Bristol Royal Infirmary

‘A Perspective View and Plans of the Charitable Infirmary at Bristol as it now is with the addition of two intended wings’ 1742. Image reproduced under licence CC BY 4.0 from the Wellcome Collection

The old Royal Infirmary at Bristol was one of the first to be founded in England outside London. Subscriptions began to be made in November 1736 and the present site was acquired shortly afterwards. The first patients were admitted the following year. It was not until 1782 that the decision to provide a new, purpose-built infirmary was taken. Thomas Paty, a local architect, drew up the plans and building proceeded in three phases. The east wing was erected first between 1784 and 1786. The central block was put up in 1788-92 and the west wing added in 1806-10. It was a large and impressive building of three storeys and basement, to which an attic storey was added later.

Early photograph of the main front, probably early 20th century. From Paul Townsend flickr site. Reproduced under Creative Commons License CC BY-NC-SA 2.0

A chapel with a museum underneath was added in 1858, an unusual combination. In 1911-12 the King Edward VII wing was built to designs by H. Percy Adams and Charles Holden in a stylish, stripped classical style which looks forward to inter-war modernism. In 2017 the original part of the hospital was empty, boarded up and under threat of demolition.

The Royal Infirmary, Bristol, from the 2nd-edition OS 25-inch map revised in 1901. Reproduced by permission of the National Library of Scotland

In November 1736 a subscription was opened for erecting ‘an infirmary in the City of Bristol for the relief of such persons as should be judged proper objects of a Charity of that kind’. [1] A site in Maudlin Lane was acquired which contained various buildings, including tenements, a warehouse and some waste ground. The existing buildings were adapted and a ward built and furnished. Out-patients were admitted to the infirmary from June 1737 and the first in-patients were admitted at the formal opening in December of that year. Initially there were 34 patients, with an equal number of men and women. As one of the first hospitals to be founded in England outside London, the Bristol Infirmary has some claim to historic importance. It vies with Addenbrooke’s Hospital in Cambridge, founded in 1719 although not built until 1740, and Winchester Infirmary, established in 1736.

This view shows the south front of the infirmary as it appeared  in 1765. Public Domain image.

Within a year or so of the infirmary’s opening, plans were made to extend the building by two new wings extending from the south front. The first wing, to the south east, was completed in 1740, the south-west wing had been added by 1750. As well as being able to take in more patients, the infirmary had two cellars – one let to a tenant, the other used for preserving meat – a cold bath, rooms for the apothecary and his apprentices, and in the garrets, along with linen rooms and staff bedrooms, were wards for patients being ‘cut for the stone’. A colonnade was formed along the south front for convalescent patients.

View of the new front, from Munro Smith’s History of The Bristol Royal Infirmary published in 1917. From the Wellcome Collection, CC BY 4.0

A few additions were made over the next decades, but by the 1780s conditions were poor. The infirmary was always overcrowded, wards were ill-ventilated and infectious diseases frequently claimed the lives of patients and staff. In 1782 it was at last decided that a new building would have to be provided. Some attempt was made to establish the new building on a new site but this was eventually rejected by the Building Committee. Plans were drawn up by Thomas Paty, a local architect, for a U-shaped hospital with the main entrance on the north side facing Marlborough Street. Work was carried on in three stages, one wing at a time. The first to be built was the East Wing, in 1784-6, followed by the central block in 1788-92 and the West Wing, completing the original scheme, was added in 1806-10. Financial difficulties had prompted the managers of the infirmary to build piecemeal, but circumstances were so straitened in 1811 that it was not possible to admit any patients to the newly completed wing. When it finally opened some three years later the infirmary provided a total of 180 beds.

The north front of Bristol Royal Infirmary, photographed in 1993 © H. Richardson

In 1858 plans were drawn up for the addition of a chapel and museum to the infirmary. The museum was to house a collection of specimens which had been presented to the infirmary by Richard Smith. The two were neatly accommodated in one building on the east side of the infirmary, the museum was at ground floor level and the chapel built over it. Work was completed and the building opened in 1860.

The chapel with its tall lancet windows with the museum on the floor below,  photographed in 1993 © H. Richardson

The chapel abuts Whitson Street to the east. Constructed of rubble masonry with ashlar dressings, it is a simple five-bay rectangle without a break for chancel or transepts. The windows are  lancets with cusped heads and plate tracery for the east end. The eaves course is ornamented by a corbel table. The interior is quite plain, but has a good stained glass window depicting Joshua and one of Saint Elizabeth.

Chapel interior, photographed in 1993 © H. Richardson

Various additions were made during the nineteenth century. An out-patients’ department was established which underwent many alterations over the century. In 1866 the west wing was extended and two new wards created. By the turn of the century a nurses’ home had been built on high ground to the west of the hospital on Terrell Street. The largest addition to the infirmary before the advent of the National Health Service was the King Edward VII Memorial Building, situated on the opposite side of Marlborough Street, erected in 1911-12. It was designed by H. Percy Adams and Charles Holden to provide new surgical wards and it was largely through the efforts of Sir George White, the president and Treasurer of the Infirmary since 1904, that it was carried out. White made his fortune working at the Stock Exchange before setting himself up in business. He developed the Bristol Tramways Company and established the Bristol Colonial Aeroplane Company in 1910. He worked hard to clear the infirmary from debt and raise sufficient funds to improve the accommodation.

Postcard showing the new wing, with the original hospital on the right  © H. Martin

A competition was held in 1908 for an extension scheme which comprised the remodelling of the old infirmary building, adding a new ward pavilion with 75 beds, a new casualty and out-patients’ department, and an isolation building with 24 beds for sceptic and infectious cases. [Allibone, J. Adams, Holden Pearson catalogue of plans in RIBA] The competition was assessed by Edwin T. Hall, and twelve firms of architects were invited to take part, amongst whom were the foremost hospital architects of the day. Apart from H. Percy Adams they were: Thomas W. Aldwinckle, W. A. Pite, J. W. Simpson, A. Saxon Snell, Alfred Hessell Tiltman, Young & Hall, all based in London; Arthur Marshall from Nottingham; Everard, Son & Pick from Leicester; Henman & Cooper, from Birmingham; T. Worthington & Son, of Manchester and E. Kirby & Sons of Liverpool. [Building News, 31 July 1908, p. 168]

South front of the King Edward VII Memorial Wing,  photographed in 1993 © H. Richardson

The site itself was awkward, being bisected by Marlborough Street which became Upper Maudlin Street at the corner with Lower Maudlin Street. The winning design by Adams and Holden comprised a large new out-patients’ block with a central waiting hall, situated nearly opposite the old infirmary building, and adjacent to it a ward pavilion, alongside which further extensions could be erected. Behind the ward pavilion was the isolation block. The plans submitted by A. H. Tiltman, which were also published at the time, are notable for comprising circular ward towers.

This detail of the postcard shows patients on the balconies at the ends of the ward wings.

Insufficient funds led to the plans being modified. It was also decided to delay the building of the new out-patients’ block until more money was available. The foundation stone was laid on 14 March 1911 and the new building formally opened by King George V and Queen Mary on 28 June 1912. The nurses’ home was extended at the same time, this pushed the total cost up to £137,000 and left the infirmary with a debt of over £12,000.

The opening of the King Edward VII Memorial Wing. Image from Paul Townsend’s Flickr site, reproduced under Creative Commons CC  BY-NC-SA 2.0

Following the outbreak of the First World War, just two years after the new wing opened,  the Memorial Building was handed over to the military authorities and, along with Southmead Hospital, it became known as the Second Southern General War Hospital (C. Bruce Perry, The Bristol Royal Infirmary 1904-1974, 1980, p.27).

Postcard showing the interior of  King George’s Ward, probably in the King Edward VII Memorial wing. Image from Paul Townsend’s Flickr site, reproduced under Creative Commons CC  BY-NC-SA 2.0

Lack of money continued to darken the administration of the infirmary. After the War costs continued to rise and income diminish. In 1921 over one hundred beds were closed at the infirmary through a shortage of funds and two years later a shortage of nurses caused beds to remain unusable. The managers laid the blame for this deficiency in nursing staff to the inadequate nurses’ home. They were able to go some way to rectifying this by using a generous gift from Henry Herbert Wills to extend the existing home. This opened in 1925, the work having been carried out by the architect Sir George Oatley.

Extract from the 25-inch OS map, revised in 1913. Reproduced by permission of the National Library of Scotland

Further additions were carried out between the Wars. The isolation block was built in 1924, an x-ray department and dental department were added in 1925, and a massage department established in 1926. Henry Hill had been appointed as the infirmary’s clerk of works in 1906 and he drew up plans for two staff accommodation blocks which were completed in 1930 and 1931. During the Second World War the infirmary was lucky to escape serious damage from bombing. Only the mortuary was destroyed. After the war, greatly in debt, the infirmary was transferred to the National Health Service.

References

  1. Minutes of Bristol Royal Infirmary, quoted in C. Saunders, The United Bristol Hospitals, 1965, p. 11

 

 

Vale of Leven Hospital, the first new NHS hospital in Britain

Postcard of Vale of Leven Hospital from the 1970s

Vale of Leven Hospital, at Alexandria in Dunbartonshire, Scotland, was the first new hospital to be completed in Britain under the National Health Service at a cost of  around £1 million. It was built in 1951-5 on the site adjacent to the Henry Brock Cottage Hospital to designs by John Keppie and Henderson and J. L. Gleave. Joseph Gleave was the lead architect on the project, carrying out extensive planning and constructional research.

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Vale of Leven Hospital, photographed in 2006 © Copyright wfmillar and licensed for reuse under this Creative Commons Licence

The hospital was to accommodate 150 patients, and comprised eight standard units, built of pre-cast concrete on a modular system. Six of the units housed wards the other two ancillary services.  General medical and surgical wards were provided, together with theatres, radiological department and laboratories, out-patient, casualty department, nurses’ teaching school and pharmacy. The general wards were designed on a standard pattern but adaptable for specialisms such as ENT or eye diseases. It was also designed with adaptability in mind: the original flat-roofed, two storey ward units were intended to allow for the addition of a third storey. [1]

Vale of Leven Hospital, photographed in 2013  © Copyright Barbara Carr and licensed for reuse under this Creative Commons Licence

After the Second World War, although there was a desperate need for new accommodation and to overhaul existing hospital buildings which had suffered from a lack of maintenance during the war, restrictions on capital expenditure meant that it was many years before much new building could take place. The original allocation of funds had to be curtailed in 1949, and then cut almost completely the following year. Thus is 1950 most building work was limited to essential maintenance and to the adaptation of existing buildings, despite the recognition that many of the buildings taken over at the inauguration of the National Health Service fell far short of hospital standards for that time. Limited funding was compounded by scarcity of materials, and a ban on new, non-residential building imposed in November 1951.

Vale of Leven Hospital, photographed in 2006 © Copyright wfmillar and licensed for reuse under this Creative Commons Licence

The Henry Brock Hospital had opened in 1924 on the outskirts of Alexandria in a converted private house, with a large area of open ground to its west – where the new general hospital was eventually built. Beyond the original bequest of £15,000 to establish the cottage hospital, further funds were gifted by Hugh Brock, brother of the founder, who left a legacy of £2,000, and John Somerville, of Camstradden, Luss, Loch Lomondside, who bequeathed a further £1,000 to the hospital in 1929.[2] Dunbartonshire County Council, with Dumbarton and Clydebank Town Councils, had resolved to build a new 150-bed general hospital in the 1930s and were considering possible sites towards the end of 1937.

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Aerial photograph of Vale of Leven Hospital taken in 2015 by RCAHMS

The outbreak of war in 1939 called a halt to most building projects in Britain that were not related to the war effort. When the prospect of war had become apparent, plans were made for the organisation of emergency hospital accommodation. In 1944, as the end of the war was coming into sight, the Department of Health for Scotland commissioned a survey of the existing hospital resources, covering all local authority and voluntary hospitals, and public assistance institutions. Mental hospitals came under the Board of Control which conducted a similar but separate survey. The Scottish Hospitals Survey was published after the war, and many of its recommendations formed the basis of post-war planning. .[3]

The priorities in the early years of the NHS in Scotland were to increase the number of maternity beds and improve staff quarters and radiology departments.  One of the first new maternity blocks built under the NHS was at Seafield Hospital, Buckie, which opened in 1950 providing a much needed additional 14 beds. Plans were also in hand for a new maternity hospital at Hawkhead, Paisley. Out-patients’ clinics and health centres were also some of the earliest new buildings built by the NHS in Scotland. In Dumbarton a new TB clinic and x-ray department were built at the existing Infectious Diseases Hospital. The first health centres were at Sighthill, Edinburgh built in 1951-3, and Stranraer in 1954-5. [4]

Aerial perspective of the proposed new hospital, 1954

Vale of Leven Hospital was built in the face of post-war financial constraints because it formed a part of the Civil Defence Programme, initiated in response to the Cold War. Glasgow was considered likely to be a prime target once again. Plans were made for the potential evacuation of all hospitals in Glasgow and the surrounding area. Existing hospitals could serve as cushion hospitals, but there was nothing available for the area to the north-west of Glasgow. Alexandria was the ideal location.

Aerial photograph of Vale of Leven Hospital from the 1960s. Henry Brock cottage hospital in foreground to the left.

Taking a virtual tour of Vale of Leven Hospital in 2016 via Google street view, some of the outlying parts of the original buildings were in a poor state of repair, particularly around the out-patients’ department. Other areas have been refurbished and modernised, yet retain a sense of their original appearance. Despite its historic and architectural importance the hospital has not been designated as a listed building.

 The Vale Centre for Health and Care, photographed after it opened in 2013 © Copyright Lairich Rig and licensed for reuse under this Creative Commons Licence

Just to the east of the hospital a new health centre opened in 2013, the Vale Centre for Health and Care. It is a two-storey building, containing GP and dental surgeries, child and mental health clinics. Constructed on a steel frame, it has timber and zinc cladding and glass curtain walls. Once Vale of Leven Hospital looked just as sparkling as the new health centre, and might have fared better over the last sixty years had money been spent more consistently on its maintenance. The same could be said of the Finsbury Health Centre, another seminal health care building, designed by Lubetkin and Tecton and built in 1937-8 for the London Borough of Finsbury. There too a lack of funding for a full restoration has left parts of the building in a sorry state.

Finsbury Health Centre, centre block with main entrance photographed in 2014 © Copyright Julian Osley and licensed for reuse under this Creative Commons Licence

Sources

  1. Fiona Sinclair, Scotstyle, p.98: PP, Report of the Department of Health for Scotland… 1951, c.7921, p.32.
  2. Dundee Evening Telegraph, 6 Nov 1929, p.4: Sunday Post, 10 August 1924, p.3: Western Daily Press, 12 June 1924, p.3
  3. 10th Annual Report of the Department of Health for Scotland, 1938 PP Cmd.5969
  4. Miles Glendinning, Ranald MacInnes, Aonghus MacKecknie, A History of Scottish Architecture…, : Alistair G. F. Gibb, Off-site Fabrication Pre-assembly and Modularisation, 1999, p.13: David Stark, Charlies Rennie Mackintosh and Co., 1854 to 2004, 2004