March News

March 21, 2025April 12, 2025 / Harriet Richardson / 1 Comment

Although I write a new post infrequently, most weeks I revise one or other of the pages on the historic-hospitals site. I thought perhaps it would be useful to share what I have been doing, and draw attention to new information.

Strathmore Hospital, Blairgowrie

At the beginning of this month I was delighted to receive this aerial photograph of Strathmore Hospital, Blairgowrie, Perthshire. It was taken from a light aircraft by the husband of one of the members of staff. Parts of the hospital are still standing – the larger square building at the centre of the photograph and the small, single-storey building to the top left. They have been converted into private houses, and other houses have been built on the site in place of the two large ward wings in the foreground of the picture. The hospital first opened in June 1904. It was for infectious diseases and built to serve the burghs in Eastern Perthshire of Couper Angus, Alyth, Blairgowrie and Rattray. The architect was Lake Falconer, who had earlier designed the cottage hospital in Blairgowrie, still functioning as an NHS community hospital. Strathmore Hospital was latterly a geriatric unit before it closed in 1987.

*Blairgowrie Cottage Hospital photographed in August 2022 ©️ H. Blakeman*

Northern Ireland

Over the last couple of months I have been reading about the hospitals in Northern Ireland in preparation for a short talk for Belfast Health and Social and Care Trust. I have started to revise and update the Northern Ireland page, but there is still a long way to go. As might be expected, there are some significant differences between the way in which hospital provision developed in Ireland from the rest of Britain, though fewer differences in architectural design. Uniquely in Ireland an Act of Parliament of 1765 aimed to encourage the establishment of hospitals for the ‘sick and diseased poor’ in the more remote rural areas. There was no comparable legislation in England, Scotland or Wales. By 1771, 26 county infirmaries had been built. The County Infirmary at Armagh is a surviving example. It closed in the 1990s but was adapted to new uses including the Armagh Irish and Local Studies Library.

*Former Armagh City Hospital, Abbey Street, photographed in 2016, © Eric Jones from Geograph*

Staffordshire

Recently I have been revising the Staffordshire page. Of the 42 hospitals listed there, the majority were still standing in the early 1990s. Six were either in the course of construction or have been built since then. There is still a lot to be added to the Staffordshire page, but at least it is a bit more up to date on the current status of the county’s historic hospitals.

Former Burton General Hospital, photographed in 1993, demolished the following year, © *H. Blakeman*

The uncertain future of historic hospitals was one of the main reasons for the survey of pre-1948 hospitals undertaken by the Royal Commission on the Historic Monuments of England in the early 1990s. When the NHS was founded in 1948 one of its main aims was to replace pre-war buildings with a network of district general hospitals that would centralise and rationalise services. The huge cost of that undertaking has meant that this has been a much slower process than had been anticipated and it was only by the 1980s that large numbers of old hospitals were becoming surplus to requirements. At the same time the ‘care in the community’ policy in the mental health sector meant that the majority of large mental hospitals were closing and up for disposal.

Part of the former St Matthew’s Hospital, much of this large hospital complex was demolished as part of its redevelopment for housing. Photograph in 1993 © *H. Blakeman*

The rebuilding policy of the NHS has had a major impact on our hospital heritage, with a high percentage of demolition despite the historic significance of these sites. In Staffordshire alone, thirty hospitals have been demolished, either completely or partly, ranging in size from cottage hospitals to large general hospitals. These include Hartshill Orthopaedic Hospital, Rugely Cottage Hospital, and large sections of St Edwards and St Matthew’s Hospitals, as well as most of the North Staffordshire Royal Infirmary.

*Architect’s perspective of the proposed new hospital at Hartshill, Stoke on Trent, from* The Builder, 30 June 1866, p.487 (Internet Archive)

The North Staffordshire Royal Infirmary in Stoke on Trent was an early example of a pavilion-plan hospital, built in 1866-9. The only part of the original hospital to have been retained is the western entrance block, the ward pavilions and all the rest of the complex that appear on the architectural perspective above have gone.

*West entrance block of the original North Staffordshire Royal Infirmary, photographed in 2012 ©* *Alf Beard from Geograph*

The Royal Infirmary grew considerably, particularly in the early twentieth century. As its services and the number of beds increased, the need to accommodate more nursing staff grew. The original nurses’ home to the west of the main complex was supplemented by a new home on the east side built in 1902 to commemorate the coronation of King Edward VII. This second home was extended in 1913 and again in 1925-7. A final extension was built during the Second World War, in 1940-2, to cope with the continuing expansion of the hospital. The 1940s wing was designed by Wood, Goldstraw and Yorath, and provided single bedrooms for 16 sisters and 83 nurses. Its most distinctive feature was a two-storey, flat-roofed projecting wing ending in semi-circular balconies that housed recreation rooms.

*The early 1940s nurses’ home extension at the North Staffordshire Royal Infirmary, Stoke on Trent, photographed in 1993. It had already been demolished before the hospital closed.*

To the south of the old Royal Infirmary, was Stoke’s workhouse which developed into the City General Hospital. More recently the site has seen the development of the Royal Stoke University Hospital. The original workhouse was constructed in 1832 with accommodation for 270 inmates. A hospital was added in 1842, and a school and chapel in 1866. These ranges survive more-or-less intact (there has been some demolition to the rear of the original workhouse and the school).

*Front range of the original workhouse complex at Royal Stoke University Hospital, photographed in May 1993*

Further hospital blocks were built in the 1870s, ’80s and ’90s in the south-west quadrant of the site. The 1870s hospital wing has gone, but part of the hospital range to its west is still extant. The twentieth-century additions to the site seem to have entirely gone, including the nurses’ home, a moderne-style hospital wing to the north of the original workhouse, and a sanatorium just east of the school all dating to the 1920s and ’30s. (The sanatorium had already been demolished by the 1990s.) Gone too is the North Staffordshire Maternity Hospital built in the late 1960s to the east of the school and sanatorium.

Inter-war ward wing that formerly stood on the *Royal Stoke University Hospital site, photographed in May 1993*

Sadly the scope of the Royal Commission’s hospitals survey did not extend to post-war hospital blocks, so it can be hard to find any photographic record of buildings from the 1940s-80s that have already been demolished. The sheer number of hospitals made a more comprehensive survey too ambitious for the team. As it was, we could not visit every site in the country. I still have the notebook in which the London team jotted down our site visits, useful now to know when we took our quick snaps that helped us write up our reports. Sometimes the weather prevented us from doing much. We were rained off on our visit to St George’s in Stafford, and there’s a note by Staffordshire General that says ‘drove past in a thunderstorm’.

Astley Ainslie Hospital, Edinburgh

August 30, 2024August 30, 2024 / Harriet Richardson / 1 Comment

Astley Ainslie Hospital, gates by Thomas Hadden, photographed February 2024, © H. Blakeman

This post looks at the early history of the Astley Ainslie Hospital and the development of a more scientific approach to convalescence in the early twentieth century.

*The balcony and veranda on the south side of the new ward wing added to Canaan Park House, from* The Nursing Times, *9 Jan. 1926*

The Astley Ainslie Hospital is the main rehabilitation hospital in the NHS Lothian region. There are buildings of various dates, from the early 19th century to the early 21st century on the large site in the Grange area of Edinburgh. The hospital was established for convalescent patients from the Royal Infirmary of Edinburgh by a generous bequest from David Ainslie. The site comprising four large villas and a golf course was acquired in 1921, and the architect John Jerdan commissioned to adapt one of the villas – Canaan Park – as the first phase of turning the new hospital. The house became the main administration department with a new wing added to the south for 34 female patients under the charge of Dr (Isabella) Mary Mears, the resident medical officer.

The first patients were admitted in 1923, and three years later the Nursing Times provided a description of the new institution along with a photograph of the recently built ward unit (see above). The article noted the beautiful grounds, with fine view to the Braid Hills, and that the new ward unit was ideally suited to its purpose of a ‘convalescent retreat’. Although the Astley Ainslie was intended for patients from the Royal Infirmary it was independently run, with its own body of governors, as intended by its benefactor, David Ainslie. It was on his instruction that the hospital was named after John Astley-Ainslie, David Ainslie’s nephew who had died at the young aged of 26. It was also intended that the institution should be for cases that required longer care than was provided at the Infirmary’s existing convalescent home at Corstorphine (see the Edinburgh page for more details).

*Canaan Lodge, Millbank, Canaan House and Canaan Park, on the 25-inch OS map surveyed in 1893 reproduced courtesy of the National Library of Scotland, CC-BY (NLS)*

The Nursing Times described the entrance hall of Canaan Park House as having a piano and that it was ‘bright with pots of growing chrysanthemums’. The colour scheme generally was white and green – colours chosen for their calming and restful qualities. No operations were to be conducted at the hospital, but post-operative treatment, such as changing dressings, was one of the potential nursing duties. Initially the patients were generally surgical, tuberculosis or adolescent heart cases. The wards were ‘big, bright, airy places built on the horseshoe plan’, the balcony and veranda were accessed from large French windows, and had five beds on each, with a further twelve within the ward. Some patients slept out on the balcony or veranda in winter and summer. As well as the two wards, the patients had the use of a dining-room that also served as a recreation room.

*Canaan Park House, with the 1920s ward wing on far right. Photographed February 2024, © H. Blakeman*

The ample grounds at the Astley Ainslie allowed out-door recreation including bowls, croquet and clock golf. Patients could also undertake gardening in the vegetable garden. Indoors there was a well-stocked library, while concerts, lectures and entertainments were organised regularly.

*Canaan House* *in 2024*, *© H. Blakeman*

Flowers, fruit and vegetables were supplied from the gardens, and the original gardeners to the large houses were retained with a view to preserving the ‘old-world appearance’ of the grounds. An ample supply of fresh produce was a vital part of providing patients with a nutritious diet, with a stress on milk, butter, eggs, green vegetables and fruit. A considerable part of the estate was laid out as a kitchen and fruit garden in order to maintain a constant supply. The best diet for convalescents was an ongoing subject of study. Early experiments at the Astley Ainslie in trying to encourage patients to consume plenty of green vegetables, especially when raw – such as lettuce and tomatoes – was too much of a novelty for some, being ‘often neither appreciated nor eaten without persuasion’.[J. Cunningham, Edinburgh Medical Journal, 1931 v.38 (9), p.146.]

*OS map revised 1913, part of site acquired for the hospital CC-BY (NLS)*

The beneficial effects of nature, of fresh air, sunlight and pleasant grounds, had long been recognised as an important part of the therapeutic treatment of convalescent patients and before the development of effective drugs to treat tuberculosis had been shown to slow the progress of that disease in some patients. Sanatoria were designed with sun-trapping angled plans – a butterfly, or half-butterfly plan – with verandas in front onto which beds could be wheeled. This was the form adopted for the new blocks built in the hospital grounds, but even in the first ward extension to Canaan Park House a sun-trap was created where ‘screen-enclosed, sun bathing takes place in summer’ and a wooden shelter was built where patients could sit out and enjoy ‘the wintry sunshine, each clad in a big coat and wrapped about with a warm fleecy blanket’.

*East Pavilion, north elevation, photographed February 2024 © H. Blakeman*

Two neighbouring villas were acquired in the 1920s to extend the site: Morelands and St Roque House. In the second half of this decade the first two new hospital blocks and a nurses’ home were constructed. For the design of the new buildings the governors turned to the architects Auldjo Jamieson and Arnott, who had taken over the practice of Sydney Mitchell and Wilson, architects of many hospital buildings including extensions to the Royal Infirmary. The grandly named and wealthy Ernest Arthur Oliphant Auldjo Jamieson (1880-1937) had worked in Mitchell and Wilson’s office early in his career before setting up on his own account around 1909-10, but soon after the two practices were merged and James Alexander Arnott (1871-1950) joined as a partner.

*OS map revised 1932 showing the East and West Pavilions, Scientific block, Kitchen Block and Nurses’ Home CC-BY (NLS)*

The 1920s hospital blocks (now the East and West Pavilions) were single-storey, butterfly-plan buildings built on the site of the ladies’ golf course (see maps above and below). The slope of the site gave uninterrupted views of Blackford Hill to the south.

*Millbank Pavilion, south elevation, photographed February 2024*, © *H. Blakeman*

A third butterfly-plan pavilion was built on the site of Millbank House which was acquired by the governors around 1930. At the same time a new main entrance to the site was created on Grange Loan with its fine wrought-iron gates made by Thomas Hadden in his characteristic Arts & Crafts style of flowing natural forms (see photographs at the top of the post and below). The gates were hung between square sentry pavilions with pyramidal roofs and over-sized circular window.

*The ornamental wrought iron gates made by Thomas Hadden, photographed when newly installed, image from HES Archives*

The nurses’ home was completed in 1930, a two-storey and attic, H-plan building, built on the site of South Bank House, just west of the former golf course. Plans of the home had been drawn up by 1925 when they were published in the Architects’ Journal. It followed the conventions of the time, with single bed-rooms for 45 nurses and shared bathrooms and toilets on the upper floors, and communal recreation rooms on the ground floor.

*Nurses’ Home, north elevation, photographed February 2024 © H. Blakeman*

Just north of the nurses’ home a central kitchen block was built, now the Blackford Pavilion and still functioning as a kitchen and canteen. It also houses NHS Lothian’s health promotion Resource Centre. A covered corridor connects the centre to the nurses’ home.

*The Blackford Pavilion* *© H. Blakeman*

A scientific block was amongst the early buildings at the Astley Ainslie, reflecting the governors’ decision that the institution should act as a centre for investigating the problems connected with convalescence and the greater prominence of rehabilitation in the years after the First World War. The large numbers of military personnel who became disabled in action led to developments in prosthetics and a range of treatments or therapies. The scientific block was designed in more formal style than the ward pavilions, its south front featuring an arcade of Grecian Doric columns within which the main entrance sits behind a pair of columns set in Antis. It housed a gymnasium for physiotherapy (at the time termed ‘massage’ and remedial exercises – a reminder of physiotherapy’s origins in ‘Swedish Gymnastics’). It also had an electric department with x-ray equipment, rooms for ultra-violet radiation and electric therapeutics, a dentist’s room, dispensary and research laboratory. Heliotherapy was an important part of convalescent treatment, but the unreliability of the weather soon led to the addition of an artificial sunlight lamp.

*Scientific Block, photographed February 2024, © H. Blakeman.*

In April 1929 Lieutenant-Colonel John Cunningham was appointed as the Medical Superintendent of the Institution. He delivered a number of papers about the new science of convalescence to the Edinburgh Medical Society that were subsequently published in the Society’s journal. In a paper of 1931 he noted that the organised study of convalescence and the methods of dealing with it were of recent growth, and that there were few publications on the subject. Historically the main ingredients of successful convalescence were ‘moderation in exercise, peace of mind, tranquil sleep, and proper hygiene’. [Cunningham, ‘The Convalescent State’, Edinburgh Medical Journal, 1931, vol.38 (9), p.137.] However, until at least the mid-19th century, convalescence had been available only to the rich – ‘the poor man had no time to be sick, and still less were facilities for recovery provided for him’. [Idem. p.138.]

*View of the Scientific block from the west* *© H. Blakeman*

The earliest convalescent hospital founded in Britain was probably the Metropolitan Convalescent Institution, founded in 1841 and later moving to purpose-built accommodation at Walton-on-Thames (later named Ellesmere Hospital, see the Surrey page for more details). The type of convalescent home that developed concentrated on cases that were already well on the way to recovery. Most were unable to take patients who required active medical attention.

*Metropolitan Convalescent Institution, later Ellesmere Hospital, Surrey Wellcome Collection*

The Health Insurance Acts improved access to basic convalescence to the working classes (see Convalescing in Colwyn Bay for more details). There had long been an economic advantage to giving the work force a proper opportunity to convalescence – both from an employers’ point of view and for hospitals. Apart from freeing beds in an acute hospital by transferring convalescents to a different setting, the relative cost per bed of a convalescent home was significantly less than for an acute hospital.

During the First World War convalescent establishments were provided as well as hospitals for the military. This spurred advances in the study and treatment of convalescence, as well as bolstering the arguments for separate convalescent institutions that were specially designed and equipped for the purpose. Classification of convalescent patients was developed to outline the different requirements of particular groups, such as cardiac, orthopaedic or psychiatric.

*Occupational Therapy Unit, photographed February 2024 © H. Blakeman*

By the 1920s America was forging ahead in refining the treatment of convalescents. The main sources of information were publication by John Bryant in the 1920s, and the example of the Burke Foundation near New York. The Burke Foundation had 300 beds and dealt with many cases previously excluded from convalescent homes, such as chronic illness and physical disabilities. Occupation and recreation as aids to recovery played an important role. There are cross-overs here with therapies in psychiatric hospitals of the time and particularly in institutions for those with learning disabilities, but the benefits of encouraging some form of occupation for convalescent patients had been recommended by many, including Florence Nightingale. Occupational therapy developed during the First World War, when it was shown to have positive effects on mental wellbeing (or in the language of the time, ‘mental tone and preventing moral deterioration).

One of the pioneering advocates of occupational therapy in Britain was Sir Robert Jones, who noted the lesson learnt during the First World War of the psychological and physical value of work. Workshops for wounded soldiers filled the hours when they weren’t undergoing treatment, usefully distracting their minds. The Canadian war hospitals were some of the first to place ‘Occupational therapy’ on an organised basis, while some of the earliest training schools for occupational therapists were established in Canada and the United States. The Astley Ainslie was one of the first to establish a school of Occupational Therapy in Scotland.

In a future post I will look at some of the later developments at the hospital.

Tenbury Cottage Hospital

July 8, 2024July 10, 2024 / Harriet Richardson / Leave a comment

I recently acquired this postcard of the cottage hospital in Tenbury. It wasn’t a hospital that I was familiar with, and it seems to have missed out of the RCHME hospitals survey – perhaps because it lies on the border of two counties, Tenbury itself being in Worcestershire while the hospital lies over the river, and over the county boundary, in the Shropshire parish of Burford. Shropshire was one of the counties that I worked on, but this hospital slipped through the net. It’s a pity, not least because it is still an NHS hospital and the original section is a listed building.

Tenbury surveyed for the 25-inch OS map in 1883, the cottage hospital is at the top right, along the road from the Swan Hotel. The main village is south of the river, with Tenbury Union Workhouse the first building to the east of the Teme Bridge. Reproduced by permission of the National Library of Scotland, CC-BY (NLS)

The hospital was established in a converted house in 1869, and originally called St Mary’s Cottage Hospital. The early nineteenth century house was extended westwards around the turn of the century. The extension is probably the part shown on the postcard to the left, with veranda and balcony. In the 20th century the hospital expanded on its east side. It is currently (2024) a community hospital administered by Worcestershire Health and Care NHS Trust.

*The cottage hospital at Tenbury from the 25-inch OS map surveyed in 1883. CC-BY (NLS)*

The original building seems to have been listed because of its interest as a house. It was built around 1835 by Richard Titt, landlord of the Swan Hotel, who died in 1843, aged 86, having been the Swan’s landlord for over 40 years. However, it is also historically important as an early example of a cottage hospital in England, having opened on 1 September 1869. This was only ten years after the very first cottage hospital which opened in 1859: Cranleigh Cottage Hospital, Surrey. It is particularly rare to find a first-generation cottage hospital still using its original building.

*The 1902 OS map shows the small western extension of the cottage hospital. CC-BY (NLS)*

The hospital featured in Horace Swete’s Handy Book of Cottage Hospitals published in 1870. Swete described the hospital as a ‘small villa, with garden, coach-house and stable, altered for the purpose’. Patients contributed a small fee towards the cost of their care and treatment, charged at a weekly rate. Mrs Arabella Prescott served as the lady president of the establishment, and it was she who had purchased the house and footed the bill for fitting it up as a hospital, including the provision of linen, dressing-gowns and slippers for the use of the patients.

*Cranleigh village hospital was the first of its kind, opening in 1859 and featured as the frontispiece of Horace Swete’s* Handy Book of Cottage Hospitals *published in 1870.*

There was no connection to a mains sewer, so earth closets (or ‘earth commodes’ as Swete termed them), were used throughout the hospital. The floors were waxed and polished ‘with a view to greater cleanliness’, but Swete was critical of this, as it might make the floors slippery: ‘A poor fellow getting out on his crutches for the first time, would find considerable difficulty in walking upon it without falling’.

The hospital had a convalescent ward, and the coach-house was converted into a mortuary chamber, top-lit and fitted with a slate-topped table. The nurse in Swete’s time had formerly been a sister at Middlesborough Cottage Hospital. By 1910 the Tenbury cottage hospital had 9 beds, later extended to 12. An extension was built on the east side of the original house in 1912 named the Elizabeth Wing.

In 1915 the hospital featured in Henry C. Burdett’s How to Become a Nurse which listed the requirements for of various hospitals for trainees. St Mary’s, as it was then still known, took on young women for a month’s trial after a personal interview, which if satisfactory, led to one year’s training. Women had to be between 20 and 22 years of age, between 5ft 2in (1.57m) and 5ft 11in (1.80m) in height, with satisfactory evidence as to character and health. ‘Applicants should be of the upper middle class and Church of England’. Training included lectures by the matron on anatomy, and examinations were held twice yearly. ‘Laundry and text-books provided. Separate bedrooms.’

*H. C. Burdett’s* How to Become a Nurse, *1915*

Although the hospital charged fees for admission and subscriptions from wealthier supporters, fund raising was an essential activity. Church collections were the main source of ad hoc donations. The nearby Swan Hotel hosted an ‘invitation charity ball’ in December 1884, and in 1899 and 1900 a ‘guess the weight of a cake’ competition. The Hotel later instituted an annual ball which took place until the outbreak of the First World War. Nevertheless, by the later 1890s the hospital’s income did not meet its expenditure, causing the hospital to dip into its endowment funds.

St Mary’s survived into the 1920s, but had to close in 1928 in the face of rising costs and staffing difficulties. All was not lost, and in 1931 it was re-orgnised and re-opened as Tenbury and District Hospital, with a further extension to the east opened in 1935 to provide an operating theatre. In the hospitals survey conducted by the Ministry of Health during the war it was described as having 16 beds, maintained by the Tenbury and District Hospital and Nursing Association. Six local general practitioners formed the honorary medical officers alongside a general surgeon from Leominster, an ear and throat surgeon from Kidderminster and a dental surgeon.

Under the NHS the hospital was well supported by the local league of friends. Expansions and modernisation improved facilities, and in 1986 a new outpatients department was built. A Millennium Project provided a further extension .

[Sources: Tenbury and District Civic and Historical Society, Tenbury and the Teme Valley People and Places, 2007: Horace Swete, Handy Book of Cottage Hospitals, 1870, pp.161-2: Report of the Royal Commission on the Poor Laws, 1908: Worcester Journal, 5 Jan. 1843, p.3: Wellington Journal, 27 October 1877, p.8: Tenbury Wells Advertiser, 16 Dec 1884, p.4; 31 Oct. 1899, p.5; 30 Jan. 1900, p.5: Kington Times, 6 July 1935, p.4: Ministry of Health, Hospital Survey. The Hospital Services of the West Midlands Area, 1945.]

St Ann’s Hospital, Tottenham

October 9, 2022October 9, 2022 / Harriet Richardson / 1 Comment

St Ann’s Hospital occupies a large site in South Tottenham in the London Borough of Haringey. About half the site is being redeveloped by the NHS, the rest – the western side of the hospital – was sold for development. As far as I can gather, it is the last remaining extant fever hospital built by the Metropolitan Asylums Board, one of nine that were built to serve the capital. St Ann’s was originally known as the North Eastern Fever Hospital. The original temporary buildings were replaced in 1900-2 by sturdy permanent brick buildings, mostly of two storeys, to designs by the architects A & C Harston. Despite the historic significance of the site, Historic England turned down an application for designating the hospital as a listed building.

Here I have put together a sequence of photographs that were sent to me by one of the campaigners and activists who have been fighting to preserve both the buildings and the fine landscape around them. The importance of hospital gardens as therapeutic spaces is much talked about these days, but has long been recognised. These valuable spaces only really began to disappear as car ownership grew in the 1960s, and landscapes were covered over by concrete or tarmac to provide much-needed carpark space. Rarely, there is still much valuable green space at St Ann’s, along with many mature trees. There is a petition to save the trees, so if you would like to sign, follow this link or search on change.org for Save St Ann’s Hospital trees.

I think these images speak for themselves of the quality of the buildings, and the interest that there is on the site. You can find more pictures and an account of the hospital’s history on Peter Higginbotham’s workhouses.org website, and on Lost Hospitals of London. For now I am going to post this piece as it is, later I will add in more information and write a supplementary post with an overview of the history of the buildings. All the images here were very kindly provided by Vivienne Youell, copyright and permission to reproduce rest with her.