Hertfordshire Hospitals Survey Revisited

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 Hospitals Investigator 5

August 1992 saw the production of newsletter number five from the RCHME Cambridge office. There are snippets here about sanitary facilities – water closets and baths – and and more on temporary buildings. There are also useful indexes to information in the Parliamentary Papers, with reports on English provincial workhouse infirmaries by Edward Smith from 1867, and the enormously useful survey of hospitals in the United Kingdom carried out by Bristowe and Holmes in 1863.

Hereford Workhouse

In 1866 an inspector from the Poor Law Board visited the Hereford Union Workhouse in order to report on the infirmary. He found that the building was being greatly enlarged, and that two new wards were being built over the dining room. There was only one water closet on each side of the main building, at first floor level, but there were some other water closets in the yards that contained water aden were flushed twice or three times a week. The dry wording leaves one in doubt about the presence of water in the closets on the first floor. The rest hardly bears thinking about.

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Fred Bulmer Building, County Hospital, Hereford, originally the Hereford Union Workhouse, built in 1834, it has been refurbished with the help of a legacy from a member of the cider-making dynasty.It is now a day hospital, which performs assessment and rehabilitation services. Photographed in 2008 © Copyright Jonathan Billinger and licensed for reuse under this Creative Commons Licence

Workhouse Visitations

The previous insalubrious snippet came from the Report (to the Poor Law Board) of Dr Edward Smith, 15 April 1867, on 48 Provincial Workhouse Infirmaries. It is published in Parliamentary Papers 1867-8 LX, pp 325 onwards. In these reports Dr Smith examined critically the provision for the sick, and gave a table for each workhouse examined, listing for each ward the dimensions, position of windows, number of beds and fireplaces, and present function. The only plan published is a block plan of Birmingham workhouse. {This was being demolished at the time the newsletter was written, in the summer of 1992.} One of the things that emerges from this report is that by 1866 rooms in workhouses were often used in a very different way from what was originally intended. Using the pagination of the original report rather than the imposed pagination of volume LX, the 48 workhouses are as follows:

Alderbury (p.26); Amesbury (28); Atcham (30); Barton on Irwell (32); Bath (35); Bedminster (37); Biggleswade (39); Birkenhead (41); Birmingham (43); Blandford (51); Bosmere (53); Chelmsford (60); Cheltenham (63); Chesterton (65); Dartford (67); Derby (70); Devonport (73); Dudley (75); Eccleshall Bierlow (82); Edmonton (85); Fareham (87); Grantham (89); Hatfield (91); Hereford (95); Ipswich (97); Keynsham (101); Leeds (102); Leicester (106); Lincoln (108); Liverpool (111); Loughborough (115); Manchester (118); Norwich (122); Nottingham (125); Portsea Island (129); St Neots (136); Sheffield (138); Stockport (142); Totnes (144); Wimborne (148); Wirrall (149); Wolverhampton (151); Worcester (154)

Cross-Ventilation

The Portsea Island Union Workhouse Infirmary at Portsmouth was built in 1842 and extended in 1860 by an additional storey. {This later became St Mary’s General Hospital} Unfortunately we did not manage to get inside this derelict building, but we do know something of its internal arrangement. The wards on all three floors were on the South side of the range, and there was a corridor along the North side. The wards had windows on the external wall and also into the corridor (part of alterations of 1860), thereby providing cross-ventilation of an indirect kind; the corridor also had windows on the external wall. The internal windows had shutters, but we are not sure of the details. The Poor Law Board inspector in 1866 was not over-critical of this arrangement, for cross-ventilaiton was still a new hobby-horse for hospital reformers. A comparable arrangement of parallel wards with a common wall pierced by windows appears at the London Fever Hospital of 1848 and in the new Halford Wing of the Devon and Exeter Hospital built in 1854.

The acceptability of this internal ventilation provides a background to the roughly contemporary alterations at the Military Hospital at Devonport. This hospital was built as a series of pavilions in 1797, each floor of each pavilion consisting of two wards side by side separated by a corridor containing a staircase. The hospital was criticised in the 1861 report on military hospitals, and was subsequently altered. The stairs were removed and windows inserted in the walls between the corridor and the wards. Presumably there are a few other hospitals with wards ventilated through corridors, but they are unlikely to date from after the 1860s.

Bristowe & Holmes

Appendix 15 of the 6th Report of the Medical Officer of the Privy Council for 1863 is titled Report by Dr John Syer Bristowe and Mr Timothy Holmes on the Hospitals of the United Kingdom. This report records the reactions of the authors to visits paid by one or both of them to what they believed to be all of the major hospitals in the Kingdom; it has a supplement of brief critical descriptions of 81 hospitals in England, and some sort of plan is published for 25 of them. The Report is Parliamentary Papers 1864 vol. XXVIII; Bristowe and Holmes’ appendix begins on p.467 as renumbered for the Blue Books (463 of the original pagination), and the supplement begins on p.575  (571 original pagination). The following list uses the titles for the descriptions of the hospitals, and the amended pagination. English hospitals were divided into metropolitan, provincial and rural; Scotland and Ireland were dealt with on pages 692 to 726.

ENGLAND
Metropolitan Hospitals
575 St Bartholomew’s Hospital, plan of block C
577 The Charing Cross Hospital, plan of front range
579 St George’s Hospital, plan of 1st floor
582 Guy’s Hospital
585 King’s College Hospital, plan of 1st floor
589 London Hospital
591 St Mary’s Hospital, plan of ground floor
594 Middlesex Hospital
596 St Thomas’s Hospital, plans of North Wing and first floor
599 University College Hospital
600 Westminster Hospital, plan of second floor
602 Royal Free Hospital

English Provincial Hospitals
605 Birmingham General Hospital
607 Birmingham Queen’s Hospital
608 Bristol General Hospital, plan of second floor
610 Bristol Royal Infirmary, plan of 1st floor
611 Hull General Infirmary
613 Leeds General Infirmary, plan of G floor
616 Liverpool Southern Hospital
619 Liverpool Northern Hospital
621 Manchester Royal Infirmary, plan of 1st floor
623 Newcastle Royal Infirmary
624 Sheffield Infirmary, plan of attic storey

English Rural Hospitals
626 Barnstaple Infirmary
626 Bath United Hospital
628 Bedford Infirmary
629 Bradford Infirmary
630 Sussex County Hospital {Brighton}
632 Suffolk General Hospital at Bury St Edmunds, plan of ground floor of old hospital and new hospital
634 Addenbrooke’s Hospital at Cambridge, plan of ground floor
636 Kent and Canterbury Hospital, plan of ground floor
638 Cumberland Infirmary, Carlisle, plan of ground floor
640 St Bartholomew’s Hospital, Chatham, outline plan of ward
641 Cheltenham Hospital
642 Chester Infirmary
643 Chichester Infirmary
644 Essex and Colchester General Hospital
646 Derbyshire General Infirmary, plan of attic {first} floor, fever house
648 Devonport Hospital {Royal Albert}
649 Dover Hospital
649 Devon and Exeter Hospital
652 Gloucester Infirmary
653 Hereford Infirmary
655 Huddersfield Infirmary
656 Ipswich and East Suffolk Hospital
657 Lancaster House of Recovery
659 Leicester Infirmary and Fever House, plan of ground floor
661 Lincoln Hospital
662 West Kent General Hospital, Maidstone
663 Northampton Hospital
664 Norfolk and Norwich Hospital, ground floor plan
667 Nottingham General Hospital
669 Radcliffe Infirmary at Oxford, plan of ground floor
672 South Devon Hospital, Plymouth
674 Royal Portsmouth, Portsea and Gosport Hospital
675 Berkshire County Hospital at Reading, plan of 1st floor
677 Salisbury Infirmary
678 Salop Infirmary
680 Royal South Hants Infirmary, Southampton
681 Stafford General Infirmary
682 Taunton and Somerset Hospital
684 Whitehaven Hospital
685 Hants County Hospital, Winchester, plan of ground floor
688 South Staffordshire General Hospital, Wolverhampton
689 Worcester Infirmary, plan of ground floor
691 York County Hospital

Special Hospitals
726 Hospital for Sick Children in Great Ormond Street
728 Dreadnought Hospital Ship
729 Haslar hospital, block plan
731 Royal Victoria Hospital, Netley
731 Hospital for consumption and Diseases of the Chest {Brompton}
732 London Fever Hospital, plan of ground floor
737 Newcastle Fever Hospital
737 Small Pox Hospital {Highgate Hill}
739 York Road Lying-in Hospital {London}
740 Liverpool Lying-in Hospital
740 Margate Sea-Bathing Infirmary
741 Southport Convalescent Hospital

More Baths

The Hospitals Investigator No.4 drew attention to how many lunatics it was possible to get into one change of bath water. It now emerges that lunatics were not the only victims of this economy. At the Royal Berkshire Hospital at Reading in 1870 they managed to wash, if that is the correct word, at least eight patients in one change of water. The full number is not known, because it was only the eighth patient who complained. The reason appears to be that it took ten minutes to fill the bath and another ten minutes to empty it again, and the hospital porter did not have time to do this.

geograph-830153-by-Andrew-Smith
Royal Berkshire Hospital, Reading (© Copyright Andrew Smith and licensed for reuse under this Creative Commons Licence). Money spent on this fine stone front with its ionic portico and coat of arms in the pediment, may have lead to economies elsewhere, notably bath water.

Suppliers of “Temporary” Hospitals

Several firms are now known to have provided wood and iron hospital buildings, especially in the early years of he twentieth century, although their hospitals and chalets are hard to find or identify. So far the list includes the following:

Humphrey’s of Knightsbridge, (a catalogue of 1900 was located by the York office team). Several of their hospitals survive.
Boulton and Paul of Norwich, who were still in business (in 1992) selling garden shelters that are almost indistinguishable from sanatorium chalets. Early chalets have been found as far away as Plymouth. {The company was taken over in 1997}
Portable Building Company of Manchester, who provided a sanatorium for the Nottingham Association for the Prevention of Tuberculosis in about 1900.
Hygienic Constructions and Portable Buildings Ltd. who supplied the Homerton College Sanatorium in 1913. This weatherboarded building still (1992) stands.
Wire Wove Roofing Company of London made tuberculosis chalets.
G. W. Beattie of Putney advertised their New Venetian Shelter, for tuberculous patients, in 1913.
Kenman and Sons of Dublin, who sold tuberculosis chalets in 1913.

boultonpaul_bungalowad1933
Not a hospital, but a temporary building that reflected the popularity of open-air living, this is taken from the rather wonderful Broadland memories blog