Herefordshire’s Historic Hospitals

October 19, 2024October 21, 2024 / Harriet Richardson / Leave a comment

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.

*Former Herefordshire General Hospital, photographed in 2013 © Stephen Richards from* ***Geograph***

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 County Hospital. Part of the former workhouse buildings remaining on the site, photographed in 2008 *© Jonathan Billinger* from Geograph*

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.

*Former Victoria Eye Hospital, now converted to housing. Photographed in the* *early 1990s © L. Holmstadt*

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.

*Holme Lacy House, photographed in 2005, © David Dixon*, *from Geograph*

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.

*Nieuport House was used as a TB sanatorium by Herefordshire County Council in the 1930s. Photographed in 2007 © Philip Halling, from Geograph*

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.

*Stonebow Unit photographed in 2008, © Jonathan Billinger, from Geograph*

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.

*Former Ledbury Cottage Hospital, converted to apartments in 2009. Photographed in 2016 © John M. from Geograph*

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.

*Former Bromyard Hospital, now Enderby House, photographed in 2021* © J. Thomas, from **Geograph**

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 former Medical Superintendent’s House of St Mary’s Hospital, photographed in 2011 © Philip Pankhurst from Geograph*

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 Hospitals Survey Revisited

October 4, 2024October 5, 2024 / Harriet Richardson / Leave a comment

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.

*Welwyn Garden City’s early post-war general hospital was demolished in 2017.* *Photograph from in February 2017 © Gerry Gerardo, on* **Geograph**

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.

*Original central administration block of West Herts Hospital, Hemel Hempstead, from the 1870s rebuilding of the infirmary. Photographed in 2018 © Dormskirk* *CC BY-SA 3.0*

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).

*Former Watford Union Workhouse from Vicarage Road, photographed in May 1992. The former workhouse building became part of Watford District General Hospital © Harriet Blakeman*

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.

*View looking up the central spine of the hospital with the ends of the ward pavilions to the left, water tower on right.* *All of the buildings in the photograph were demolished as part of the redevelopment of the site. © Harriet Blakeman*

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).

One of the former ward blocks of Hill End Hospital, photographed in May 1992. Only the chapel and the southernmost blocks were retained when the site was redeveloped for housing. *© Harriet Blakeman*

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).

Part of the former Shenley Hospital, photographed in May 1992, now demolished, *© Harriet Blakeman*. Only the chapel, medical superintendent’s house and one small accommodation block were retained

The chapel at Shenley Hospital, photographed in May 1992 *© Harriet Blakeman*

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.

*Former Harperbury Hospital, photographed in May 1992 © Harriet Blakeman*

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.

*Former St Pancras Industrial Schools that became part of Abbots Langley Hospital, photographed in the early 1990s, now demolished. © Harriet Blakeman*

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.

*The wartime extension of EMS hutted ward blocks* *at Abbots Langley Hospital, photographed in the early 1990s, now demolished. © Harriet Blakeman*

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 mansion was adapted for convalescent patients at Shenley Hospital. *© Harriet Blakeman*

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 1950s* *and 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).

One of the detached villas at Napsbury Hospital, photographed in the 1990s. Sadly, this villa was demolished *© Harriet Blakeman*

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.*

*Bennett’s End Hospital, administration block © Harriet Blakeman*

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.

*Potters Bar and District Hospital, Mutton Lane, built* c.1938, *closed 1995 © Harriet Blakeman*

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 the* *Welwyn-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.

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.

The Hospitals on Islay

June 2, 2019May 1, 2023 / 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

The Hospitals Investigator 9

December 6, 2015November 20, 2024 / Harriet Richardson / 11 Comments

In December 1992 Robert Taylor circulated the ninth edition of his newsletter amongst his colleagues working on the Royal Commission’s hospitals project. In this issue he provided more useful source material on isolation hospitals from Parliamentary Papers: a ‘Sanitary Survey’ undertaken in 1893-5 and the annual report of the Local Government Board of 1914-15, which highlighted the problems encountered in municipal hospital provision during the first year of the war.

The Sanitary Survey covered England and Wales and was prompted by ‘the ever recurring source of danger’ to Britain of cholera spreading from the continent. Publication of the inland survey was delayed following a ‘serious accident’ which befell Dr Frederick W. Barry, Senior Medical Inspector of the Local Government Board, who was supervising the work. A year later he died suddenly, it was presumed from the injury he sustained. The inland survey followed one on the ‘Port and Riparian Districts of England and Wales’ submitted in September 1895. When attention was turned inland, districts where the purity of the water supply was in doubt were investigated as a priority and then districts in which the administration was believed to be defective or ‘in which former experience had shown that filth diseases prevailed’.

Screen Shot 2015-12-05 at 17.22.50 — *The late Dr F. W. Barry, from* The Graphic, 23 Oct 1897, p.17. Barry had struck his head on a stone doorway causing severe injury to his skull the previous year. He died suddenly after he had retired to bed at the Grand Hotel, Birmingham, and was found the following morning by the chambermaid.

The actual work of inspection was conducted under Barry’s supervision by a team of doctors in the LGB Medical Department. The bulk of the sites were covered by Dr Bruce Low, Dr Fletcher, Dr Reece, Dr Wilson, and Dr Wheaton, a few were inspected by the late T. W. Thompson, Dr Sweeting, Dr Theodore Thomson, Dr Coleman, Dr Bulstrode, Dr Horne and Mr Evan Evans (surely one of the inspectors of Welsh hospitals). Each inspector was given a set of forms containing questions as to the general sanitary circumstances of the district, its sanitary administration and cholera precautions.

Under the first of these three headings the inspectors were to report on the condition of dwellings and their surroundings, the purity and sufficiency of the water supply, the efficiency of public sewage, domestic drainage and sewage disposal, methods of excrement and refuse disposal and removal, and the condition and nature of supervision over registered premises and trades. As regarded ‘sanitary administration’ the inspectors were to report on the general character and efficiency of the administration of the local sanitary authority, noting the bylaws, regulations and adoptive Acts in force. They were also to report on the work done by the local Medical Officer of Health and Inspector of Nuisances, and on the provisions made for dealing with infectious diseases and ‘infected articles’.

As to ‘Cholera Precautions’ the inspectors were instructed to ascertain what general arrangements existed in each district to deal with an outbreak of cholera and what special arrangements had been made for action in an emergency. Detailed reports were made and submitted to the local sanitary authorities together with recommendations for improvements. Only the detailed reports for Sunderland were reproduced in the Report, for the other districts abstracts were published.

The inspection of the County Borough of Sunderland was made on 19 April 1894, the district covered Sunderland, Bishopwearmouth, South Bishopwearmouth and Monkwearmouth with a population in 1891 of 131,015. The chief industries were shipbuilding, engineering, mining, seafaring and glass-blowing. The sewers are described in detail and house drainage. There were an estimated 4,000 water closets and 1,100 ‘tub closets’ (galvanised iron tubs) in the district, but the majority of houses used privy middens which were found to be mostly of a ‘very defective type’. The local Medical Officer of Health was John Caudell Wood, who was paid a salary of £500 p.a. with an additional £20 as Port Medical Officer of Health and £5 as Public Analyst. He was described as having a good knowledge of his district but ‘wanting in judgment’, and therefore ‘cannot be regarded as a very satisfactory officer’.

*Extracts from the 6-inch OS map of Sunderland published in 1898. Reproduced by permission of the National Library of Scotland*

Sunderland Isolation Hospital was found to be a good brick building for 42 patients, situated on an isolated site about two miles north-west of the Town Hall. (This is probably what became Havelock Hospital east site, formerly Sunderland Borough Infectious Diseases Hospital, the west site being formerly the infectious hospital for Sunderland Rural District, situated to the west of Bishopwearmouth cemetery on Hylton Road.) It had been built in 1890, and consisted of two fever pavilions each for 16 beds designed generally on the lines of Plan C of the LGB 1892 memorandum, and an isolation pavilion for 10 beds on the lines of Plan D in the 1888 memorandum. There was also an admin block, with accommodation for 11 nurses and 9 servants as well as a medical officer and matron, a mortuary, post-mortem room, laundry, and disinfecting house.

Emergency plans included arrangements for opening the ‘House of Recovery’ as a cholera hospitals, this had been the old borough fever hospital a the end of Dunning Street near the river and could take about twelve patients.The following is Robert Taylor’s list of the English isolation hospitals noted in the report. The page numbers are those given in the Blue Books, not the report’s pagination. There are some oddities: Bishop Auckland Urban District’s isolation hospital was in converted dog kennels, while at Lyme they set aside a room in a warehouse on the Cobb. At Dudley they had built a hospital comprising three blocks and a tent on a pit mound, which the inspector described as ‘very bad’. It supposedly only had space for six patients, although it had been used for 23 smallpox patients.

Sanitary Survey

The ‘Report on the Inland Sanitary Survey, 1893-95’, by the late F. W. Barry, undertaken for the Local Government Board was published in Parliamentary Papers 1896 XXXVII, pp 669ff. Just how Mr Barry met his death is not recorded, but we trust that it was not a direct result of the time spent investigating hospitals. He presented, albeit posthumously, a series of short descriptions of a sample of infectious diseases hospital visited between 1893 and 1895. A list and summary may be of some use, even if only to show what sort of buildings are missing from our own survey a century later. The abbreviations used are familiar – UD for Urban District, B for Borough, CB for County Borough.

Amble UD. A small cottage is rented for an isolation hospital, an unsatisfactory arrangement. [p.682]
Ashby de la Zouch UD. An old barn converted into a four-room cottage, very unsatisfactory. [p.684]
Ashton in Makerfield. A small eight-bed hospital, with no accommodation for two diseases in both sexes. [p.685]
Bacup B. A converted mill is used in common with Todmorden, Mytholmroyd and Hebden Bridge UDs. no means of separating two diseases. [p.687]
Banbury B. A well-built hospital of 1890. [p.688]
Bedlingtonshire UD An old granary converted to isolation hospital, with eight beds; unsatisfactory. [p.694]
Berwick on Tweed B. There are two wooden hospitals, one with four beds for the town, one with eight beds for port cases. [p.698]
Beverley B. Two hospital tents purchased in 1892. [p.700]
Bideford B. A six-bed hospital built in 1885; cannot separate two diseases. [p.701]
Bingley UD. Temporary hospitals shared with Keighley UD and RD, for smallpox cases only. [p.703]
Bishop Auckland U. Dog kennels converted, with five beds; unsatisfactory. [p.704]
Boston B. A converted farmhouse with 12 beds, used jointly with the Rural and Port authorities. [p.706]
Brandon and Byshottles UD. A temporary hospital built in 1891 with 16 beds; cannot isolate two diseases in both sexes. [p.707]
Bridport B. Temporary wooden hospital provided for cholera in 1866. [p.710]
Burton on Trent B. Three temporary hospitals; a permanent 30-bed hospitals being built in August 1893. [p.714]
Calne B. With Calne RD has a well-arranged hospital of 10 beds built in 1889. [p.716]
Carlisle B. Sixteen beds are provided permanently at Crozier Lodge Hospital, and further 16 are reserved. [p.719]
Chesterfield B. An unsatisfactory 10-bed hospital. [p.723]
Clay Cross. A four-ward building for smallpox on an old pit heap, used as two cottages in May 1894. [p.724]
Darlaston U. A house was purchased in 1885 and a tent was recently bought. Very unsatisfactory.[p.737]
Doncaster B. An old dilapidated house for smallpox, very unsuitable. In 1892 temporary wooden buildings were erected for cholera, but it is only used for the families of smallpox victims. [p.741]
Dronfield U. Four four-room cottages have recently been bought, but were unfurnished in May 1894. [p.744]
Dudley CB. The Infectious Diseases Hospital consists of three blocks and a tent on a pit mound, and is very bad. There is only space for six patients, but it was used for 23 smallpox patients. [p.745]
Durham B. An iron hospital being built in June 1894, very unsatisfactory. [p.746] {Is this by any chance the hospital supplied by Humphreys of Knightsbridge some time before 1914?}
East Retford. A farmhouse, only suitable for one disease at a time. [p.747]
Exeter CB. There are two ward blocks, one of wood and cement with four wards, one of brick and stone with two wards. Unsatisfactory and crowded.[p.753]
Faversham B. A brick hospital, with an administration building, a ward block with two wards each 10 by 13 feet and 13 feet high, and outbuildings. [p.756]
Gainsborough UD. Hospital consists of an administration building, two ward pavilions of brick, and a temporary wooden ward block. Apparently only used for smallpox. [p.759]
Great Yarmouth. Hospital being erected November 1893. [p.767]
Harwich B. Hospital at Dovercourt, built in 1882 with eight beds. [p.770]
Hastings CB. A building was purchased in 1874 and has 35 beds. Later a 30-bed iron hospital was bought for smallpox. The site is inadequate. [p.771]
Havant UD. Hospital shared with Havant RD, consists of two ward blocks, with 16 beds. [p.772]
Heanor UD. An eight-room cottage, used for smallpox; unsatisfactory. [p.775]
Heath Town UD. A temporary 10-bed smallpox building was recently erected with Wednesfield UDC. [p.777]
Hereford B. A 16-bed corrugated iron hospital built in 1893; unsatisfactory. [p.779] {Another Humphreys hospital?}
Herne Bay UD. Two cottages bought in 1891; unsatisfactory. [p.780]
Huntingdon B. An old brick house called the ‘Pest House’ with five beds, very unsatisfactory. [p.790] {Built in 1760 for £95 15s and now demolished}
Ilfracombe UD. A farmhouse at Mullacott for four patients, and a private house at Ilfracombe for six patients; very unsatisfactory. [p.793]
Ilkeston B. An 18-bed temporary wooden building provided in 1888 during a smallpox epidemic. [p.795]
Ipswich CB. Satisfactory 36-bed hospital. [p.796]
Keighley B. Keighley and B. J. H. B. have a temporary smallpox hospital. [p.797]
Lincoln CB. Temporary wooden building for smallpox cases. [p.805]
Longton B. An old cottage used for smallpox cases. [p.810]
Loughborough B. A cottage is rented as a hospital; unsatisfactory. [p.811]
Lyme B. A room in a warehouse on the Cobb. [p.817]
Margate B. Temporary 44-bed hospital at Northwood, shared with Ramsgate and Broadstairs. [p.819]
Maryport UD. A 4-bed hospital built on the model plan. [p.821]
Millom UD. A temporary hospital near the pier is used for cholera. [p.824]
Newark on Trent B. A 6-bed wooden hospital. [p.831]
Newbold and Dunston UD. A 12-bed temporary hospital used for smallpox cases only. [p.832]
Newcastle under Lyme B. An 18-bed hospitals built in 1872, now dilapidated. [p.834]
New Romney B. A temporary 12-bed iron hospital built in 1893, unsatisfactory. [p.837]
Northam UD. A temporary iron and wood hospital near Appledore, with no fittings, water supply, etc. [p.838]
Norwich. An excellent hospital completed in 1893. [p.840]
Oldbury UD. Smallpox hospital is a block of cottages leased by the Authority; unsatisfactory. [p.842]
Ormskirk UD. Hospital of four wards and six beds in one acre, built shortly before March 1894. [p.843]
Pemberton UD. One pavilion containing four wards and eight beds, built in 1886. [p.845]
Penrith UD. Hospital has two pavilions with 12 beds. In 1894 a new hospital building of two pavilions with eight beds, set in 2.5 acres. [p.848]
Poole B. Permanent hospital of 6 beds built in 1875. A temporary smallpox hospital built in 1886, with poor fencing. [p.850]
Runcorn UD. Two wards with 12 beds, built in 1881. Temporary building with 20 beds for smallpox cases erected on same site. [p.858]
Salford CB. Hospital at Ladywell built in 1884 with 5 pavilions set in 13 acres. Also a modern smallpox hospitals with 50 beds. [p.864]
Shipley UD. A ten-bed hospital at Stoney Ridge built according to the Board’s model plan. [p.872]
Shrewsbury B. An emergency hospital built in 1893 with two wards each with 3 beds, of iron lined with wood. Very unsatisfactory. [p.873]
Sidmouth UD. Wooden 10-bed hospital built in 1884, with no furniture, and which has never been used. [p.874]
Sittingbourne UD. A satisfactory 24-bed hospitals built in 1884. [p.876]
Stalybridge B. A building bought in 1888 and partly fitted up but never used. [p.887]
Stockport CB. Hospital with 28 beds in two pavilions, each with three wards, opened in 1881. A separate smallpox hospital at Whitehall. [p.891]
Truro B. St Mary’s Parish Workhouse fitted up, suitable for one disease only. [p.906]
Warrington B. A satisfactory 40-bed hospitals built in 1877. [p.916]
Widnes B. A satisfactory 24-bed hospital built in 1887. [p.920]
Wigan CB. A satisfactory 60-bed hospital built in 1889. [p.921]
Workington B. The old workhouse used, unsatisfactory. [p.927]

Isolation Hospitals

The Annual Report of the Local Government Board for 1914-15 (P.P. 1914-15 XXV, 29-30) gives some interesting information about hospitals. It is also interesting for referring to the conflict as the Great War as early as 1915.

In the early months of the First World War, it was discovered that the existing isolation hospital accommodation was often insufficient for the extra military population of the area. This was particularly the case in Eastern Command. In some districts, huts of an army pattern were built in the grounds of existing isolation hospitals by agreement between the local military and the hospital authorities. It was intended that after the war the local authority would buy the building from the military at a percentage of the original cost. These huts did not provide floor space to the requirements of the Local Government Board, and after a meeting with the Board, Eastern Command adopted a design by their architect which was a modification of the Board’s Model D of the Memorandum of May 1902. The pavilion had two ten-bed wards and two one-bed wards, was 24 feet wide, and provided 144 square feet of floor space for each bed.

The War Office built these pavilions at the following hospitals: Biggleswade (1 pavilion); Bedford (1 pavilion); East Grinstead (1 pavilion); Guildford (1 pavilion); Tring (2 pavilions); Chelmsford (1 pavilion); Bletchingley (1 pavilion); Dunstable (1 pavilion); Rochester (1 pavilion); Folkestone (2 pavilions).

Screen Shot 2015-12-05 at 16.42.28 — Folkestone Isolation Hospital. The two blocks added during the First World War are the pair to the south. Extract from the 2nd edition OS map revised 1937-8, reproduced by permission of the National Library of Scotland

Before this plan was completed, several authorities who objected to the original army hut prepared plans of their own, which were submitted to the LGB in the usual way. These authorities were: Northampton (2 pavilions); Colchester (2 pavilions); Ipswich (2 pavilions); Orsett Joint Hospital Board (1 pavilion).

Of those which came within the area covered by the Cambridge office (where Robert Taylor was based), the two wards built at Ipswich had been demolished, although OS maps showed their distinctive outline (which was the same as the single pavilion built in 1914-15 as the Ipswich Smallpox Hospital). At Northampton there was a pair of pavilions with sanitary annexes with stalks at each end, and the readily identifiable double projections of single wards flanking the duty room. The potentially more interesting military blocks at Bedford, Biggleswade and Dunstable did not survive. The block at Biggleswade appears from maps to have been a plain rectangular structure without any projections for sanitary annexes or duty rooms. The most likely pavilion shown on maps of Biggleswade was another plain rectangular building, with a central rear sanitary annexe with narrow stalk. no building can be identified on maps of Bedford.

Humphreys’ Hospitals

August 30, 2015February 3, 2022 / Harriet Richardson / 5 Comments

This post takes another look at prefabs and temporary buildings, following on from those featuring Doecker and Ducker. Perhaps the most prolific supplier and manufacturer in England was Humphreys of Knightsbridge. It was Humphreys’ firm which, in 1907, provided the wood and iron hut for the British Antarctic Expedition led by Ernest Shackleton, that was assembled by the team in 1908 at Cape Royds, on the coast of the Antarctic continent. The hut was still standing in 2009 when Henry Worsley and two descendants of that party retraced Shackleton’s steps, and stayed in the hut.

By lin padgham – Shackleton’s hut, CC BY 2.0,

James Charlton Humphreys (1848-1932) ‘small in stature… big in business’. Humphreys’ activities in Knightsbridge were covered in the Survey of London’s Knightsbridge volume. James’ father, also James, had been a corn dealer in the 1850s moving into iron and steel by the 60s. James Charlton Humphreys, was the youngest of the five sons listed in the 1851 census at their home in Smith Street, Chelsea. He started out as a dealer in iron before becoming an iron merchant and contractor. In the 1881 census he was employing 20 men and living at Albert Gate, Knightsbridge with his wife and two young daughters.

*This is the most familiar form of corrugated-iron building to be seen today, a ‘tin tabernacle’.* Corrugated-iron building at Snelsdon © Copyright Andrew Abbott and licensed for reuse under this Creative Commons Licence

The iron-buildings business at one time had occupied a former floorcloth factory in Hill Street (Trevor Place), but by the early twentieth century was largely carried on in Pimlico, the company’s offices and showrooms remaining at Albert Gate Mansions. Humphreys himself became a well-known local figure, not only as an industrialist and property-owner but also as a member of the Westminster Vestry and a Volunteer officer. In the 1911 Census when James Humphreys was living in a large house in Haslemere, Surrey, he described himself as chairman of the firm, Humphreys Ltd ‘contractors for buildings of every description’.

In the 1922 edition of Henry Franklin Parsons’ book on isolation hospitals there is a chapter titled ‘Movable hospitals and hospitals of more or less perishable construction’ which illustrates some of Humphreys’ temporary hospital buildings and discusses their construction, merits and deficiencies. The one deficiency that they were unaware of at the time, sadly, was the health risk associated with asbestos. Fireproofing was a primary concern for this type of building which was essentially a large wooden shed heating by an iron coal or wood-burning stove. Lozenge-shaped asbestos-cement tiles in red, white or grey were often used in place of corrugated iron for the walls or roofs, internal lining of the huts was either the highly flammable match-boarding or asbestos-cement fireproof sheeting. As Parsons noted, match-board lining became very dry over time, and flames ran along the spaces between the timbers so that ‘buildings of this sort have in many instances been rapidly consumed, in some case with loss of life’. The danger point was where the flue of the stove passed through the roof or wall. As the buildings were so badly insulated, the stove was stoked up and the pipe overheated. Generally they were hot in summer, cold in winter and noisy in hail storms or heavy rain. (When I was a child, my family lived for a time in a house with a corrugate-iron roof, and I well remember waking up in terror the first time it rained as the noise was extraordinary – l thought it sounded like gunfire.)

The lightness of these buildings held further dangers: ‘Frame buildings covered with wood or iron have also been on several occasions blown over or wrecked during a storm, causing much hardship to the patients’. This seems something of an understatement. In Scotland a Deocker hospital hut put up in 1895 by the Lorn District Committee at Ellenabeich, Kilbrandon, was mostly blown into the sea and lost during a gale within a year of its erection.

Screen Shot 2015-08-30 at 09.43.48 — *I don’t know where exactly the but was erected, but this is an extract from the first edition OS map showing Ellenabeich, Reproduced by permission of the National Library of Scotland*

Humphreys’ patent iron hospitals were covered in Robert Taylor’s Hospitals Investigator issue no.8. He had come across an advertisement for their buildings in The Hospital, one of the most useful journals published in that period for information on hospital design. The advertisement, on p.429, volume 57 for 6 February 1915, gave a list of places where Humphreys’ iron hospitals had been erected.

‘From the presence of names such as Thingoe it is clear that this is not simply a list of places where hospitasl were built, but includes an uncertain number of names of local authorities that are different from the locations of the buildings, an important difference when it comes to identifying the buildings. ‘Oxford’ clearly means the surviving hospital at Garsington, the Gosport and Portsmouth hospitals survived in the early 1990s, and the Wareham hospital was said to survive in use as a house. Netley was of course the Welsh Hospital. Many others are known to be demolished, including Eton, Hardingstone, Ipswich, Loewstoft, Plymouth, Slough, Stowmarket, and Thingoe. Of those that can be identified at present, a large proportion seem to be smallpox hospitals. The Bury St Edmunds example could be either the municipal smallpox hospital or a private tuberculosis sanatorium already known to be by Hmphrey; both are now gone.

The advertisement also gives the current prices for hospitals, but omits to say how much ground work has to be done by the client. The prices quoted range from £403 for a 12-bed hospital to more than twice that, £820, for 40 beds.

The list of places in England is a long one:

Abingdon, Accrington, Amble, Ampthill, Annfield Plain, Ashby de la Zouch, Asylums Board, Barking, Barrow in Furness, Barton Regis, Beaconsfield, Bedford, Bedminster, Biddulph, Bideford, Bierley Hall, Birmingham, Bishops Castle, Blackpool, Blyth, Bolton, Bootle, Bournemouth, Boxmoor, Bracknell, Bradford, Bridgenorth, Brighton, Bristol, Buckingham, Bury, Bury St Edmunds, Canterbury, Castleford, Chatham, Charlton, Chester, Chester le Street, Chesterfield, Cleckheaton, Coalville, Crediton, Croydon, Dagenham, Darenth, Dartford, Devonport, Doncaster, Dorking, Dover, Durham, Easling, Eastbourne, East Ham, Eastry, Enfield, Eston, Eton, Finchley, Fulham, Gillingham, Gravesend, Grays, Great Yarmouth, Greenhithe, Gloucester, Godalming, Gosport, Guildford, Halifax, Hambledon, Hampstead Norris, Hanley Castle, Hants reformatory, Hardingstone, Harrogate, Hayes, Hebburn on Tyne, Hereford, Hertford, Hexham, Hitchin, Homerton, Houghton le Spring, Hungerford, Hythe, Ilkley, Ipswich, Jarrow, Keighley, Kendal, Keynsham, Kidderminster, Kingsholme, Kings Norton, Lambeth, Leeds, Leicester, Leigh (Essex), Leigh (Manchester), Leighton Buzzard, Lewes, Leyton, Liverpool, Liversedge and Mirfield, Lowestoft, Ludlow, Luton, Macclesfield, Maidenhead, Maidstone, Malvern Link, Manchester, Mansfield, Manson, Market Harborough, Melton Mowbray, Netley, New Quay, Northfleet, Northleach, Newcastle on Tyne, Oldham, Orsett, Otley, Oxford, Plymouth, Portland, Portsmouth, Ramsgate, Rawtenstall, Redcar, Redhill, Rochester, Rochford, Rushden, St Albans, Salford, Scarborough, Seacroft, Sedgefield, Shanklin, Sheffield, Shirehampton, Slough, Southampton, South Shields, South Stoneham, Stamford, Stannington, Stapleton, Stockwell, Stone, Stowmarket, Stratford upon Avon, Tadcaster, Taunton, Thingoe, Tonbridge, Tottenham, Tunbridge Wells, Tynemouth, Uppingham Upton on Severn, Uxbridge, Wakefield, Ware, Wareham, Warwick, Watford, Wellingborough, Welwyn, West Ham, Weston super Mare, Whatstandwell, Whitehaven, Whitwood, Wigan, Willesden, Willington Quay, Wimbledon, Windsor, Wolverhampton, Wombourne, Worcester

Of these, further information can be given the following:

Bury St Edmunds: this is probably the Humphrey sanatorium built in 1910 for a private company as the Bury and West Suffolk Sanatorium.

Chesterfield: the Borough Council had a temporary 10-bed hospital in 1895, considered unsatisfactory by the LGB inspector (PP 1896 XXXVII, 723)

Durham: the Borough Council built an iron hospital in 1894 which the LGB considered unsatisfactory even before completed (PP 1896 XXXVII, 746).

Gosport: one building was extant in the early 1990s, collapsing but still in use, recognizable as Humphrey’s.

Hereford: the Borough Council erected a 16-bed hospital of corrugated iron lined with wood in 1893, considered unsatisfactory by the LGB inspector (PP 1896 XXXVII, 779)

Keighley: perhaps the ‘temporary’ smallpox hospital here in 1894 (PP 1896 XXXVII, 797)

Leigh (Manchester): Leigh Joint Hospital Board was constituted in 1894; a smallpox hospital at Astley consisted of two corrugated iron buildings, presumably Humphrey’s. One had 16 beds and a nurses’ bedroom, the other 12 beds and a nurses’ bedroom and a kitchen (PP 1909 XXVIII, 81).

Macclesfield: in 1887 a ‘Ducker temporary hospital’ was erected here for smallpox, this may have been replaced or supplemented by a Humphreys model about 1890 (PP 1890 XXXIV, 129).

Netley. The Welsh Military Hospital, built in 1914 to the designs of E. T. and E. S. Hall at a cost of between £6,500 and £7,000 as a gift from the people of Wales to the fighting forces. It was first erected on the parade ground at Netley Hospital, with the intention of moving it to France later.

Orsett: the Joint Hospital Board erected a Humphrey’s corrugated iron building at Thurrock in 1901 (PP ?1901, XXVI, 140)

Oxford: the borough smallpox hospital was in Garsington parish, with a building recognizable as Humphrey’s containing two wards, an administration building with a few characteristics, and a small mortuary, all surviving in the early 1990s.

Portsmouth: A recognizable Humphrey block with two wards survives as an addition of 1909 to the municipal infectious diseases hospital now (1992) St Mary’s Hospital; it is used as Medical Records.

Thingoe: Thingoe Rural District Council, Bury St Edmunds, built a ‘temporary’ wood and iron hospital for smallpox in 1902 for £606 (PP 1909 XXVIII, 57).

Windsor: the smallpox hospital here was a temporary corrugated iron building erected alongside the sewage farm in 1893 to cope with a smallpox epidemic (PP 1900 XXXIV 99).

See also the isolation hospital, Arne, Purbeck, Dorset. From Michael Russell Wood’s Dorset’s Legacy in Corrugated Iron, 2012. “Halfway between Wareham and Corfe Castle, just off Soldiers Road, Arne, stand the Isolation Hospital and Nurses’ Bungalow. They were put up in the early 1900s. This hospital is the finest remaining example of the type and, together with the bungalow, is listed grade II. These are the only listed iron buildings in Dorset.”

The Hospitals Investigator 7

August 23, 2015May 2, 2023 / Harriet Richardson / Leave a comment

The Hospitals Investigator issue 7, circulated in November 1992, included an update on the memoranda concerning the provision of isolation hospitals produced by the Ministry of Health in the 1920s, a preliminary look at school sanatoria – specifically those built for boarding schools, considers the question of lifts in hospitals and finally provides some references for hospitals built just prior to the outbreak of the Second World War as part of the Emergency Medical Scheme. EMS hospitals and hutted annexes added to existing sites often remained in use for decades, despite having been considered as temporary buildings. The availability of materials affected their construction, and they vary from timber to brick. At the former workhouse in Amersham, which by the 1930s had become St Mary’s Hospital, a small annexe of these huts was built. By the early 1960s one of these was in use as a maternity ward, serving the local area – and that was where I was born.

Memoranda on Isolation Hospitals (again): Cubicle Isolation Blocks

In our third number we dealt at length with the memoranda on isolation hospitals issued by the Local Government Board. In 1924 a further edition was published, by which time the LGB had become the Ministry of Health. The main change in 1924 was that the facing-both-ways plan (Plan B in the 1902-21 editions) had been omitted, leaving only the former plans C and D, which became B and C respectively, without any alteration. The overall site plan (Plan A) was amended in line with this, and had only simple pavilion outlines. Space for a future boiler house had been added behind the administration block, perhaps indicating a change in technology, from stoves to central heating, in small hospitals.

Plan C is described as an Observation (Cubicle) Block, intended for single cases of diseases other than smallpox, mixed or doubtful infection. One nurse may, provided rigid precautions are taken, attend to more than one patient. The Department is prepared to accept wards as small as 12ft by 10ft. An air space of 1,872 cubic ft is said to be permissible in cases of diseases other than smallpox, if the 12 linear feet of wall space and 144 sq ft of floor space are provided, but in smallpox hospitals 2,000 cubic ft per bed are required.

This basic and small-scale isolation ward works on the cubicle principle, it was published in the early 1920s as a model plan in the Cambridge Public Health series.

Interestingly, the sentences saying that unnecessary duplication of small hospitals in an area is to be avoided, have been tightened up to increase the emphasis.

The types of wards suggested were thus reduced by 1924 to two only, the pavilion and cubicle blocks. Thus ‘official’ isolation hospital ward planning had begun with the simple huts of 1876, then gone through a phase of great diversity and finally settled down with two basic and simple types. This was still the position in 1947 when E. and O. E. published the final edition of their useful book Planning: the architect’s handbook. The same two basic types are given, along with a fanciful plan with hexagonal cubicles that was actually built at Tolworth.

This block was destroyed during the Second World War. A similar design was adopted in the two cubicle blocks added to the Mogden Isolation Hospital (later South Middlesex Hospital), Twickenham, in 1937. They were unoccupied and due for demolition by the early 1990s.

School Sanatoria

Robert Taylor noted that having attended a working-class day school in the Black Country, he felt that his knowledge of public schools was minimal: ‘Innocently we assumed that a school sanatorium was a glorified sick-bay, although we should have suspected something when we discovered that the sanatorium at Uppingham School had more beds than any other hospital in the county. It seems that this simple and obvious sick-bay interpretation is wrong, and that we were forgetting our own childhood illnesses. Jeremy Taylor ignores school sanatoria, thus presenting a challenge. In the meantime, here is a theory to set discussion or argument rolling.’

‘At present sanatoria dating from before 1864 are unknown to us. The earliest seems to be that at Harrow School, built in 1864 to designs by C. F. Hayward, and resembling a cottage hospital with square ward-rooms lit on one or two sides; it held 16 beds for a school of 500 pupils. It supplemented but did not entirely replace the earlier system of sick rooms at each house at school. Despite the unspecialized nature of the very domestic plan it had, apparently in common with all other school sanatoria, built in the last quarter of the 19^th century, the primary function of the instant isolation of infectious diseases.’

Perspective view, with First and Ground floor plans of Harrow School Sanatorium published in The Builder, 23 Jan 1869, pp.66-7

‘Boys could not be sent home but had to be treated institutionally, hence there was a generous provision of beds in relation to the number of pupils. Any other accident or illness could also be treated in the same building, but the planning was determined by the treatment of infectious diseases. At Harrow it seems that the sick bays of the houses had been unsuccessful for the treatment of infectious diseases, and after the building of the new sanatorium they remained in use for other ailments.

‘So far during fieldwork we have seen two types of sanatorium (apart from Harrow), both suitable for infectious diseases, but differently planned, and these differences have a chronological significance. It will be valuable if it can be discovered whether this distinction has real meaning. The two late-19^th century sanatoria, at Sherborne and Warwick, consist of two separate two-storey blocks linked only by an open corridor, one containing the wards and the other the ‘administration’ and at least in the case of Sherborne a third ward as well. These wards are thus surrounded and isolated by fresh air in the approved manner, and are also designed in accordance with contemporary principles. At Sherborne Keith Young was chosen instead of the usual retained architect because of his special knowledge of hospital building. There were 22 beds for a school of 270 pupils. We have yet to see the sanatorium at the Asylum for Fatherless Children at Reedham, where three wards on each of two storeys gave isolation for three diseases for both boys and girls, presumably one sex on each storey. Again the declared aim of the sanatorium was to treat infectious diseases first, and any other diseases as they arose.’

Sherborne School sanatorium

‘The second type of school sanatorium was seen at Oundle and built about 1930. It is a two-storey cubicle block added to one side of an older house that became the administration department. The 16 cubicles all opened Southward onto balconies. Again this is in accordance with current planning ideas, but it is far more flexible than the larger wards of Sherborne and Warwick, and so more suitable to the mixed use of a school sanatorium as suggested above.’

Lifts

We have often marveled at the steep staircases in hospitals, and wondered whether female wards were often placed on the first floor because ladies were easier than gentlemen to carry upstairs. Lifts seem to be almost impossible to date, and some documentary evidence may help understand how patients were moved.

At the Northampton Infirmary patients were carried from 1793 until 1872 when two hand-operated lifts were installed in the wells of the two main staircases. These remained hand-cranked until 1911 when they were converted to electricity. Two lifts were installed in the two staircases at the North Devon Infirmary at Barnstaple in 1872 and 1873, but we do not know how they were operated.

Dates for events like Otis’ experiments to demonstrate the safety of his ratchet mechanism in 1854, and its first installation in a public lift in 1857, and the first successful electric lifts developed in 1889, are well-published, but the process of installing lifts in hospitals is not yet clear. Most seem to be inserted in the generous wells of already existing large staircases, the dreadful blind towers of the modern lift shaft being a phenomenon of the second half of the 20^th century rather than earlier.

Emergency Medical Scheme Hospitals

The Builder carried brief notices of Government and Military contracts, sometimes hopelessly brief and uninformative. Emergency Hospitals were reported until 13 October 1939, when the lists of H.M.O.W. contracts were discontinued because they were regarded as being of potential use to the enemy.

Stoke Mandeville Hospital was originally built as part of the Emergency Medical Scheme, many of the hutted ward blocks remained in use in the early 21st century, but have since been demolished, the area where they stood has been developed for housing.

This OS Map from 1955 shows the easily recognisable layout of the blocks. The small group of buildings at the south-west corner were a pre-existing municipal isolation hospital. Reproduced by permission of the National Library of Scotland

This OS map from the 1930s shows the isolation hospital and the future site of the EMS hospital. Reproduced by permission of the National Library of Scotland

The Emergency Hospital buildings that were recorded up to that date are as follows.

21 July 1939
Sunderland

4 August 1939, p.222
Mount Vernon Hospital, Hammersmith
Hemington Infectious Hospital, Middlesborough

11 August 1939, p.250
Highwood Hospital, Brentwood
Furse Hospital, Hillingdon
Windosr Public Assistance Institution
St Mary’s Hospital, Amersham

25 August 1939, p.347
Farnborough Hospital, Kent
Stanmore Hospital
Staines Institution

1 September 1939, p.385
Bishop Auckland
Evesham Public Assistance Institution
Black Notley Sanatorium
Pinewood Sanatorium, Woking
Middleton in Wharfedale
Otley
Chapel Allerton
Chester le Street

8 September 1939, p.419
Horsham P.A.I.
Three Counties Hospital
Boleys Park Mental Hospital
Preston Hall Hospital, Kent
Arclid PAI
Nantwich PAI
George VI Sanatorium
Scotton Banks Sanatorium
Clatterbridge Hospital
Ormskirk PAI

15 September 1939
Aylesbury PAI
St Andrews PAI, Billericay
Hexham
West Malling Institution
Warkwich PAI
Botleys Park (West Surrey Waterworks)

22 September 1939, p.483
Warranford Hospital, Guildford
Cuckfield PAI

29 September 1939, p.513
Hereford PAI

6 October 1939, p.541
Wrightington Hospital
Langho Epileptic Colony
Pembury Hospital

The Builder published plans of two Emergency Medical Service hospitals, one said to be in the Home Counties and the other in the Midlands. The precise locations were concealed as a matter of national security, but the areas given prove to be grossly misleading. Both hospitals can now be identified. The hospital said to be in the Midlands (Builder, 9 October 1942, p.306) is readily identifiable by its amazing plan as Stoke Mandeville Hospital. Not only does the plan show the hospital as built, but in the 1990s most of it survived. The Home Counties Hospital (Builder, 24 April 1942, p.359) turned out to be the Churchill Hospital in Oxford, which again survived largely intact into the 1990s.

The Hospitals Investigator 6

July 25, 2015February 3, 2022 / Harriet Richardson / 2 Comments

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.

Screen Shot 2015-09-08 at 17.58.53 — 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.

Screen Shot 2015-09-08 at 16.16.38 — 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.

Screen Shot 2015-09-08 at 16.18.45 — 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.

EPW024131 — 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.

Screen Shot 2015-09-08 at 16.05.56 — *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.

The Ducker House, American prefab of the 1880s

July 18, 2015February 3, 2022 / Harriet Richardson / 3 Comments

While hunting for Doecker portable hospital buildings I came across its American counterpart, including an illustrated catalogue advertising their wares published in or after 1888. Founded by William M. Ducker of Brooklyn, New York, U.S.A. who had patented his invention, the Ducker Portable House company had offices in New York and London. The catalogue showed a variety of uses for their buildings, ranging from the utilitarian hospital hut to more elaborate garden buildings. Ease of transportation was also emphasised.

Here one of their portable buildings is neatly packed onto a horse-drawn wagon. While below the image shows the mode of transporting a Ducker building in mountainous countries. The buildings were ‘light, durable, well ventilated, warm in winter, cool in summer, healthful and cheap’. From reading the description of the buildings they seem to be almost indistinguishable from the Danish Doecker system, the components being wooden frames, hinged together, and covered with a special waterproof fibre. The same claims are made for both that they could be assembled without skilled labour.

This example was said to be at Wellington Barracks in London. Another was erected in Blackpool; Henry Welsh, the local Medical Officer of Health, noted in August 1888 that the recently erected building ‘gives great satisfaction, and answers its purposes admirably’. The cost of this model was given as $600. The German War Department bought one, and they had been adopted by the United States Naval and Marine Hospital Service, and several Departments of Charities and Correction. In 1885 the Red Cross Society had organised an exhibition in Antwerp of portable hospitals at which the Ducker buildings (and Doecker prefabs) had been shown. Ducker’s was awarded a special medal by the Empress of Germany and, so it was claimed, garnered the ‘warmest encomiums from civil and military surgeons, engineers, architects and philanthropists from all parts of the civilised world’. Wards are suitably Spartan, the interior here measured 18 x 34 ft.

The Department of Public Charities and Correction, Randall’s Island Hospital erected a Ducker house. Of the many pest houses, generally for smallpox cases, erected in America, it seems likely that if they were not actually Ducker houses, they were of a similar design, as is suggested by an early photograph of a pest house put up at Storm Lake, Iowa, photographed in 1899 (see University of Iowa libraries)

Temporary buildings were widely used at large construction sites to house migrant workers. Above is an administrative building, suitable for ‘Contractors and Construction Companies’ or for a private residence. It comprised a main building 16 x 30 ft and a separate kitchen and store-room connected by a covered passage. The workforce would be accommodated in huts such as this one.

This is its interior, with simple iron bunk beads, it put me in mind of the description of the bunk house in Of Mice and Men. These huts were bigger than the hospital buildings, at 30 x 30 ft, and cost just over twice as much at $1,250.

Versatility was key to healthy sales figures, so the catalogue demonstrates a variety of different uses for the Ducker portable building. Sports pavilions were an obvious use; above an athletic and bicycle hall, others illustrated were a racing stable, a boat house and a bowling alley. A photographer’s studio could be constructed for just $375, or a billiard room for $400 (billiard table not included). ‘The attention of hotel men is called to the fact that for annexes to hotels, to be used for sleeping apartments during the rush of midsummer, these building just exactly answer the purpose’.

For the domestic market there was a range of summer cottages (above), lawn pavilions (below) and camping houses. The Norton Camp House could have been yours for $150 (and upward), measuring a cosy 9 x 12 feet and weighing 450 pounds. It could accommodate four people, and opened out on all sides. Camping was not necessarily a leisure pursuit, and this camp hut was also touted for cattle ranchmen, miners, prospectors, surveyors and contractors.

If you were on vacation, however, you might have considered a bathing house. ‘The portability of these buildings make them simply invaluable… At the end of the season they can be taken down and stored until the opening of another season. They can be constructed in any form or style desired and can be made to comfortably accommodate more people than any other building known’.

The Lawn pavilions were the most decorative, being intended for ornament as well as usefulness, aimed at owners of large summer residences. ‘They are constructed in decidedly artistic style.’ ‘and will be found useful and delightful for ladies’ sewing, reading and painting rooms, children’s play rooms, tea and lunch rooms, tennis purposes, and sleeping rooms as well if required’ If you didn’t run to summer residence with large grounds in need of a lawn pavilion, then don’t worry, you could have an entire summer cottage or camping cottage. The latter pretty much the same as the hospital huts, but the former comprised the most ornate in the Ducker range.

This example seems to be giving a stylistic nod towards a Chinese pagoda or an Indian bungalow. As I am heading to Fife in Scotland later in the summer, I was particularly tickled to read the testimonial on the back cover of the catalogue which was furnished by one George C. Cheape, of Wellfield house, Strathmiglo in Fife, master of the Linlithgow and Stirlingshire hounds. ‘No country house should be without one’ he wrote: ‘It was put up in one day by the village joiner and my gamekeeper.’ He continued to effuse about the merits of the building: ‘In wet weather the children quite live in it, and play all day. I have gymnastic apparatus put up in it, swings, etc; the consequence is a quiet house, whilst the children are enjoying healthy exercise and games to their heart’s content, where they disturb no one, and their tea-parties in the Ducker House are enjoyed by all.’ Cheape was a Captain in the 11th Hussars, Justice of the Peace and Deputy Lieutenant of Fife. He was also widely travelled, had served in India, and had visited America on three occasions, having business interests in Texas, Colorado, Arizona and California. While in America he also travelled to Canada and Mexico, and worked to promote the interests of the International Company of Mexico, of which he was a shareholder. Sources: The catalogue for Ducker Portable House Co. can be found online from archive.org, information on George Cheape was from the census, marriage records, passenger lists etc and there is a brief biography in David Pinera Ramirez, American and English Influence on the Early Development of Ensenada, Baja California, Mexico, 1995 pp.99-100

The Hospitals Investigator 4

June 17, 2015May 2, 2023 / Harriet Richardson / 6 Comments

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 washe by hospital orderlies. Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Male patients being washed by hospital orderlies, Long Grove Asylum, Epsom. In the Royal College of Psychiatrists. circa 1930? Published: - Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/ — 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.’

Tattingstone Hospital in 1990 © Copyright Clint Mann and licensed for reuse under this Creative Commons LicenceOriginally built as a House of Industry in 1766, and later extended as Samford Workhouse, it became St Mary’s Hospital in 1930, finally closing in 1991 and was converted into housing around 2001. see also http://www.workhouses.org.uk/Samford/

‘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.’

VLUU L210 / Samsung L210 — *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.’

6830047491_273bab4af1_o — *Old postcard with aerial photograph of Herrison Hospital, posted on flickr by Alwyn Ladell and licensed under CC BY-NC-ND 2.0* *Originally 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’.

L0012311 Middlesex County Lunatic Asylum, Colney Hatch, Southgate, Mi — *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

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Sanitary Survey

Isolation Hospitals

Share this:

Like this:

Share this:

Like this:

Memoranda on Isolation Hospitals (again): Cubicle Isolation Blocks

School Sanatoria

Perspective view, with First and Ground floor plans of Harrow School Sanatorium published in The Builder, 23 Jan 1869, pp.66-7

Sherborne School sanatorium

Lifts

Emergency Medical Scheme Hospitals

Share this:

Like this:

Victoria Cottage Hospital, Wimborne

Sleaford Hospital

Mortuaries

Asylum Farms

Secondary Employment

Income

Share this:

Like this:

Share this:

Like this:

Baths

Fire Precautions in Asylums

A Letter from Cornwall

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

Share this:

Like this: