The Hospitals Investigator 9

In December 1992 Robert Taylor circulated the ninth edition of his newsletter amongst his colleagues working on the Royal Commission’s hospitals project. In this issue he provided more useful source material on isolation hospitals from Parliamentary Papers: a ‘Sanitary Survey’ undertaken in 1893-5  and the annual report of the Local Government Board of 1914-15, which highlighted the problems encountered in municipal hospital provision during the first year of the war.

The Sanitary Survey covered England and Wales and was prompted by ‘the ever recurring source of danger’ to Britain of cholera spreading from the continent. Publication of the inland survey was delayed following a ‘serious accident’ which befell Dr Frederick W. Barry, Senior Medical Inspector of the Local Government Board, who was supervising the work. A year later he died suddenly, it was presumed from the injury he sustained. The inland survey followed one on the ‘Port and Riparian Districts of England and Wales’ submitted in September 1895. When attention was turned inland, districts where the purity of the water supply was in doubt were investigated as a priority and then districts in which the administration was believed to be defective or ‘in which former experience had shown that filth diseases prevailed’.

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The late Dr F. W. Barry, from The Graphic, 23 Oct 1897, p.17. Barry had struck his head on a stone doorway causing severe injury to his skull the previous year. He died  suddenly after he had retired to bed at the Grand Hotel, Birmingham, and was found the following morning by the chambermaid.

The actual work of inspection was conducted under Barry’s supervision by a team of doctors in the LGB Medical Department. The bulk of the sites were covered by Dr Bruce Low, Dr Fletcher, Dr Reece, Dr Wilson, and Dr Wheaton, a few were inspected by the late T. W. Thompson, Dr Sweeting, Dr Theodore Thomson, Dr Coleman, Dr Bulstrode, Dr Horne and Mr Evan Evans (surely one of the inspectors of Welsh hospitals). Each inspector was given a set of forms containing questions as to the general sanitary circumstances of the district, its sanitary administration and cholera precautions.

Under the first of these three headings the inspectors were to report on the condition of dwellings and their surroundings, the purity and sufficiency of the water supply, the efficiency of public sewage, domestic drainage and sewage disposal, methods of excrement and refuse disposal and removal, and the condition and nature of supervision over registered premises and trades. As regarded ‘sanitary administration’ the inspectors were to report on the general character and efficiency of the administration of the local sanitary authority, noting the bylaws, regulations and adoptive Acts in force. They were also to report on the work done by the local Medical Officer of Health and Inspector of Nuisances, and on the provisions made for dealing with infectious diseases and ‘infected articles’.

As to ‘Cholera Precautions’ the inspectors were instructed to ascertain what general arrangements existed in each district to deal with an outbreak of cholera and what special arrangements had been made for action in an emergency. Detailed reports were made and submitted to the local sanitary authorities together with recommendations for improvements. Only the detailed reports for Sunderland were reproduced in the Report, for the other districts abstracts were published.

The inspection of the County Borough of Sunderland was made on 19 April 1894, the district covered Sunderland, Bishopwearmouth, South Bishopwearmouth and Monkwearmouth with a population in 1891 of 131,015. The chief industries were shipbuilding, engineering, mining, seafaring and glass-blowing. The sewers are described in detail and house drainage. There were an estimated 4,000 water closets and 1,100 ‘tub closets’ (galvanised iron tubs) in the district, but the majority of houses used privy middens which were found to be mostly of a ‘very defective type’. The local Medical Officer of Health was John Caudell Wood, who was paid a salary of £500 p.a. with an additional £20 as Port Medical Officer of Health and £5 as Public Analyst. He was described as having a good knowledge of his district but ‘wanting in judgment’, and therefore ‘cannot be regarded as a very satisfactory officer’.

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Extracts from the 6-inch OS map of Sunderland published in 1898. Reproduced by permission of the National Library of Scotland

Sunderland Isolation Hospital was found to be a good brick building for 42 patients, situated on an isolated site about two miles north-west of the Town Hall. (This is probably what became Havelock Hospital east site, formerly Sunderland Borough Infectious Diseases Hospital, the west site being formerly the infectious hospital for Sunderland Rural District, situated to the west of Bishopwearmouth cemetery on Hylton Road.) It had been built in 1890, and consisted of two fever pavilions each for 16 beds designed generally on the lines of Plan C of the LGB 1892 memorandum, and an isolation pavilion for 10 beds on the lines of Plan D in the 1888 memorandum. There was also an admin block, with accommodation for 11 nurses and 9 servants as well as a medical officer and matron, a mortuary, post-mortem room, laundry, and disinfecting house.

Emergency plans included arrangements for opening the ‘House of Recovery’ as a cholera hospitals, this had been the old borough fever hospital a the end of Dunning Street near the river and could take about twelve patients.The following is Robert Taylor’s  list of the English isolation hospitals noted in the report. The page numbers are those given in the Blue Books, not the report’s pagination. There are some oddities: Bishop Auckland Urban District’s isolation hospital was in converted dog kennels, while at Lyme they set aside a room in a warehouse on the Cobb. At Dudley they had built a hospital comprising three blocks and a tent on a pit mound, which the inspector described as ‘very bad’. It supposedly only had space for six patients, although it had been used for 23 smallpox patients.

Sanitary Survey

The ‘Report on the Inland Sanitary Survey, 1893-95’, by the late F. W. Barry, undertaken for the Local Government Board was published in Parliamentary Papers 1896 XXXVII, pp 669ff. Just how Mr Barry met his death is not recorded, but we trust that it was not a direct result of the time spent investigating hospitals. He presented, albeit posthumously, a series of short descriptions of a sample of infectious diseases hospital visited between 1893 and 1895. A list and summary may be of some use, even if only to show what sort of buildings are missing from our own survey a century later. The abbreviations used are familiar – UD for Urban District, B for Borough, CB for County Borough.

Amble UD. A small cottage is rented for an isolation hospital, an unsatisfactory arrangement. [p.682]
Ashby de la Zouch UD. An old barn converted into a four-room cottage, very unsatisfactory. [p.684]
Ashton in Makerfield. A small eight-bed hospital, with no accommodation for two diseases in both sexes. [p.685]
Bacup B. A converted mill is used in common with Todmorden, Mytholmroyd and Hebden Bridge UDs. no means of separating two diseases. [p.687]
Banbury B. A well-built hospital of 1890. [p.688]
Bedlingtonshire UD An old granary converted to isolation hospital, with eight beds; unsatisfactory. [p.694]
Berwick on Tweed B. There are two wooden hospitals, one with four beds for the town, one with eight beds for port cases. [p.698]
Beverley B. Two hospital tents purchased in 1892. [p.700]
Bideford B. A six-bed hospital built in 1885; cannot separate two diseases. [p.701]
Bingley UD. Temporary hospitals shared with Keighley UD and RD, for smallpox cases only. [p.703]
Bishop Auckland U. Dog kennels converted, with five beds; unsatisfactory. [p.704]
Boston B. A converted farmhouse with 12 beds, used jointly with the Rural and Port authorities. [p.706]
Brandon and Byshottles UD. A temporary hospital built in 1891 with 16 beds; cannot isolate two diseases in both sexes. [p.707]
Bridport B. Temporary wooden hospital provided for cholera in 1866. [p.710]
Burton on Trent B. Three temporary hospitals; a permanent 30-bed hospitals being built in August 1893. [p.714]
Calne B. With Calne RD has a well-arranged hospital of 10 beds built in 1889. [p.716]
Carlisle B. Sixteen beds are provided permanently at Crozier Lodge Hospital, and further 16 are reserved. [p.719]
Chesterfield B. An unsatisfactory 10-bed hospital. [p.723]
Clay Cross. A four-ward building for smallpox on an old pit heap, used as two cottages in May 1894. [p.724]
Darlaston U. A house was purchased in 1885 and a tent was recently bought. Very unsatisfactory.[p.737]
Doncaster B. An old dilapidated house for smallpox, very unsuitable. In 1892 temporary wooden buildings were erected for cholera, but it is only used for the families of smallpox victims. [p.741]
Dronfield U. Four four-room cottages have recently been bought, but were unfurnished in May 1894. [p.744]
Dudley CB. The Infectious Diseases Hospital consists of three blocks and a tent on a pit mound, and is very bad. There is only space for six patients, but it was used for 23 smallpox patients. [p.745]
Durham B. An iron hospital being built in June 1894, very unsatisfactory. [p.746] {Is this by any chance the hospital supplied by Humphreys of Knightsbridge some time before 1914?}
East Retford. A farmhouse, only suitable for one disease at a time. [p.747]
Exeter CB. There are two ward blocks, one of wood and cement with four wards, one of brick and stone with two wards. Unsatisfactory and crowded.[p.753]
Faversham B. A brick hospital, with an administration building, a ward block with two wards each 10 by 13 feet and 13 feet high, and outbuildings. [p.756]
Gainsborough UD. Hospital consists of an administration building, two ward pavilions of brick, and a temporary wooden ward block. Apparently only used for smallpox. [p.759]
Great Yarmouth. Hospital being erected November 1893. [p.767]
Harwich B. Hospital at Dovercourt, built in 1882 with eight beds. [p.770]
Hastings CB. A building was purchased in 1874 and has 35 beds. Later a 30-bed iron hospital was bought for smallpox. The site is inadequate. [p.771]
Havant UD. Hospital shared with Havant RD, consists of two ward blocks, with 16 beds. [p.772]
Heanor UD. An eight-room cottage, used for smallpox; unsatisfactory. [p.775]
Heath Town UD. A temporary 10-bed smallpox building was recently erected with Wednesfield UDC. [p.777]
Hereford B. A 16-bed corrugated iron hospital built in 1893; unsatisfactory. [p.779] {Another Humphreys hospital?}
Herne Bay UD. Two cottages bought in 1891; unsatisfactory. [p.780]
Huntingdon B. An old brick house called the ‘Pest House’ with five beds, very unsatisfactory. [p.790] {Built in 1760 for £95 15s and now demolished}
Ilfracombe UD. A farmhouse at Mullacott for four patients, and a private house at Ilfracombe for six patients; very unsatisfactory. [p.793]
Ilkeston B. An 18-bed temporary wooden building provided in 1888 during a smallpox epidemic. [p.795]
Ipswich CB. Satisfactory 36-bed hospital. [p.796]
Keighley B. Keighley and B. J. H. B. have a temporary smallpox hospital. [p.797]
Lincoln CB. Temporary wooden building for smallpox cases. [p.805]
Longton B. An old cottage used for smallpox cases. [p.810]
Loughborough B. A cottage is rented as a hospital; unsatisfactory. [p.811]
Lyme B. A room in a warehouse on the Cobb. [p.817]
Margate B. Temporary 44-bed hospital at Northwood, shared with Ramsgate and Broadstairs. [p.819]
Maryport UD. A 4-bed hospital built on the model plan. [p.821]
Millom UD. A temporary hospital near the pier is used for cholera. [p.824]
Newark on Trent B. A 6-bed wooden hospital. [p.831]
Newbold and Dunston UD. A 12-bed temporary hospital used for smallpox cases only. [p.832]
Newcastle under Lyme B. An 18-bed hospitals built in 1872, now dilapidated. [p.834]
New Romney B. A temporary 12-bed iron hospital built in 1893, unsatisfactory. [p.837]
Northam UD. A temporary iron and wood hospital near Appledore, with no fittings, water supply, etc. [p.838]
Norwich. An excellent hospital completed in 1893. [p.840]
Oldbury UD. Smallpox hospital is a block of cottages leased by the Authority; unsatisfactory. [p.842]
Ormskirk UD. Hospital of four wards and six beds in one acre, built shortly before March 1894. [p.843]
Pemberton UD. One pavilion containing four wards and eight beds, built in 1886. [p.845]
Penrith UD. Hospital has two pavilions with 12 beds. In 1894 a new hospital building of two pavilions with eight beds, set in 2.5 acres. [p.848]
Poole B. Permanent hospital of 6 beds built in 1875. A temporary smallpox hospital built in 1886, with poor fencing. [p.850]
Runcorn UD. Two wards with 12 beds, built in 1881. Temporary building with 20 beds for smallpox cases erected on same site. [p.858]
Salford CB. Hospital at Ladywell built in 1884 with 5 pavilions set in 13 acres. Also a modern smallpox hospitals with 50 beds. [p.864]
Shipley UD. A ten-bed hospital at Stoney Ridge built according to the Board’s model plan. [p.872]
Shrewsbury B. An emergency hospital built in 1893 with two wards each with 3 beds, of iron lined with wood. Very unsatisfactory. [p.873]
Sidmouth UD. Wooden 10-bed hospital built in 1884, with no furniture, and which has never been used. [p.874]
Sittingbourne UD. A satisfactory 24-bed hospitals built in 1884. [p.876]
Stalybridge B. A building bought in 1888 and partly fitted up but never used. [p.887]
Stockport CB. Hospital with 28 beds in two pavilions, each with three wards, opened in 1881. A separate smallpox hospital at Whitehall. [p.891]
Truro B. St Mary’s Parish Workhouse fitted up, suitable for one disease only. [p.906]
Warrington B. A satisfactory 40-bed hospitals built in 1877. [p.916]
Widnes B. A satisfactory 24-bed hospital built in 1887. [p.920]
Wigan CB. A satisfactory 60-bed hospital built in 1889. [p.921]
Workington B. The old workhouse used, unsatisfactory. [p.927]

Isolation Hospitals

The Annual Report of the Local Government Board for 1914-15 (P.P. 1914-15 XXV, 29-30) gives some interesting information about hospitals. It is also interesting for referring to the conflict as the Great War as early as 1915.

In the early months of the First World War, it was discovered that the existing isolation hospital accommodation was often insufficient for the extra military population of the area. This was particularly the case in Eastern Command. In some districts, huts of an army pattern were built in the grounds of existing isolation hospitals by agreement between the local military and the hospital authorities. It was intended that after the war the local authority would buy the building from the military at a percentage of the original cost. These huts did not provide floor space to the requirements of the Local Government Board, and after a meeting with the Board, Eastern Command adopted a design by their architect which was a modification of the Board’s Model D of the Memorandum of May 1902. The pavilion had two ten-bed wards and two one-bed wards, was 24 feet wide, and provided 144 square feet of floor space for each bed.

The War Office built these pavilions at the following hospitals: Biggleswade (1 pavilion); Bedford (1 pavilion); East Grinstead (1 pavilion); Guildford (1 pavilion); Tring (2 pavilions); Chelmsford (1 pavilion); Bletchingley (1 pavilion); Dunstable (1 pavilion); Rochester (1 pavilion); Folkestone (2 pavilions).

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Folkestone Isolation Hospital. The two blocks added during the First World War are the pair to the south. Extract from the 2nd edition OS map revised 1937-8, reproduced by permission of the National Library of Scotland

Before this plan was completed, several authorities who objected to the original army hut prepared plans of their own, which were submitted to the LGB in the usual way. These authorities were: Northampton (2 pavilions); Colchester (2 pavilions); Ipswich (2 pavilions); Orsett Joint Hospital Board (1 pavilion).

Of those which came within the area covered by the Cambridge office (where Robert Taylor was based), the two wards built at Ipswich had been demolished, although OS maps showed their distinctive outline (which was the same as the single pavilion built in 1914-15 as the Ipswich Smallpox Hospital). At Northampton there was a pair of pavilions with sanitary annexes with stalks at each end, and the readily identifiable double projections of single wards flanking the duty room. The potentially more interesting military blocks at Bedford, Biggleswade and Dunstable did not survive. The block at Biggleswade appears from maps to have been a plain rectangular structure without any projections for sanitary annexes or duty rooms. The most likely pavilion shown on maps of Biggleswade was another plain rectangular building, with a central rear sanitary annexe with narrow stalk. no building can be identified on maps of Bedford.

The Hospitals Investigator 3

Isolation Hospitals

Issue number three of the Hospitals Investigator was produced by Robert Taylor in April 1992 and was largely devoted to the subject of isolation hospitals, and more particularly the model plans published by the Local Government Board from 1888 onwards. Just about all local authority isolation hospitals built after that adopted these plans.

V0047600 Hanley, Stoke & Fenton Joint Infectious Diseases Hospital, S

This plan from the Wellcome Images collection of Bucknall Hospital  is a typical example. Colin and I visited the hospital in May 1993, when it was still functioning under the NHS specialising in care for the elderly – a not uncommon re-use of former infectious diseases hospitals. It closed in 2012, and plans for housing on the site were in the pipe line in 2014, retaining just two of the hospital buildings.

Bucknhall Hospital was originally the Hanley, Stoke and Fenton Joint Infectious Diseases Hospital and the first five blocks were built in 1885-6. G. W. Bradford drew up the plans. One of the five blocks was a temporary ward block that was later demolished. Additions were made to the site from 1898, mostly carried out by Elijah Jones, architect to the Joint Hospitals Board. In the 1920s two cubicle isolation blocks were added.  [see Historic England Archives file on the hospital ref NBR No.101124]

All the original blocks at Bucknall Hospital closely followed the model plans produced by the Local Government Board.  Robert’s summary of the Board’s instructions and different types of plans issued follows:

The Local Government Board issued several memoranda to local authorities on the subject of arrangements for infectious diseases. The Board had the duty of persuading local authorities to make suitable provision, preferably by means o  hospitals, but also gave or withheld sanction to raise loans for such purposes. This meant that plasm for proposed hospitals had to be approved by the Board if the building costs were to be raised by borrowing money The hospital plans contained in the Board’s memoranda were thereof important guides to local authorities wanting to building hospitals.

The first memorandum was issued in 1876 and was titled Memoranda for Local Arrangements relating to Infectious Disease; it related to hospitals and ambulances. It addresses itself to those authorities who have power to provide hospitals under section 131 of the Public Health Act of 1875, and begins by laying down several principles:

  1. The sick should be separated from the healthy. this is especially important with the poor, living in crowded and ill-ventilated conditions
  2. The accommodation must be ready beforehand
  3. Patients with different infectious diseases cannot be kept in the same ward.

Villages should be able to accommodate about four patients in two separate rooms at small notice, and the memorandum, and all editions up to and including 1893 then describes the type of arrangement associated with ‘pest houses’. Tents or huts could be used to extend this basic accommodation if needed, but tents are not mentioned after 1888.

Towns need more accommodation more frequently, and there is greater likelihood that more than one disease will have to be treated. Consequently the minimum provision is two pairs of rooms, the size depending on the size of the town. Permanent building should ideally provide for more than the average requirements of the town, and should have space around for the erection of tents.

Several basic points regarding hospital planning are made:

  1. The hospital should be reasonably accessible
  2. Each patient to have 2,000 cubic feet of ward space and not less than 400 square feet of floor space
  3. Thoroughly good ventilation
  4. Security against foul air entering the ward
  5. Means of warming the wards in winter and keeping them cool in summer
  6. Safe disposal of excrement

In an epidemic it may be necessary to extend the hospital, by means of huts or, in summer, tents. The tents may be bell tents or Army Hospital Tents, with paved approaches and boarded floors. Regulation bell tents are said to be 14 feet in diameter, and regulation hospitals marquees 29 feet by 14 feet. Huts should be raised eighteen inches above ground level, and spaced not less than three times wall height apart. they should have ventilators along the length of the ridge.

There are plans of two types of hut. The first is arranged on one or both sides of a covered walkway, and consists of a hut with bathroom and kitchen next to the walkway, and a lower sanitary annexe at the outer end. these are arranged on either side of an administrative building, and resemble Emergency Medical Scheme hutted hospitals. The second contains two wards and a central nurses’ room etc in one hut, and a sanitary annexe at each end, generally resembling later simple ward blocks. There is also a detached kitchen.

The second memorandum, the first of several to be titled On the Provision of Isolation Accommodation by Local Sanitary Authorities, was dated March 1888. Although it is only an edited version of the earlier document, it reflects the experience gained since the Public Health Act of 1875. The principal change is in the plans of hospitals Both of the original plates are abandoned in favour of three new plates with four plans – A to D.

LGB A 1888 to 92

Local Government Board model plan A, 1888

Plan A is a small building for four patients, with two-storeyed nurses’ accommodation flanked by two single-storey wards reached independently by a verandah. There is a detached laundry and mortuary. The same plan was also published in the 1892 memorandum, but not thereafter.

LGB B 1888 to 92

Local Government Board model plan B, 1888-1892

LGB plan D 1888

Local Government Board model plan D, 1888

Plans B and D are of a completely new type of ward block, characterised by having the verandahs in front of the male and female wards facing opposite directions, and having the duty room recessed between two flanking wards. Plan B is a single range with all wards in line, while D has the larger end wards set at right-angles as cross-wings. Water closets and sinks are in detached blocks against the outer face of the verandahs. Plan B was included in the 1892 memorandum, but otherwise these distinctive plans were not published in the later editions.

Flat_Holm_isolation_hospital_plan_April_1895

An example of  ‘Plan C’: Plan, elevations and section of proposed Cholera Hospital for the Couty Borough of Cardiff, Flat Holm Island, drawn up by the Borough Engineer M. Harpur. It appears to be stamped 1905, or perhaps 1906. Posted by J W Smith (Flat Holm Project Archives) licensed under CC BY 3.0 

Plan C is of a rectangular block with two wards separated by an entrance lobby and a projecting duty room. At the outer ends of the wards are small projections with water closet and sink. This basic plan was repeated in all subsequent memoranda. In 1900 it is described as the most advantageous and convenient plan, and it is suggested that one ward could be larger than the other so that children could be included with women.

LGB plan c 1888 to 9

Local Government Board model plan C 1888-9

In 1902 and 1921 the plan was repeated along with an alternative arrangement, having two projecting single-bed wards flanking the duty room. In all of these later publications, the original plan letters were retained.

LGB C 1900 to 21

Local Government Board model plan C 1900-21 (top) and 1902-21 (below)

To the requirements of 2,000 cubic feet of air space and 144 square feet of floor space are added 12 linear feet of wall space for each bed, and also the necessity for a space of 40 feet between wards and hospital boundary. In 1892 a height of 6 feet 6 inches is given as the minimum height of the boundary fence, which should be a wall or close fence. In a note added in 1902 a hedge between barbed wire fencing is regarded as acceptable in ‘unfrequented situations’.

The special recommendations regarding isolation of smallpox hospitals first appears in the 1895 re-issue of the 1892 memorandum. Smallpox hospitals are forbidden where the site:

  1. is within quarter of a mile of a hospital of any kind, workhouse or population of 150 to 200 people (200 people after 1900)
  2. is within half a mile of a population of 500 to 600 people (600 people after 1900)

V0031473 Gloucester smallpox epidemic, 1896: a ward in the Hempsted Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Gloucester smallpox epidemic, 1896: a ward in the Hempsted isolation hospital. Photograph by H.C.F., 1896. 1896 By: nameNegatives of the Gloucester smallpox epidemic, Published: 1896. Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Gloucester smallpox epidemic, 1896: a ward in the Hempsted Isolation Hospital.  Wellcome Library, London. Wellcome Images

An enlarged edition of the memorandum was published in 1900 and reprinted with minor changes in 1902, 1908 and 1921. It is emphasised that the hospital should be in readiness beforehand, and that it is for the protection of the pubic at large rather than the benefit of individuals, so that restrictive charges should not be imposed. The combination of authorities in sparsely populated districts is encouraged, provided that patients do not have to travel long distances. A proportion of one bed to each thousand inhabitants is mentioned as a rough but unreliable guide to size of hospital.

Although a site plan had been published in 1892 showing the three principal buildings and the 40 foot cordon around them, they were not defined and described until 1900. They are ward block, administration block and out-offices. A new site plan is published, appearing as plan A from 1900 onwards. Wooden and iron buildings are poorly insulated and difficult to maintain, and so unsuitable; the Board does not sanction loans for them.

The administration block should contain no patients, but accommodate the matron, nurses and servants, and have a single-storey kitchen. It may be an existing house, and should control the entrance to the hospital. It should also be larger than at first required. Ward blocks should be single-storey unless unavoidable, in which case each storey should have a separate entrance from the open air. Two types are described as being suitable for small hospitals; large hospitals may need other types. Plan C has been discussed above; a note added in 1902 says that the space in the centre over the duty room is sometimes used as a day room for convalescent patients.LGB B 1900

Local Government Board model plan B 1900

Plan B is a new plan that underwent several changes. It is called Isolation Block on the site plan, and is described as useful under a variety of circumstances, such as keeping complicated cases under observation, for paying patients, and for extra diseases. The plan of 1900 is of a rectangular block with a recessed duty room between two small wards; there is a continuous verandah across one side, with a single detached toilet block opposite the duty room. An internal lobby protects the door of each ward.

LGB B 1902 to 21

Local Government Board model plan B 1902-21

In 1902 this plan is modified significantly. The duty room is made to project slightly, and the internal lobbies removed from the wards. More important, the toilet block is divided into two separate blocks, with an enclosed lobby linking them to the ward doors, and also separating the two end sections of the verandah. The sink room is only accessible from in front of the duty room.

LGB D 1908 to 21

Local Government Board model plan D 1908-21

A third plan D, was added in 1908 and repeated in 1921. It is called an observation block, and is said to be for single cases of a disease, or for mixed or doubtful cases. The lower provision of 1,400 cubic feet of air is justified on the grounds of efficient ventilation and the separation of individual patients. It consists of a rectangular block with two single-bed wards on each side of a central duty room. A glazed partition separates the pairs of wards. All rooms are reached from a continuous verandah, on the outer side of which is a single block containing water closet, sink and portable bath.

The space for each bed is repeated, wight he additional restriction that in calculating the 2,000 cubic feet any space above 13 feet from the floor should be ignored. One square foot of window to every 70 cubic feet of ward is regarded as suitable.

The out-offices as defined as laundry, disinfecting chamber, mortuary, and ambulance shed; boiler house and engine house are only needed in large hospitals. A discharging block is said to be provided in some hospitals.

Bibliography: 

  1. Memoranda for Local Arrangements relating to Infectious Diseases (December 1876), published in the Annual Report of the Medical Officer of the Local Government Board, PP 1882 XXX pt2, 503-7
  2. On the Provision of Isolation Hospital Accommodation by Local Sanitary Authorities. (March 1888) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1888 XLIX, 875-83
  3. On the Provision of Isolation hospital Accommodation by Local Authorities (September 1892)
  4. Memorandum on the Provision of Isolation hospital Accommodation by Local Authorities. (January 1895) published in the Annual Report of the Medical Officer of the Local Government Board, PP 1895 LI, 627-35
  5. On the provision of Isolation Hospital Accommodation by Local Authorities. (August 1900)
  6. On the provision of Isolation Hospital Accommodation by Local Authorities. (1902) published in the Annual Report of the Medical Officer of the Local Government Board, PP, 1912-13 XXXVI, 136-40
  7. On the provision of Isolation Hospital Accommodation by Local Authorities. (1921)

former Murthly Hospital, Perthshire

canmore_image_SC00785517-3

MURTHLY HOSPITAL   Built as the Perth District Asylum, it was designed by Edward & Robertson, of Dundee and opened in 1864. It was the second district asylum to open in Scotland. Five architects submitted plans from which the Dundee architects were chosen. David Smart designed the Italianate administration block at the centre. In 1885 a cottage hospital was added on the site which later became the nurses’ home. In 1894 two villas were built which were an early attempt at providing accommodation for pauper patients on the colony system. They were named after the pioneers in psychiatry Pinel and Tuke. The hospital closed in 1984.

 

canmore_image_SC01043901-3aerial photograph taken in 2001  © RCAHMS

Now largely demolished and the site developed as a housing estate called Druids Park (inspired by the stone circle on the eastern side of the site).

canmore_image_SC00785510-2south front photographed in 2001 © RCAHMS ref SC 785510

A few of the old hospital buildings have been retained. The administrative block on the north side of the asylum , though considerably altered, which is the only part to be listed (at grade C). Although I previously stated that this was designed by David Smart, and elsewhere it has been dated to 1871, I have been unable to find – or re-find – any evidence of such an addition at that time, and the wing seems to appear on the first edition OS Map, so I am inclined to conclude that it is a part of the original building. (A possible caveat is an advertisement for tenders for the erection of additional offices at the asylum but this is not until 1893) Also surviving are the two villas, Pinel and Tuke, built in 1894 and of similar design by David Smart.

These are historically of great significance, being particularly early examples of detached villas for patients added to asylums. The medical superintendent’s house, to the east of the site, appears to have survived, if so this is also one of the earliest buildings on the site, being part of the first phase of building. Lastly the nurses’ home, added in 1885 by David Smart, which has been incorporated into Stewart Lodge, on the south-west side of the site.

canmore_image_SC00785534-2

Staff houses photographed in 2001 by RCAHMS

Perthshire Advertiser gave a list of the contractors for the original building, and noted that the stone for the rubble work was from Arbroath, while the hewn stone, used for dressings and quoins, was from Bannockburn. 

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Lennox Castle

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Lennox Castle in 2014, photographed by Robert Adam at RCAHMS One of a series of aerial photographs of the site

Lennox Castle has been on the Buildings at Risk register for Scotland since 1992, the website provides a good summary of the history of the building and the site. Rather wonderfully, the Book of Lennox Castle produced for the opening ceremony of the hospital in 1936 has been scanned and put online by S J McLaughlin, who has charted the history of the hospital and includes numerous photographs. Records from the hospital are deposited with NHS Greater Glasgow and Clyde Archives.

An extraordinary aerial photo  posted early in 2014 shows part of the site after the patients’ blocks had been demolished. In 2006 planning permission was granted for this area to be developed as the Celtic FC training centre. Below is an aerofilms photograph, taken from the north in 1953, showing Lennox Castle on the right, and the former female division to the left. But this was only a part of the hospital site overall. The OS map from 1958 shows the other sections of the hospital. At this date the blocks to the north-east formed a separate maternity hospital.

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Aerial photograph 1953 in the collection of RCAHMS

The aerial photograph of that section of the hospital (below) was taken in 1953. It was turned into a maternity unit in 1941, as part of the Emergency Medical Scheme during the Second World War and continued as such until 1964. All the buildings were demolished to make way for a housing development, for which planning permission was granted in 2006.

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Aerial photograph 1953 in the collection of RCAHMS. This shows the former male division which became an emergency hospital during the Second World War and partly used as a Maternity Hospital.

Below is a revised version of the piece I wrote on the hospital around 1990. I remember the hospital quite well, it was one that was particularly impressive, architecturally and for its setting. It was quite a shock to see what has happened since.

LENNOX CASTLE HOSPITAL, LENNOXTOWN   Lennox Castle, situated at the western edge of the hospital complex, was built between 1837 and 1841 to designs by David Hamilton.

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Lennox Castle, before it became a roofless ruin, photographed by RCAHMS

It was designed in a picturesque neo‑Norman style with castellated and battered walls, and an imposing porte‑cochere. In the 1980s there were some fine interiors on the principal floor but the building had suffered badly from subsidence. The external stonework was also in very poor condition near the ground and had been roughly patched up with concrete rendering.

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View of the dining-room ceiling at Lennox Castle, photograph from RCAHMS, nd.

In April 1925 Glasgow Parish Council resolved to build a new Mental Deficiency Institution under the provisions of the 1913 Act. In 1927 Lennox Castle and its vast estate were purchased, and plans prepared for what was to be the largest and best equipped hospital of this type in Britain. It was to provide 1,200 beds at a cost of 1.25 million. Work began in 1929 to designs by Wylie, Shanks & Wylie. The hospital was finally completed in 1936. The site was divided into five sections; a male division, a female division, a hospital section, married staff houses and the engine house. The male and female sections each consisted of ten dormitory blocks for 60 patients. These were split into two main wards with 28 beds and two side rooms with two beds, together with a day‑room and sanitary annexe. Meals were to be provided in two central dining‑halls capable of seating 600 patients each. Above the dining‑hall, accommodation was provided for unmarried male attendants.

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The Assembly Hall, Lennox Castle Hospital, photographed around 1990 © Harriet Richardson

Lennox Castle itself was adapted into a nurses’ home. There was also a central Assembly Hall for all the patients, it contained a large hall with a stage and equipment for cinema shows as well as some administrative offices. All the new blocks were built of brick and incorporated many innovative features, in particular the heating system which operated on a system of underground tunnels.

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The dining-hall block, Lennox Castle Hospital, photographed about 1990 © Harriet Richardson

There was a considerable variety of plan and composition which added interest to the site. The Assembly Hall and dining‑halls featured arched windows on the ground floor and each had a central bold entrance bay. On the Assembly hall this comprised a grand arch rising the full‑height of the building and framing the porch, and on the dining‑hall blocks the door was set into an arch, which in turn was in a tall gabled centrepiece. The varied roof-line also added interest. A charming octagonal tea‑room in two tiers with plenty of windows, echoed the tea pavilion at Glen‑o‑Dee Hospital.

Lennox Castle Maternity Hospital and Institution, from the OS map published in 1958. Reproduced with permission of the National Library of Scotland.

During the Second World War the male division (on the map below) was taken over by the government for use as an Emergency Hospital and the male patients were moved to six of the villas in the female division and hutted ward blocks that were constructed near the Castle. Although intended for air raid casualties, the emergency hospital was not needed and so the beds were made available to relieve pressure on hospital accommodation in Glasgow. A post-confinement maternity unit was established at the site in 1941, initially in one villa consisting of three wards, plus another villa that was reserved for gynaecology cases.

The Maternity Hospital from the OS map revised in 1966, after it had ceased to take maternity patients. Reproduced with permission of the National Library of Scotland.

Although Lennox Castle was twenty miles from Glasgow, the maternity provision here, with its beautiful rural surroundings, proved very popular. Initial space for 30 patients was soon increased to 60 by using another villa. A certain number of women each week were transferred after confinement from one or other of Glasgow Corporation’s maternity units. The increasing demand for maternity beds in Glasgow was becoming harder to meet. In 1942 the total number of maternity beds available in voluntary and municipal institutions was 461, including ante-natal beds. In addition there were about 150 in nursing homes, and 44 beds for unmarried girls in four private homes. An extension of 32 beds was made at the Eastern District Hospital, and under the government evacuation scheme beds for expectant mothers were available at Haddo House, Peebles, Kilmacolm and Airthrey Castle.

Further beds were made over for maternity cases at Lennox Castle during and after the war. In 1960 work began on a new maternity hospital at Yorkhill, and additional beds were  provided at Redlands, and Robroyston Hospitals, and pavilions at Belvedere Fever were converted to maternity use, but there were still not enough beds to meet demand. Lennox Castle continued to provide maternity beds until 1964 when the Queen Mother’s Hospital at Yorkhill was completed. [Sources: Glasgow Corporation, The Book of Lennox Castle, Glasgow, c.1936. Glasgow Herald, 15 May 1936, p.12; 29 Sept. 1936, (ill.): RCAHMS, Inventory, Stirling, Vol.2, p.358.]

Ayrshire Central Hospital

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‘Deco and Memories’ by Trawts1 Photograph taken in 2008. Licensed under CC BY-NC-ND 2.0

AYRSHIRE CENTRAL HOSPITAL, IRVINE   Comparable to both Inverurie and Hawkhead Hospitals, though lacking the flair of Tait’s buildings at the latter, these three hospitals constitute a interesting and important group of local authority infectious diseases hospitals built in the international modern style, adopting bold cubic shapes and flat roofs.

canmore_image_SC01332623Ayrshire Central Admin block, photographed in 1997 by RCAHMS

Ayrshire Central, designed in 1935 by William Reid, the County Architect, has a strong impact with its brilliant white finish enhanced by good maintenance and sympathetic extensions. The hospital was built to replace the old, small infectious diseases hospitals scattered over the county, and to meet the local authority’s new responsibility for maternity cases. The site was split into two halves to cater for the different functions. The infectious diseases section opening in 1941, and the maternity section in 1944. The specialities within the hospital altered when cases of tuberculosis declined and hospital confinements increased. Eventually, the infectious section became a general area with the ward pavilions adapted to various new functions.

The nurses’ home, in a central position between the two sections of the hospital, was designed on a U-plan and is a particularly pleasing small-scale example of its type. It has an almost Italian feel with the arcaded ground floor. The glazing and contemporary fire escapes are particularly notable details. [Sources: Ayrshire and Arran Health Board, Souvenir Brochure of Opening, 1941, site plan: Architect & Building News, 18 June 1937, p.359]

Revisions:

By 1933 Ayrshire County Council were considering the provision of a 70-bed maternity hospital to take the place of Seafield Maternity Home in Ayr. Plans for the hospital were drawn up in the office of William Reid, the County Architect, but it seems to have been Robert Govan Lindsay who was responsible for the design. From 1921 he worked for Ayrshire Education Authority which was taken over by the County Council in 1929, here he gained a broad experience in designing municipal institutional buildings. The plans were approved and work commenced in 1935 comprising 250 beds for infectious diseases cases, 70 beds for maternity cases and 46 children’s cots. In June 1937 The Architect and Building News reported that Reid was the architect of ‘new quarters for certain staff members’, costing £11,000. Perhaps this was the Nurses’ Home, which differed somewhat in style from the other buildings on the site. 

The hospital was nearing completion in 1938, but costs had risen dramatically, that and the outbreak of war sufficiently explain the slowness in completing this hospital. Despite the war, there was an official opening for the hospital in October 1941. The cost was given as £400,000 and the number of beds provided had been increased to 436. [Annual Reports, Department of Health for Scotland: Sunday Post, 19 Oct 1941]

canmore_image_DP00182871Aerial photograph of the site taken in 2014 by RCAHMS. The original blocks are to the left of the picture. Bare ground can be seen marking the sites of demolished pavilions at the centre of the site.

Ayrshire Central Hospital continues to provide  young disabled rehabilitation services, and has a number of assessment beds for Elderly Mental Health Services.  In 2010-12 the grade B listed buildings on the site were refurbished and modernised, although one block, the original maternity section, has been demolished.  A new General Outpatient Department and Rehabilitation Centre has been added to the site, and  in 2014 work commenced on a new 206-bed, acute mental health and community hospital for NHS Ayrshire and Arran designed by Lawrence McPherson Associates. Balfour Beatty are the building contractors (they were awarded the contract after ‘a robust procurement process’).[ref 1] Opening is planned for 2016.