[For further information concerning Herefordshire hospitals, see Charles Renton, The Story of Herefordshire's Hospitals, Logaston Press, 1999]
With the rapid growth of the population during the 18th and 19th centuries (the population of Herefordshire in 1664 was 65,505 and in 1801 87,927), it was obvious that local charities and the workhouse system could not provide sufficient medical care for the poor. Many people managed to find enough work to just get by, but they would not have been able to build up any savings for a rainy day and medical care was expensive. It had become apparent that there was a great need not only for institutional care, but also for places where doctors, surgeons and nurses could gain experience and be trained, and where medical and surgical discoveries could be made and shared.
Westminster Hospital in London, constructed in 1720, was the first public hospital in England. Herefordshire did not get a hospital until 1779, after a 16 year fund-raising campaign kicked off by the Rev. Dr. Thomas Talbot, who was desperate to find a solution to the plight of the poor and sick in his rural parish, just north of Hereford. According to Charles Renton, the Hereford General Infirmary (as it was called) was only the twenty-second provincial voluntary hospital, preceding any hospital in Birmingham or Wales (Charles Renton, The Story of Herefordshire's Hospitals, Logaston Press, 1999, p. 6).
Until the turn of the 20th century hospitals were funded by charitable donations. This took several forms: annual subscriptions, small donations, and church collections might be used for the daily running of the hospital. Large donations and legacies, more often than not, would be invested to achieve a regular income. Wealthy people were treated at home or in private hospitals. Cottage hospitals could charge the patients small sums and sometimes companies established contributory schemes so that employees could pay toward treatment in a hospital if required, as a form of insurance.
Many hospitals in 19th century England had a terrible reputation. They were dirty places where more often than not you went to die rather than to be cured. The quality of nursing was often shockingly bad and because the transmission of infectious diseases was not understood, many patients became infected in hospitals. Florence Nightingale called them "gateways to death" and calculated that 90% of patients in London hospitals died (Ben Walsh, British Social and Economic History, 1997, p. 320).
Hereford General Infirmary managed to avoid some of the pitfalls encountered in London hospitals by introducing strict measures governing the management and admission of patients.
The rules governing the hospital were unlike any we are familiar with today. Only poor patients who could not afford to pay for medical care and were over the age of seven were admitted, and then only if they had a medical condition which fell into a specific category: the chronic sick, the dying and those with incurable diseases were excluded, as were cases of childbirth and mental illness. Patients with infectious diseases, such as smallpox, were also refused admission (Renton, p. 8).
Access to the hospital was governed by a complex rule which involved donations (Renton, pp. 7-8). If you gave money to the hospital, you would receive a certain number of tickets to sponsor both in-patients and out-patients; the number of tickets depended on your generosity. Sometimes workhouse inmates were sent to the hospital, in which case the workhouse had to pay for their treatment.
For a person to be admitted to the hospital, they had to turn up punctually at 10am on a day specified for admissions, bring a ticket from a sponsor, be clean and free from vermin, and bring two shirts and other pieces of necessary clothing (Renton, p. 8).
The General Infirmary (HER 35705), which had opened its doors to patients in 1776 at 162 Eign Street, was replaced in 1783 by the purpose-built General Hospital on the north-west bank of the river Wye (HER 26936).
This hospital was first erected after the 1875 Public Health Act made the City Council responsible for controlling infectious diseases. At first tents were used to house patients, however in 1893 these were replaced by a prefabricated iron hospital with twelve beds. The Isolation Hospital, as the name suggests, was used for patients with contagious illnesses and was administered by the medical officer of health for the City of Hereford. Needs dictated that another wing with a further twelve beds was opened in 1898. During outbreaks of scarlet fever or diphtheria additional staff were hired, such as in 1896 when seven extra nurses and three domestics were temporarily employed (Renton, pp. 200-202).
The Victoria Eye Hospital was initially established in 1882 by an eye surgeon in a leased building in Commercial Road; at this time it was known as the "Herefordshire and South Wales Eye and Ear Institution". The surgeon, Mr. Francis Woodley Lindsay, was supported by private subscribers and by John Venn, the well-known local philanthropist. In 1884 this specialist hospital became a charitable institution treating the needy poor through a system of referral tickets. A wealthy benefactor helped to purchase a site in Eign Road, where in 1888 a new hospital was built. This impressive building, which was extended during the 20th century, has now been converted into flats after the medical activities were moved to the County Hospital site in 2002 (Renton, pp. 169-182).
The General Infirmary was quite successful in treating accidents and emergencies, however the journey to Hereford from the outlying parts of the county was too long and uncomfortable for many patients. The railways made travel easier, but poor people were more likely to travel by cart and some people were reluctant to be treated in a place where their relatives might not be able to visit regularly. (Keep in mind that some people in the county considered Hereford to be a faraway place.) Five of Herefordshire's market towns therefore built cottage hospitals and dispensaries during the second half of the 19th century.
For more information on each of the listed cottage hospitals, please consult the HER database by typing the appropriate HER number into the HER Number box and clicking on the Start Search button.
[Original author: Toria Forsyth-Moser, 2004]