The making of a ‘new model hospital’ – with ‘buried treasure’?

I have heard many people mistakingly say that St. Bartholomew’s Hospital, at Rochester, was the oldest hospital in the country. The site could be oldest that has had a hospital on it, but it needs a fair stretch of imagination to accept that there was a functioning hospital on that site prior to the ‘new model’ hospital opening on 10 October 1863. I also suspect some 150 years ago there were folk in Chatham who believed the new hospital was not built on the site of the original 1078 hospital – as that was in Chatham! Further, the ground upon which the new 1863 hospital was built was described as “garden ground on New-road, in the occupation of Mr. J. Hulkes, the whole of which was be covered by the building.”

Nevertheless there is a story to be told. I therefore offer the following as a ‘starter for 10’ in the hope that it may help someone far more able than I to pull together a history of the hospital. In this blog I offer a sequence of events that led to the building of the hospital that we know today as St. Barts. In a later blog I will tell something of its history from 1863 to the creation of the NHS.

Early history

The original St. Bartholomew’s founded by Gundulph, bishop of Rochester in 1078, was a ‘lazer-house’ or ‘lepers house’ that received leprous and other poor persons native to Kent. It would have been built on the edge of the City but close enough and on a route that would enable lepers to beg or trade. The actual design is not known but based on other sites it probably consisted of a group of small cottages close to a chapel – a news report on findings relating to the chapel at St. Barts did refer to the recent demolition of old houses. Reference was made to the removal of houses on the south side of the chapel revealing the original Norman work .

Gundulph endowed the hospital with land that provided an annual income of £13. Its original staffing was a prior, and sisters & brethren from the priory of St. Andrews, that was part of Rochester Cathedral.

Funding has always been a challenge for St. Barts as the rental income realised from its land was insufficient to meet the cost of running the hospital. It was therefore always dependent on grants from the Crown (Henry III, Edward III and Henry IV all made grants) and other persons, and a liberal allowance from the monks of St. Andrew’s Priory.

Before the dissolution of the priory the brethren of St. Bartholomew’s received allowances from the convent, and the oblations of two alters in the cathedral. They also had the privilege of collecting alms from the persons who dined at the bishop’s table on the day of his installation. 

After the dissolution of the Priory of St Andrew the only income the brethren could expect was the rental income that it received from its land – in fact the hospital was so poor it was of no interest to Henry VIII who commandeered most of the hospitals in the kingdom, so he left it in the hands of the Dean & Chapter of Rochester Cathedral. At the beginning of the reign of Elizabeth I (1558-1603) it is said the hospital was only occupied by two “impotent persons”. 

The hospital’s financial circumstances improved somewhat when the royal dockyard at Chatham began to establish itself as the value of the land rapidly increased through the necessity of needing to provide accommodation for artisans and others involved in the development and running of the dockyard. By 1849 it was accepted that the income from the hospital land was £3,500 but still insufficient to support the hospital!

Questions were therefore raised as to where that money was going if it wasn’t being used to bring more benefit for the poor in the district. This was regarded by some as a scandalous situation made all the worse by the scandal of the minuscule allowance the Dean & Chapter paid to the poor scholars of the Kings School – but that’s a story for another blog! At the same time there were also serious concerns related to the way in which the trustees of the Watt’s Charity were administering the bequeath of Richard Watts.

In 1849 it was reported that several influential inhabitants of Rochester made a claim to the whole amount due to the hospital with a view to building and maintaining a new hospital for in-door and out-door patients.

Was St. Barts in Rochester or Chatham?

This became an important issue when consideration was being given to how the land endowed to the hospital could be divvied out. Certain deeds described the hospital as being “at or near Rochester” whilst other deeds fixed the hospital as being “in the parish of Chatham”.  In the Charter granted to the City of Rochester by Edward IV the hospital was set as one of the boundaries. Despite numerous court hearing that set St. Bartholomew’s in Rochester, the Rev. S. Arnott at the Court Leet dinner at Chatham, was still supporting, in 1863, the view that the old hospital was in Chatham.

Matters end up in Court

A complex series of events took place between 1849 and 1859 with the Court of Chancery and the Attorney General becoming involved in resolving matters relating to the management of the Watt’s charity, the Dean & Chapter’s management of the Cathedral School and the management of St. Bartholomew’s hospital. Concerns about the mismanagement of these charitable funds became a national scandal – even Dickens in his “Seven Poor Travellers” made mention of concerns about the management of the Watt’s Charity and the poor scholars of the Cathedral School. (As these matters were resolved the Government came to accept some statutory oversight was needed and the foundations were laid for what we know today as the Charity Commission.)

In 1858 the Court of Chancery ordered that St. Bartholomew’s hospital was to be restored and remodelled, and set up new trustees under the management of the Dean of Rochester. It directed that an 80 bed hospital and dispensary was to be built to receive and relieve poor persons of the parishes of Chatham, Frindsbury, Gillingham, Rochester Cathedral precincts, St. Margaret’s and St. Nicholas, in the City of Rochester, and Strood. The Court further directed that the hospital should receive patients with any kind of disease excepting, no parish pauper, no lunatics, no person with small pox, or confirmed consumption, ulcerated legs of long standing or the itch, (this could have been scabies) or any female far advanced in pregnancy except where she had had a severe accident and required surgery. The Court further directed that 30 of the 80 beds should be for the reception and treatment of women infected with a venereal disease in a ‘Lock’ ward, and that the Ministry of War and the Admiralty would share the cost of the building and running of that facility.

The first meeting of the new trustees took place in August 1859. The building had not started –  indeed the land had not yet been acquired from Mr. J. Hulkes  – but the mayor was in receipt of a beautifully executed drawing of the exterior of the building provided by the Attorney General. The design was not very ornamental but provided for two large charity wards for males and females respectively – capable of receiving 40 patients, and some smaller wards for 10 accident patients. The design also made provision for the locked wing that was secured from the rest of the hospital. (More about Locked Wards and how they may have laid the foundations for the local feminist movement in the Towns, in a future blog.) The most prominent feature of the hospital was the tower of four floors that housed two slate water tanks that together were capable of holding 1,500 gallons.

The building cost was put at £7,000 or which £4,000 was to come from the Watt’s charity and £3,000 from the hospital’s estates. The Government supplemented this amount with a large grant for the construction of the Lock ward. It was expected that the revenue funding would come from the hospital estates, £1,000 from the Watt’s charity, £750 from the war office, and that the Admiralty would pay £25 for each bed provided for a Lock patient.

The invitation to tender was issued in January 1861 for the building, on ground near New Road in the parishes of St. Margaret’s and Chatham, a dispensary and hospital comprising wards for 80 patients, with “apartments for Officers and Servants of the establishment”. (No mention was made on any existing hospital buildings.)

By April 1861 it was reported that Mr Stump, the winning contractor, had made great progress but it was not until August that the Foundation Stone was eventually laid. It had been hoped that HRH Prince Consort would perform the ceremony but this was not possible so HRH the Prince of Wales was invited but he was unable to attend because of his military duties in Ireland. So as not to delay progress, as it was hoped to open the hospital in early 1862, it was decided to hold a private ceremony.

Laying of the Foundation Stone – celebrated by dignitaries and workers alike.

The foundation stone was placed to the right of the entrance. Beneath the commemoration stone was placed a sealed leaden box containing the inscription written on vellum, that was read out at the ceremony, and one each of the current coins of the realm.

“To the glory of God, and in honour of St. Bartholomew the Apostle, this stone commemorating the building of this Hospital, and the resurrection of the Charity founded by Bishop Gundulph, 1078, was laid by Thomas Hermitage Day Esq., one of the brethren on behalf of the Patron, Brethren and Trustees of the Hospital.”

After the ceremony the trustees repaired to the Deanery where an elegant luncheon was prepared for them and other dignitaries. In the afternoon a substantial dinner was provided for about 90 workman who were employed on the building of the hospital. After their dinner they indulged in various outdoor amusements on the greensward until dusk. They then returned to the house and were regaled with punch etc. ad libitum, provided by the same liberal hands which supplied the dinner.  After enthusiastically drinking the health of the Trustees the men departed to their own home – highly gratified with the day’s proceedings.

The hospital opens

The hospital opened on the 10th October 1863 with no pomp other than it was opened for public inspection on the 9th. The Trustees wished it to be known that their funds were not in a “flourishing condition” and they had been compelled to borrow £1,500 to complete the hospital. They also believed that the hospital’s annual income would not become sufficient for some years, and not until regeneration of the Towns improved land values and in turn, rental income. Until that time the hospital trustees pressed hard to recruit more subscribers and requested gifts of old linen or cotton to be sent to the matron.

Hospital staffing

Staff on the opening of the hospital comprised of a consulting physician, consulting surgeon and an honorary dentist who provided their services gratuitously, others received an annual salary – bracketed. 

Chaplain (£150) 

Surgeon (£120)

Dispenser (£60) 

Steward (£50) 

Matron (£30, aged between 30 & 50, with experience in the management of a hospital for the sick)

Nurses – female x 7. (£12 / annum aged between 25 & 50 and accustomed to nursing)

Porter (£15, unmarried aged between 35 and 55)

Cook – female (£16)

Laundress (£16), 

Housemaid (£12), 

Under housemaid (£8) and a 

Scullery maid (£8).

Gaining admission to St. Bartholomew’s for treatment

As was the case with all hospitals patients who had had a recent accident were admitted at once without recommendation. In other cases the applicants had to be recommended for admission by one of the following:

A trustee, a medical officer, the Dean or Canons of Rochester, clergyman of Parish churches, Trustees of Watt’s charity, or a subscriber to the funds of the hospital. As a rule no patient was to be permitted to remain more than two months – although cases would be considered on their merit. 

Out patients could be prescribed everyday but Sunday. The Watt’s Trustees could nominate no more than 20 in-patients or outpatients. In order to recruit more regular donors and to encourage larger subscriptions, a donor could nominate one in-patient and two outpatients for every guinea they subscribed. If a Trustee wished to nominate someone for admission they were required to become a subscriber. (This probably dealt with the concern at the root of the earlier scandals that trustees in the past had managed charities for their own best interests.)

Within a week of opening seven women were admitted to the Locked wards from the Medway Union which previously provided those wards.

Weekly admission figures were published in the press:

Beginning of November: 

33 general patients, and 15 women in the Locked ward. 152 out-patients treated.

Beginning of December: 

44 general patients, and 16 women in the Locked ward. 245 out-patients treated.

To be continued …… the story of a hospital that was to become a truly modern hospital of its time.

References

South Eastern Gazette – 29 June 1852

Maidstone Journal and Kentish Advertiser – 4 October 1853

West Kent Guardian – Saturday 31 March 1855

Maidstone Journal and Kentish Advertiser – 8 May 1855

Maidstone Journal and Kentish Advertiser – 18 September 1855

South Eastern Gazette – 2 August 1859

South Eastern Gazette – 30 August 1859

South Eastern Gazette – 29 January 1861

South Eastern Gazette – 16 April 1861

Kentish Gazette – 27 August 1861

Maidstone Journal and Kentish Advertiser – 27 August 1861

South Eastern Gazette – 4 February 1862

South Eastern Gazette – 25 March 1862

Kentish Gazette – 30 September 1862

Chatham News – 24 January 1863.

Chatham News – 21 February 1863

Chatham News – 30 May 1863

Bath Chronicle and Weekly Gazette – 16 July 1863

Chatham News – 19 September 1863

Chatham News – 26 September 1863

Chatham News – 3 October 1863

Dover Express – 10 October 1863

Chatham News – 17 October 1863

Chatham News – 31 October 1863

Chatham News – December 1863

Chatham News – 19 December 1863

John Bull – Saturday 18 October 1873

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