Some of the most interesting documents that I have catalogued recently – albeit photocopies – relate to local hospitals. They include an annual report on the Basingstoke Cottage Hospital, for the period June 1st 1899 to May 31st 1900. This gives a good idea of how the hospital was organised, run and financed, and how it was supported and by whom.
It also tells us much about the patients themselves, and makes an interesting supplement to Barbara Applin’s excellent compilation Taking the Pulse of Basingstoke
The title page of the 23 page report printed by John Bird, (founder and printer of the Hants and Berks Gazette), tells us that this report was the 21st and that the hospital was established in 1879.
This was in accordance with what might be called “The Cottage Hospital Movement.” Cottage hospitals were small hospitals set up for the main purpose of treating poorer people near their own homes by doctors to whom they were already known. (The alternative was to send them to the nearest county hospital where they would not be known). According to Wikipedia, the first cottage hospital was established at Cranleigh in Surrey in 1859, and by 1866 sixteen were already in existence with plans being drawn up for at least 67 more. Some still exist such as the one at Odiham, still managed by a charitable trust and continuing to fulfil the original objectives.
In 1867 the subject was “brought under the consideration of” Basingstoke’s Town Council; we have a copy of a letter dated 16thSeptember of that year from the town clerk to W S Portal, Esq. about the first meeting to be held the following Friday of a committee to progress the creation of a “Village Hospital”. The earliest printed document relating to the project of which we have a copy is a report of a meeting of the “Basingstoke Village Hospital Committee” dated June 9 1874 and chaired by Arthur Wallis, an Alderman and former Mayor. This tells us that the Town Council was willing to provide a site for the hospital on a 99-year lease with a nominal rent of £1. (The plot was quite large, and thanks to Bob and Barbara Applin we now have a copy of a contemporary letter from a landscape gardener recommending how the grounds should be laid out). Plans prepared by Mr J H Moore were produced and the cost of building a hospital for eight patients was reckoned to be about £600, [in today’s money a surprisingly modest £47,000].* Those present agreed to “use every exertion to obtain funds for the purpose of building and furnishing” the hospital.
[* I have made use of the assistance of another website, (www.moneysorter,co.uk) to give present day equivalents in square brackets to all the sums quoted. This will give you a far better idea of how much people were really contributing].
It is worth noting at the outset that the Cottage Hospital received no funding from central or local government sources. It was financed entirely by local subscriptions and fund raising, and by (subsidised) payments by the patients themselves. (In this respect the closest present day counterpart is St Michael’s Hospice which derives a large part though not all of its income from local fund raising). Some of this income took the form of legacies, and the balance sheet included in the report refers to three legacies totalling £695 including £200 left by the Alderman Wallis who had chaired the 1874 meeting.
Page 2 of the 1900 report lists the hospital’s trustees, committee, medical staff, “committee of lady visitors”, honorary solicitors, treasurers, Hon. Secretary and lastly the matron. I have tried to find out more about some of the persons mentioned by reference to Kelly’s Directory.
There were three trustees, one of whom the Rev A G Barker was also the chairman of the committee. (Thanks to Dilys Eaton I now know that he was the vicar of Sherfield on Loddon). The second trustee was Hawkesley Roche Hayes, a doctor, surgeon and borough magistrate. He was also one of the medical staff and had been so from the opening of the hospital. The third was Wyndham S Portal (resident at Malshanger House and of the family owning the paper mill). Back in 1874 he was the president of the “Village Hospital” committee.
Besides being a trustee the Rev Barker also chaired the hospital’s management committee of twelve persons. Other well-known local names on the committee were A T E Jervoise (of Herriard?), T M Kingdon, (in business as a “furnisher and general iron monger”), H. Portsmouth, of Norn Hill, a farmer and borough magistrate, C J Steevens, and J E Wallis of Wallis and Steevens, and, yes, Lieut-Col May. Mrs Wallis and Mrs Portal were both members of the Committee of Lady Visitors. The Hon Sec was Mr H M Kingdon, (a son of T M Kingdon), the Hon Solicitors were Messrs Lamb, Brooks, Sherwood and Bullock, and the Treasurers were the Capital and Counties Bank (later taken over by Lloyds).
Pages 3 to 5 contain Rules of the Hospital, (an initial draft of which was included in the 1874 report referred to above) followed by Rules of the Committee of Lady Visitors. We learn that the hospital provided for “suitable cases of sickness or accident among the poor of Basingstoke and its neighbourhood” but not infectious or “incurable” cases. There was of course also an isolation hospital.
Also stored in folder C29 is a news cutting from the Hants and Berks Gazette announcing the opening of a new isolation hospital in Kingsclere Road to replace the building used for the previous twenty years. This was scheduled for demolition as it stood on land acquired by the London and South Western Railway to quadruple their main line and construct a new goods yard. For chronically sick poor people there was the Workhouse Infirmary later replaced by Cowdery Down Hospital using former workhouse buildings and unpopular for that reason.
The rules also specify the composition and function of the management committee, (to be chosen by subscribers at the AGM), the medical staff, the Committee of Lady Visitors, whose function it was to supervise the “domestic arrangements”, (very effectively I should think), and the role of the Matron. Except for accident and emergency cases, patients were to be admitted by a subscriber’s “letter of recommendation”, every annual subscriber of one guinea [£90.23] being entitled to recommend one patient annually, and every subscriber of two guineas two patients and so on. In addition every clergyman or minister making a collection from his congregation could recommend one patient for every guinea collected.
The “letter of recommendation” was a proforma, a copy of which is printed on the last page of the report. The applicant had to state how much he or she considered prospective patients capable of contributing to their own keep. Patients were required to pay a weekly sum ranging from 3 shillings to 20 shillings [£12.89 to £85.93]“according to circumstances”. A medical officer’s counter signature was required, and there was a “hospital guarantee” section (“to be signed by a responsible person subject to the approval of the committee”). This signatory had to ensure that the patient paid his or her weekly contribution, to undertake to remove the patient when required to do so by the committee, and in the event of the patient’s death to pay all funeral expenses. The pro forma states that applications must be made two days before the admission of the patient and that the first week’s keep must be paid in advance, advising that the average weekly cost of food per patient was 7s 6d. [£32.23] Finally the applicant is warned in heavy type that infectious and incurable diseases are not admissible. Accident and emergency cases could be admitted solely on the authority of one of the medical staff.
The Committee of Lady Visitors had to select from its twelve members a visitor for each month whose duty it was “to visit the patients generally and take notice of the state of the wards etc as to cleanliness and tidiness, and if necessary, to call the attention of the Matron to it”. Among their other duties was to “provide, gratuitously, some newspapers, periodicals and flowers for the patients.”
The Chairman’s statement which also bears the signature of the secretary occupies pages 6 and 7. It states that a record number of 106 patients were treated during the past year, 41 of them males, including four soldiers transferred from a military hospital at Netley as convalescent patients recovering from injuries in the Boer War. Sixty-eight patients had been discharged “cured,” twenty-two “relieved or improved”, and one in the same condition. Six were currently still under treatment and five had died. The average stay for a patient was 21 days, the longest being 112 days and the shortest one day.
Some generous donations were singled out for special mention. W S Portal had given £100 [£8593.48] and a rustic summerhouse “which supplies a long felt want, and is not only useful but ornamental to the grounds.” Lieut-Col May gave £50 [£4296.74] and Mrs Adams £49 12s 5d, [£4264.08] the proceeds from two clearly very popular concerts performed by her “Banjo and Mandoline (sic) Orchestra”. Mrs Adams was the composer of the May Centenary Song mentioned in a recent Gazette “Memories” article, and thanks to Bob Clarke I now know that she was the wife of the brewer Edward Adams, and the daughter of H E Powell who kept the music shop in London Street. (You can still aintly see the shop’s embossed sign beneath later layers of paint what was its end wall in May Place).
The doctors who attended to the patients at the cottage hospital appear not to have charged fees as they were thanked for “their kind and gratuitous services, always so readily given.”
The statement went on to thank all those clergymen who had organised collections in aid of the hospital, but the Rev Barker had a rebuke for the local non-conformist congregations who “with one exception appear to have overlooked the claims of the hospital” and hoped that “increased interest will be shown by their having annual collections in the future.” (The same seems to have applied to the Roman Catholic community).
Pages 8 to 10 list 87 subscribers by name with the amount subscribed. These varied from 10s 6d [£45.12] which, as we now know, did not carry the right to recommend a patient each year, (or did it perhaps carry the right to recommend one patient every two years?), to the £10 each [£859.35] subscribed by the Rev Barker and by Mr W S Portal, setting an example of generosity as trustees. Most subscriptions were in the guineas that carried the right to recommend patients. Lieut Col May subscribed two guineas [£180.46], (in addition to the £50 donation) therefore having the right to recommend two patients, and George Willis (father of our George Willis), subscribed one guinea. Among the other subscribers were Mrs Blencowe of Skippets, – her husband was a County Magistrate – Mrs Chute of The Vyne, and Sir Richard Rycroft, a magistrate and the Chairman of the Board of Governors of the Basingstoke Union. Some subscribers were businesses, among them May’s Brewery, Milwards (shoes), Gerrish, Ames and Simkins (garment makers), Messrs Smith and Gripper, (grocers and bakers of Wote Street), and Messrs Stephens, Phillips and Co, (coal merchants). I think it likely that most of the subscribers employed servants, so they probably regarded the subscriptions as a form of health insurance for these employees. The firms that subscribed probably did the same with regard to their workers.
Subscriptions totalled £158 16 6 [£13648.59] added to which was £234.6 11 [£20138.82] in donations, (listed on page 11 of the report); the largest have already been mentioned. Other donations included £1 0s 0d [£85.93] from Basingstoke Cycle Club, the 15s 6d [£66.60] proceeds from a billiard handicap at the Mechanics’ Institute and £1 1s 0d [£90.23] from the Borough and Constitutional Club collected by the dog “Jack”. (Dogs with collecting boxes strapped to their backs were quite often seen at this time, particularly at railway stations where they collected for railway orphanages).
Page 12 details the proceeds from collections at 24 Anglican churches, a total of £61.17 7s, [£5317.64] ranging from £9 13s 0d [£829.97] from St Michael’s to 13s 0d [£55.86] from Farleigh Wallop Church. Most of this was collected at Harvest Thanksgivings. A number of churches also gave the flowers, fruit and vegetables from their Harvest Festivals. One of these was London Street Congregational Church, presumably the one non-conformist exception the chairman referred to in his statement.
Gifts in kind are listed on pages 13 and 14 with the names of the givers. There was food comprising butter, cakes, eggs, game, fish, fruit, a goose, hares, honey, jelly, marmalade, milk, rabbits, turkeys and vegetables. Mrs Gerrish gave the marmalade and Mrs Portal the honey. The game was given by a party of gentlemen shooting at Ellisfield, including Lieut-Col May who also gave the hares. There were gifts of beds and bedding, clothing, old linen and crutches, plus recreational items, such as a bagatelle board (Lieut. -Col May again), playing cards (Mr Portal), books, games, papers and toys, and – something no longer allowed in hospitals – cigarettes and tobacco. (The patients were forbidden to smoke in the wards, but this was probably not for health reasons but because of the risk of fire). They were allowed to smoke outside the building. I wonder if the smokers congregated in the summerhouse given by Mr Portal on wet or cold days. The annual “Pound Day” described in Taking the pulse of Basingstoke still lay in the future. This was when schoolchildren marched to the hospital to give a pound in weight of whatever provision their mothers could spare.
A section headed “Investment Account” on page 14 revealed that the hospital owned five blocks of shares, all legacies. Three of these were of shares in the London and South Western Railway Company and the others were also railway shares. Dividends produced an income of £142 [£12202.74] in 1900. On page 15 “donations and legacies of £25 and upwards” are listed chronologically from 1874. Lieut. -Col May and Mr Portal are prominent among these givers, and in addition the “Victoria Ward” (Jubilee offering, 1887) by the Rev Barker and the “May Wing” of 1896 are referred to with no figure against them. Taking the pulse of Basingstoke refers to a brass plaque at the hospital on which these major donations were recorded. I wonder if this survives anywhere.
Next comes a tabulated list of the patients treated during the reporting year (pages 16 to 18). They are not named but they are listed under sex, age, residence, occupation, “recommended by”, date of admission, nature of case, date of discharge, and result. (“cured”, “improved”, “recovered”, “deceased”, “still in hospital” etc). I have compiled an alphabetical list of the occupations mentioned as this gives a rather interesting picture of the work scene in 1900. (Where more than one person came into a particular category, I have added the number of persons concerned). Notice how many were employed in some form of manual labour, the number in service, and the number of “housewives”, suggesting that a high proportion of women from the poorer sections of society did not go out to work; in non-emergency cases servants were probably recommended for treatment by the master or mistress of the house:
Apprentice, bank clerk, blacksmith, bricklayer (2), butcher, butler, carter, coachman (2), domestic servant (4), engineer, errand boy (2), farm boy (2), footman, game keeper, grocer (2), housemaid, housewife (11), labourer (9), laundress, milkman, navvy (3), no occupation (8), painter, school servant (2), schoolboy (4), schoolgirl (4), scullery maid, servant (2), showman, shunter, soldier (4), St Thomas’s Home (2), stable boy, station master, stoker (2), waiter
As well as the town itself, most of the villages covered by Basingstoke Rural District Council are mentioned as places of residence. Anaemia, rheumatism and pneumonia were among the more common complaints dealt with as non-emergency cases.
Forty of the 106 cases were “accident” or “urgent” cases, and here the patient’s occupation often enables us to make an educated guess about how the injury was sustained. Two errand boys were brought in on the same day. One had been “kicked by a horse”; the other had sustained a “fractured tibia and fibula”. (No doubt the same horse was responsible for this too. Were they teasing it, I wonder?) A housewife sustained a burn to the arm, and a scullery maid was brought in with a poisoned finger, – a cut infected by something nasty in the washing up, I guess; a farm boy received a fracture of the tibia and fibula; a blacksmith was an urgent hernia case; a labourer suffered an injury to the face, and another labourer an injury to both face and eye (something thrown up by a hammer perhaps, the kind of injury that would be prevented today by protective clothing); a gamekeeper from Hackwood suffered a gunshot wound, another occupational hazard – he recovered – and it is not hard to imagine how a Basingstoke railway shunter could have received an injury that required an amputation that was carried out “very satisfactorily” and probably by Mr Hayes the surgeon trustee. It is a little harder to guess how the Hook stationmaster suffered “concussion of the brain” in an accident (cured). And what, I wonder, had happened to the 26 year old bank clerk from Nately Scures who was brought in with a cut throat from which he died? Could it have been a horrific accident with the kind of cutthroat razor then in common use, or a suicide attempt that was not immediately successful?
A balance sheet appears on page 19 and financial comparisons with past years on the two following pages. Items of expenditure included what seems like a relatively modest £79 16s 0d [£6857.60] for nursing (an increase of about £27 [£2320.24] on the previous year), and £26 9s 1 ½ d for servants’ wages, a decrease of nearly £6 [£515]. The most expensive food item was meat at £69 9s 6d [£5959.03], considerably more than the outlay on “drugs and appliances” at £48 9s 6d [£4165.69].
We are back to the rules on page 22, to “House rules” for the patients this time. There are twelve of them. These are the rules for visitors:
III. The friends of patients will be admitted to visit them on Wednesdays and Saturdays from 2 pm to 4 pm. Husbands and fathers unable to come at these hours will be admitted on Wednesdays from 7 pm till 8 pm except when prohibited in the interest of the patient by the medical attendant. In special cases, however, the Matron may, with the sanction of the medical attendant, admit friends on other days. (Half-day holidays were of course most common on these two days).
IV. Not more than one friend at a time may be permitted to visit a patient without the special leave of the Matron
And here are some of the rules governing the behaviour of the patients:
VIII No male patient shall enter the female wards and no female shall enter the male wards
X No patient shall use bad language
XII Wilful disobedience to any of the rules will subject the offender to expulsion.
All in all the report provides a very interesting insight into medical services before the beginnings of the Welfare State and long before the advent of the National Health Service. It is a window into an age of self- reliance, but we can also see that many of the better off did make a very serious contribution towards helping the less fortunate in their own society. Quaint it may seem in some ways, but it also leaves one with a sense of admiration for what was achieved.
Note: There is also a copy of an excerpt from the report for 1916, comprising the balance sheet, and part of the list of patients. In both cases the format is similar to that of the 1900 report.