Records relating to Hertfordshire Voluntary Hospitals

HV

Records relating to Hertfordshire Voluntary Hospitals

HV 1 Bishops Stortford Cottage Hospital

HV 2 West Hertfordshire Hospital, Hemel Hempstead

HV 3 Hertford County Hospital

HV 4 North Hertfordshire and South Bedfordshire Hospital, Hitchin

HV 5 Letchworth Hospital

HV 6 Royston Cottage Hospital

HV 7 Home Hospital for Women, Stevenage (formerly at Stoke Newington)

HV 8 Watford Peace Memorial Hospital

HV 9 Queen Victoria Memorial Hospital, Welwyn

HV 10 Welwyn Garden City Cottage Hospital

1 ADMINISTRATIVE RECORDS

A Board of Management (General Committee)

B House Committee

C Finance Committee

D Ad hoc Committees

2 FINANCIAL RECORDS

A Annual reports and audited accounts

B General financial records

3 PATIENT RECORDS

A In-patient registers

B Out-patient registers

C Registers of Military cases

D Miscellaneous patient registers

4 STAFF RECORDS

A Index cards

B General staff records

5 MEDICAL RECORDS

A Case books

B Anaesthetic books

6 MISCELLANEOUS

A Hospital Associations

B Visitors' books

C General

English

The first voluntary hospitals in England were established after the Reformation, for before the Reformation care of the sick poor was undertaken by the Established Church in the form of the monastic orders. When the monasteries were dissolved care of the sick fell on the parish. The first voluntary hospital to be established was St Bartholomew's in the City of London which is said to have pre-reformation origins, followed in the seventeenth century by the foundation of St Thomas's Hospital, Southward and Thomas Coram's Foundling Hospital. It was not until the mid-nineteenth century, however, when public benefaction was at its height, that most of the Hertfordshire voluntary hospitals were established. Voluntary hospitals were privately endowed, in the first place, usually by a local landowner, although they were subsequently maintained by subscriptions and donations. Anyone was open to subscribe, and then became known as a governor or subscriber which entitled them to certain privileges. In the case of the West Herts Infirmary a subscription of £1 entitled the subscriber to nominate an out-patient, one of £5 to nominate an in-patient and a donation of £50 or more entitled the benefactor to become a life member. A Board of Management was appointed from the governors to administer the daily running of the hospital, usually with the help of a House Committee and a Finance Committee. Many local organizations adopted the hospitals and held fetes, garden parties and other fund raising events to raise money for the maintenance of the hospital and especially for the purchase of equipment. Many of the hospitals had contributory schemes which entitled a member of the scheme to medical treatment.

The voluntary hospitals, unlike the large sprawling workhouse infirmaries, were usually small, containing as few as six or seven beds in some cases, and served the "deserving" poor of the immediate area. It is interesting to note that the workhouse infirmaries were unwilling to admit anyone who was eligible to be admitted to a voluntary hospital and the voluntary hospitals would not admit the destitute or "undeserving" poor. Frequently, too, the hospitals would make arrangements with local companies. In Hemel Hempstead, for example, the West Herts Infirmary made an arrangement with the local railway company to treat their employees working on the line and to supply them with trusses.

Hertford County Hospital had an endowed trust fund, as trusses were considered to be very expensive items of equipment. The rules of admittance to the hospital were very strict; at Bishops Stortford any patient not completing his course of treatment was warned that he would not be accepted for future treatment.

In the early days of the voluntary hospitals the medical staff were usually unpaid It was considered to be prestigious to be appointed to the medical staff of a voluntary hospital. The medical staff maintained themselves by private practice, this is again in contrast to the poor law doctors who were paid, albeit badly, for their services. The nursing staff were on the whole either "Nightingale" nurses or had been trained at other nursing establishments. The nurses were paid a small wage in addition to board and lodging. As some of the hospitals grew more prominent at the turn of the twentieth century they were permitted to establish medical schools. It was considered a great privilege to be allowed to train at a voluntary hospital for the students were studying under some of the best doctors in the area. The medical staff were paid small amounts as the hospitals grew bigger and required more of their time. In the same way some of the larger voluntary hospitals established schools of nursing. The girls accepted for training at these schools were considered to be far superior to those accepted at other places, especially in the 1920s and 1930s. In contrast, the workhouse infirmaries were not permitted to establish either medical schools or schools of nursing (see HW introduction). Trained nurses may have been in short supply, but there was no shortage of applicants for the posts advertised by voluntary hospitals.

Unlike the workhouse infirmaries the voluntary hospitals could chose which patients to admit (then referring all other cases to the workhouse), and if their beds were full they could refuse to admit patients altogether. They did not take the chronic infirm, infectious cases or long term sick patients, which is another reason why the voluntary hospitals attracted better quality staff as the variety of nursing skills they could teach was greater. The voluntary hospitals did, on the whole, perform all the surgical work, the workhouse infirmaries referred their patients to the voluntary hospitals for surgery.

Most of the voluntary hospitals started life in cottages or other buildings, which were either bought by the governors or left by the benefactor. West Herts Infirmary started in a tied cottage belonging to its benefactor (see HV2 introduction). As the hospitals became more financially stable and more prestigious they were able to finance larger, purpose built buildings. These building, some of which are still in use today, were usually built in the pavilion style with high ceilings and lofty corridors, as fresh air and light was considered to impede infection.

The voluntary hospitals played their part in both world wars, making both their buildings and equipment freely available to the Emergency Medical Service, a government run agency. Therefore the records show the treatment of military cases in several of the Hertfordshire hospitals. Hertfordshire being so close to London proved popular for the treatment of these cases and in one case, that of the Home Hospital for Women, Stoke Newington, which was evacuated to Stevenage, the hospital did not return to London.

In 1946 when the formation of the National Health Service was being debated, many of the smaller cottage hospitals faced closure or amalgamation with the larger hospitals. Hospitals like the West Herts Infirmary, however, offered the National Health Service a sound basis for a general hospital. On July 5th 1948 control of the voluntary hospitals passed from the Board of Management and therefore the local community to the Minister of Health.