the foundation of Hospitals those in the population who could afford to pay
chose to have a Doctor attend them in their own homes. Those who couldn’t
afford assistance usually had to apply for charity. Much assistance was given by
the Monks before the dissolution of the Monasteries. The Elizabethan
poor laws introduced parochial relief for the sick and needy, being replaced
by the Poor Law Unions of
the 19th century. Provision was also made for Children in Orphanages
away from the large Poor Law Workhouses.
Hospitals were introduced as charitable hospitals usually built by funds
raised by local people or out of great benevolence. These hospitals were
governed by a Committee and admission was by a letter of recommendation or
subscription. This practice was later ceased and financial status was
ascertained by the Doctor during the admission process. Those who could afford
to pay something toward their treatment did so.
number of prospective patients were excluded from treatment within the Voluntary
hospitals, including Vagabonds, Tramps, Incurable patients, Pregnant Women,
Mentally sick (classified as Insane), Patients with Infectious Diseases, and
those with Chronic Conditions.
hospital had it’s own pharmacy with a Dispenser, and indeed many hospitals
owed its foundation to the Town’s Dispensary
which grew in want and need. The Hospital would also provide it’s own laundry
and kitchen facilities, and provide a Hospital Almoner to assist Patients with
schemes for Workers commenced to assist Hospital finances, but as the cost of
Medical care increased a number of charity events were held to help the
struggling hospitals. Gala Days, Charity Balls and Concerts to raise money were
held in addition to the Saturday and Sunday Hospital movements.
A number of small Cottage Hospitals were founded in rural areas to prevent local people having to travel far. The first of which was at Cranleigh in Surrey founded in 1859. A modest weekly fee was charged to maintain the small number of beds available.
larger Towns and Cities, Specialist Hospitals were founded to fill the gap
formed by the Voluntary Hospital omissions. Eye Hospitals, Ear, Nose and Throat
Hospitals, Cripples Hospitals, Hospitals for Women and Lying In (now called
Law Infirmaries filled the greatest void for the poor, the destitute, the
sick and the aged. The change in Nursing
followed the lead of Florence Nightingale and slowly improved the level of care
given in Hospitals and Infirmaries.
Disease cases were sometimes admitted to separate blocks within Workhouses or
often separate hospitals were provided by the Local Authority under the control
of the Medical Officer of Health. Sanatoriums
were operated on the basis of separation.
Mentally Ill were treated as paupers, vagabonds or criminals (often being
sentenced to Gaols or Reformatories)
prior to any legislation, but the County Asylums Act 1808 allowed for the
erection of County Asylums which became compulsory in 1845. Although there were
a small number of privately maintained Asylums, there began a large increase in
the number of County Asylums.
Local Government Act 1930 many Poor Law Infirmaries became large Municipal
Hospitals providing healthcare for the general public. The introduction of the National
Health Service in 1948 brought free healthcare to the population. Specialist
Hospitals were gradually integrated into the large general hospitals to provide
specialist departments. Medical
and Surgical advances
introduced new treatments that saw the end of any need for Infectious Disease
Hospitals, many of which were modernized to provide a different type of medicine
and others demolished.
Health Care changed significantly with the introduction of “Care in the
Community” and the large County Asylum
buildings are rapidly being replaced by small short term units.
are now redefining their provision and locating all resources onto one large
site. Large new General Hospitals provide modern facilities and treatments, and
the decaying architecture of the Poor
Law, Voluntary and Subscription Hospital era is rapidly disappearing.
updated March 12, 2008
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