Hertfordshire was one of the counties covered by the London team of the national hospitals survey, carried out in the early 1990s by the Royal Commission on the Historic Monuments of England. The London team comprised myself and Colin Thom (now Director of the Survey of London). At that time we only investigated hospitals built prior to the inauguration of the NHS in 1948 – so major post-war hospitals, such as those at Welwyn and Stevenage, were excluded.

Fieldwork for the survey was carried out in 1991-3. There was not enough time to visit every single site, and some were considered in greater detail than others. The selection had as much to do with ease of access as it did with the historic significance of the buildings. This meant that some ‘important’ sites were either missed out or only briefly dealt with. I am puzzled now as to why some weren’t visited. In Hertfordshire we seem not to have managed to get to Welwyn, Royston or Hitchin, and also didn’t photograph Letchworth Hospital. The rest we visited on various dates between May 1992 and June 1993, while also covering the rest of the South East (Greater London, Essex, Kent, East and West Sussex, and Surrey) as well as Avon, Staffordshire, Shropshire and parts of the West Midlands, added late on to help out the York-based team. We covered a lot of ground, so perhaps I shouldn’t be too surprised that I’m struggling to remember visiting some of them.

For each site a building file was created, and these can be consulted in Historic England’s Archive based in Swindon. (The reference numbers for the files can be found on each of the county pages of the gazetteer after the name of the hospital following the grid reference.) These files vary in content, but generally have a report, photographs and maps.

Follow the link to the Hertfordshire page of this website for more details of individual sites.

What does Pevsner say?

The best known architectural guide to the buildings of Britain is the series begun by Nikolaus Pevsner after the Second World War. The Pevsner guides are generally the first place to look for information about the historic buildings throughout the UK. The original Pevsner guide to Hertfordshire was published in 1953, with an extensive revision published in 1977 (revised by Bridget Cherry). A further revised guide with new material edited by James Bettley was published by Yale University Press in 2019. I have relied heavily on this for updates to the condition of the various hospitals that we visited back in the 1990s. However, hospitals, especially former hospitals, are not easy to find in the guides and often receive only cursory mentions, if any at all. It is not a reflection of their historic significance as public buildings, but rather their relatively lowly architectural status, as they were seldom designed by ‘top’ architects, many are more interesting for their plans than their outward appearance, and where there have been many additions and alterations they can seem muddled and incoherent.

In its introductory overview, the guide notes that the first purpose-built hospitals appeared around the same time as the first workhouses built after the Poor Law Amendment Act of 1834. The West Herts Infirmary at Hemel Hempstead was built in 1831-2 followed swiftly by Hertford’s County Hospital in 1832-3 to designs by Thomas Smith. In 1840 Hitchin Infirmary was built designed by Thomas Bellamy. The last two have since been replaced, and only the core of their original buildings has been retained. Bellamy’s Hitchin Infirmary is now Bellamy House – the remainder of the site now occupied by a Waitrose supermarket. Hertford County Hospital has been replaced by a new building constructed alongside in 2003-4 (architects Murphy Phillips) leaving the old building rather marooned. West Herts is a typical multi-phase hospital, with much of its built heritage remaining in use, including the early Cheere House of 1831 and Coe and Robinson’s 1875-7 pavilion-plan infirmary (see photo above).

As well as general hospitals, there was a private asylum at Much Hadham established around 1803 (principally of architectural interest to the Guide because it occupied The Palace), and a crop of workhouses. Of the latter, there are partial survivals at Buntingford (1836-7 by W. T. Nash); St Albans (1836-7 by John Griffin); Ware (1839-40 by Brown & Henman) and more substantially at Watford (1836-7 by T. L. Evans) where the workhouse developed into the general hospital.

During the Victorian and Edwardian eras Hertfordshire attracted children’s homes and mental hospitals, including the Metropolitan Asylums Board’s ‘Imbeciles’ Asylum’, later Leavesden Hospital, at Abbots Langley designed by John Giles & Biven and built in 1868-70. This asylum was the twin of Caterham Hospital which served the south of the Metropolitan area.

Of Leavesden Hospital only the former administration block, chapel and recreation hall have been retained, converted to the residential Leavesden Court – a gated development – with new housing built to the north and west on the site of the former ward pavilions and parkland to the east.

Setting aside children’s homes, the Guide also notes Holman & Goodrham’s TB sanatorium built for the National Children’s Home built in 1909-10 (survives as the King’s School); Rowland Plumbe’s Napsbury Hospital built in 1901-5 (partially demolished, parts converted to housing); and G. T. Hine’s Hill End Asylum of 1895-9 (largely demolished). The only ‘local hospitals’ during this period mentioned in the Pevsner Guide are the cottage hospital at Watford of 1885 designed by C. P. Ayres (still extant) and the Sisters Hospital at St Albans designed by Morton M. Glover of 1893 (later extensions demolished, original main buildings converted to housing).

In the 1920s Royston Hospital was built to designs by Barry Parker (still an NHS hospital, but much extended). Then in the 1930s the large new mental hospital at Shenley was built, designed by W. T. Curtis (mostly demolished), and ‘a rather utilitarian general hospital’ at Welwyn designed by H. G. Cherry (still an NHS hospital with a newer block built to the south).

There is no mention in the introduction of the post-war hospitals, and the Lister at Stevenage is quickly covered by two sentences that provide the date (1966-72), the architect (E. A. C. Maunder of the North West Metropolitan Regional Hospital Board) and summary of its appearance (A central Block of nine storeys, a symmetrical elevation with projecting balconies, surrounded by extensive lower buildings.) Before too long, I hope to produce a separate post on the Lister and the other post-war hospitals in Hertfordshire.

Hertfordshire Hospitals in the 2020s

Hospital services in the 21st Century have become significantly more complex since the early years of the NHS. The NHS currently has thirteen hospitals in the county (not including those that were formerly in Hertfordshire which now lie within Greater London – such as in Barnet). There have been at least 44 hospitals in Hertfordshire in the past, not including a few small local authority hospitals for infectious diseases. The decline in the number of hospitals reflects increasing centralisation of services and changing practices in medical care and treatment. Of the 44 that feature in the Hertfordshire gazetteer page, only five are still NHS hospitals; 15 have been converted to housing or other use, including partial demolition; and 24 have been either entirely or largely demolished. The scale of demolition is larger than even that figure suggests, as it includes some of the largest hospital complexes in the county.

It has been depressing to discover the extent of destruction of former hospital buildings, a great many of them only having been demolished in the last ten to twenty years. A great deal more should and could have been retained, particularly of the large former mental hospitals such as Shenley, Harperbury and Hill End.

Leavesden Hospital, as mentioned above, has largely been demolished to make way for housing. The hospital also had an annexe to the south. This had formerly been the St Pancras Schools, together with detached hospital and babies home. It had an Emergency Medical Scheme spider block built at the start of the Second World War on vacant ground behind the buildings which became Abbots Langley Hospital when transferred to the NHS in 1948. These emergency hutted buildings were intended to be temporary, and it is perhaps more surprising that they lasted into the 1990s than that few of them are left in the 2020s.

I have always had a few favourite hospitals – ones that were particularly attractive or interesting. In Hertfordshire, Shenley was one – at least in part because of its lovely grounds. The hospital was laid on the Porters Park estate, along with the mature landscape around the mansion house.

Porters Park has a complicated history having been substantially rebuilt or remodelled on more than one occasion. Its present appearance is largely due to the rebuilding of 1902 for C. F. Raphael by the architect C. F. Harold Cooper. The house and estate were transformed into Shenley Mental Hospital in the 1930s. The map below show the extent of the hospital in the 1950s. It was designed on a colony plan, whereby all the patients’ accommodation and treatment blocks were detached, and arranged in the manner of a village, with central service buildings and chapel.

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.

Napsbury was another favourite – here too the landscape setting was particularly good, but the architect for this large asylum, Rowland Plumbe, was allowed to bring his characteristic style to the buildings, which were more decorative than Hine’s more pedestrian Hill End. The picturesque qualities of Napsbury no doubt made its adaptation appealing for the developers of the site, and it is now at the heart of Napsbury Park – a residential development near St Albans largely constructed between 2002 and 2008 (see blog post on Napsbury here).

If I had to name a top three of Hertfordshire hospitals, Napsbury would probably be at number one, with Shenley at number two. At number three I would put Bennett’s End – and I was particularly saddened to see that this one has been demolished. It was the perfect small local authority isolation hospital, built in accordance with the Local Government Board’s model plans.

There were a few other losses that I am particularly saddened by. Potters Bar Hospital was a charming low-rise late 1930s Deco-ish building that has been replaced by a Tesco supermarket. A new Community Hospital was built on Barnet Road.

I was also shocked to find that I had missed Welwyn Garden City’s Queen Elizabeth II Hospital, demolished in 2017 after the new QEII was built on the adjacent site. The original QEII opened in 1963 and was one of the first new general hospitals to be completed by the NHS. There is a little more information on the Hertfordshire page.

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.