become a Nurse which listed the requirements for of various hospitals for trainees. St Mary’s, as it was then still known, took on young women for a month’s trial after a personal interview, which if satisfactory, led to one year’s training. Women had to be between 20 and 22 years of age, between 5ft 2in (1.57m) and 5ft 11in (1.80m) in height, with satisfactory evidence as to character and health. ‘Applicants should be of the upper middle class and Church of England’. Training included lectures by the matron on anatomy, and examinations were held twice yearly. ‘Laundry and text-books provided. Separate bedrooms.’
H. C. Burdett’s How to Become a Nurse, 1915
Although the hospital charged fees for admission and subscriptions from wealthier supporters, fund raising was an essential activity. Church collections were the main source of ad hoc donations. The nearby Swan Hotel hosted an ‘invitation charity ball’ in December 1884, and in 1899 and 1900 a ‘guess the weight of a cake’ competition. The Hotel later instituted an annual ball which took place until the outbreak of the First World War. Nevertheless, by the later 1890s the hospital’s income did not meet its expenditure, causing the hospital to dip into its endowment funds.
St Mary’s survived into the 1920s, but had to close in 1928 in the face of rising costs and staffing difficulties. All was not lost, and in 1931 it was re-orgnised and re-opened as Tenbury and District Hospital, with a further extension to the east opened in 1935 to provide an operating theatre. In the hospitals survey conducted by the Ministry of Health during the war it was described as having 16 beds, maintained by the Tenbury and District Hospital and Nursing Association. Six local general practitioners formed the honorary medical officers alongside a general surgeon from Leominster, an ear and throat surgeon from Kidderminster and a dental surgeon.
Under the NHS the hospital was well supported by the local league of friends. Expansions and modernisation improved facilities, and in 1986 a new outpatients department was built. A Millennium Project provided a further extension .
[Sources: Tenbury and District Civic and Historical Society, Tenbury and the Teme Valley People and Places, 2007: Horace Swete, Handy Book of Cottage Hospitals, 1870, pp.161-2: Report of the Royal Commission on the Poor Laws, 1908: Worcester Journal, 5 Jan. 1843, p.3: Wellington Journal, 27 October 1877, p.8: Tenbury Wells Advertiser, 16 Dec 1884, p.4; 31 Oct. 1899, p.5; 30 Jan. 1900, p.5: Kington Times, 6 July 1935, p.4: Ministry of Health, Hospital Survey. The Hospital Services of the West Midlands Area, 1945.]
At the end of September my husband, Chris, and I took a trip to the south-west corner of Scotland, to the Rhins of Galloway. On the way there and on the way back we stopped off at various hospitals, including this one at Girvan, on the Ayrshire coast.
This small cottage hospital was designed by the Glasgow firm of architects Watson, Salmond and Gray and built in 1921-2. It was officially opened on 15 June 1922. Thomas Davidson founded and endowed the hospital as a memorial to his mother. The Builder described the style as ‘a free treatment of the Scottish domestic’ and noted that the roofs were slated with Tilberthwaite slates (silver grey). The builders were the local masons, Thomas Blair & Son, who fashioned the handsome Auchenheath stone. They worked with J. & D. Meikle, joiners; William Auld & Son, slater, and William Miller, plasterer, all from Ayr. Tile work was carried out by Robert Brown & Sons of Paisley and the plumbing was done by William Anderson, Ltd, Glasgow. [The Builder, 1 July 1921, p.10.]
When it was visited in the 1940s as part of the Scottish Hospitals Survey it was praised for its good condition. At that time it had 14 beds in two wards, and two single rooms available for maternity cases. It was mostly used for accident cases and work connected with the local medical practitioners. It had a fairly well-equipped operating theatres and good domestic offices.
It is one of my favourite Scottish cottage hospitals, but it has been on the Register of Buildings at Risk since 2014. It has been replaced by a new Community Hospital on the outskirts of Girvan.
This extension was added in 1971. An effort was made to respect the original building, being small, low, set back and with stone cladding.
Plans to turn the building into an Enterprise Centre came to nothing. More recently an application was submitted for the conversion of the building into two dwellings. I do hope that the former hospital will be cherished by its new owners.
Rear of the building. The single storey wing probably contained the kitchens, but I have never seen the original plans of the building
Lovely matching wing to the rear of the main building, although it looks of a date with the original building, it must have been built after 1963 as it does not appear on the OS map of that date.
Large-scale OS map, surveyed 1963. Reproduced by permission of the National Library of Scotland (CC-BY) NLS
The future of this fine old building is under threat. It has stood empty for many years and there are fears that it may be demolished, despite its important place in the local history of Grantham and in the wider history of hospital architecture in England.
Postcard of the hospital c.1900
A day of public celebration, parade and partying accompanied the ceremony of laying the foundation stone of Grantham Hospital on 29 October 1874. The band of the Royal South Lincoln Militia lead a procession, followed by the architect and builder, local dignitaries, and interested parties, that marched from Grantham Guildhall to the site of the new hospital on the Manthorpe Road to the north of the town centre.
Countess Brownlow, who was closely associated with the project from its inception, conducted the actual ceremony, once she had listened to an address by the chairman of the building committee, a short service by the Vicar, and been presented with a silver trowel. A public luncheon was given at the Guildhall presided over by Earl Brownlow. Tickets for this event could be purchased for 2s 6d. Earl Brownlow and his wife donated funds towards the hospital and took an interest in the plans, and the Earl of Dysart gave £1,000 to the building fund. [Grantham Journal, 24 Oct 1874, p.4]
Extract from the 25-inch OS map, surveyed in 1885. Reproduced by permission of the National Library of Scotland.
Extract from the 25-inch OS map, revised in 1903. Reproduced by permission of the National Library of Scotland. This shows extensions to the rear of the hospital and an additional block.
Grantham Cottage Hospital was designed by the London architect Richard Adolphus Came (1848-1919), who went on to lay out the development of Woodhall Spa in Lincolnshire where he later settled, designing many of its buildings. He appears in the 1901 census as the proprietor of the Royal Hydro Hotel there. Came freely adapted a basic pavilion plan to create a picturesque elevation. Unusually, the wards were T-shaped, an arrangement which was commended by the great champion of hospital architecture in the late 19th century, Henry C. Burdett. He thought the wards were novel, pleasing and noteworthy, presenting a cheerful and airy appearance ‘which fills the visitor with pleasure’.[H. C. Burdett, Cottage Hospitals, 2nd edition 1880 p.412]
Baroness Brownlow also officiated at the official opening on 5 January 1876. ‘As it now stands approaching completion, the building with its neatly arranged grounds, and trim Gothic porch, forms a somewhat picturesque object’, reported the Grantham Journal.
The hospital, which is Gothic in character, is constructed of local stone with Ancaster dressings, and consists of three distinct blocks of buildings. The main building, which faces the road … is composed of a central block of two stories, providing a waiting-room, entrance lobby, surgeons’ sitting-room and operating-room, kitchen, offices and store-rooms, &c. on the ground floor; convalescent and board rooms, and four bedrooms on the first floor; and two bedrooms and lumber room in attics. There are wings stretching right and left of this block, forming the wards for male and female patients, and containing seven beds each, together with nurses’ room, bathroom, and other offices. The Gothic timber porch, which certainly contributes much to the appearance of the building, has been erected at the expense of the Earl Brownlow. Some distance in the rear of the main building, the fever hospital has been erected, and will contain five beds, bathroom, nurses’ room, kitchen &c., the working of this department being kept entirely separate from the other part of the hospital. A convenient laundry is also provided, with the addition of washing and ironing rooms, drying closet, and other similar accommodation. [Grantham Journal, 8 Jan 1876, p.4]
A major extension to Grantham Hospital was built in the mid-1930s to designs by the local architect F. J. Lenton, of Traylen & Lenton. The plans were approved by the British Hospitals Association, the Ministry of Health and the County Council. It was partly as a result of Kesteven County Council’s obligation to provide hospital accommodation that Grantham Hospital was extended, and the enlarged hospital was to take patients from the county as a whole. This raised the number of beds provided in the hospital from 33 to 76 initially. A new entrance was formed to the south of the original building. New ward blocks ‘of the latest verandah type’ were built for men, women and children. There was also separate provision for private patients, a new isolation block and operating theatre unit.
Architectural perspective of the extensions to Grantham Hospital by F. J. Lenton, architect
Verandah wards with folding windows, usually occupying the length of one side, originated in Denmark, and were introduced to England by Charles Ernest Elcock at the County Hospital, Hertford. Beds were placed parallel to the the side walls in groups of four, separated by glass partitions, instead of the old pattern in Nightingale-style wards where the beds were placed in rows at right-angles to the side walls. Each ward had five groups of four beds and two separate observation wards. The south-facing children’s ward had a paved terrace in front of the folding windows to allow cots to be wheeled out into the open air.
Verandah wards were hailed as revolutionizing hospital planning by providing improved access to fresh air and sunshine, and the psychological effect of smaller groups of beds (‘cosy communities’). It is interesting to note that the local paper praised the hospital for its functional design. ‘Rigid economy’ was observed in order to be able to provide the most up-to-date equipment: ‘In past days Hospitals were so often designed for external effect first and foremost’… ‘present-day designers always have in mind that their building should not be monumental, but sufficient for the present, and of a type that can be readily altered or adapted to the possible requirements of the future. [Grantham Journal, 27 Jan 1934, p.5]
In the new hospital, the private wards occupied a separate unit to the west of the complex which had its own enclosed garden. It had six private wards, with bedrooms for special nurses and separate ward kitchens. A subterranean boiler house was constructed at the edge of the site to provide heating and hot-water, operating on the panel-heating system by low pressure hot water, accelerated by electric pumps. All pipework was concealed in the ceilings. This was supplemented in the wards either with conventional open coal fires or gas fires. The building contractors for the extension were Bernard Pumphrey Ltd of Gainsborough. [Grantham Journal, 22 Sept 1934, p.5]
Extract from the 6-inch OS map, revised in 1938. Reproduced by permission of the National Library of Scotland. This shows the extension to the south of the hospital.
The new buildings were completed early in March 1935, after which the old hospital was refurbished to provide accommodation for the nursing and domestic staffs. At the same time a maternity unit was created in the old south ward wing of and the old theatre converted into a special labour ward. These alterations brought the hospital’s capacity up to 100 beds. [Nottingham Evening Post, 24 March 1936.]
Further additions were made following transfer to the NHS, including a new maternity unit which opened in 1972. Grantham Hospital has retained huge local support, as witnessed by the demonstrations that took place earlier this year to protest against the drastic reduction of the opening hours of the A&E department.
Bak in 2016 the future of the former Galashiels Cottage Hospital seemed to be uncertain once again. When the Borders District General Hospital opened at Melrose in 1988, it had been intended that the cottage hospitals at Galashiels and Selkirk should close permanently, but the local health board changed its mind and decided it could find a new use for the buildings. For Galashiels, that new use was a rehabilitation unit for people with long-term mental health problems, and it re-opened as such under the name Galavale House. But more recently there have been concerns that the standard of accommodation is not longer fit for purpose, and a scheme was under consideration in 2015 to relocate services to Crumhaugh House, Hawick. However, when I visited the Galashiels in September, it was still very much in use.
In 2006 Galavale House and lodge were listed category C (s) for their architectural and local historic interest. The origins of the hospital date back to 1891 when subscriptions were first raised for a cottage hospital in the town. Originally it was intended to be for accident cases, but in the end it took in medical and surgical cases, though paupers were excluded. Sick paupers were cared for at the local poorhouse.
Galashiels Cottage Hospital, engraved view from Building News, 1893
Built to designs by John Wallace of Edinburgh, the hospital was formally opened by the Earl of Dalkeith in November 1893. Wallace was originally from the Borders, and the few architectural commissions that he is known to have carried out were all in this area. In 1891, the year before he was commissioned to design the cottage hospital, he had designed Blynlee Tower in Galashiels.
The plan below was not as executed, only the front wards were built, so at first there were just two wards with six beds each, and two single wards for private patients. The local building firm of Robert Hall & Co. carried out the construction work.
Detail showing the proposed plan of the hospital.
Extract from the Galashiels & Selkirk Almanac and Directory of 1903
As built, the hospital comprised an appealing small scale building. The wide single‑storey centrepiece of the main block has generous roofs with dormers, and the eaves are supported on cast‑iron columns to create a verandah. The wards in the projecting outer bays are lit by broad bay windows.
A small nurses’ home was built on the site with thirteen bedrooms in 1929-30 to designs by the local architects J. & J. Hall, John Hall was the nephew of Robert Hall, the builder of the original hospital. In 1938 extensions were built, in sympathetic style, to the south-west (Hume Ward) and north. In that year four beds were set aside for maternity cases.
Extract from the 25-inch OS map revised in 1930. Reproduced by permission of the National Library of Scotland
October 1992 brought forth the sixth newsletter from the Cambridge team of the RCHME Hospitals Project. It included short pieces on mortuaries and asylum farms, and accounts of the Victoria Cottage Hospital, Wimborne, Dorset, with thoughts on holiday closures of hospitals. There is also a note on Sleaford’s isolation hospital, a portable hospital with what sounds like a camper van for the nurse. Extra curricular activities at hospitals were discovered too, with money making schemes in a Yorkshire madhouse and an unofficial B&B at Addenbrooke’s Hospital in Cambridge.
Victoria Cottage Hospital, Wimborne
This unremarkable little Dorset hospital has a history written in 1955 by someone hiding behind the initials G. H. W. From this booklet we can extract several amusing bits of hospital history.
First must come the sanitation. In 1887 when the hospital was built there was one earth closet for the patients. This came to light in 1907 when water was installed along with an extra closet. The operating theatre was another horror for it doubled as the bathroom from 1887 until 1904 when a new operating room was built. Even this new theatre did not have an electric light until 1934. Provision of a separate operating theatre did not end the dual use of the bathroom, however. Until 1927 it housed the telephone. In that year the telephone was moved to the matron’s office.
Extract from the 1901 OS map. The cottage hospital is to the north-west of the town, almost on a level with the union workhouse, which is to the north-east. Reproduced by permission of the National Library of Scotland
Until 1924 the hospital closed completely for about a moth every year, for cleaning and repairs. During this time the staff took holidays, and the patients were dismissed. Some were sent to the small 18th-century workhouse in Wimborne, for in 1922 the Guardians sent the hospital a bill for care of patients. We have met this sort of annual closing and cleansing elsewhere, but it seems poorly documented. In 1946 the Passmore Edwards Hospital at Liskeard closed for a moth because that was the only way in which the staff could take a holiday; our source does not say whether this was a regular event. The Royal National Sanatorium at Bournemouth closed in winter, allegedly because the hospital was only intended to provide a summer break for consumptives (and thus for their carers as well). At Northampton the General Infirmary managed cleaning and repairs by simply closing one ward at a time, but as this was a large hospital part-closing was easier than in a small hospital like Wimborne.
Finally, on a frivolous note, when the townsmen were discussing whether to commemorate Victoria’s jubilee by building a hospital or by some other means, one suggestion was ‘erecting a statue of Queen Victoria with a clock on top’. Just how this was to be arranged is not explained.
Sleaford Hospital
The Sleaford Rural District Council bought an isolation hospital in 1901 for the sum of £127. It was ‘an ingenious contrivance’ of numbered wooden sections that could be put together in a few hours, measured 20 feet by 12 feet and could hold up to four patients. A van on wheels provided both accommodation for a nurse and the necessary cooking arrangements. There was also a portable steam disinfector that was reported to be too heavy to be portable. This magnificent hospital was stored at the Sleaford Workhouse, and was erected for the very first time for the benefit of an inquisitive Local Government Board inspector in 1905. It is not known whether it was ever used after that. [The inspector’s report is in Parliamentary Papers, 1907 XXVI, 200-201.]
The East Stow Rural District Council in Suffolk had a ‘small portable hospital’ for smallpox cases in 1913, and presumably this was also a sectional wooden building. [PP 1914 XXXVII, 746] In 1913 Bournemouth Corporation had lent the neighbouring Rural District Council a Doecker Hut for use as an extra hospital ward during an outbreak of enteric fever at Ringwood, another portable structure. [PP 1894 XL, 565 and see Doecker Portable Hospitals]
At least these buildings were of wood. Shortly before 1890 the Gainsborough Rural Council bought a hospital marquee for patients and a bell tent for the nurses. They were aired from time to time, but appear not to have been used. [PP 1894 XL, 565] Perhaps even these tents were better than the converted dog-kennels at Bishop Auckland in 1895. [PP 1896 XXXVII, 704]
Mortuaries
In the course of research for the project a file copy turned up of a Government questionnaire headed ‘Isolation Hospital Accommodation’, and filled in for the Southampton Smallpox Hospital. The printer’s rubric shows that it dates from 1926 and that some 10,000 copies were printed. The answers, together with a crude plan from another source, make a description of this vanished hospital possible, but there is little of interest until the question ‘is there a mortuary at the hospital?’ The answer is simply ‘Cubicles in Observation Hut used for this purpose’. The observation hut was a small building with two single-bed wards and a duty room If one cubicle was occupied by a patient, the psychological effect of comings and goings in the other cubicle can hardly have been good. Perhaps the real significance of this arrangement is that the observation wards of isolation hospitals were probably rarely used, and that there never was a living patient to be disturbed by the arrival and departure of a dead one. It also helps to suggest ways in which hospitals without mortuaries might have functioned.
Extract from the 1934 OS map. Reproduced by permission of the National Library of Scotland
The smallpox hospital was at Millbrook Marsh, an inhospitable looking place even as late as the 1930s, surrounded by mud and marsh. It is interesting to see that development of the estuary was just beginning at this time, to the east is the King George V graving dock under construction. By the 1950s the hospital site had become a boat yard, re-using the existing buildings. A couple remained in the late 1960s, when the area to the north had become a sewage works, which eventually swallowed the remaining former hospital buildings.The huge Prince Charles Container Port was built over the mud flats and saltings.
Extract from the 1897 OS map. Reproduced by permission of the National Library of Scotland
Southampton, in common with other ports, provided a number of isolation hospitals. As well as the smallpox hospital there was another isolation hospital at West Quay.
It is in the usual location, close to the water so that anyone arriving by ship suspected of having contracted an infectious disease could be taken directly to the hospital by boat. The site was later an Out-bathing and Disinfection Station for Infectious Diseases and later still used for a clinic and a mortuary.That was in the post-war era, and by then land reclamation had seen the site removed from the water’s edge. As far as I can make out, the Grand Harbour Hotel seems to occupy the site now.
Asylum Farms
Slowly it is becoming clear that asylum farms were unlike those in the world outside, at least in the South of England. Large barns for storing crops are absent from those seen so far, but piggeries are ubiquitous and any fragments of yards and single storey buildings appear to have been for cattle. Sometimes there are stables and cart sheds, but it is not certain that these were specifically for farm use. Indeed the buildings suggest that attention was concentrated on stock, especially pigs and cattle, and perhaps market gardening, where there was greater scope for farming as occupational therapy. At Digbys, Exeter, there is a tall building which had large opposed loading doors, one opening on to the yard, the other on to a lane outside the hospital grounds. The building is not large enough to hold much, and certainly is not suitable for storing a grain crop. It seems to have been intended for receiving bought-in material, presumably feedstuff for the pigs and cattle.
Digby Hospital, formerly the Exeter Lunatic Asylum. The small farm complex is on the east near to the London & South Western Railway line. The buildings have been converted to housing as part of the re-development of the hospital and its site for housing.
Extract from the 1st Edition OS Map published in 1889. Reproduced by permission of the National Library of Scotland
The advantages of concentration on livestock is that it would provide the asylum with pork, bacon, milk and beef, while a market garden would provide soft fruit and vegetables. All of these are labour-intensive occupations, providing maximum work throughout the year for the relatively large number of patients.
Secondary Employment
John Beal was the proprietor of a private madhouse at Nunkeeling in the Yorkshire Wolds. The financial success of this venture seems out of proportion to the small number of patients and the remoteness of its position. The truth emerged in 1823 when the excise men found 24 casks of tobacco, 25 of tea, and 264 of assorted spirits, mainly gin, concealed about the premises. Perhaps we should pay greater attention to such institutions, in the hope that more than just buildings survive.
Income
Those hospital administrators busy trying to generate income have all failed to exploit one obvious opportunity that was seen as long ago as 1770 by the Matron of Addenbrooke’s Hospital, Cambridge. The town has long had a shortage of short-term accommodation. The matron saw this and let beds to overnight visitors, presumably giving them breakfast as well. On discovering this the Governors dismissed her, partly because she was pocketing the income.
Issue 4 of Robert Taylor’s Hospitals Investigator was circulated in July 1992 and in his editorial he wrote that the theme for this issue would be lunacy, in particular, baths and fire precautions. It concluded with a report on the Cambridge team’s trip to Cornwall and what they found there.
Baths
‘One of the many criminal economies practised in public institutions in the 19th century was the sparing use of bath water. At the Suffolk Asylum at Melton the male attendants used a single filling of the bath for five men, but on the opposite side of the same institution the female attendants managed to make a single filling serve ten women. This amazing achievement gives a new and unexpected meaning to sexual discrimination. At some asylums things were managed differently, and they put two lunatics at a time into the same tub, thereby ensuring that all and an equal chanced to enjoy hot water. Oxford, however, held the record and regularly managed to bath three at a time, thereby beating Cambridge by a factor of three. We have yet to see the size of the Oxford baths.
Considering that the water was frequently delivered at such a high temperature that patients were in real danger of scalding themselves and the taps could only be controlled by the attendant, one wonders at the temperature of the bath water at Melton when the first woman got in, and when the tenth got out.’
While looking for an illustration of bathrooms in asylums, I searched through the Wellcome Images collection which has this photograph taken around 1930 of Long Grove Asylum, Epsom in Surrey. Shared bath water was no longer acceptable, and a modicum of privacy was afforded by the fixed screens.
L0015468 Male patients being washed by hospital orderlies. Wellcome Library, London.
Fire Precautions in Asylums
‘Methods of preventing the start and avoiding the spread of fire in hospitals have developed in stages, usually one set of ideas at a time.’
‘The first fire precautions in the 18th and 19th centuries were purely structural, along the same lines as the various contemporary local regulations and the London Building Acts. The aim was to make buildings unlikely to catch fire or to burn, in other words, fireproof construction. Most of these techniques had become standard best building practice by the beginning of the 18th century, and included such things as not having timbers let into chimneys. This particular concern can be seen in an obvious form at the workhouse at Tattingstone in Suffolk, where ceiling beams are skewed in order to miss the fireplaces. The use of masonry for walls, and slates or tiles for roof covering were standard from the beginning; timber frame and thatch are not used for purpose-built hospitals.’
‘At a later date non-burning floor structures were used, called ‘fireproof’ and depending at first on the use of iron beams and shallow brick vaults. This system had the disadvantage that it relied on exposed iron girders, which were liable to buckle in a fire. Later in the 19th century, devices such as hollow bricks forming flat arches, sometimes strengthened by steel rods cased in concrete, were used to avoid this problem and produce a lighter structure. Perhaps the most common fireproofing device is the use of stone for staircase treads, almost invariably combined with iron balusters.’
‘Despite all of these precautions, fires broke out and even spread. Limiting the damage done by a fire was an important consideration, and it is interesting to learn that in asylum building in the middle of the century it was considered desirable to restrict patients to two storeys, for greater ease of escape or rescue in case of fire, as well as to reduce the amount of building that might be damaged. [The Builder, 27 Nov 1852 p.754] This is a contrast with the earlier practice at workhouses, where three-storey main ranges to accommodate the inmates were common. The Commissioners in Lunacy seem to have been particularly concerned by the fire at the Cambridgeshire Asylum in 1872. No lives were lost, and damage was limited, but the general opinion was that the fire very nearly destroyed the whole asylum.’
Central block of Fulbourn Hospital, originally Cambridgeshire County Asylum, and now reconstructed NHS offices. (Photograph by Tom Ellis taken in 2009 and licensed under CC BY-NC-ND 2.0)
‘The boilers and pumps were in the basement of the central block, and as the call for steam and hot water had increased, the size of the boilers had been increased, well beyond the capacity of both the basement and the flues. It seems that this situation was very common, and it was this that led to a new wave of precautions in asylums during the 1870s, particularly after 1875. In that year the reports of the Commissioners on their annual visits to asylums pay great attention to fire prevention, and include descriptions of a number of devices.’
‘The major new concern of this decade was with the provision of a sufficient quantity of water at high enough pressure to extinguish any fire that should break out. Water mains with hydrants were installed both inside and outside the buildings and examined during visitations, when the Commissioners hoped to see an efficient fire drill and a jet of water that toped the highest roofs of the asylum. The pressure was usually produced by a steam engine. A sufficient quantity of water to extinguish a fire was essential and the problem was underlined when the Commissioners visited Ipswich Asylum on the day when each week the water company did not supply water. Under such circumstances a large reserve supply was essential. Tanks at a high level, thereby providing a head of water without recourse to a steam engine that would take time to get going, were favoured. There was a water tower on each side of the establishment at Herrison, Dorset, in 1863.’
Old postcard with aerial photograph of Herrison Hospital, posted on flickr by Alwyn Ladell and licensed under CC BY-NC-ND 2.0Originally the Dorset County Asylum, near Charminster, it has now been converted into housing, with much additional new building on the site, and re-named Charlton Down.
‘A new concern with the structural side of fire prevention is shown in 1874 by the visit to the Leicester and Rutland Asylum of Captain Shaw of the Metropolitan Fire Brigade. He suggested a system of intersecting walls with iron doors to prevent the spread of fire. From the way in which the Commissioners in Lunacy reported this visit, one senses that they wished that more asylums would follow the same course and obtain professional advice. The extent to which this was done is not clear.’
There is a fascinating set of photographs of the asylum from the University of Leicester Archives and the Record Office for Leicestershire, Leicester & Rutland which can been seen on the website expresseumpoetics.org.uk
‘In the 1880s the major concern of the Commissioners in Lunacy was with the escape of patients from an asylum should it catch fire. Every ward had to have a second means of getting out, an alternative exit. As many rooms seem to have had only one entrance, this sometimes tested the ingenuity of those responsible. By 1885 the provision of external fire escape staircases was in full swing. The stairs had to be suitable for both infirm and deranged patients to use, and it is interesting to see how many still meet these requirements. It was necessary to have sufficient space a the top of the stair for patients to be prepared for the descent, and the stairs themselves had to be wide and easy. The time scale of this development is shown by the second Birmingham asylum at Rubery, opened in 1882 without fire escape staircases, which were provided in 1886.’
‘References to fire escapes should, however, be interpreted carefully, for not all were fixed to the building. In 1888 Cornwall Asylum bought a fire escape and built a house to put it in; the two similar contraptions at the Norfolk asylum in 1896 were of wood. At Norfolk the Commissioners were more concerned with their inadequate number than with their material. The introduction of fire escapes at asylums continued into the present century. It seems that in workhouse infirmaries the similar provision of fire escapes was about a decade later than in asylums, only getting under way in the 1890s’.
Perspective view and ground-floor plan of Middlesex County Asylum, Colney Hatch, later Friern Hospital. Now converted into housing. From the Wellcome Library, London
‘The fire at Colney Hatch on 27 January 1903, when 51 patients lost their lives in a fire in temporary buildings of 1895, brought a new realisation of the problems associated with fire. Rescue had been hampered by smoke, and a new urgency was now given to the containment of smoke in large asylums, particularly on staircases. In that same year, smoke doors were called for at the heads of certain staircases at Knowle in Hampshire, and at the Buckinghamshire asylum the doors with bars that opened onto the staircase had to be made solid. Smoke doors had already appeared in some institutions, as at Northampton in 1901, but are rarely mentioned.’
‘Immediately after the Colney Hatch fire, the Commissioners in Lunacy enquired after other temporary buildings, and tried hard to have them removed. They continued to accept timber framed buildings clad in corrugated iron, particularly it seems when the interiors were plastered rather than clad in boarding.’
A Letter from Cornwall
‘Five days of fieldwork were allotted by the Cambridge Office to investigate … the hospitals of Cornwall… The first that we visited, Truro workhouse, introduced us to the intractable nature of granite and the most informed attempt at Grecian style so far. The granite was so hard and difficult to work that the mason could do no more than produce a blocky outline of what was wanted but the result was still striking.’
‘Much of the county is swept by high, wet, winds, so that most of the early settlements hide in hollows or the lee of hills for shelter. The windward side of a building is often slate-hung to give extra protection. Although rendering houses is not as common as in some other exposed communities, the fashion for rendered walls in the 1920s was welcomed here. The textures are not always interesting, and when the paint is not renewed the effect is usually sombre.’
‘Despite the winds, workhouse were built on hills just as everywhere else in England, although the thick jungle around some of them shows that they are on the sheltered side. Palm trees were an unexpected impediment to photography at Truro and elsewhere. The usual Cornish workhouse consists of three parallel ranges. First comes an entrance range, often single storey; then comes the House, sometimes with short cross-wings but always a linear building with a single-storey kitchen behind. Finally comes either a row of workshops with the infirmary in the middle, or just the infirmary in large workhouses. There is almost no variation on this pattern. Bodmin had a rectangular infirmary, but several including Truro and Redruth had a small U-shaped block usually with a lean-to on the workhouse side There were always two doorways, but the internal arrangements could not be discovered.’
For images of Liskeard Union Workhouse, built 1937-9 to designs by Scott & Moffatt, including a postcard from around 1915 see workhouses.org.uk
‘Many workhouses also had a small isolation hospital placed close to the main building. Few are dated, including Falmouth of 1871, and that at Bodmin could be 1842. They have a standard arrangement of two wards flanking a central duty room or set of central rooms, and all are uniformly plain. Some may by chance respect the 40-foot cordon sanitaire that was required by at least 1892, but they probably all date from before about 1880. It is interesting to compare them with Suffolk, where the only isolation hospitals associated with workhouses respected the quarter-mile cordon required for smallpox hospitals, and none was recognised closer to the workhouse except at Semer.’
‘Apart from these workhouse examples, surviving isolation hospitals were prominently absent from the cornish landscape, and one of the two that we did manage to find was occupied by such a desperate character that we did not approach too closely. …’
‘The Cornish cottage hospitals were frankly disappointing, for they had been savagely treated by enlargements. A curiously high proportion had a main range and cross-wings type of plan, or appearance, for the plans did not always accord with the outside. Our greatest joy was to discover that the Falmouth hospital, built in 1894 and replaced by a new building on a new site in 1930, survived intact and unaltered…’
Images of Falmouth Hospital, designed by H. C. Rogers and built with funds from J. Passmore Edwards can be seen on the web site passmoreedwards.org.uk
‘Two hospitals, at Redruth and St Austell, and been established with the needs of accident-prone miners in mind, but the buildings told us nothing about these needs.’
‘Cornwall has a large number of ports, and had a corresponding number of Port Sanitary Authorities in the late 19th century. In general they provided makeshift hospitals of no size, and only a fragment of the Falmouth hospital, which also served the local urban population, was discovered. Fowey, constituted in 1886, had a corrugated iron building with a duty room and four beds by 1899; it got its water from a nearby spring, and although last used about 1920 it was still being maintained in 1943. The Truro hospital was near the centre of the town and has not survived. Perhaps because the provision in the county was so small the Truro workhouse was converted into a 110-bed isolation hospital in 1940, mainly for the benefit of evacuees. We did not notice any evidence of pest-houses to either explain or supplement this poor provision of isolation hospitals.’
See also: old photograph of Truro workhouse on Truro Uncovered website
In July 1991 Robert Taylor produced the second edition of The Hospitals Investigator, the newsletter he wrote and circulated to his five colleagues working on the RCHME survey of historic hospital buildings. Here he pondered Pest Houses, discussed deposited plans, and thought about (operating) theatres. In part 2b I will relay his discussion of ridge lanterns, sanatoria, and sewage works – we really knew how to enjoy ourselves.
Pest Houses
“Pest houses have been emerging from the Suffolk countryside at an alarming rate. The name indicates a house, usually an ordinary farm house, which was used by the local authority as an isolation hospital in the event of an outbreak of infectious disease, usually smallpox but in some early cases the plague as well. Details of the arrangements must have varied, but it seems that the tenant had an obligation to either nurse the victims or to move elsewhere for the duration of the sickness. The latter was perhaps the more common practice in the seventeenth century. The possibility of such an arrangement was taken for granted in the 1875 Public Health Act, although the Local Government Board did not like ad hoc hospitals very much and put pressure on local authorities to provide specialised buildings. A very few pest houses remained in use in the first years of this century.”
“So far the Cambridge office has seen only three surviving pest houses, at Halesworth, Framlingham and Bury St Edmunds. The first was a standard three-cell two-storey farmhouse of the late seventeenth century, and remained the centre of a working farm until the land was sold away recently. That at Framlinhgam was an early seventeenth century two-cell house with central stack, and similarly showed no sign of specialised planning. Although reputedly built in 1665, the Bury pesthouse displayed nothing earlier than the eighteenth century, and was a three-cell, single-storey house with internal stack. Other pest houses remain to be located at Eye, Nayland and Huntingdon, as well as a few less certain cases.”
I couldn’t find any photographs of these particular pest houses, though there will be photos taken by Robert and Kathryn in the relevant files in Historic England Archives. Here is a much smaller version in Hampshire at Odiham, where presumably, a small population did not require anything bigger.
The Patrick Stead Hospital continues to function as a community hospital, and was designed as a cottage hospital by Henry Hall. It opened in 1882.
Above is a postcard showing the hospital, and below an elevation and plans produced in The Builder in 1880. Originally it provided a dispensary, outpatients’ clinic and accident ward, all on the ground floor, with further wards above. Patrick Stead set up a maltings business in Halesworth, and bequeathed a generous £26,000 to establish the hospital. Deposited Plans
“Recently one of us was reading a letter written by an official of the Ministry of Health in 1926 when it suddenly became clear that the writer of the letter had in front of him a set of plans for an isolation hospital that had been sent to the Local Government Board in 1888 in connection with an application for sanction to raise a loan. Plans of isolation hospitals were deposited when an authority applied for permission to borrow money for hospital building, and also when the more responsible authorities voluntarily sought approval of their proposed hospital. The Local Government Board was replaced by the Ministry of Health, whose archive should contain these immeasurable riches, along with similar material for workhouses. Unfortunately most of the material dating from after about 1902 was lost in the blitz, and what survived that seems to have been mostly destroyed in a fire in Brighton. All that survives is at [the National Archives, at] Kew, hidden behind the catalogue code MH. The three main groups seem to be MH.12, MH.14 and MH.34.”
“MH.12 consists of Poor Law Union Papers, of which 16,741 bound volumes, arranged under Unions, survive from between 1834 and 1900… MH.14 is called Poor Law Union Plans, and there are 38 boxes of them dating from between 1861 and 1900. They have reference numbers linking them to MH.12… MH.34 is a register in 11 volumes of authorisations on workhouse expenditure between 1834 and 1902.”
Reading this today, it is a reminder of how much researchers now gain from online digitised archive catalogues, and perhaps a lesson not to grumble about them (as I frequently do) when we can’t find what we’re looking for, they crash, they change, or they assault ones aesthetic sensibilities.
“One of the problems met in small hospitals is the identification of the jumble of buildings behind the main block. As in a mediaeval house the identification of the hall acts as a key to understanding, or at least knowing the rough layout of, the entire house, so one might expect that the operating theatre might stand out and give some help in finding a way through the maze. Unfortunately this does not always happen. Plenty of light was necessary, so a roof light is an important indicator. A large North-facing window is another but less reliable sign, and far too often the windows appear to be ordinary ones, the lower parts filled with obscured glass, as at Southwold. At Felixstowe the theatre has a semi-octagonal North end, like a sitting room, with ordinary-sized windows that are now blocked. The Beccles Hospital of 1924 has a magnificent but sadly un-photographable theatre with a North wall and roof of glass. Sometimes it is possible, if we are very tall or can manage to balance on tip-toe or on a convenient upturned bucket, to glimpse through the windows the white-tiled walls, or even the upper parts of lighting equipment.”
