The Falkirk Ward

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

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

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

381-F

Falkirk Royal Infirmary, photographed by in 2008. These buildings were demolished some time after 2010. © Copyright John Lord and licensed for reuse under this Creative Commons Licence.

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

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

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

Screen Shot 2016-03-20 at 14.08.52

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

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

The Falkirk Ward Unit, photographed in 1991 © RCAHMS

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

Falkirk Ward Unit, First-floor, reception © RCAHMS

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

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

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

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

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

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

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

 

 

 

Victoria Hospital, Fife

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

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

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

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

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

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

Screen Shot 2016-03-10 at 09.55.18

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

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

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

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

East wing of Phase I, Surgical Ward Block, north elevation, photographed in October 2019. The final plans for the ward block are dated 1955 and signed by a number of the architects working under John Holt, Chief Architect to the South East Regional Hospital Board. © H. Richardson

Phase I

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

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

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

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

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

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

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

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

Nurses’ Home, Hayfield House

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

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

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

Phase II

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

View across the Den to the ward tower of Phase II, photographed in October 2019, © H. Richardson

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sources 

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

 

The Hospitals on Islay

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Islay Hospital, main entrance  © H. Richardson

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

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

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

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

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

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

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

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

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

Sources: 

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

Brechin Infirmary and St Drostan’s House

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

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

Screen Shot 2015-10-15 at 09.57.31

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

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

Screen Shot 2016-02-29 at 08.08.30

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Post-War Changes

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

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

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

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

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

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

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

 

The Western Isles Hospital, Stornoway, and its forebears

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References:

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

Sources:

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

The first Glasgow Royal Infirmary

Glasgow Royal Infirmary, from the Wellcome Collection, CC BY 4.0

The old buildings of Glasgow Royal Infirmary have long since been demolished. It was there that Joseph Lister pioneered antiseptic surgery in the 1860s. But by then the original part of the infirmary designed by Robert Adam was seventy years old, and had been added to and extended many times.

In comparison with the other Scottish infirmaries which were in existence by the end of the eighteenth century, such as those at Aberdeen or Dumfries, Adam’s design for the Glasgow infirmary was far more ambitious and its impressive principal elevation was a dignified expression of civic pride. Its grandeur and the choice of architect suggest a degree of one-upmanship. However, Robert Adam was not the infirmary managers’ first choice and he was only brought in, almost by chance, following the death of the first appointed architect, William Blackburn. Blackburn had made his name in London when he won a competition to design a national prison in 1782. He became best known as a prison architect, but he was also surveyor to both St Thomas’s and Guy’s hospitals in London. Michael Port succinctly captures Blackburn’s character: ‘Corpulent in figure, medium in height, Presbyterian in religion, Blackburn was noted … for his candour and modesty’.[1] Blackburn was on his way to Glasgow to discuss a new goal there when he died suddenly at Preston, Lancashire. Many of his uncompleted works were taken over by his brother-in-law, William Hobson, but Hobson would not take on the infirmary commission. Fortuitously, Robert Adam was in Glasgow around this time overseeing the construction of the Trades House, in Glassford Street, and was conveniently placed to step into Blackburn’s shoes.

Main elevation of the Trades House, photographed in 2012, by Trades House of Glasgow

As Glasgow grew and found prosperity in the late eighteenth century, the need for an infirmary became pressing. There was the Town’s Hospital on the banks of the Clyde, but there may well have been a desire to have an infirmary closer to the University, the college buildings at this time were near to Cathedral. Amongst those who came together to found the hospital, two key figures were George Jardine, lecturer in Logic and Alexander Stevenson, Professor of Medicine at the university. Support also came from the city’s leading merchants, merchant and trade guilds, and the Faculty of Physicians and Surgeons. The first meeting of subscribers to the new institution was held in June 1787.

Robert Adam was requested to produce plans for the infirmary in November 1791, and more particularly to design it in such a way that it could be built in phases, just as his father had been instructed by the managers of the Royal Infirmary in Edinburgh in the 1730s.  His first designs were presented in October 1791, but were rejected as being too expensive at a cost of just over £8,725. Adam was asked to make the design plainer. This he succeeded in doing, reducing the cost to £7,185 10s, with the further option of having a rusticated or plain basement. As he offered the rusticated basement at no added cost, that was the version the managers chose. [2]

Glasgow Royal Infirmary, R. Chapman (1812) The picture of Glasgow or a Stranger’s Guide (2nd Ed.) Glasgow, facing p.105. Public Domain

By the end of December estimates were being advertised for the building tradesmen. In February 1792 the Infirmary received its Royal Charter, but in early March Robert Adam died, leaving his younger brother James to continue as architect to the Infirmary. The building contract was awarded to Morrison and Burns, on their estimate of £7,900 and the foundation stone was laid with full Masonic honours in May.

Detail of Fleming’s map of Glasgow of 1807 showing the original extent of the infirmary and its proximity to the cathedral. Note also the circular area in front of the infirmary, which was part of Adam’s original design. Reproduced by permission of the National Library of Scotland.

Death continued to shadow the new building as James Adam died in 1794, the year that the first patients were admitted: an ironic echo of Edinburgh’s Royal Infirmary, where William Adam had died in 1748, the year that his infirmary building was completed. When the Glasgow infirmary first opened, not all the wards were furnished, and the second report makes it clear that other parts of the hospital were not exactly finished. In 1796 money was spent on conducting water from the Monkland canal by lead pipes, making a reservoir and erecting cisterns. Hot and cold baths were installed, a high stone wall around the grounds behind the infirmary and laying out a kitchen garden there, as well as furnishing new wards, rooms for the physician, clerk and house surgeon.

Screen Shot 2016-06-26 at 16.14.24

Raphael Tuck & Sons postcard, showing the Royal Infirmary to the left of the cathedral.

The end result did not lack the flair that one would expect from Adam. The Scots Magazine in 1809 described it as magnificent, and grandly, if not entirely accurately, claimed that ‘Its front has some resemblance to the Hôtel des Invalides in Paris’. The main façade was symmetrical with a broad, central entrance bay which was slightly advanced with canted returns. Above the entrance a typical Adam-style arched tripartite window was set within a pediment carried on coupled columns.  A dome was placed at the centre, with its drum ornamented with carved swags. The only other infirmary to come near to this in richness was Gillespie Graham’s Grays Hospital in Elgin of 1815.

Detail of Adam’s façade, photographed in 1910. Wellcome Collection CC BY 4.0

The internal arrangements of the infirmary were not dissimilar to William Adam’s Edinburgh infirmary, though in Glasgow the building was one single range rather than the U-shaped plan in Edinburgh. On the ground floor were single cells for ‘lunatics’, and on the upper floors the wards took up the full width of the building and had opposing windows. There were separate stairs to access the wards at each end of the block, allowing for a seemly segregation of male and female patients, as well as separate access for the operating theatre, which, like Edinburgh’s was at the top of the building under the dome with ample seating for students. The 1809 Scots Magazine account was by Dr Joseph Frank who had been shown round the hospital in 1803. He noted that there were eight wards or sick rooms, two on each floor, ‘besides one underground’. The wards had twelve beds in each, standing ‘two and two in the spaces between the windows, quite close to each other’.

Ground plan of the infirmary in 1832, the original building to the left, with the wing added in 1814-15, is to the left, and the fever block to the right. Reproduced from M. S. Buchanan,  The History of Glasgow Royal Infirmary…, 1832.

The entrance led into a handsome porch, but he was less impressed by the rooms in the basement, the kitchen (disgustingly dirty), pantry (in bad order), laboratory (so narrow that there was scarcely room to turn around in it),  apothecary’s shop (small and dark) and the warm and cold baths (the cold bath small and damp). For patients who were too weak to be able to use these baths, there were tin-plate bath tubs, which could be brought to their bedside. These had ‘the appearance of a shoe’. Quite how the the patients managed to get in or out of these contraptions puzzled the writer.

One of the Glasgow infirmary’s  first physicians, Robert Cleghorn, called attention to the superior quality of the sanitary facilities, with water-closets even on the upper floor, and the use of iron bedsteads, rather than the wooden cubicles at Edinburgh. Up-to-date literature on hospitals was influential in the design, including the work of Jacques Tenon who had made a tour of hospitals and prisons in England in the 1780s for the Académie des Sciences in Paris. The report and plans produced by the Académie in 1788 had been supplied to Adam by Cleghorn himself. There are at least superficial parallels between the ward pavilions in the Académie’s plan for the Hotel Dieu in Paris and Adam’s upper-floor plans. In both the end bay contain stairs and ancillary rooms, and project forward from the central part of the range.

The operating theatre under the dome was the piece de resistance. The early historian of the infirmary, Dr Buchanan, writing in the 1830s, waxed lyrical on the beauty of the space:

The centre area is about 42 feet in circumference, and rising in a circular form all around this surgical, and clinical arena, may be remarked five ranges of high-backed steep benches, for the accommodation of at least 200 individuals. The whole of this splendid and commodious operating theatre is crowned by the large central dome … whose vertical lattices, descending to a considerable depth, thus throw the light to great advantage on the table of the operator. This beautiful termination to the edifice, which rises to the height of about 35 feet above the floor of the operation room is supported on twelve chaste pillars of the Ionic order, and by this means, as in the construction of all the other parts of the building, convenience, simplicity, and elegance, are seen mutually to harmonise and assist each other.

The first addition to the infirmary was a wing projecting north from the central bays, added in 1814-15. This provided a staff dining-room, accommodation for female servants, and additional wards for about 80 patients. Each ward had a nurse’s room and water-closet and communicated with the kitchen, apothecary’s shop, mortuary etc. in the main building. A detached block to the north-east of the main building designed as a fever hospital was built in 1828-9, designed by George Murray, architect.

View of the Royal Infirmary from the north west, with the fever hospital to the left. Reproduced from M. S. Buchanan,  The History of Glasgow Royal Infirmary…, 1832.

Dealing with outbreaks of infectious diseases in the rapidly expanding, and increasingly overcrowded city, was one of the main challenges for the infirmary managers. The addition of a separate fever hospital had been anticipated for some years, but funds had not been forthcoming. As the need became more acute, first rented accommodation was used and then a temporary ‘shed’ put up in the grounds. The original plans for the new block were to provide 220 beds at a cost of £2,900. But with rising building costs, these were scaled back to provide 120 beds. During later epidemics temporary accommodation had again to be found.

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

By about 1842 the detached fever hospital had been linked to the main infirmary by a further wing, shown on the OS map below. It contained a large clinical lecture room, waiting room, dispensary, inspection room and a pathological museum. David Hamilton designed a west extension built c.1839, but more research is needed to discover whether he also designed the block on the east side.

Extract from the OS large-scale Town Plans, 1857. This shows the extent of the infirmary prior to the addition of the surgical wing on the north side, which was built a little to the north of the wing shown on this map labelled ‘wards’. Reproduced by permission of the National Library of Scotland.

Around 1859 work began on the third major addition to the site: the Surgical Hospital. The additional accommodation had been under discussion for some ten to fifteen years, with opinions divided as to whether the original hospital should be further extended or a new one built in a less overcrowded part of the city. A major consideration in remaining on the spot was that a third of the infirmary’s patients came from the old city districts in the immediate vicinity, the remainder fairly evenly from the city suburbs and more distant parts of Scotland.

Typical floor plan of the new surgical hospital, from the Proceedings at the Opening of the New Surgical Hospital of the Glasgow Royal Infirmary…, Glasgow, 1861.

Plans for the new surgical wing were prepared by the architect William Clarke of  Clarke and Bell. It was completed in 1861, and formally opened in May. The contractors were Mr Brownlie, mason, Messrs Lamb & Rankin, wrights, Mr Dalron, plaster work, and Mr Moffat was the clerk of works. Designed in accordance with the ‘most approved modern theories of hospital architecture’, it was an early example in Scotland of the pavilion plan, with two ward wings placed in line on either side of a central block containing the main staircase. Nurses’ rooms, sculleries, side rooms, bath rooms, water closets, and a hoist for raising and lowering patients were all placed at the extremities of the wards, while the wards themselves had opposed windows – seven on each side – destined for 24 patients, but in the first instance fitted up for a more comfortable 16. The operating theatre was, as before, at the top of the building in the centre. It was arranged in a horse-shoe shape and had tiered seats for 214 persons.

Aerial Perspective of the Royal Infirmary, with the new surgical wing to the rear, and the fever hospital to the right, from the Proceedings at the Opening of the New Surgical Hospital of the Glasgow Royal Infirmary…, Glasgow, 1861.

Ventilation and heating were key concerns in the design of large public buildings in the Victorian era. Glasgow Royal Infirmary’s superintendent, Dr McGhie, published an article in the Glasgow Medical Journal in January 1861 on the site and construction of hospitals with particular reference to the Royal in which these themes were fully explored. The new Surgical Hospital was heated by open fires, two per ward placed back-to-back, roughly in the centre of the ward. Vitiated air was carried away through a shaft containing two smoke flues and one ventilating flue for each ward except the top floor which was ventilated by four circular openings in the ceiling. An experimental heating system was fitted in one of the wards which had a heated chamber at the back of the fires into which fresh air from outside was warmed before passing into the ward.

Photograph of the surgical wing and the adjoining fever block, from Lister and the Lister ward in the Royal Infirmary of Glasgow : a centenary contribution, published in 1927, from Wellcome Images

Another innovation in the surgical wing was the provision of a day room on each floor for the benefit of convalescent patients. With three windows facing northwards, each day room was equipped with tables, books and ‘other means of amusement’. David Smith, the chairman of the building committee, pushed for this inclusion, arguing that recovery was facilitated by removing the patients from ‘moribund patients in the same ward’. [3]  Convalescents could also benefit from the pleasure ground laid out to the north of the new building. An acre in extent it was laid out in three terraces from a design by Mr Clarke of the Botanic Gardens. A verandah was built at the upper end of the ground, 150ft by 10ft for shade and shelter.

Extract from the OS Town Plan of Glasgow, 1892-4. Reproduced by permission of the National Library of Scotland.

In 1887-8 a nurses’ home was built to designs by J. Baird and J. Thomson.The contractors were Alex. Muir & Sons, masons; Anderson & Henderson, wrights; Wm Davie, slater; Brown & Young, plumbers and Alex. Brown, plasterwork. The new home was markedly more comfortable than the previous accommodation, and was aimed at attracting a ‘superior class of nurses’. Situated well away from the main infirmary complex, this four storey building had views to the south over the Necropolis and the Cathedral, but was linked to the surgical wing by a covered way some 180ft long and 15ft wide with an arched roof of glass and heating so that it could double as an amenity for convalescent patients.

The Home itself had 85 nurses’ bedrooms, rooms for the superintendents, bathrooms, and a large recreation room. There was a box room to stow the nurses belongings, a wide and airy staircase ‘almost elegantly finished’. Heating was primarily by hot-water pipes, with fireplaces only in the superintendents’ rooms, and ventilation was by Tobin’s tubes. At the back of the building a tennis court was laid out: the infirmary’s Superintendent, Dr Thomas, believed strongly in the game of tennis as a ‘health-giving exercise’.[4]

Extract from the 25-inch OS map of Glasgow, surveyed in 1892-3. Reproduced by permission of the National Library of Scotland.

As the nineteenth century drew to a close, the condition of the older infirmary buildings became an increasing source of concern. There was a general consensus that the oldest blocks needed to be replaced, but much disagreement as to whether the infirmary should be rebuilt on a new site – as had the Edinburgh Royal Infirmary in the 1870s – or on its existing site. Queen Victoria’s jubilee in 1897 prompted the Lord Provost of Glasgow to launch a campaign to rebuild the infirmary to commemorate the Queen’s long reign. Those in favour of remaining on the the original site won the day, and over the next seventeen years the new infirmary was constructed. The map above shows the site as it was before reconstruction, the two below are from 1910, part way through the rebuilding, and 1933, when it had been completed.

Extract from the 25-inch OS map of Glasgow, surveyed in 1910. Reproduced by permission of the National Library of Scotland.

Extract from the 25-inch OS map of Glasgow, surveyed in 1933. Reproduced by permission of the National Library of Scotland.

Notes & Sources:

  1. quoted from Michael Port’s entry on William Blackburn in the Oxford Dictionary of National Biography, accessed online.
  2. Robert Adam’s plans an elevations for the infirmary are held by the Sir John Soane Museum
  3. Glasgow Herald, 22 May 1861, p.4
  4. Glasgow Herald, 30 Aug 1888, p.8

Christine Stevenson Medicine and Magnificence, British Hospital and Asylum Architecture 1660-1815, Yale University Press, 2000: Buildings of Scotland, Glasgow, 1990, p.146‑7: The Builder, 29 Dec. 1900, p.592; 18 May 1907, p.604‑6: Scots Magazine, 1 May 1809, pp 333-4: Paisley Herald and Renfrewshire Advertiser, 25 May 1861, p.2

 

 

Raigmore Hospital, Inverness

Inverness’s general hospital at Raigmore is the largest and only acute hospital in the NHS Highland’s estate, serving patients from a huge area. It was designed in the post-war era as one of the new National Health Service’s centralised district general hospitals, in this instance to replace the Royal Northern Infirmary and numerous smaller hospitals,  providing a full range of medical and surgical facilities, as well as specialist departments. It was constructed in two main phases in the 1960s—’70s, and ’70s—’80s, but its history begins during the Second World War.

geograph-1247053-by-Richard-DorrellRaigmore Hospital, Inverness, photographed in 2009 © Copyright Richard Dorrell and licensed for reuse under this Creative Commons Licence 

Raigmore Hospital began as an Emergency Medical Scheme (EMS) hospital, one of seven large new hospitals built in Scotland for the anticipated casualties during the War. Work on the site started in 1940. The builders were James Campbell & Sons, builders, with MacDonald, joiners, and the first wards were completed in 1941. The hospital followed the standardised EMS design, but restrictions on the use of timber and steel for building construction meant that here the single‑storey, flat-roofed ward blocks were constructed of brick.

Raigmore Hospital, Perth Road, Inverness. Oblique aerial photograph taken facing north-west, taken September 1948 © HES (Aerofilms Collection)

On the 40‑acre site, on the southern outskirts of Inverness, sixteen standard wards and one isolation block were built to provide around 670 beds. Staff quarters were located in the blocks on the north-west side of the complex, with a tennis court just to their south. At the heart of the site, between the staff quarters and the main ward huts was the admin section with the central kitchens, dining rooms, laboratories, matron’s quarters and services. An isolation block, Ward 17, was to the east of the central section. This was converted into a maternity unit in 1947, and then became a children’s ward in 1955. The buildings on the north-east side of the site were part of the Raigmore home farm.

Block plan of Raigmore based on the  OS 1:1,250 map revised in 1961. 

As with the other six war-time hospitals, Raigmore became part of the National Health Service on the appointed day in July 1948. Some new specialist departments were created, wards changed function, and additions were built – including an outpatients department in 1956. Raigmore had already become a General Training School for nursing in 1946.

Plans for a new central general hospital at Inverness formed part of the 1962 Hospital Plan  drawn up by the Department of Health for Scotland. Raigmore was the obvious choice of site. The new hospital was designed to be built in two major phases of construction, and J. Gleave & Partners were appointed as architects. Phase one was commenced in May 1966, and was largely completed and opened in 1970 having cost some £1.42 million. The largest part of the new hospital was situated to the south of the main wards, comprising a low-rise complex providing outpatient, radiotherapy, physiotherapy, occupational therapy, pharmacy and records departments.

A standard plan for out-patients departments issued by the Scottish Home and Health department was adopted here. The architect to the Northern Regional Hospitals Board (NRHB),  D. P. Hall, was part of the project team, as he was on the two other contemporary major schemes carried out by outside architects for the Board, Belford Hospital (also designed by Gleave & partners) and Craig Phadrig. All senior officers of the NRHB were also part of the team, ensuring that there was advice from administrators and medical staff. Other additions to the site at this time included a new Inverness Central School of Nursing and Post Graduate Medical Centre, built to the north of the original ward block, and nurses’ accommodation, located to the west of the old central admin area.

The second phase was approved in 1977, comprising the eight-storey ward block with operating theatres, kitchen and dining rooms, an administration block, a chapel and a works department. Work commenced in 1978, and the tower block was opened in March 1985. Further staff accommodation formed a separate contract, with three blocks of 32 bed-sitting rooms, 32 three-apartment houses and a block of two-apartment flats.

Raigmore Hospital today. © OpenStreetMap contributors

Gradually all the war-time buildings were demolished. Part of the cleared ground was allocated to a new maternity unit which opened in January 1988. The last huts went in 1990, the same year that a new isolation unit was completed. The fourth Maggie’s Centre in Scotland opened beside Raigmore in 2005. Situated in a green space to the south of the main hospital complex, the leaf-shaped building was designed by David Page of the Scottish architectural firm Page and Park Architets, with gardens designed by Charles Jencks.

Maggie’s Centre, Raigmore Hospital, photographed in 2007 by TECU consulting UK. Reproduced under Creative Commons Licence CC BY-NC-ND 2.0

In stark contrast to the EMS hospital, the central feature of Raigmore Hospital today is the multi‑storey ward‑tower, which strikes the view of all who arrive in Inverness by car from the south on the A9.

Sources

Inverness Courier, 2/11/2017 online: Glasgow Herald, 6 June 2005, p.2: Aberdeen Press & Journal, 3 May 1977, p13; 22 Sept 1979, p.2: Builder, 22 July 1960, p.174, 24 July 1964, p.201: Hospital Management, vol.34, 1971, pp 108-10: The Hospital, vol.67, 1971, p.175: PP Estimates Committee 1 (sub-committee B) 1969-70, minutes of evidence, 2382-93, 2422, 2503: J. & S. Leslie, The Hospitals of Inverness, Old Manse Books, 2017

Arbroath Infirmary

Arbroath Infirmary consists of a pleasing if mismatched group of buildings in a variety of dates and styles. The oldest is the former Rosebrae House, probably dating to around the 1830s-40s. The original infirmary of the 1840s was demolished to make way for the present main stone building, erected in 1913-16 and added to in the 1920s and 30s. Most recent of the additions is the Queen Mother Wing of the 1960s.

Abroath infirmary poscard

Postcard of Arbroath Infirmary from the 1930s, after the children’s ward had been added (far left of picture). © H. Martin

The original infirmary was built on this site in 1844-5 to designs by David Smith and had been preceded by a dispensary, providing medical aid to out-patients, set up in 1836. During an epidemic of typhus in 1842 a small ward was set aside to take fever patients. Fund raising to build a hospital was boosted by a donation of £1,000 from Lord Panmure. (William Maule, 1st Baron Panmure, of Brechin Castle. He served as MP for Forfarshire for many years before he was raised to the peerage.)

Principal elevation of the 1840s infirmary, reproduced from The Builder

As well as medical and surgical cases, the infirmary was open to accident cases and also to those suffering from contagious diseases. It was a handsome building, in the fashionable simplified Tudor or Jacobean style much in vogue for domestic villas, and apart from its rigid symmetry, was barely distinguishable from a private house.

Return elevation of the 1840s infirmary, reproduced from The Builder

David Murray, mason, Forfar and Messrs Nicol and Wallace, wrights, Arbroath won the building contracts. Local sandstone was the main building material, faced in ashlar on the main elevation and the side returns, but brick was used for internal walls. ‘Arbroath pavement’ was used to floor the service areas, with polished stone for the stairs, and timber for the ward floors – ‘Petersburg battens’ on Memel pine joists. Doors and windows were of American yellow pine, and Easdale slates covered the roof. Natural ventilation was introduced through fresh air flues within the walls, carried behind the skirting boards with vents into the wards. Ornamental openings in the ceilings connected to flues carried through the rear wall to extract foul air.

Ground-floor plan of the 1840s infirmary, reproduced from The Builder. A: Consulting-room B: Housekeeper’s room C: Servants’ room D: Medicine room E: Ward for maimed females F: Ward for maimed males G: Bed closet H: Bath room I: Water-closet J: Store place K: Lobby L: Passages M: Closet under stair N: Kitchen O: Porter’s room P: Wash-house Q: Coal house R: Dead house

First-floor plan. S: Staircase landing T and U: Fever ward for females V: Water closets 

Bristowe and Homes’s account of the Hospitals of the United Kingdom, published in 1866, described the infirmary as it then existed as a single, long building of two floors with the kitchen and offices built out behind. By then the original accommodation had been extended to the west, almost doubling the number of beds that were provided, from thirty-six to sixty.

This postcard shows the extended infirmary, with the new wing to the left in the same style as the original building. Reproduced by permission of D. Robertson.

Extract from the OS Town plan of Arbroath, 1858, with the western addition. Reproduced by permission of the National Library of Scotland

This old postcard shows the extended infirmary with its encircling wall, railings and entrance gates. Reproduced by permission of D. Robertson.

Despite the additional wing, by the end of the nineteenth century there was a pressing need to provide more accommodation to meet the needs of the growing population of Arbroath. Unusually, the new hospital was largely constructed during the First World War. Plans by the local architect  Hugh Gavin were drawn up by June 1912, but the estimates exceeded the expected upper limit of £12,000 by £2,500. This meant that more money had to be raised, but also prompted some of the infirmary managers to question whether a new building should be built at all, or whether it would be better to find a different site. It was largely for these reasons, and, once they had settled on rebuilding on the existing site, finding a temporary home for the displaced patients and staff, that delayed the start of construction.

In 1913 Greenbank House was purchased to serve as the temporary infirmary, and work looked set to begin until it was decided to seek advice on the plans from Dr Mackintosh, of the Western Infirmary Glasgow. He was the pre-eminent authority on hospital design and administration in Scotland at that time, and whilst this was a laudable decision, it resulted in some early decisions being changed, not always to everyone’s satisfaction. Mackintosh was repeatedly approached for his advice on everything from the best sterilizer to the type of paint to be used. (For the paint he recommended a new process, appropriately called ‘Hygeia’.)

Arbroath Infirmary, photographed in April 2018. © H. Richardson

Postcard showing the same view, perhaps around the 1930s when the children’s ward to the left was newly completed. Reproduced by permission of D. Robertson.

Arbroath Infirmary, photographed in April 2018. © H. Richardson. The open sun veranda at the end of the ward to the left has only recently been enclosed at first-floor level.

Estimates submitted by the various tradesmen for the erection of the new building were considered in March 1913 and were awarded as follows: mason works Messrs Christie and Anderson, builders, Arbroath, £3,775; joiner work Mr Rowland, Chapel Farquhar, joiner, Arbroath £1,828 17s 6d; plumber work Mr Thomas Raitt Grant, plumber Arbroath £1,148 15s 11d; slater work Messrs William Brand & Son, Slaters, Arbroath £191 16s 7d;  plaster work Mr Archibald Donald Senior, plasterer, Arbroath  £521 2d 4s; tile work Messrs Robert Brown & Son Limited, Ferguslie Works, Paisley £401 8s 2d.

Screen Shot 2015-10-15 at 10.25.44

The second edition OS map, revised  1921, shows the rebuilt infirmary. Reproduced with permission of the National Library of Scotland

The new infirmary was almost finished before the outbreak of the First World War, but it took two more years before it was ready to receive its first patients, as it became increasingly difficult to source materials and workmen. Furniture was acquired late in 1915 from George Rutherford Thomson and Son, cabinetmakers. Bedsteads were separately supplied by Messrs J. Nesbit-Evans & Co. of Birmingham.

 

The building in the foreground of this old postcard is the toll-house. Behind to the right, up on the hill, is the new infirmary, as completed by the end of the First World War. Reproduced by permission of D. Robertson

Despite hopes that the new infirmary would be ready for patients early in 1916 it was April when it was officially opened, and June before the first patients arrived. With the war still raging, it was clear that beds should be set aside for war wounded. At the outset of the war 30 beds at Greenbank had been offered to the Red Cross Society.

On the left is Rosebrae House and to its right the nurses’ home. Photographed in April 2018 © H. Richardson.

After the war the infirmary directors turned their attention to additions to the buildings. In particular there was a need for accommodation for the nurses and for the resident medical officer. Sketch plans were made by Gavin in 1922 for a new nurses’ home costing around £4,000, and the home was completed by March 1924.

This photograph shows roughly the same view of the toll-house as the earlier postcard, but here the new nurses’ home can be seen to the left, with the boiler-house chimney rising behind it. Reproduced by permission of D. Robertson

This view looking towards the nurses’ home has Rosebrae House on the left and part of the 1913-16 hospital on the right.  Photographed in April 2018 © H. Richardson.

The next addition that was urgently required was a children’s ward. Plans were prepared in 1925, but differences arose between the medical staff and the infirmary directors. In April the medical staff submitted their views to the directors. They agreed that a children’s ward was needed, but pointed out that there was an equal need to provide space for maternity cases, cases of venereal diseases, and out-patients.

‘… year by year the Public are demanding an increasing number of hospital beds for the treatment of general medical and surgical diseases. We are in agreement with the Directors that an extension of the hospital is required, but we view with regret and misgiving a proposal to provide one of those departments, in this instance the Children’s Ward, according to a plan which seems to us to be essentially unsound, and, of even greater importance, which blocks one of the natural paths of extension of the hospital.

We beg to suggest that in the preparation of a plan for ultimately providing a complete hospital service the Directors should secure the advice and assistance of a recognized expert in hospital planning and administration, to the end that the various new departments (which need not be provided simultaneously) may be harmoniously correlated and be neither mutually obstructive nor detrimental to the existing hospital.’

The whole question of extending the infirmary was referred back to the building committee and the position of the new children’s ward revised. However, the deepening economic depression of the 1920s, the Second World War, the building restrictions in the years after the war, and then the transfer of the hospital to the National Health Service in 1948, meant that all the new facilities were only provided with the opening of a new wing in 1961.

The diminutive Rosebrae House on the left, with the south end of the children’s ward block in the foreground. Photographed in April 2018. © H. Richardson.

For the children’s ward, advice was sought from John Wilson, the chief architect to the Scottish Board of Health, who judged a competition for its design in 1928. Thomas W. Clark, architect of Arbroath, came first, James Lochhead of Hamilton was placed second, and  Charles S. Soutar of Dundee third. After criticism from the medical staff, Wilson and Clark amended the plans, and the new wing together with additional accommodation for the nursing staff were built in 1930- 33. Rosebrae House, which adjoined the hospital to the west, had been purchased in 1928 and was used for stores and to accommodate the night nurses. Although the work began under Clark, he resigned part way through the commission, perhaps as a result of conflict with Wilson. James Lochhead, the runner up in the competition, took over the commission.

Extract from the  OS 1:2,500 map surveyed in 1964. Reproduced by permission of the National Library of Scotland

As to the 1961 wing, this comprised consultative out-patients department, physiotherapy department and maternity unit. The total cost was £90,000 of which £53,000 came from the Board of Management’s Endowment Funds.

The Queen Mother Wing, built 1958-61 to provide for out-patients, maternity and physiotherapy departments. Photographed in April 2018. © H. Richardson.

The architect to the Eastern Regional Hospitals Board, James Deuchars, and the regional engineer, R. G. McPherson, drew up the first set of plans for the wing back in 1952, although the building was only put out to tender in 1958. The building contractor was R. Pert & Sons Ltd of Montrose, the clerk of works, Mr Groves, and the engineer in charge, Mr Moodie. The Angus Hospitals Board of Management blamed delays in construction on a lack of collaboration between Duechars and McPherson, an accusation hotly denied by the Eastern Regional Hospitals Board.

Detail of the Queen Mother Wing. Photographed in April 2018. © H. Richardson.

Later work on site, including a new X-ray department, was designed by  Baxter, Clark and Paul in 1968.

Sources: Coventry Herald, 14 April 1843, p.3: The Edinburgh Medical and Surgical Journal 1847The Builder, 28 Sept 1844, pp 494-5; 7 March 1896, p.217; 22 March 1957, 28 Feb p.572, 10 Oct 1958, p.423, 633: Glasgow Herald, 21 Jan. 1913; 15 Feb. 1913; 13 March 1913: Dundee University Archives, Minutes of Directors, THB 20/1/1/1-3, Minutes of Board of Management Angus Hospitals, THB 20/1/4; ERHB Magazine, No.9, vol.1 Winter Dec 1964; ERHB Mins THB 18/1/5: The Scotsman, 4 Feb 1933, p.11: Dictionary of Scottish Architects

Dundee Royal Infirmary, now Regents Gardens

Postcard showing the principal south elevation of the Royal Infirmary

Dundee Royal Infirmary closed in 1998, commemorative plaques and other items from the infirmary were transferred to Ninewells Hospital which replaced the infirmary as Dundee’s general and teaching hospital. Since then the original building and the main later additions have been converted into housing, renamed Regents Gardens, completed in 2008 by H & H Properties. The original planning brief for the site was approved before the infirmary had even closed, in 1996. The masterplan was approved in 2000, amended the following year. The architects for the conversion were the local firm of Kerr Duncan MacAllister.

canmore_image_DP00095836

Aerial photograph of the site in 2010 from RCAHMS

Listed Grade A, the original infirmary, now Regents House, was the last of the former hospital buildings to be tackled. It was reconfigured to provide 63 apartments, with ground-floor flats some having individual main door entrances, and the high-ceilinged flats on the upper two floors featuring galleries looking over the living-rooms. Caird House (listed Grade B, built in 1902-7 as the cancer wing), was turned into 22 apartments and 5 pent-house flats; Dalgleish House, the 1890s nurses’ home, provided 19 apartments; Loftus house, which was originally the Caird Maternity Home and later a nurses’ home, was converted into six town houses; and the small Gilroy House was converted into two houses.

This view of Dundee Royal Infirmary from the Law shows the former Cancer Wing, photographed in 2005 by TheCreator, public domain image on Spanish Wikipedia’s entry for Dundee.

The old wash-house and drying green to the east of the infirmary was built up with housing as part of the redevelopment of the infirmary site. The wash-house itself had been demolished and replaced by the Constitution Campus tower of Dundee College in the 1960s (opened in 1970). By 2015 this was closed and awaiting redevelopment as flats with a cinema, gym, office space etc., known as Vox Dundee (why? who comes up with these names? I’m sure there’s a perfectly good explanation).

Extract from the 1st Edition OS Map surveyed in 1872. Reproduced by permission of the National Library of Scotland

Dundee Royal Infirmary was officially opened on 7 February 1855, having been completed towards the end of 1854. It was designed by Coe & Goodwin of London. This building replaced the earlier infirmary built in the 1790s in King Street. By 1849 a committee had been appointed to select a site for the new infirmary and a competition was held for the plans. The eminent medical Professors James Syme and Robert Christison of Edinburgh were consulted in the selection of the winning design, and had also supplied a block plan of the necessary arrangements when designs were first invited. Although 30 sets of plans had been submitted by the summer of 1851, only three were considered acceptable and put on display. The Northern Warder was scathing in its criticism of the majority of the plans, which it thought must have been produced by ‘aspiring joiners’ hoping to win the £50 prize for the winning design.

canmore_image_DP00101612

The main front of the hospital photographed around 1875 from Dundee Valentine Album, RCAHMS

Coe and Goodwin’s design was for a hospital of three storeys on a U‑shaped plan. It was of the corridor type of plan which was generally current before the introduction of the pavilion‑plan. Indeed, it was built in the declining years of corridor-plan hospitals, lending irony to Professor Syme’s description of it as ‘a model after which institutions similar in kind might well be constructed’. It is a bold essay in the Tudor style applied to a large public building (claimed to be the largest public building in Dundee at that time).  David Robertson, a local builder was appointed to erect the building and work was commenced in 1852.

Screen Shot 2015-09-11 at 17.09.37

This more detailed plan is from the OS Town Plans, also of 1871. Reproduced by permission of the National Library of Scotland.

Many extensions were built and sister institutions provided, one of the first was a convalescent home at Barnhill built in 1873-7  (since demolished). Problems associated with the plan had to be rectified – the chief of these being the sanitary facilities. One of the key aspects of pavilion-plan hospitals was the placement of the WCs, sinks and baths in rooms that were separated from the ward by a short lobby with windows on each side. This created a through-draught and was designed to prevent ‘offensive effluvia’ from being carried into the ward – bad smells or miasmas that were believed to cause disease. Plans to improve these and to build a new wash-house and laundry were prepared, and other similar institutions visited so as to provide the best and most up-to-date conveniences.

Plan of Dundee, 1906, by William Mackison, Burgh Engineer. Reproduced by permission of the National Library of Scotland

The plan of Dundee above marks the principal additions built to the north of the original hospital in the late 19th and early 20th centuries. These have been retained and converted to housing. To the left is the nurses’ home, built in 1896-7 and named after Sir William Ogilvy Dalgliesh, president of the hospital and benefactor of the University’s Medical School. On the right hand side is the Caird Maternity Hospital, designed in 1897 and opened in 1900, named after its benefactor, the jute baron (Sir) James Key Caird. Though marked here as a maternity hospital it served a dual function, with one block for maternity cases and one for diseases of women; the third, central block contained administrative offices and staff residences. It was designed by Murray Robertson. Caird also funded  the cancer wing, built in 1902-7 to designs by James Findlay.

Detail from the OS plan of Dundee surveyed in 1952, showing the extent of the infill building. At this time the public wash-house and allotment gardens still occupied the site to the east. Reproduced by permission of the National Library of Scotland

The map above shows the extent of the extensions and additions to the site up to the 1950s, many of these were demolished following the closure of the infirmary. These included an extension to the west rear wing of 1895 providing a new operating theatre. Another building removed was the maternity wing, which had been opened in 1930, erected and equipped by R. B. Sharp and his brother F. B. Sharp of Hill of Tarvit, Fife (pictured below, and labelled maternity hospital on the map above). The architects were D. W. Baxter & Son. After it was built the former Caird Maternity Hospital was turned into nurses’ accommodation. A further addition providing new dispensary and pathology departments was opened in 1935, named the Sir James Duncan building.

This rather gloomy photograph shows the maternity wing in about 1989-91. It was a plain enough building but the assorted bits of piping, ducting and plant added to the roof and meandering over the wall surface do it no favours. Photograph © Harriet Richardson

This view shows the main front with the maternity wing to the right. Photograph taken c.1990 © Harriet Richardson

The grand centrepiece of the original infirmary with steps leading up to the main entrance. Photograph taken c.1990 © Harriet Richardson

Detail of main infirmary building, showing the end bays of main front with angle turret on the return. Photograph taken c.1990 © Harriet Richardson

Looking west along the main front towards the entrance. Photograph taken c.1990 © Harriet Richardson

Sources: Henry J. C. Gibson, Dundee Royal Infirmary 1798-1948… 1948: Dundee City Archives: The Builder, 23 Aug. 1851, p.529, 16 Oct 1897, p.312; Dundee Courier, 13 April 1895, p.3; 10 March 1896, p.6; 11 Dec 1977, p.4; Dundee Evening Post, 9 Dec 1901, p.4; Dundee Evening Telegraph, 13 Sept 1897, p.2: Dictionary of Scottish Architects; Unlocking the Medicine Chest: PGL ForfarshireThe Scotsman, 23 March 1900, p.4; 16 July 1935, p.7:

For more information on Sir James Caird see the James Caird Society

 

Stracathro Hospital

Stracathro House, from Gershom Cumming, Forfarshire Illustrated, 1843

Stracathro House was built in 1827 to designs by Archibald Simpson for Alexander Cruickshank Esq whose fortune came from plantations in the West Indies. Cruickshank owned estates in British Guiana and St Vincent, and was awarded over £30,000 in compensation for freed slaves in 1836. Nevertheless, by the 1840s he was facing financial embarrassment and he returned to Demerara where he died in 1846.

canmore_image_SC01250851

Stracathro House photographed by RCAHMS in 2003

Stracathro House was built into a sloping site, thus the principal front is of two storeys without basement and the garden front to the rear has a raised basement. The main nine‑bay façade comprises slightly advanced outer bays capped by a stone balustrade and between these five bays set behind a screen of fluted Corinthian columns in antis. This screen breaks forwards in front of the centre three bays forming a tetrastyle portico.

feb-17001

Postcard with views of Brechin, including, top left, the mansion house at Stracathro Hospital, © H. Martin, reproduced with permission.

Following Cruickshank’s death Strathcathro House and estate were put up for sale at auction in July 1847. It failed to sell on that occasion. The house was fully furnished, the estate extended to 1,939 acres, of which 447 were wooded and 161 laid out as park and pleasure grounds, the rest being farmland. Eventually it was bought by Sir James Campbell, former Lord Provost of Glasgow, when it was put up for sale again in December at a reduced price of £40,000, reckoned to be about half the amount that it had cost Cruickshank. Campbell’s second son was Sir Henry Campbell-Bannerman, liberal MP and Prime Minister 1905-8. His eldest son, James Alexander Campbell, who inherited Stracathro, married Ann Peto, daughter of the railway baron, Sir S. Morton Peto. James died within weeks of his brother in 1908. James Morton Peto Campbell inherited, but died in 1926 after a prolonged illness at Careston Castle, Brechin, the home of his sister and brother-in-law, William Shaw Adamson. Stracathro House passed to the Shaw Adamsons. William’s son, William Campbell Adamson, was in the Royal Flying Corps and was killed in action in France in 1915. His son, William John Campbell Adamson inherited from his grandfather in 1936 when he was only about 22 years of age.

Rear view of the house. The wings were added later. Photographed in 2012 by Cisco, reproduced under creative commons license CC-BY-SA-3.0

During the First World War Stracathro was used as a military hospital, and was afterwards returned to the Campbells. The young William Campbell Adamson leased the house to the Department of Health for Scotland in 1938, when it was earmarked as a site for an emergency hospital. This was one of seven Emergency Medical Scheme hospitals built in Scotland. Hutted ward blocks were erected in the grounds to take the anticipated civilian casualties from air raids, while the house was used for staff accommodation.

screen-shot-2017-02-10-at-16-18-30

Extract from the OS 1:25,000 map published in 1957. Reproduced by permission of the National Library of Scotland

The hospital was ready for occupation by the summer of 1940. Guidelines for the design and construction were given by the Department of Health to local architectural and/or engineering firms to erect EMS hospitals. For Stracathro the scheme was carried through by the firm of Maclaren, Soutar and Salmond, a Dundee practice which had an office in Brechin at that time.

Postcard with aerial photograph of the hospital

Nationally the programme for building these hutment hospitals, either on new sites or adjoining existing hospitals, was designed to provide 35,000 beds in England and Wales by the end of December 1939, and 10,000 additional beds in hutments (i.e. ward huts – single storey detached blocks) in Scotland on twenty sites.

This postcard showing the admin block of the hospital is not dated, but looks to me to be of the 1950s or 60s

Stracathro provided 999 beds, and took troops, local residents and later casualties. After the war it became a local general hospital, and was transferred to the National Health Service in 1948 under the Eastern Regional Hospital Board.

Another postcard with an aerial photograph of the hospital. On the right are flat-roofed ward blocks, the rest of the blocks having pitched roofs, suggesting that they are a different building phase. 

geograph-4400936-by-anne-burgess

One of the few surviving war-time ward blocks at Stracathro Hospital, photographed in 2013 © Copyright Anne Burgess and licensed for reuse under this Creative Commons Licence

Stracathro is the only one of the seven independent EMS hospitals built in Scotland to have so far retained any of its original ward blocks. Most on the site have been largely, if not completely rebuilt, although the original footprint of much of the hospital remains. In 2011 the Susan Carnegie Centre, for patients with mental illnesses, opened here, designed to replace Sunnyside Hospital. Stracathro House itself was sold by Tayside Health Board in 2003 and was converted back into a private residence.

Sources

Legacies of British Slave Ownership, profile of Alexander Cruickshank: The Garden History Society in Scotland, Survey of Gardens and Designed Landscapes: Stracathro HousePP: 10th Annual Report of the Department of Health for Scotland, 1938 Montrose, Arbroath and Brechin Review, 7 May 1847; 29 Aug 1847; 31 Dec 1847; 31 Dec 1847: London Daily News, 16 Feb 1847, p.8:  The Scotsman, 10 July 1940: Hansard, Commons Sitting 1 August 1939: University of Dundee Archive Services, records of the Eastern Regional Hospital Board; Museum Services, Hospitals at War