Second World War

Raigmore Hospital, Inverness

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

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

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

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

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

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

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

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

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

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

Raigmore Hospital today. © OpenStreetMap contributors

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

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

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

Sources

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

Stracathro Hospital

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Stracathro House, from Gershom Cumming, Forfarshire Illustrated, 1843

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

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Stracathro House photographed by RCAHMS in 2003

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

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

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

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

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

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

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

Postcard with aerial photograph of the hospital

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

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

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

Another postcard with an aerial photograph of the hospital. On the right are flat-roofed ward blocks, the rest of the blocks having pitched roofs, suggesting that they are a different building phase. 
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One of the few surviving war-time ward blocks at Stracathro Hospital, photographed in 2013 © Copyright Anne Burgess and licensed for reuse under this Creative Commons Licence

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

Sources

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

Hospitals Investigator 11 revised

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In February 1993, Robert Taylor from the Cambridge team of the RCHME Hospitals Project, produced his eleventh newsletter. Here are snippets on prefabricated hospitals by Humphreys, early prison infirmaries, provision of accommodation for tuberculosis in workhouses, the Metropolitan Asylums Board, Portal Frames and Wimborne Cottage Hospital (with a few digressions from me).

More Humphreys’ Hospitals

Another advertisement for Humphreys’ Iron Hospitals lists places where hospitals have been provided, but this time of 1895. All but three of the hospitals are also on the list published in 1915. As Humprheys provided buildings for the Metropolitan Asylums Board, is there any chance that they made the iron buildings of about 1894 at Colney Hatch asylum that burnt with such dramatic effect in 1903?

The three mentioned on the earlier list but not on the later one were: New Calverley, Romney, and Nottingham. ‘London’ is also listed. There are 102 places listed altogether.

Howard and Prisons

That a shortened version of John Howard’s The State of the Prisons should have been considered a sufficient work of literature to be added to the Everyman Library in 1929 is almost as amazing as the record of cruelty and discomfort contained within the book. The Everyman edition is taken from the third edition of Howard’s book, published in 1784.

Gateway to the County Gaol at Southwark, from Survey of London vol.25

By 1784 few prisons had an infirmary. The impression gained from skipping through Howard is that there were normally two rooms, one for each sex, but that these rooms were commonly on an upper storey and that they were not very large. At the Manchester County Bridewell, built in 1774, there were two rooms 14ft by 12ft. The Chelmsford County Gaol, completed in about 1778, had only one room, described by Howard as ‘close’ and therefore not used. The two rooms at the recently built Southwark County Gaol were also described as close, with only one small window each, and they too appear to have been little used because of this unsuitability. Whether the infirmaries were on the upper floor to get superior ventilation above the noisome cells is not clear; it could be that they were less convenient and so devoted to a less important function.

Howard himself considered that dryness and ventilation should be the principal factors. Howard also paid attention to the extent to which building were lime-washed. This he regarded in keeping with contemporary theory, as the one remedy for both infectious diseases and ‘bugs’ (vermin). Lime-washing as often as twice a year would kill disease and infestation. Many years later, in 1832, lime-washing houses was often tried as a precaution against cholera.

The fourth edition of Howard’s book published in 1792 was illustrated, and included a model plan and elevations.

Howard listed the most important features of an infirmary or sick ward in a prison as:
1. It should be in an airy part of the court
2. It should be detached from the rest of the gaol
3. It should be raised on arcades
4. The centre of the ward floor should have a grating for ventilation, 12 to 14 inches square
5. Perhaps there should be hand ventiltors

Some of these features can be seen in his model plan for a county gaol published in the 1792 edition of the State of Prisons.

TB in the Workhouse

By the beginning of 1904 some 27 English Poor Law Unions admitted to having adapted wards in their workhouse for consumptive patients, so that they could be separated from the rest of the occupants. Until then consumptives were mixed indiscriminately with the rest of the inmates, and remained so mixed at other workhouses for some time. Just how little work this involved will only emerge from further investigation, but my suspicion is that a French window and a balcony was probably a generous amount of alteration. At that time, open-air treatment for tuberculosis at Sheffield Royal Infirmary consisted simply of leaving half of the windows in the ward permanently open, and it seems that many or most unions took the same approach.

The unions are as follows:
Chester – two rooms in the hospital block
Plymouth – wards (unidentified)
South Shields – 1 ward
Portsmouth – 2-storey south-facing wards adapted by insertion of French windows and balconies. Electric fans were installed but little used.
Southampton –wards (unidentified)
Bishops Stortford – 1 ward in infirmary
Medway –wards
Blackburn –men have 2nd storey of infirmary, women to have new wards then building
Prescot –ward for 20 men
Camberwell –infirmary wards
City of London –south block of infirmary
Fulham -2 infirmary wards
Hampstead – south facing wards
Kensington – 2 wards adapted
St Mary Islington –top floor of infirmary
Wandsworth –iron buildings at Tooting annex
Atcham –top ward of infirmary for 20 men
Axbridge -4 dayrooms and 4 bedrooms
Bath –two 10-bed wards adapted, windows altered, shelters and dining-room built
Frome –wards built
Stoke – 2 wards with balconies
Richmond (Surrey) -2 wards
Brighton – 3-bed ward and balcony for men; women under consideration
Stourbridge –wards with end verandas adapted
Ecclesall – wards
Sheffield –small 20-bed block being adapted

Source: L. A. Weatherley, ‘Boards of Guardians and the Crusade against Consumption’ in Tuberculosis, 3, 1904-6, p.66

Photograph showing the roof garden c.1915 with revolving shelters, probably for convalescents rather than Tb patients. From the RAMC Muniment Collection in the care of the Wellcome Library. Reproduced under Creative Commons licence CC BY 4.0

(The mention of shelters at Bath put me in mind of this photograph of the King George V military hospital, for more on this hospital see the excellent Lost Hospitals of London website.)

Nurseries

A brief paragraph in Paul Davies’ book The Old Royal Surrey County Hospital tells us that ‘the Metropolitan Asylums Board designated King George V Hospital, Godalming, and two other of their hospitals as ‘plant propagation centres’. This is a change of use that does not appear in any of the directories, and suggests that the M. A. B. operated a very successful cover-up. Presumably they also ran a very successful and profitable business, far more profitable than curing Londoners of their physical and mental ills.

Portal Frames

Robert Taylor succinctly described the portal frame as ‘a modern version of a jointed cruck’ but was struggling to date this type of construction until stumbling over an article in The Builder from the 1940s.

Cruck Framed Barn on Aldford Village Green photographed in 2014. This thatched, oak cruck framed barn was built in 2013 in a joint project between the Eaton Estate and Chester Renaissance. The purpose was to keep heritage skills alive by using modern and old-style building materials and methods. The barn is used as a public shelter and has a brick barbecue built into the chimney. © Copyright Jeff Buck and licensed for reuse under this Creative Commons Licence

The Ministry of Works and Planning carried out experiments between 1939 and 1942 to design a cheap, quickly erected hut that was largely prefabricated, infinitely adaptable, and durable. By 1942 they had developed the M.O.W.P. Standard Hut with reinforced concrete jointed crucks (two bracketed posts bolted to a pair of rafters, for the benefit of readers who are not members of the Vernacular Architecture Group) as its main feature. The trusses at each end were different, having two posts carrying a tie-beam with a wooden frame above to which corrugated asbestos was nailed. The corner posts are of a distinctive shape, with a quarter-round hollow. The trusses are usually at 6-foot centres, and the building is just under 20 feet wide overall. Wall panels and roof covering are whatever is available.

These huts crop up on every type of hospital site, usually as ancillary buildings such as laboratories, if indeed any function can be ascribed to them. At Ipswich workhouse they were used to create an H-shaped addition to the infirmary with operating theatre in the central range. It seems therefore that they are unlikely to be earlier than 1942. How late this design, with concave corner posts, remained in use is not known.

This answers an old question, where the name portal frame came from. The minister of Works and Planning from 1942 to 1944 was Sir Wyndham Portal, 3rd baronet, created a baronet in 1935 and viscount in 1945. Like an earlier minister of transport he gave his name to something he did not invent, but unlike Mr Hore-Belisha’s beacon the invention took place before he became minister.

Whilst the idea that the Ministry of Works named its design after their minister, Sir Wyndham Portal, it has been gently pointed out to me that the term ‘portal frame’ was in use long before 1942. Indeed, a very quick search on the British Newspaper Archive provides evidence of its use in 1902. An article from Engineering News  reported on a novel suspension bridge constructed in Freiburg, Switzerland, designed by the Swiss engineer M. Grimaud. The bridge was supported on a timber portal frame. (Source: the article was covered in the Irish News & Belfast Morning News, 4 Oct 1902, p.6)

Operations

In 1892 the committee of Wimborne Cottage Hospital in Dorset discussed the propriety of treating pauper patients. One of the doctors said that they should not be admitted because the workhouse infirmary was better equipped to deal with operations.

Wimborne, Victoria Hospital, the original building photographed in 2015 © Copyright Mike Searle and licensed for reuse under this Creative Commons Licence

The hospital historian’s comment on this in 1948 was that as neither the cottage hospital or the workhouse infirmary had any equipment for operations, this probably meant that the workhouse had a bigger kitchen table. We should also remember that at this time the theatre doubled as a bathroom.

Mike Searle’s photograph above from Geograph.org.uk, is captioned with this brief account of the building’s history: 

The hospital was built in 1887 to commemorate Queen Victoria’s Golden Jubilee. The land was owned by Sir John Hanham of Deans Court who leased it at a peppercorn rent on condition that the poor would be treated there. Many local people donated money towards the cost of the building including Sir Richard Glyn of the Gaunt’s estate who gave £700. It opened initially with only thirty beds, and was limited to accepting local parishioners only, but as it grew, this was extended to outlying villages. It came under the authority of the NHS in 1947 when it ceased to be a voluntary hospital.

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

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Postcard of Vale of Leven Hospital from the 1970s

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

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

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

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

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

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

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

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

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

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

Aerial perspective of the proposed new hospital, 1954

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

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

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

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

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

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

Sources

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

The Hospitals Investigator 7

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The Hospitals Investigator issue 7, circulated in November 1992, included an update on the memoranda concerning the provision of isolation hospitals produced by the Ministry of Health in the 1920s, a preliminary look at school sanatoria – specifically those built for boarding schools, considers the question of lifts in hospitals and finally provides some references for hospitals built just prior to the outbreak of the Second World War as part of the Emergency Medical Scheme. EMS hospitals and hutted annexes added to existing sites often remained in use for decades, despite having been considered as temporary buildings. The availability of materials affected their construction, and they vary from timber to brick. At the former workhouse in Amersham, which by the 1930s had become St Mary’s Hospital, a small annexe of these huts was built. By the early 1960s one of these was in use as a maternity ward, serving the local area – and that was where I was born.

Memoranda on Isolation Hospitals (again): Cubicle Isolation Blocks

In our third number we dealt at length with the memoranda on isolation hospitals issued by the Local Government Board. In 1924 a further edition was published, by which time the LGB had become the Ministry of Health. The main change in 1924 was that the facing-both-ways plan (Plan B in the 1902-21 editions) had been omitted, leaving only the former plans C and D, which became B and C respectively, without any alteration. The overall site plan (Plan A) was amended in line with this, and had only simple pavilion outlines. Space for a future boiler house had been added behind the administration block, perhaps indicating a change in technology, from stoves to central heating, in small hospitals.

Plan C is described as an Observation (Cubicle) Block, intended for single cases of diseases other than smallpox, mixed or doubtful infection. One nurse may, provided rigid precautions are taken, attend to more than one patient. The Department is prepared to accept wards as small as 12ft by 10ft. An air space of 1,872 cubic ft is said to be permissible in cases of diseases other than smallpox, if the 12 linear feet of wall space and 144 sq ft of floor space are provided, but in smallpox hospitals 2,000 cubic ft per bed are required.

Beddington Corner

This basic and small-scale isolation ward works on the cubicle principle, it was published in the early 1920s as a model plan in the Cambridge Public Health series.

Interestingly, the sentences saying that unnecessary duplication of small hospitals in an area is to be avoided, have been tightened up to increase the emphasis.

The types of wards suggested were thus reduced by 1924 to two only, the pavilion and cubicle blocks. Thus ‘official’ isolation hospital ward planning had begun with the simple huts of 1876, then gone through a phase of great diversity and finally settled down with two basic and simple types. This was still the position in 1947 when E. and O. E. published the final edition of their useful book Planning: the architect’s handbook. The same two basic types are given, along with a fanciful plan with hexagonal cubicles that was actually built at Tolworth.

This block was destroyed during the Second World War. A similar design was adopted in the two cubicle blocks added to the Mogden Isolation Hospital (later South Middlesex Hospital), Twickenham, in 1937. They were unoccupied and due for demolition by the early 1990s. 

School Sanatoria

Robert Taylor noted that having attended a working-class day school in the Black Country, he felt that his knowledge of public schools was minimal: ‘Innocently we assumed that a school sanatorium was a glorified sick-bay, although we should have suspected something when we discovered that the sanatorium at Uppingham School had more beds than any other hospital in the county. It seems that this simple and obvious sick-bay interpretation is wrong, and that we were forgetting our own childhood illnesses. Jeremy Taylor ignores school sanatoria, thus presenting a challenge. In the meantime, here is a theory to set discussion or argument rolling.’

‘At present sanatoria dating from before 1864 are unknown to us. The earliest seems to be that at Harrow School, built in 1864 to designs by C. F. Hayward, and resembling a cottage hospital with square ward-rooms lit on one or two sides; it held 16 beds for a school of 500 pupils. It supplemented but did not entirely replace the earlier system of sick rooms at each house at school. Despite the unspecialized nature of the very domestic plan it had, apparently in common with all other school sanatoria, built in the last quarter of the 19th century, the primary function of the instant isolation of infectious diseases.’

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Perspective view, with First and Ground floor plans of Harrow School Sanatorium published in The Builder, 23 Jan 1869, pp.66-7

‘Boys could not be sent home but had to be treated institutionally, hence there was a generous provision of beds in relation to the number of pupils. Any other accident or illness could also be treated in the same building, but the planning was determined by the treatment of infectious diseases. At Harrow it seems that the sick bays of the houses had been unsuccessful for the treatment of infectious diseases, and after the building of the new sanatorium they remained in use for other ailments.

‘So far during fieldwork we have seen two types of sanatorium (apart from Harrow), both suitable for infectious diseases, but differently planned, and these differences have a chronological significance. It will be valuable if it can be discovered whether this distinction has real meaning. The two late-19th century sanatoria, at Sherborne and Warwick, consist of two separate two-storey blocks linked only by an open corridor, one containing the wards and the other the ‘administration’ and at least in the case of Sherborne a third ward as well. These wards are thus surrounded and isolated by fresh air in the approved manner, and are also designed in accordance with contemporary principles. At Sherborne Keith Young was chosen instead of the usual retained architect because of his special knowledge of hospital building. There were 22 beds for a school of 270 pupils. We have yet to see the sanatorium at the Asylum for Fatherless Children at Reedham, where three wards on each of two storeys gave isolation for three diseases for both boys and girls, presumably one sex on each storey. Again the declared aim of the sanatorium was to treat infectious diseases first, and any other diseases as they arose.’

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Sherborne School sanatorium

‘The second type of school sanatorium was seen at Oundle and built about 1930. It is a two-storey cubicle block added to one side of an older house that became the administration department. The 16 cubicles all opened Southward onto balconies. Again this is in accordance with current planning ideas, but it is far more flexible than the larger wards of Sherborne and Warwick, and so more suitable to the mixed use of a school sanatorium as suggested above.’

Lifts

We have often marveled at the steep staircases in hospitals, and wondered whether female wards were often placed on the first floor because ladies were easier than gentlemen to carry upstairs. Lifts seem to be almost impossible to date, and some documentary evidence may help understand how patients were moved.

At the Northampton Infirmary patients were carried from 1793 until 1872 when two hand-operated lifts were installed in the wells of the two main staircases. These remained hand-cranked until 1911 when they were converted to electricity. Two lifts were installed in the two staircases at the North Devon Infirmary at Barnstaple in 1872 and 1873, but we do not know how they were operated.

Dates for events like Otis’ experiments to demonstrate the safety of his ratchet mechanism in 1854, and its first installation in a public lift in 1857, and the first successful electric lifts developed in 1889, are well-published, but the process of installing lifts in hospitals is not yet clear. Most seem to be inserted in the generous wells of already existing large staircases, the dreadful blind towers of the modern lift shaft being a phenomenon of the second half of the 20th century rather than earlier.

Emergency Medical Scheme Hospitals

The Builder carried brief notices of Government and Military contracts, sometimes hopelessly brief and uninformative. Emergency Hospitals were reported until 13 October 1939, when the lists of H.M.O.W. contracts were discontinued because they were regarded as being of potential use to the enemy.

Stoke Mandeville Hospital was originally built as part of the Emergency Medical Scheme, many of the hutted ward blocks remained in use in the early 21st century, but have since been demolished, the area where they stood has been developed for housing.

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This OS Map from 1955 shows the easily recognisable layout of the blocks. The small group of buildings at the south-west corner were a pre-existing municipal isolation hospital. Reproduced by permission of the National Library of Scotland

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This OS map from the 1930s shows the isolation hospital and the future site of the EMS hospital. Reproduced by permission of the National Library of Scotland

The Emergency Hospital buildings that were recorded up to that date are as follows.

21 July 1939
Sunderland

4 August 1939, p.222
Mount Vernon Hospital, Hammersmith
Hemington Infectious Hospital, Middlesborough

11 August 1939, p.250
Highwood Hospital, Brentwood
Furse Hospital, Hillingdon
Windosr Public Assistance Institution
St Mary’s Hospital, Amersham

25 August 1939, p.347
Farnborough Hospital, Kent
Stanmore Hospital
Staines Institution

1 September 1939, p.385
Bishop Auckland
Evesham Public Assistance Institution
Black Notley Sanatorium
Pinewood Sanatorium, Woking
Middleton in Wharfedale
Otley
Chapel Allerton
Chester le Street

8 September 1939, p.419
Horsham P.A.I.
Three Counties Hospital
Boleys Park Mental Hospital
Preston Hall Hospital, Kent
Arclid PAI
Nantwich PAI
George VI Sanatorium
Scotton Banks Sanatorium
Clatterbridge Hospital
Ormskirk PAI

15 September 1939
Aylesbury PAI
St Andrews PAI, Billericay
Hexham
West Malling Institution
Warkwich PAI
Botleys Park (West Surrey Waterworks)

22 September 1939, p.483
Warranford Hospital, Guildford
Cuckfield PAI

29 September 1939, p.513
Hereford PAI

6 October 1939, p.541
Wrightington Hospital
Langho Epileptic Colony
Pembury Hospital

The Builder published plans of two Emergency Medical Service hospitals, one said to be in the Home Counties and the other in the Midlands. The precise locations were concealed as a matter of national security, but the areas given prove to be grossly misleading. Both hospitals can now be identified. The hospital said to be in the Midlands (Builder, 9 October 1942, p.306) is readily identifiable by its amazing plan as Stoke Mandeville Hospital. Not only does the plan show the hospital as built, but in the 1990s most of it survived. The Home Counties Hospital (Builder, 24 April 1942, p.359) turned out to be the Churchill Hospital in Oxford, which again survived largely intact into the 1990s.