The other day I was searching through boxes of old photographs and came across a bundle of colour negatives which turned out to be photographs that I had taken of the Royal Alexandra back in 1988. It would have been great to have had them when I wrote the blog post on the former Royal Alexandra Infirmary, Paisley back in December 2016, but better late than never! I would be the first to admit that the photos are for the most part pretty terrible, and scanning the negatives may not have improved them. However, I thought it would be worth sharing them in a new post.
The Royal Alexandra Infirmary was built between about 1894 and 1902, to designs by the architect T. G. Abercrombie. Above is a detail of the ends of two of the ward blocks with their semi-circular sun balconies. The square tower to the right housed the WCs and wash-hand basins. These ‘sanitary towers’ were typical adjuncts to the ends of Victorian hospital ward pavilions. Often there were a pair of towers with a simple balcony strung between them – as at St Thomas’s Hospital in London or the Royal Infirmary of Edinburgh’s Lauriston Place buildings (now the Quartermile development).
The photographs above and below show the main east front the infirmary. You can just glimpse the balconies of two more ward pavilions behind on the top photograph, and on the right the circular ward tower. This main range has been converted into private flats, and re-named Alexandra Gate. Back in 1988 the hospital had not long closed. It was replaced by the new Royal Alexandra Hospital, off Craw Road to the south west. That was built roughly on the sites of the former Riccartsbar Hospital and the Craw Road Annexe.
Circular wards are very rare in Britain. There was a brief fashion for them around the turn of the 19th to the 20th centuries. I think the only other one built in Scotland was in Kirkcaldy at the old cottage hospital there – long since demolished. I have an old postcard that shows the hospital which you can find on the Fife page of this site. At the apex of the roof of the ward tower is a lantern or cupola that was part of the ventilation system. They feature along the ridge of the ward pavilions and atop the sanitary towers. It is not uncommon to find this kind of decorative treatment of a functional element, such as the ventilation system, in hospital architecture of the Victorian and Edwardian eras.
I barely remember visiting the site – let alone having managed to get access to the interior, but here are two snaps of the interior of the circular ward. Rather gloomy I’m afraid, but hopefully you get an impression of what it was like.
You can see the rails from which the bed curtains would have been hung. That will have been a post-war addition. Originally the beds would not have had individual curtains. The idea of providing patients with privacy became much more important after the foundation of the National Health Service, when free hospital treatment became available to everyone. Previously charitable hospitals, or voluntary hospitals, such as the Royal Alexandra were designed to provide free treatment for the poor. Wealthy patients were either treated at home, in a private nursing home or a paying patients wing of a voluntary hospital. By the 1920s and 1930s different standards of hospital accommodation for the poor and the well off were common, sometimes even in the same institution.
OS Map from 1967 showing the layout of the infirmary, with the nurses’ home to the north (marked N) and the Lodge on the east (L). National Library of Scotland Maps CC-BY (NLS)
The Nurses’ Home was as grand as the hospital itself, with a rich array of decorative elements. It is Scottish Baronial in style, with turrets and crowstepped gables, although the tall chimneys, dormer windows and this broad arched entrance have some of the sinuous elegance that is typical of Glasgow’s late 19th and early 20th century buildings. This is particularly evident in the sculptural elements, such as the female head on the keystone over the entrance.
Entrance to the Nurses’ Home, photographed in 1988
The Nurses’ Home is one of the survivors on the site, having been converted into flats. It is named after Peter Coats, who had paid for its construction. Coats was one of the brothers that owned the great thread manufacturing company in Paisley; Peter managed the company’s finances. The nurses’ home was built before the hospital itself, and was opened 1896. There is an inscription round the archway which reads ‘They brought unto him sick people and he healed them’, and the two shields are carved with the thistle and the rose. The hospital replaced an earlier infirmary in the town, located near Bridge Street by the river, which had originated with a dispensary for the poor in the late 18th century.
The two images above of nurses’ home show the transformation from abandoned and boarded up building to well-cared for flats. It is particularly good to see that the original small-paned glazing has been either kept or reproduced, and the tall chimneys preserved. .
The former entrance range to the infirmary has been converted for use as a nursery. It originally housed a dispensary and opened in 1902. The gate piers are very striking, the banded stonework picks up on the chunky banded pilasters flanking the gabled bays of the lodge. There is another fine stone gateway that used to lead in to the south of the infirmary site further down Neilston Road, that now gives pedestrian access to the flats that have been built there.
If you explore Google maps on street view for the old infirmary you can tour round most of the buildings, and really get a sense of how those that have not been converted into flats decayed between about 2011 and 2019, and obviously how much more ruinous it has become since the late 1980s.
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.
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.
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.
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]
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.
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.
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.
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]
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]
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.
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]
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]
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.
Montrose, Arbroath and Brechin Review; and Forfar and Kincardineshire advertiser, 13 Feb 1846, p.5
Brechin Advertiser, 14 Sept 1852, p.2: 2 March 1880, p.2
Dundee Courier, 23 Aug 1864, p.4; 12 Dec 1865, p.4; 19 Dec 1866, p.4: Dundee Advertiser, 29 Dec 1864, p.3
Montrose, Arbroath and Brechin review; and Forfar and Kincardineshire advertiser, 19 April 1867, p.4: Dundee Courier, 6 May 1867, p.4
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.6: Dundee Evening Telegraph, 11 Dec 1929, p.10
Brechin Advertiser, 2 March 1880, p.2
Brechin Advertiser, 16 March 1880, p.2
Brechin Advertiser, 16 March 1880, p.3
Dundee Courier, 1 Feb 1893, p.3: Aberdeen Press & Journal, 12 April 1893, p.5; 19 Aug 1896, p.6: Dundee Advertiser, 10 April 1895, p.2; 23 Oct 1896, p.2: Dundee Evening Telegraph, 25 Aug 1897, p.3
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
In 2016 the Royal Hospital for Sick Children was put up for sale, well in advance of its scheduled move to its new home alongside the Royal Infirmary at Little France. When the Sciennes Road buildings are finally vacated it will mark the end of more than 120 years on that site. But the foundation is even older, having started out in 1860 in a house in Lauriston Lane with just eight beds. A Royal charter was granted in 1863 when the hospital moved to nearby Meadowside House. This provided more beds (around 40, although accounts vary) and a separate fever ward for infectious cases. The conversion of the house into a hospital was undertaken by the architect David Macgibbon. A new wing was built in 1870 providing a further 30 beds.
Meadowside House, shown here on the OS large-scale Town Plan of 1876, between the new Royal Infirmary (to the right) and Watson’s College. Reproduced by permission of the National Library of Scotland.
The map above shows the block behind the hospital that housed the hospital laundry and ‘dead house’. In November 1884 there were calls from the Ladies’ Committee to provide a separate mortuary so that the ‘dead house’ need no longer serve as both mortuary and post-mortem room: ‘…not only are the feelings of Mothers and relations shocked by seeing the necessary surroundings when taken to see the bodies of their little ones, but the combination of the two purposes in one room has a hardening effect on the nurses…'[1]
It was found that a coal house might be converted without any great expense. At first the mortuary was intended to be quite plain, but in February 1885 the hospital secretary wrote to the newly established Edinburgh Social Union with a request for it to be decorated. The Social Union was already active in providing decoration for the Fountainbridge Dispensary and the Children’s Shelter in the city. In April Phoebe Traquair was entrusted with the decoration of the mortuary chapel.[2] The tiny space, just 12 feet by 8 feet, was adorned by murals, painted directly on to the plaster. A study for the original scheme is in the National Gallery in Edinburgh.
Just five years later the future of this jewel-box of a mortuary chapel was under threat, when an outbreak of typhoid in 1890 prompted a temporary relocation to Plewlands House at Morningside. The managers then decided that Meadowside House was no longer suitable and a new building was required. They purchased Rill Bank House, then occupied by the Trades Maiden Hospital, and on the site erected the present building in 1892-5 to designs by by George Washington Browne, a leading architect in Edinburgh. Washington Browne also designed other public buildings including the Edinburgh City Library. The old site, being right next to the Royal Infirmary, was readily disposed of to the Infirmary managers who wished to acquire additional land for their planned extensions. Neither the Royal Infirmary nor the Sick Children’s Hospital had any wish to preserve the murals in the mortuary chapel. The fact that they had been painted directly on to the wall surface made their preservation problematic at the very least.
Rill Bank House was purchased as the site for the new Sick Children’s Hospital. Town Plan, OS Map of 1851, Reproduced by permission of the National Library of Scotland
At first it was simply planned to demolish the mortuary chapel along with the rest of Meadowside House. Phoebe Traquair wrote to her nephew in August 1891, angry and distressed at the proposed destruction. She blamed the directors of the hospital ‘the horrid Edinburgh little handful of bigots’, and could not see why the whole structure could not be ‘raised bodily from its foundations’ and moved to a new position.[3] There was enough support for the preservation of the chapel to grant it an initial stay of execution, but it was only once the new hospital was nearing completion, three years later, that Washington Browne managed to negotiate an agreement between the hospital directors and the Social Union to move the murals to the new building. This agreement put the responsibility squarely upon the Social Union to manage and pay for the removal.[4]
‘Royal Hospital for Sick Children (Mr G. Washington Browne).Illustration from The Builder, Jan 1st 1898
The new Sick Children’s Hospital was officially opened by Princess Beatrice on 31 October 1895. It was built of bright red sandstone, with a tall three‑storey and attic central block rising to twin, shaped gables, and an ornate triumphal-arch doorpiece. The style was ‘based upon the English Renaissance’, according to The Scotsman, where the new building was described in detail.[5]
The hospital was designed on a U‑shaped plan with central administration section. The main entrance at the centre gave onto a broad corridor running the length of the building, and which gave access to the ward pavilions at either end. These were of three stories, terminating in balconies between turrets housing the sanitary facilities – sinks, baths and WCs. Each ward had 24 beds, arranged in pairs between the windows, and was a lofty 15ft high, with its own kitchen and services. In addition there was a spare ward on the upper floor of the east wing with 16 beds and a smaller four-bed observation ward, plus two single-bed isolation rooms, on the upper floor of the west wing.
OS Map, Edinburgh Town Plan of 1893. Reproduced by permission of the National Library of Scotland
The administration section contained two lecture theatres, one on the ground floor one on the first, fitted with galleries for students and demonstrating platform tables, lit by large north-facing oriel windows. Rooms were provided for resident doctors, honorary visiting physicians and the matron. There was also a board room, a small museum, dispensary, ophthalmic room, staff dining-room, nurses’ sitting-room, and, on the upper floors bedrooms for the nursing staff. Domestic staff had accommodation in the attics.
Reinstallation of the mortuary chapel murals proved almost impossible, and in the end only fragments were able to be saved. Some that were moved turned out to be too thick to be incorporated in the new chapel, as they included the sawn-through bricks that had been plastered and then painted. Others were more successfully moved, where the painted plaster rested on laths, but were badly cracked and damaged during the move. Phoebe Traquair carried out their restoration, but it became by and large a complete repainting following the underlying design. The new mortuary chapel was also larger, and so the artist painted new decoration to fill the gaps between the relocated panels. [6]
Hopefully, when the hospital moves again, modern technology will enable the murals to be transferred to the new site without losing any of them, and without them sustaining any damage. Hopefully, too, the present managers of the hospital are more keen to preserve them than their forebears were.
After the hospital opened in Sciennes Road in 1892, various additions were made and the hospital slowly expanded into the surrounding houses. In 1903 Washington Browne added an out‑patients’ department in Sylvan Place, and in 1906-9 Muirfield House at Gullane was built as a convalescent home (see separate entry in Lothian).
25-inch OS map surveyed in 1947. Reproduced by permission of the National Library of Scotland
The hospital was extended from 1959 with a new lecture hall and operating theatre designed by Cullen, Lochhead & Brown of Hamilton, a well established firm in hospital design.
For the new hospital, due to open in 2018, the designs were drawn up by HLM Architects. It is of five storeys over a basement with its main entrance opening into an atrium. Beyond are the main hospital, with around 154 beds, and a new department of clinical neurosciences, with a further 67 beds, as well as a small mental health service unit for children and adolescents. There is also to be a family hotel – a free place to stay for families of patients. [7]
References
LHSA, RHSC Minutes, meeting of committee of Management, 6 Nov 1884, quoted in Elizabeth S Cumming, PhD Thesis ‘Phoebe Anna Traquair, HRSA )1852-1936) and her Contribution to Arts and Crafts in Edinburgh’, University of Edinburgh, 1986
Mins of Edinburgh Social Union 17 Feb 1835 – Edinburgh Public Library YHV 250 E235, quoted in E. Cumming Thesis
NLS MS 8122 fols 10,11, quoted in E. Cumming Thesis
LHSA, mins HH 69/1/2, quoted in E. Cumming Thesis 5. The Scotsman, 18 Oct 1892 p.5
E. Cumming, Thesis 7. Edinburgh Evening News, 21 April 2014
Further reading and other sources: Caledonian Mercury, 18 May 1863, p.2: The Builder, 1 Jan. 1898: LHSAStory of the ‘Sick Kids’ Hospital: Guthrie, D Royal Edinburgh Hospital for Sick Children, 1860 – 1960, 1960:see nhslothian.scot.nhs.uk
The future of this fine old building is under threat. It has stood empty for many years and there are fears that it may be demolished, despite its important place in the local history of Grantham and in the wider history of hospital architecture in England.
Postcard of the hospital c.1900
A day of public celebration, parade and partying accompanied the ceremony of laying the foundation stone of Grantham Hospital on 29 October 1874. The band of the Royal South Lincoln Militia lead a procession, followed by the architect and builder, local dignitaries, and interested parties, that marched from Grantham Guildhall to the site of the new hospital on the Manthorpe Road to the north of the town centre.
Countess Brownlow, who was closely associated with the project from its inception, conducted the actual ceremony, once she had listened to an address by the chairman of the building committee, a short service by the Vicar, and been presented with a silver trowel. A public luncheon was given at the Guildhall presided over by Earl Brownlow. Tickets for this event could be purchased for 2s 6d. Earl Brownlow and his wife donated funds towards the hospital and took an interest in the plans, and the Earl of Dysart gave £1,000 to the building fund. [Grantham Journal, 24 Oct 1874, p.4]
Extract from the 25-inch OS map, surveyed in 1885. Reproduced by permission of the National Library of Scotland.
Extract from the 25-inch OS map, revised in 1903. Reproduced by permission of the National Library of Scotland. This shows extensions to the rear of the hospital and an additional block.
Grantham Cottage Hospital was designed by the London architect Richard Adolphus Came (1848-1919), who went on to lay out the development of Woodhall Spa in Lincolnshire where he later settled, designing many of its buildings. He appears in the 1901 census as the proprietor of the Royal Hydro Hotel there. Came freely adapted a basic pavilion plan to create a picturesque elevation. Unusually, the wards were T-shaped, an arrangement which was commended by the great champion of hospital architecture in the late 19th century, Henry C. Burdett. He thought the wards were novel, pleasing and noteworthy, presenting a cheerful and airy appearance ‘which fills the visitor with pleasure’.[H. C. Burdett, Cottage Hospitals, 2nd edition 1880 p.412]
Baroness Brownlow also officiated at the official opening on 5 January 1876. ‘As it now stands approaching completion, the building with its neatly arranged grounds, and trim Gothic porch, forms a somewhat picturesque object’, reported the Grantham Journal.
The hospital, which is Gothic in character, is constructed of local stone with Ancaster dressings, and consists of three distinct blocks of buildings. The main building, which faces the road … is composed of a central block of two stories, providing a waiting-room, entrance lobby, surgeons’ sitting-room and operating-room, kitchen, offices and store-rooms, &c. on the ground floor; convalescent and board rooms, and four bedrooms on the first floor; and two bedrooms and lumber room in attics. There are wings stretching right and left of this block, forming the wards for male and female patients, and containing seven beds each, together with nurses’ room, bathroom, and other offices. The Gothic timber porch, which certainly contributes much to the appearance of the building, has been erected at the expense of the Earl Brownlow. Some distance in the rear of the main building, the fever hospital has been erected, and will contain five beds, bathroom, nurses’ room, kitchen &c., the working of this department being kept entirely separate from the other part of the hospital. A convenient laundry is also provided, with the addition of washing and ironing rooms, drying closet, and other similar accommodation. [Grantham Journal, 8 Jan 1876, p.4]
A major extension to Grantham Hospital was built in the mid-1930s to designs by the local architect F. J. Lenton, of Traylen & Lenton. The plans were approved by the British Hospitals Association, the Ministry of Health and the County Council. It was partly as a result of Kesteven County Council’s obligation to provide hospital accommodation that Grantham Hospital was extended, and the enlarged hospital was to take patients from the county as a whole. This raised the number of beds provided in the hospital from 33 to 76 initially. A new entrance was formed to the south of the original building. New ward blocks ‘of the latest verandah type’ were built for men, women and children. There was also separate provision for private patients, a new isolation block and operating theatre unit.
Architectural perspective of the extensions to Grantham Hospital by F. J. Lenton, architect
Verandah wards with folding windows, usually occupying the length of one side, originated in Denmark, and were introduced to England by Charles Ernest Elcock at the County Hospital, Hertford. Beds were placed parallel to the the side walls in groups of four, separated by glass partitions, instead of the old pattern in Nightingale-style wards where the beds were placed in rows at right-angles to the side walls. Each ward had five groups of four beds and two separate observation wards. The south-facing children’s ward had a paved terrace in front of the folding windows to allow cots to be wheeled out into the open air.
Verandah wards were hailed as revolutionizing hospital planning by providing improved access to fresh air and sunshine, and the psychological effect of smaller groups of beds (‘cosy communities’). It is interesting to note that the local paper praised the hospital for its functional design. ‘Rigid economy’ was observed in order to be able to provide the most up-to-date equipment: ‘In past days Hospitals were so often designed for external effect first and foremost’… ‘present-day designers always have in mind that their building should not be monumental, but sufficient for the present, and of a type that can be readily altered or adapted to the possible requirements of the future. [Grantham Journal, 27 Jan 1934, p.5]
In the new hospital, the private wards occupied a separate unit to the west of the complex which had its own enclosed garden. It had six private wards, with bedrooms for special nurses and separate ward kitchens. A subterranean boiler house was constructed at the edge of the site to provide heating and hot-water, operating on the panel-heating system by low pressure hot water, accelerated by electric pumps. All pipework was concealed in the ceilings. This was supplemented in the wards either with conventional open coal fires or gas fires. The building contractors for the extension were Bernard Pumphrey Ltd of Gainsborough. [Grantham Journal, 22 Sept 1934, p.5]
Extract from the 6-inch OS map, revised in 1938. Reproduced by permission of the National Library of Scotland. This shows the extension to the south of the hospital.
The new buildings were completed early in March 1935, after which the old hospital was refurbished to provide accommodation for the nursing and domestic staffs. At the same time a maternity unit was created in the old south ward wing of and the old theatre converted into a special labour ward. These alterations brought the hospital’s capacity up to 100 beds. [Nottingham Evening Post, 24 March 1936.]
Further additions were made following transfer to the NHS, including a new maternity unit which opened in 1972. Grantham Hospital has retained huge local support, as witnessed by the demonstrations that took place earlier this year to protest against the drastic reduction of the opening hours of the A&E department.
October 1992 brought forth the sixth newsletter from the Cambridge team of the RCHME Hospitals Project. It included short pieces on mortuaries and asylum farms, and accounts of the Victoria Cottage Hospital, Wimborne, Dorset, with thoughts on holiday closures of hospitals. There is also a note on Sleaford’s isolation hospital, a portable hospital with what sounds like a camper van for the nurse. Extra curricular activities at hospitals were discovered too, with money making schemes in a Yorkshire madhouse and an unofficial B&B at Addenbrooke’s Hospital in Cambridge.
Victoria Cottage Hospital, Wimborne
This unremarkable little Dorset hospital has a history written in 1955 by someone hiding behind the initials G. H. W. From this booklet we can extract several amusing bits of hospital history.
First must come the sanitation. In 1887 when the hospital was built there was one earth closet for the patients. This came to light in 1907 when water was installed along with an extra closet. The operating theatre was another horror for it doubled as the bathroom from 1887 until 1904 when a new operating room was built. Even this new theatre did not have an electric light until 1934. Provision of a separate operating theatre did not end the dual use of the bathroom, however. Until 1927 it housed the telephone. In that year the telephone was moved to the matron’s office.
Extract from the 1901 OS map. The cottage hospital is to the north-west of the town, almost on a level with the union workhouse, which is to the north-east. Reproduced by permission of the National Library of Scotland
Until 1924 the hospital closed completely for about a moth every year, for cleaning and repairs. During this time the staff took holidays, and the patients were dismissed. Some were sent to the small 18th-century workhouse in Wimborne, for in 1922 the Guardians sent the hospital a bill for care of patients. We have met this sort of annual closing and cleansing elsewhere, but it seems poorly documented. In 1946 the Passmore Edwards Hospital at Liskeard closed for a moth because that was the only way in which the staff could take a holiday; our source does not say whether this was a regular event. The Royal National Sanatorium at Bournemouth closed in winter, allegedly because the hospital was only intended to provide a summer break for consumptives (and thus for their carers as well). At Northampton the General Infirmary managed cleaning and repairs by simply closing one ward at a time, but as this was a large hospital part-closing was easier than in a small hospital like Wimborne.
Finally, on a frivolous note, when the townsmen were discussing whether to commemorate Victoria’s jubilee by building a hospital or by some other means, one suggestion was ‘erecting a statue of Queen Victoria with a clock on top’. Just how this was to be arranged is not explained.
Sleaford Hospital
The Sleaford Rural District Council bought an isolation hospital in 1901 for the sum of £127. It was ‘an ingenious contrivance’ of numbered wooden sections that could be put together in a few hours, measured 20 feet by 12 feet and could hold up to four patients. A van on wheels provided both accommodation for a nurse and the necessary cooking arrangements. There was also a portable steam disinfector that was reported to be too heavy to be portable. This magnificent hospital was stored at the Sleaford Workhouse, and was erected for the very first time for the benefit of an inquisitive Local Government Board inspector in 1905. It is not known whether it was ever used after that. [The inspector’s report is in Parliamentary Papers, 1907 XXVI, 200-201.]
The East Stow Rural District Council in Suffolk had a ‘small portable hospital’ for smallpox cases in 1913, and presumably this was also a sectional wooden building. [PP 1914 XXXVII, 746] In 1913 Bournemouth Corporation had lent the neighbouring Rural District Council a Doecker Hut for use as an extra hospital ward during an outbreak of enteric fever at Ringwood, another portable structure. [PP 1894 XL, 565 and see Doecker Portable Hospitals]
At least these buildings were of wood. Shortly before 1890 the Gainsborough Rural Council bought a hospital marquee for patients and a bell tent for the nurses. They were aired from time to time, but appear not to have been used. [PP 1894 XL, 565] Perhaps even these tents were better than the converted dog-kennels at Bishop Auckland in 1895. [PP 1896 XXXVII, 704]
Mortuaries
In the course of research for the project a file copy turned up of a Government questionnaire headed ‘Isolation Hospital Accommodation’, and filled in for the Southampton Smallpox Hospital. The printer’s rubric shows that it dates from 1926 and that some 10,000 copies were printed. The answers, together with a crude plan from another source, make a description of this vanished hospital possible, but there is little of interest until the question ‘is there a mortuary at the hospital?’ The answer is simply ‘Cubicles in Observation Hut used for this purpose’. The observation hut was a small building with two single-bed wards and a duty room If one cubicle was occupied by a patient, the psychological effect of comings and goings in the other cubicle can hardly have been good. Perhaps the real significance of this arrangement is that the observation wards of isolation hospitals were probably rarely used, and that there never was a living patient to be disturbed by the arrival and departure of a dead one. It also helps to suggest ways in which hospitals without mortuaries might have functioned.
Extract from the 1934 OS map. Reproduced by permission of the National Library of Scotland
The smallpox hospital was at Millbrook Marsh, an inhospitable looking place even as late as the 1930s, surrounded by mud and marsh. It is interesting to see that development of the estuary was just beginning at this time, to the east is the King George V graving dock under construction. By the 1950s the hospital site had become a boat yard, re-using the existing buildings. A couple remained in the late 1960s, when the area to the north had become a sewage works, which eventually swallowed the remaining former hospital buildings.The huge Prince Charles Container Port was built over the mud flats and saltings.
Extract from the 1897 OS map. Reproduced by permission of the National Library of Scotland
Southampton, in common with other ports, provided a number of isolation hospitals. As well as the smallpox hospital there was another isolation hospital at West Quay.
It is in the usual location, close to the water so that anyone arriving by ship suspected of having contracted an infectious disease could be taken directly to the hospital by boat. The site was later an Out-bathing and Disinfection Station for Infectious Diseases and later still used for a clinic and a mortuary.That was in the post-war era, and by then land reclamation had seen the site removed from the water’s edge. As far as I can make out, the Grand Harbour Hotel seems to occupy the site now.
Asylum Farms
Slowly it is becoming clear that asylum farms were unlike those in the world outside, at least in the South of England. Large barns for storing crops are absent from those seen so far, but piggeries are ubiquitous and any fragments of yards and single storey buildings appear to have been for cattle. Sometimes there are stables and cart sheds, but it is not certain that these were specifically for farm use. Indeed the buildings suggest that attention was concentrated on stock, especially pigs and cattle, and perhaps market gardening, where there was greater scope for farming as occupational therapy. At Digbys, Exeter, there is a tall building which had large opposed loading doors, one opening on to the yard, the other on to a lane outside the hospital grounds. The building is not large enough to hold much, and certainly is not suitable for storing a grain crop. It seems to have been intended for receiving bought-in material, presumably feedstuff for the pigs and cattle.
Digby Hospital, formerly the Exeter Lunatic Asylum. The small farm complex is on the east near to the London & South Western Railway line. The buildings have been converted to housing as part of the re-development of the hospital and its site for housing.
Extract from the 1st Edition OS Map published in 1889. Reproduced by permission of the National Library of Scotland
The advantages of concentration on livestock is that it would provide the asylum with pork, bacon, milk and beef, while a market garden would provide soft fruit and vegetables. All of these are labour-intensive occupations, providing maximum work throughout the year for the relatively large number of patients.
Secondary Employment
John Beal was the proprietor of a private madhouse at Nunkeeling in the Yorkshire Wolds. The financial success of this venture seems out of proportion to the small number of patients and the remoteness of its position. The truth emerged in 1823 when the excise men found 24 casks of tobacco, 25 of tea, and 264 of assorted spirits, mainly gin, concealed about the premises. Perhaps we should pay greater attention to such institutions, in the hope that more than just buildings survive.
Income
Those hospital administrators busy trying to generate income have all failed to exploit one obvious opportunity that was seen as long ago as 1770 by the Matron of Addenbrooke’s Hospital, Cambridge. The town has long had a shortage of short-term accommodation. The matron saw this and let beds to overnight visitors, presumably giving them breakfast as well. On discovering this the Governors dismissed her, partly because she was pocketing the income.
In the Hospitals Investigator number 5 the following list of suppliers of temporary hospital buildings was given: Humphrey’s of Knightsbridge; Boulton and Paul of Norwich; Portable Building Company of Manchester; Hygienic Constructions and Portable Buildings Ltd; Wire Wove Roofing Company of London; G. W. Beattie of Putney; and Kenman and Sons of Dublin. To this list should be added Spiers and Co. of Glasgow, prolific providers of isolation hospitals pretty much throughout Scotland.
A Doecker hospital hut at Netley Hospital during the Boer War, from Wellcome Library, London. Wellcome Images http://wellcomeimages.org V0015643
The Hygienic Constructions and Portable Buildings Ltd were the agents for temporary buildings constructed on the Doecker system invented by Captain Döcker (usually rendered Doecker in English) of the Royal Danish Army. Johann Gerhard Clemens Döcker (1828-1904) first patented his portable building system in 1880. (He filed patents in France and Germany in October 1880, in Denmark and Austria-Hungary in 1881, in Norway, England, Spain, Belgium, and Italy in 1882; in Russia, Sweden and Victoria in 1883; and in New Zealand and the United States in 1884.) The full text of the patent he submitted in the United States can be read online here http://www.google.com/patents/US308833.
Three sheets of drawings provided details of his system:
Sheet 1 from Doecker’s USA patent 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]
‘My improved portable and impermeable structure is composed of a series of light frames which may be made of wood or metal, and for general purposes such frames are polygonal in shape. Each frame a is covered with a sheet of impermeable material, permanently connected therewith in any suitable manner, as by nailing, riveting, or gluing. Two such frames are permanently hinged together by means of any suitable form of hinge, and a pair of such frames constitute a panel.
Sheet 2 from Doecker’s USA patent of 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]
‘The frames are hinged together so as to fold inwardly toward each other, so that their covering will not come in contact when folded. I prefer to cover the frames with strips of felt, which may be rendered water-proof either before or after being attached to the frames, and I prefer the latter method, especially when the felt is attached by means of nails or rivets, for the reason that the points of attachment will then be covered by the waterproofing substance applied, and produce water-proof joints, which would not be the case when the felt is applied after being rendered impermeable. This impermeability may be imparted to the felt by any one of the many waterproofing compositions or water and fire proofing compositions, or by means of oil-paints. I prefer to use felt, owing to its density and non-conductive properties, it being better adapted than any other material to shield the occupants of the structure both from heat and cold.’
Sheet 3 of Doecker’s USA patent of 1884. [Source: United States Patent and Trademark Office, www.uspto.gov]
The term Doecker hospital was sometimes used generally for portable hospital buildings, whether or not they were in fact of Doecker construction. Doecker buildings were largely used on the continent, and in Britain were also used for elementary and open-air schools. There were two types: strong or light. The strong type were intended asa a substitute for permanent brick or stone buildings, while the light were for temporary and/or portable buildings, which could be put up quickly and cheaply.
For both types the buildings were made in sections roughly 3ft x 3ft (a little less than a metre squared). These sections could be fastened together with iron hooks and studs, allowing for de-construction and re-erection on another site. The strong type comprised timber frames weather-boarded on the outer side and covered on the inside with a composition called ‘Doecker material’ – a non-inflammable, water- and acid-proof. These two layers provided a cavity that was filled with insulating material, though the walls were only 4 1/2 inches thick (about 11 cm). The roof was covered with a flexible and water-proof material (‘ruberoyd’).
The light construction had a lighter frame covered on both sides by Doecker material. The whole building was made in sections, and the packing formed the floor ‘thus saving weight, space, and freight in transit’. No foundations were required, the building sat on adjustable wooden feet. Constructed these light buildings measured 50ft x 16ft (15.24m x 4.8m) and could be erected in one day by unskilled labour. Their insulation properties were commended: ‘Portable hospitals of this construction were used by the German Red Cross Society during the cold of a Manchurian winter in the Russo-Japanese war, and they have also been used in the tropical heat of South-West Africa’.
An image from 1900 of Doecker hospital huts, Wellcome Library, London. Wellcome Images http://wellcomeimages.org V0015642
Doecker system hospital buildings, along with other prefabricated buildings, featured in H. Franklin Parson’s book Isolation Hospitals, originally published in 1914 and revised in 1922 by R. Bruce Low.
This hospital pavilion, with is sun-catching angled wards, was a type provided by the Hygienic Constructions and Portable Buildings Ltd, Stockholm Road, South Bermondsey.
The 1922 second edition formed part of a series of books on public health and hygiene (the Cambridge Public Health series) designed to advise those working for the government and the medical profession. It addressed the way in which infectious diseases were contained and treated, and defended the government’s decision to spend a significant amount of money on isolation hospitals. Parsons and Low discussed the most advantageous designs and locations for these institutions, the containment of diseases such as small pox and tuberculosis, and the issues that arose around both the staffing of isolation hospitals and the changing provisions made for those patients affected by severe poverty.
August 1992 saw the production of newsletter number five from the RCHME Cambridge office. There are snippets here about sanitary facilities – water closets and baths – and and more on temporary buildings. There are also useful indexes to information in the Parliamentary Papers, with reports on English provincial workhouse infirmaries by Edward Smith from 1867, and the enormously useful survey of hospitals in the United Kingdom carried out by Bristowe and Holmes in 1863.
Hereford Workhouse
In 1866 an inspector from the Poor Law Board visited the Hereford Union Workhouse in order to report on the infirmary. He found that the building was being greatly enlarged, and that two new wards were being built over the dining room. There was only one water closet on each side of the main building, at first floor level, but there were some other water closets in the yards that contained water aden were flushed twice or three times a week. The dry wording leaves one in doubt about the presence of water in the closets on the first floor. The rest hardly bears thinking about.
The previous insalubrious snippet came from the Report (to the Poor Law Board) of Dr Edward Smith, 15 April 1867, on 48 Provincial Workhouse Infirmaries. It is published in Parliamentary Papers 1867-8 LX, pp 325 onwards. In these reports Dr Smith examined critically the provision for the sick, and gave a table for each workhouse examined, listing for each ward the dimensions, position of windows, number of beds and fireplaces, and present function. The only plan published is a block plan of Birmingham workhouse. {This was being demolished at the time the newsletter was written, in the summer of 1992.} One of the things that emerges from this report is that by 1866 rooms in workhouses were often used in a very different way from what was originally intended. Using the pagination of the original report rather than the imposed pagination of volume LX, the 48 workhouses are as follows:
The Portsea Island Union Workhouse Infirmary at Portsmouth was built in 1842 and extended in 1860 by an additional storey. {This later became St Mary’s General Hospital} Unfortunately we did not manage to get inside this derelict building, but we do know something of its internal arrangement. The wards on all three floors were on the South side of the range, and there was a corridor along the North side. The wards had windows on the external wall and also into the corridor (part of alterations of 1860), thereby providing cross-ventilation of an indirect kind; the corridor also had windows on the external wall. The internal windows had shutters, but we are not sure of the details. The Poor Law Board inspector in 1866 was not over-critical of this arrangement, for cross-ventilaiton was still a new hobby-horse for hospital reformers. A comparable arrangement of parallel wards with a common wall pierced by windows appears at the London Fever Hospital of 1848 and in the new Halford Wing of the Devon and Exeter Hospital built in 1854.
The acceptability of this internal ventilation provides a background to the roughly contemporary alterations at the Military Hospital at Devonport. This hospital was built as a series of pavilions in 1797, each floor of each pavilion consisting of two wards side by side separated by a corridor containing a staircase. The hospital was criticised in the 1861 report on military hospitals, and was subsequently altered. The stairs were removed and windows inserted in the walls between the corridor and the wards. Presumably there are a few other hospitals with wards ventilated through corridors, but they are unlikely to date from after the 1860s.
Bristowe & Holmes
Appendix 15 of the 6th Report of the Medical Officer of the Privy Council for 1863 is titled Report by Dr John Syer Bristowe and Mr Timothy Holmes on the Hospitals of the United Kingdom. This report records the reactions of the authors to visits paid by one or both of them to what they believed to be all of the major hospitals in the Kingdom; it has a supplement of brief critical descriptions of 81 hospitals in England, and some sort of plan is published for 25 of them. The Report is Parliamentary Papers 1864 vol. XXVIII; Bristowe and Holmes’ appendix begins on p.467 as renumbered for the Blue Books (463 of the original pagination), and the supplement begins on p.575 (571 original pagination). The following list uses the titles for the descriptions of the hospitals, and the amended pagination. English hospitals were divided into metropolitan, provincial and rural; Scotland and Ireland were dealt with on pages 692 to 726.
ENGLAND Metropolitan Hospitals 575 St Bartholomew’s Hospital, plan of block C 577 The Charing Cross Hospital, plan of front range 579 St George’s Hospital, plan of 1st floor 582 Guy’s Hospital 585 King’s College Hospital, plan of 1st floor 589 London Hospital 591 St Mary’s Hospital, plan of ground floor 594 Middlesex Hospital 596 St Thomas’s Hospital, plans of North Wing and first floor 599 University College Hospital 600 Westminster Hospital, plan of second floor 602 Royal Free Hospital
English Provincial Hospitals 605 Birmingham General Hospital 607 Birmingham Queen’s Hospital 608 Bristol General Hospital, plan of second floor 610 Bristol Royal Infirmary, plan of 1st floor 611 Hull General Infirmary 613 Leeds General Infirmary, plan of G floor 616 Liverpool Southern Hospital 619 Liverpool Northern Hospital 621 Manchester Royal Infirmary, plan of 1st floor 623 Newcastle Royal Infirmary 624 Sheffield Infirmary, plan of attic storey
English Rural Hospitals 626 Barnstaple Infirmary 626 Bath United Hospital 628 Bedford Infirmary 629 Bradford Infirmary 630 Sussex County Hospital {Brighton} 632 Suffolk General Hospital at Bury St Edmunds, plan of ground floor of old hospital and new hospital 634 Addenbrooke’s Hospital at Cambridge, plan of ground floor 636 Kent and Canterbury Hospital, plan of ground floor 638 Cumberland Infirmary, Carlisle, plan of ground floor 640 St Bartholomew’s Hospital, Chatham, outline plan of ward 641 Cheltenham Hospital 642 Chester Infirmary 643 Chichester Infirmary 644 Essex and Colchester General Hospital 646 Derbyshire General Infirmary, plan of attic {first} floor, fever house 648 Devonport Hospital {Royal Albert} 649 Dover Hospital 649 Devon and Exeter Hospital 652 Gloucester Infirmary 653 Hereford Infirmary 655 Huddersfield Infirmary 656 Ipswich and East Suffolk Hospital 657 Lancaster House of Recovery 659 Leicester Infirmary and Fever House, plan of ground floor 661 Lincoln Hospital 662 West Kent General Hospital, Maidstone 663 Northampton Hospital 664 Norfolk and Norwich Hospital, ground floor plan 667 Nottingham General Hospital 669 Radcliffe Infirmary at Oxford, plan of ground floor 672 South Devon Hospital, Plymouth 674 Royal Portsmouth, Portsea and Gosport Hospital 675 Berkshire County Hospital at Reading, plan of 1st floor 677 Salisbury Infirmary 678 Salop Infirmary 680 Royal South Hants Infirmary, Southampton 681 Stafford General Infirmary 682 Taunton and Somerset Hospital 684 Whitehaven Hospital 685 Hants County Hospital, Winchester, plan of ground floor 688 South Staffordshire General Hospital, Wolverhampton 689 Worcester Infirmary, plan of ground floor 691 York County Hospital
Special Hospitals 726 Hospital for Sick Children in Great Ormond Street 728 Dreadnought Hospital Ship 729 Haslar hospital, block plan 731 Royal Victoria Hospital, Netley 731 Hospital for consumption and Diseases of the Chest {Brompton} 732 London Fever Hospital, plan of ground floor 737 Newcastle Fever Hospital 737 Small Pox Hospital {Highgate Hill} 739 York Road Lying-in Hospital {London} 740 Liverpool Lying-in Hospital 740 Margate Sea-Bathing Infirmary 741 Southport Convalescent Hospital
More Baths
The Hospitals Investigator No.4 drew attention to how many lunatics it was possible to get into one change of bath water. It now emerges that lunatics were not the only victims of this economy. At the Royal Berkshire Hospital at Reading in 1870 they managed to wash, if that is the correct word, at least eight patients in one change of water. The full number is not known, because it was only the eighth patient who complained. The reason appears to be that it took ten minutes to fill the bath and another ten minutes to empty it again, and the hospital porter did not have time to do this.
Several firms are now known to have provided wood and iron hospital buildings, especially in the early years of he twentieth century, although their hospitals and chalets are hard to find or identify. So far the list includes the following:
Humphrey’s of Knightsbridge, (a catalogue of 1900 was located by the York office team). Several of their hospitals survive. Boulton and Paul of Norwich, who were still in business (in 1992) selling garden shelters that are almost indistinguishable from sanatorium chalets. Early chalets have been found as far away as Plymouth. {The company was taken over in 1997} Portable Building Company of Manchester, who provided a sanatorium for the Nottingham Association for the Prevention of Tuberculosis in about 1900. Hygienic Constructions and Portable Buildings Ltd. who supplied the Homerton College Sanatorium in 1913. This weatherboarded building still (1992) stands. Wire Wove Roofing Company of London made tuberculosis chalets. G. W. Beattie of Putney advertised their New Venetian Shelter, for tuberculous patients, in 1913. Kenman and Sons of Dublin, who sold tuberculosis chalets in 1913.
Not a hospital, but a temporary building that reflected the popularity of open-air living, this is taken from the rather wonderful Broadland memories blog
We visited the former Atkinson Morley Hospital in 1992 as part of the RCHME Hospitals Project. It was then still functioning as an acute hospital, specialising in brain surgery. The hospital closed in 2003 and remained empty and decaying for more than ten years. It is currently being converted into apartments by Berkeley Homes. It was designed as a convalescent home in conjunction with St George’s Hospital, Westminster, and was built in 1867 with generous funds left by Atkinson Morley, for the purpose of ‘receiving and maintaining and generally assisting the convalescent poor patients from St George’s Hospital’ in Westminster (Kelly, 1887). Atkinson Morley, the proprietor of the Burlington Hotel in Cork Street, Burlington Gardens, London, died in 1858 a wealthy man. He left a number of bequests to his relatives and friends and also for charitable purposes. These included the establishment of surgical scholarships at University College, a fund for the widows of tradesmen from St James’s parish in Westminster, and gifts of £1,000 each to Queen Charlotte’s Lying-in Hospital, the Lock Hospital, St Mary’s Hospital at Paddington, and the Royal Sea-Bathing Infirmary at Margate.
South side of the Atkinson Morley Hospital, photographed in November 1992 (c) H. Richardson
In the terms of Morley’s will, the residue of his property was to be allowed to accumulate for five years before being applied to the building of the hospital. The foundation stone was laid on 25 July 1867, and the hospital was opened on July 14 1869, the anniversary of Morley’s death. There was not the usual elaborate ceremony on the occasion, as the governors of St George’s Hospital, who acted as the trustees of Morley’s bequest, felt that it would be inappropriate to spend any of the new hospital’s funds on such an event. It is unclear which architect should be credited with the design of the hospital. Edward and John Kelly seem to have been acting as architects to the hospital from 1866-7 and John Crawley took over in 1867-70.
Second Edition OS Map 1899 (Reproduced by permission of the National Library of Scotland )
The hospital was built on Copse Hill, on a site which sloped gently to the south. Built of stock brick, with black and white brick string courses and white brick window heads, it was of two storeys and basement and was designed on a T-shaped plan.
Floor plan of Atkinson Morley Convalescent Home from H. C. Burdett’s Hospital and Asylums of the World, 1893. This shows the basement plan of the north block (at the bottom of the plan) which, because of the sloping site, was the ground floor of the main south block (at the top of the plan)
This shows the ground/first floor plan. The wards are of the Nightingale type, although later convalescent homes often departed from the pavilion plan for something more homely, as the patients were no longer ill, and many were ambulant, and so pleasant grounds were also an important feature.
The first/second floor plan.
The main entrance and administration offices were on the north side, linked to the patients’ wing by the kitchens in the basement and the chapel above. The patients’ wing, which formed the cross-bar of the T, had a long south elevation. The basement here was in fact at ground level, due to the slope of the ground.
Entrance to the Atkinson Morley, photographed in November 1992. (c) H. Richardson
A portico, since removed, sheltered the main entrance which led into a square hall with the committee room on one side and a sitting-room for the resident medical officer on the other. Two corridors extended to the south, on either side of the chapel, which gave access to the patients’ wing, with the men’s accommodation on the east side and the women’s on the west. The chapel rose up through two storeys and was lit by arched windows with geometrically patterned glazing. There was a gallery at the south end, the altar being placed at the north end. The kitchen in the basement had nothing above it so that it could be provided with a large sky-light. Directly below the chapel were the stores, larders and scullery.
The central room on the south front, with a canted bay window, was Matron’s sitting room. To either side of this was a linen room and the Matron’s bedroom. On the exterior these central three bays were slightly advanced and rose up to an additional storey with a steep pitched roof ornamented by decorative iron brattishing. To either side of this central section were four bays standing slightly advanced from the outer wings. On the ground floor this area was occupied by children’s wards, and in the single bay between this and the outer ward wings, there was a small ward containing one bed. Below the children’s wards were dining-rooms for the patients, and in the centre a dining-room and day-room for the nurses. On the first floor there were staff bedrooms over the children’s wards and the bay-windowed room was a spare bedroom.
The outer wings, lit by five tall and narrow windows on each long side, contained wards on the ground and first floors and large day-rooms in the raised basement. The wards were furnished with between 15 and 22 beds and had a fireplace or stove in the centre. The sanitary towers were on the north side, as were the stairs.
The hospital was modernized, probably under the direction of Adams, Holden and Pearson, in 1931 (Allibone, F, Catalogue of Adams, Holden and Pearson drawings, RIBA). In the early 1940s the hospital began to take head injury cases to relieve the accommodation at St George’s. After its transfer to the NHS in 1948 it developed further as an acute hospital. The buildings suffered from the usual rag bag of additions, largely obscuring the original south elevation.
Architects John Thompson & Partners (JTP) were appointed by Berkeley Homes (Urban Renaissance) to work on the redevelopment of the Atkinson Morley Hospital in Wimbledon, London. Part of the site is designated Metropolitan Open Land. The site was previously owned by Laguna Quays until April 2010 when it was purchased by Berkeley Homes.
The present Royal Infirmary of Edinburgh was built in 1996-2002 as a PFI project, to designs by Keppie Design of Glasgow on a large green-field site south-east of the city, close to the A7 at Little France, by Craigmillar Castle, in a large area of open countryside. If you follow the A7 northwards, and cross over the A701, you reach its predecessor on the north side of the Meadows, fronting Lauriston Place.
Main entrance from Lauriston Place, taken in 1999 (c) Diane King, from the Public Monuments and Sculpture Association collection, RCAHMS
Architectural perspective showing the north elevation of the infirmary fronting Lauriston Place, from RCAHMS
At the end of May 2004 The Scotsman reported that demolition work had begun on the old Edinburgh Royal Infirmary complex in Lauriston Place to make way for the £400m development. Contractors moved on to the site earlier that week to begin knocking down the Florence Nightingale nurse home, the boiler house and the dermatology ward (known as The Skins). The original developer was Southside Capital, which bought the site from Lothian University Hospitals Trust in 2001, and comprised a consortium with the Bank of Scotland, Taylor Woodrow and the Kilmartin Property Group. Planning permission was granted in December 2003, ‘after a battle with heritage watchdogs’, which included formal objections by Historic Scotland. By 2009 the development was being undertaken by a joint venture of Gladedale Capital and the Bank of Scotland.
This aerial photograph was taken in 2007 and shows the empty space where the Simpson Memorial Maternity pavilion and the nurses home formerly stood on the right, from RCAHMS
Quartermile is a mixed development, combining residential and commercial premises over the 19-acre site. The design team was headed by Foster + Partners as the masterplanners and Architects working with Richard Murphy Architects; Hurd Rolland Architects; CDA – Architects and EDAW – Landscape Architects.
Edinburgh Royal Infirmary in the snow, from the Meadows in the late 1980s. (photograph (c) Harriet Richardson)
After years of adapting itself to the needs of modern medicine, and having enjoyed decades of Crown immunity which enabled additions to be made to the buildings without deference to the usual planning procedures, the Infirmary was a bit of a mess. All these accretions have been cleared away and the ranks of ward pavilions are as imposing and uncluttered as the day they were first completed. But much more than just the clutter of late twentieth century lift towers and sundry infill buildings have been removed, other casualties include the listed Simpson’s Memorial Maternity Pavilion, the Queen Mary Nursing Home and the George Watson’s wing of the Surgical Hospital.
The same view, pretty much, taken in April 2015. (Photograph (c) Harriet Richardson)
Walking round the site in April this year (2015), there are positive aspects to the works that have been done. Clearing away the accretions around the ward pavilions allows them to be appreciated, with open balconies once more, where residents can sit out and take the air, and communal gardens laid out between the pavilions. The unity of style of the new glass curtain-walled buildings acts as a foil or counter-balance to the stone-built Victorian hospital blocks, retaining the Simpson Pavilion might have interrupted Foster’s flow, but as it was on the edge of the site it could have provided an impressive termination, and provided a gentler transition between the new development and the tenements beyond.
Perhaps the most surprising loss is the eighteenth-century William Adam school building, George Watson’s Hospital, that had been retained by Bryce and about which he had designed his large infirmary complex.
Plans and elevation of George Watson’s Hospital, William Adam, from RCAHMS
It was not demolished without comment or protest. Even after the protests had failed to keep the building on the site, James Simpson made a plea for the building to be taken down stone by stone so that it might be rebuilt at some distant time.
The heart of the site today, a cavernous view between grey-glass curtain walls to the back end of the old infirmary admin block, with the clock tower rising beyond. (photograph (c) Harriet Richardson)
The OS map of 1882 shows what was then the recently completed Royal Infirmary on that site designed by David Bryce and built between 1870 and 1879.
Extract from 2nd Edition OS Map reproduced by permission of National Library of Scotland
It was one of the first in Scotland to adopt the pavilion plan, widely adopted for new hospital buildings from the 1860s. Though it was pipped to the post by the Western Infirmary in Glasgow by John Burnet senior, designed in 1867 and built in 1871-4, Edinburgh’s infirmary was far bigger. The Western Infirmary in Glasgow was hampered by a lack of funds, which both delayed building work and reduced the scale of the project, so that it could only provide 150 beds at first. The new Royal Infirmary in Edinburgh had 600 beds, placed in eight 3-storey ward pavilions, with one large ward per floor.
This aerial perspective of the infirmary, from RCAHMS, makes an interesting comparison with the map of 1882 as it makes the hospital look as if it is almost in the middle of the countryside. It is apparently surrounded on all sides by green space, which of course was not actually the case.
This early photograph from across the Meadows, with its artfullyposed sheep, similarly evokes the image of the hospital set in a rural idyl, from RCAHMS
At the heart of the new hospital, Bryce incorporated a part of William Adam’s school building, George Watson’s Hospital, built in 1738 the same year that the previous royal infirmary building was begun to Adam’s designs. It is easily identified on the ground plan below at the centre, being the range that is slightly askew in relation to the alignment of the rest of the buildings. It was adapted to house some of the administrative offices and the hospital chapel. To its north and south the ward pavilions were disported, linked by single-storey corridors, with surgical wards to the north facing Lauriston Place, and the medical section on the south side. What the pavilion plan enabled were the primary requirements of separation and classification. Each ward was a self-contained unit, its occupants having no connection with any other ward, and thus hopefully preventing the spread of infection.
Plan of Royal Infirmary, Edinburgh, Wellcome Library, London (L0011802). Engraving from H. C. Burdett, Hospitals and asylums of the world, 1893
The ward itself featured windows placed opposite each other to promote the all important cross-ventilation, there were single rooms at the corridor end, which could be fitted up for a patient, the supervising nurse, a ward kitchen and sluice room.
This photograph shows the interior of one of the top-floor wards, taken during the First World War, c.1917, from RCAHMS
The turrets at the opposite end were to contain water-closets and a bath. These sanitary towers evolved over the second half of the nineteenth century to become ever more separate from the ward itself, with the introduction of a small lobby, again, cross-ventilated, between ward and water-closet. Often a balcony was strung between the towers, offering a small space to sit out for ambulant patients.
One of the southern, medical ward pavilions photographed in 2015 after conversion to private flats. (photograph (c) Harriet Richardson)
Each pavilion could serve a different classification of patient. As mentioned, here Bryce located the surgical cases to the northern pavilions and the medical cases to the south, further classification allowed men and women to be separated, but the possibilities were endless. It was this adaptability of the plan which made it ubiquitous for almost all types of hospital for decades: in hospitals for infectious diseases the separation was made more complete between the pavilions by omitting the connecting corridors.
Elevation drawing of 1872 showing the southern medical ward pavilions connected by an arcaded link corridor, from RCAHMS
Despite the apparent vastness of the new Infirmary it was not long before additions and alterations were necessary. Sydney Mitchell & Wilson added a nurses’ home in 1890, the laundry in 1896, and the Diamond Jubilee Pavilion in 1897. In 1900 they designed two new pavilions for ear, nose and throat and ophthalmic patients.
Drawing of 1896 for additions to the infirmary, this was the Jubilee pavilion and has been retained. It sits alongside the southern ward pavilions on the west side, from RCAHMS
The photograph above is of Sydney Mitchell’s Nurses Home of 1890, fondly known as the Red Home. A courtyard plan, offered an internal garden where the nursing staff could escape for some peace and quiet. It was originally intended to retain this handsome building, but the developers were given permission to demolish. It was argued that the building did not make a positive contribution to the local townscape, as its design, scale and form were out of keeping with neighbouring buildings, including the retained listed buildings. It was also considered to be ‘not a particularly good example of a building by Sydney Mitchell’, the neighbouring Ear, Nose and Throat pavilion being thought ‘a much better example’. More credibly it was claimed that it was not commercially viable to convert it. Demolition was permitted on the grounds that what would replace it would be of high quality and create a local public space at the heart of the site.
This is what replaced the Red Home, photographed in February 2015. ( ‘Lines’ by Byronv2 is licensed under CC-BY-NC 2.0)
The major addition of the twentieth century was the Simpson Memorial Maternity Pavilion constructed in 1935 to designs by Thomas W. Turnbull, with James Miller acting as consultant. An imposing steel framed building faced with concrete, as was the Florence Nightingale Nurses’ Home which was built at the same time. The Pavilion was officially opened on 1 March 1939.
The Simpson Memorial Maternity pavilion, photographed around 1940, viewed from the Meadows. Classically elegant, and a sad loss, from RCAHMS
The monumental nurses’ home built to the rear of the maternity wing, photographed around the time that building work was completed in 1939, from RCAHMS
The Simpson Memorial had its origins in the Edinburgh Lying‑in Hospital which opened in Park Place in November 1793. This was financed by Professor Hamilton and then by his son, James, until his death in 1839. It moved in 1843 and occupied five further sites before becoming the Edinburgh Royal Maternity and Simpson Memorial Hospital, in commemoration of the achievements in obstetrics of Sir James Young Simpson who died in 1870. The resultant building, designed by D. Macgibbon & T. Ross, opened in May 1879 and later became the School of Radiology, at No.79 Lauriston Place. The first ante‑natal clinic in Britain was opened there in 1915 as a result of the work of James Haig Ferguson. After the First World War buildings in Lauriston Park and Graham Street were acquired to try to combat overcrowding but this was not satisfactorily overcome until the new Pavilion was provided in the 1930s.
Aerial view of Claybury, undated. (posted on flickr by Jeroen Komen and licensed under CC BY-SA 2.0)
Repton Park at Woodford Bridge in Essex is a large housing estate that has been created on the site of the former Claybury Hospital, using many of the former hospital buildings and keeping the new buildings to a minimum, so as to retain the open southern aspect and the original south elevation of the main hospital complex. (The aerial photograph above shows the western half as it appears in 2015 on Bing.com) The hospital closed in 1997 and it was originally intended to build much denser housing on the site.
Claybury Hospital was recorded as part of the RCHME’s Hospitals project and was visited in August 1991 by three of the project team (myself included) together with our photographer, Derek Kendall, and a student who worked with us over the summer.
Claybury was built as the fourth County Pauper Lunatic Asylum for Middlesex. It was designed on an échelon plan by G. T. Hine in 1888 and built in 1889-93. The site included the modest country house, Claybury Hall, of c.1790, which was retained and extended for private patients. It was an extensive complex of largely two- and three-storey asylum buildings linked by single-storey enclosed corridors, constructed of red brick with terracotta ornament, dominated by the central water tower.
This view of Claybury Hall was photographed by Lil Shepherd in September 2010 and is licensed under CC BY 2.0 There is a painting of the house in the Government Art Collection painted c.1800 by Abraham Pether
A competition was held for the design in 1887 and Hine was selected from among seven specially invited architects. A notable and prolific designer of asylums, he had been responsible for planning the borough asylum for his native Nottingham (1877). It was following his success in the Claybury competition that Hine moved to London and subsequently was appointed consulting architect to the Commissioners in Lunacy for England. [The Builder, 5 May 1916, 331]
Claybury Asylum, ground floor plan from H. C. Burdett, Hospitals and asylums of the world, 1891 image ref: L0023315
In 1888 the plans for the Asylum were approved by the Lunacy Commissioners and in June 1890 the memorial stone was laid over the principal entrance of the administration block by Lord Rosebery, the first Chairman of the London County Council (LCC). The asylum was formally opened on 17 June 1893.
Claybury Asylum, first-floor plan from H. C. Burdett, Hospitals and asylums of the world, 1891 image ref: L0023316
Whilst Claybury had been begun as the fourth County Pauper Lunatic Asylum for Middlesex, it was opened as the 5th LCC Pauper Lunatic Asylum, following the Local Government Act of 1888 and the inauguration of the LCC. The LCC took over Hanwell, Colney Hatch and Banstead Asylums from Middlesex, and Cane Hill from Surrey. In June 1889 the Asylums committee was authorised to provide a fifth asylum for London by completing Claybury and a new building contract was drawn up in the following October. The building contractor under the LCC was E. Gabbutt of Liverpool. George Wise, who had been appointed Clerk of Works by the Middlesex Justices, was retained, as was Hine. A tramway was constructed to link up with the Great Eastern Railway for transporting building materials. In 1891 Hine was obliged to modify his plans following a decision to install electric lighting. This involved providing three additional boilers.
OS Map 1914 revision reproduced by permission of the National Library of Scotland
The site had been selected by the Middlesex Justices in 1886. It comprised the house and estate of Claybury Hall. The mansion of c.1790 was probably designed by Jesse Gibson (c.1748-1828), the District Surveyor of the eastern division of the City of London. [Essex Review, xxxvii, pp.99-108, cited in H. Colvin, Biographical Dictionary of British Architects, 1978] The house was a relatively modest two-storey building. The principal façade, facing south, was symmetrical with a central bow flanked by two outer bays, slightly advanced and contained beneath a shallow pediment. The bow at ground floor level was further defined by a semi-circular portico with coupled columns. The grounds extended to 269 acres and were landscaped by Repton. Burdett gave a description of the site, although at the time of writing the asylum buildings had not yet been completed.
Claybury Hall in 1991 (photograph (c) Colin Thom)
‘Part of the land is charmingly wooded, affording shaded walks for the patients. No better site could be found for such a building, and although only 1½ miles from Woodford Station, and 6½ miles from Tower Hamlets, from which district it is expected most of the patients will be sent, the asylum will be perfectly secluded, and comprise in its own grounds all the beauties of an English rural district’. [H. C. Burdett Hospitals and Asylums of the World, 1893, vol.iv, p.345).
The asylum was placed on the summit of the hill rising to the north of the mansion house. The hill was levelled to provide a plateau of 12 acres giving a largely uniform ground-floor level from which some of the outer main corridors sloped to the outside blocks. Hine emphasized the importance of a flat site arguing that the additional cost was justified compared with ‘the perpetual inconvenience and extra cost of working a building filled with feeble, irresponsible patients, which has numerous steps on the ground-floor, up and down which food trolleys as well as patients have constantly to be conveyed’. [G.T. Hine ‘Asylums and Asylum Planning’ in Journal of the Royal Institute of British Architects, 23 Feb. 1901, p.16]
Claybury was designed on an échelon plan. This was a development from the pavilion-plan asylum which comprised a sequence of pavilions or blocks, each designated for a different class of patient. Each pavilion contained a combination of wards, single rooms and day rooms, together with provision for staff and sanitary arrangements. The pavilions were generally linked by single storey corridors, either enclosed or as covered ways. The échelon plan differed from the pavilion plan only in its general layout, which, as the term suggests, consisted of pavilions arranged in an arrow head or échelon formation. This allowed Hine to provide all the patient blocks with day-rooms that had a southern aspect and uninterrupted views.
At the heart of the asylum was the recreation hall. It was particularly finely ornamented, was 120 feet long, 60 feet wide, and 40 feet high, and was capable of seating 1,200 people. At one end there was a gallery supported on iron columns and at the other the stage, with an elaborate proscenium arch in Jacobethan style, topped by a bust of Shakespeare. The high quality of decoration in the hall was integral to the philosophy of asylum planning and design at this date, as The Builder noted:
‘The modern treatment of lunacy demands also more provision for the embellishment of the asylum than is to be found in the barrack like interiors of our older institutions. Hence the interior of Claybury Asylum is almost palatial in its finishings, its pitch-pine joinery, marble and tile chimney pieces, and glazed brick dados, so much so that some of the visitors rather flippantly expressed a desire to become inmates. The recreation hall, for example, is lavishly decorated with an elliptical ceiling, richly ornamented with Jackson’s fibrous plaster work, while the walls are panelled in polished oak, and the floors are to be finished in a similar manner.’ [The Builder, 30 July 1892, p.88]
The interior of the recreation hall in 1991 (photographs (c) Colin Thom)
It is notable, however, that the majority of the fine interior work was reserved for the more public areas, such as the recreation hall, the chapel and the administration block.
This photograph of one of the dormitories was taken around 1893 and shows a spartan interior, with the beds closely spaced. Note the fireproof construction of the ceiling. Photograph by the London &County Photographic Co. (c)Wellcome Library, London. Wellcome Images ref: L0027370
Above is one of a series of photographs from the Wellcome Library which look to have been taken when the asylum was newly completed. It shows a large dormitory of the type provided for chronic cases. Acute cases were housed in small wards with a large allowance of single rooms.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027373
This view of a dining hall, presumably for patients rather than staff, although it is not so easy to tell as some of the decorative elements, such as wallpaper, curtains, potted plants, pictures on the walls, a hearth rug and the bird cage might seem a little luxurious for a pauper institution. However, homeliness and comfortable surroundings were recognised as important factors in treating mental illness. There is an almost identical photograph in Historic England Archives collection taken in 1895 by Bedford Lemere.
Photograph by the London & County Photographic Co. (c)Wellcome Library, London. Wellcome Images ref: L0027374
The photograph above is labelled as showing a ‘social room’. Wallpaper, pictures, rugs, and potted plants are all in evidence again along with the piano, and the shawls draped over the backs of the chairs might suggest that the patients have just stood up and moved out of view. The ceiling has the same fireproof vaulting seen in the previous photograph. It creates a slightly less institutional feel to the room than the exposed iron beams in the dining hall.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027372
The caption for these two photographs (above and below) suggest they might have been a day rooms for the nurses. The one below looks more like a staff room perhaps, particularly with the stained glass in the end window.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027371
The snap above was taken in 1991, and shows similar stained glass, with the coats or arms of the local borough councils. It was in the administration block, in the main stair window. This block also contained the board and committee rooms and offices for staff as well as sitting and bedrooms for three assistant medical officers. The corridors were floored with mosaic tiling, and a faience panel marked the entrance to the board room, which had oak-panelled walls and an enriched plaster ceiling. Amongst the collection of photographs at the Wellcome Library are views of the service areas, the laundry and kitchens etc. These blocks, to the north of the water tower, have all been demolished, along with the blocks for the attendants and nurses which originally flanked the recreation hall.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027368
This shows the linen room, and below is the ironing room. The work was strictly segregated for men and women. At this date patients would have assisted with many of the duties involved in the daily running of the asylum.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027377
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027369
While the women washed and ironed, the men worked in the kitchens. I think this might be my favourite of the photographs of the working side of the hospital. Except perhaps this last one. These must be some of the senior staff, I think, though they are not identified and look very young.
Photograph by the London & County Photographic Co. (c) Wellcome Library, London. Wellcome Images ref: L0027376
Historic Hospitals 
