Houses for the mad have been built for a long time. Most of them were monastic and cared also for poor sick people. But after dissolution of the monasteries in the 1530s and 1540s only some of them had escape destruction and were refounded as secular institutions. Among them: St. Bartholomew’s and St. Thomas’ hospitals caring for the physically sick and Bethlem hospital for the insane. In 1725 Thomas Guy founded Guy’s Hospital. Other major London hospitals, including the Westminster, Royal London, Middlesex, and St. George’s Hospitals, were established in the 18th century on the voluntary principle.
In the beginning of the 19th century, a different approach to mental illness became very popular. The number of madhouses and asylums became increase, already legacy institutions were enlarged. But this practice was not effective. Sick people were just gathered, but there was no real treatment. They were maintained in dreadful conditions in overcrowded smelly buildings, where they suffer much more than at home. It was just isolation from society. People with mental illnesses mostly were considered close to animals. The Lunatic Asylum Enabling Act 1808 gave permission for asylums to be built in each county.
The County Asylums Act 1845 required boroughs and counties to provide adequate asylums at public expense for pauper lunatics. This led to a rapid building programme. It was in the 25 years after the Act that most of Britain’s mental hospitals were built. By 1847, 36 of the 52 counties had built asylums. By 1900 there were about 100 in the country. [2] Many categories of the sick, including pregnant women, the mentally ill, and patients suffering from incurable or infectious diseases were excluded from most hospitals.
Voluntary hospitals were established especially to care for some of these patients. They included Queen Charlotte’s Hospital, the City of London Lying In Hospital, the Smallpox Hospital, St. Luke’s Hospital for Lunatics, and the London Lock Hospital (for patients suffering from venereal disease). [3] The London Boards of Guardians were obliged to build separate workhouse infirmaries into which trained nurses were introduced. Nurses from the Nightingale School started schools of nursing at Highgate Infirmary in 1871 and at St Marylebone Infirmary in 1882.
The Metropolitan Poor Act also established the Metropolitan Asylums Board which provided fever and smallpox hospitals for those suffering from infectious diseases as well as asylums for harmless and incurable pauper lunatics for the whole metropolitan area. From 1774 to 1842 on the area of London existed four commissions which regulated the system of mental health care. They are: The Physician Commission (established by 1774 Madhouses Act) Metropolitan Commission (established by 1828 Madhouse Act) Lunacy Commission (established by 1845 Lunacy Act)
Board of Control (established by 1913 Mental Deficiency Act) [2] In 1889 responsibility for the county lunatic asylums passed to the newly formed county councils. The City of London retained control of its asylum, Stone House Hospital. The Local Government Act of 1929 abolished the Metropolitan Asylums Board and the Boards of Guardians for London and Middlesex and transferred their responsibilities, including those of the former City of London Board of Guardians, to the London County Council and Middlesex County Council, which thus became major providers of health care.
Their plans for the modernisation and development of their hospitals were brought to an abrupt halt by the outbreak of war in 1939. In 1948 the post war Labour Government established the National Health Service with the intention of providing free health care for all from cradle to grave. [3] Many smaller hospitals in London have closed during the last 30 years. Services have been concentrated on fewer sites either in large modern hospitals or often, as at Guy’s and St Thomas’ Hospitals, in a combination of old and new buildings.
The large Victorian mental hospitals on the periphery of London are in the process of being closed to be replaced by care in the community. Major London hospitals are at present under threat of partial or total closure in the search for rationalisation and economy in the provision of medical services. [4] Andrew Roberts, the author of Index of English and Welsh Lunatic Asylums and Mental Hospitals Based on a comprehensive survey in 1844, and extended to other asylums, presented a list of the largest London mental hospitals and the short history of each:
Hanwell (1st Middlesex) County Asylum Built 1829 to 1830. Opened 16. 5. 1831 Architect: William Alderson. A third floor added in 1859. Became a London County Asylum in 1889. Hanwell Mental Hospital from 1929 to 1937. St Bernard’s Hospital from 1938 to 1980. Uxbridge Road, Southall, UB1 3EU. Sometime before 1962, Andrew O’Brien visited his uncle in St Bernard’s Hospital. It was “like a small town in itself”. There was a church, a laundry, and a point on the Grand Union Canal where barges brought the coal for the Hospital.
He can remember the tall Victorian wards and that there seemed to be many patients in each ward, and white coated male orderlies who seemed to spend some of their time lighting patients cigarettes. He felt very sad and could not face going again after his second visit. In 1971 it had 2,039 beds, 189 in locked wards. Two general hospitals: King Edward Memorial Hospital and Claypond’s (started as an isolation hospital) form Ealing Hospital between 1978 and 1980. Surrey County Asylum Springfield, near Wandsworth opened 14. 6. 1841 Architect: E Lapidge 1. 1. 1844: 382 patients. All pauper.
Transferred to Middlesex County Council after the 1888 Local Government Act, when it was known first as Wandsworth Asylum. From about 1918 known as Springfield Asylum. A detached annexe for 260 “low-grade mental defectives, 180 children and 80 adults” was built under the 1913 Mental Deficiency Act. In 1939 “Springfield (Mental) Hospital” had 2,000 patients, 83 acres of farm land and 14 acres of garden. There was close cooperation between Springfield and Westminster Hospital. Now Springfield Hospital, 61 Glenburnie Road, London, SW17 7DJ. Bethlem Hospital, (1844) St George’s Fields, South London.
1. 1. 1844: 355 patients of whom 90 were criminals. 1377: old Bedlam (St Mary of Bethlem) 1676: Moorfields Bedlam 1814: 119 patients 1815: St George’s Field Bedlam 1930: Kent Bethlem Hospital Today: Bethlem Royal Hospital Archives and Museum City of London Lunatic Asylum Built by the Corporation of London at Stone near Dartford, Kent during 1862 to 1866. Designed by James Bunstone Bunning, the City’s Clerk of the Works (later City Architect and Surveyor). Opened 16. 4. 1866. From 1892, private patients were admitted. From 1924 known as the City of London Mental Hospital.
From 1924 able to receive voluntary boarders In 1948 the hospital was transferred to the Minister of Health under the National Health Service Act 1946. Became Stone House Hospital, Cotton Lane, Stone, Dartford, Kent, DA2 6AU. The hospital is due to close and will be converted into luxury apartments. The City of London Record Office has most of the archives (to 1948/1949), but some appear to be in the London Metropolitan Archive St Clement’s The City of London Union Workhouse opened in 1849. After a period of standing empty, the building was re-opened on 1st March 1912 as Bow Institution.
It was later renamed the City of London Institution, then in May 1936 it was renamed St. Clement’s Hospital which it is still known as today. ” St Clement’s Hospital (from 1936) was administratively absorbed by The London Hospital in 1968 and became The London Hospital (St Clement’s), 2A Bow Road, London, E3 4LL. St Luke’s Hospital probably not receiving paupers in 1844 The first patients were admitted in July 1751. In February 1753 the number was increased to 57 1910 the Hospital bought the Welders Estate near Jordans in Buckinghamshire, with the intention of building a substantial convalescent home.
The project was never brought to completion, but an Encyclopedia reference in 1922 refers to new buildings being constructed at Gerrards Cross, Buckinghamshire. Until later than 1958, the building was used as a printing works for Bank of England notes. 1930 “Third St Luke’s” opened in Woodside Avenue, Muswell Hill after an “association with Middlesex Hospital” that began in 1923″ 1930: Woodside Nerve Hospital 1940: St Luke’s Woodside Hospital for Functional Nervous Disorders 1948 St Luke’s Woodside, Woodside Avenue, Muswell Hill, London, N10 3HU 2001 250 year history booklet
Guy’s Hospital Lunatic Ward not receiving paupers in 1844 1. 1. 1844: 25 private patients 1889 Became a London County Council asylum Became Colney Hatch Mental Hospital from 1918 to 1937 May 1871 nearly 1,400 patients 1920 Caterham Mental Hospital 1941 St Lawrence’s Hospital, Caterham 1889? Became a Surrey asylum In 1960s and 1970s (about), part of Kensington and Chelsea and Westminster Area Health Authority (West London) Demolished 1989 Site used for a prison. The Colney Hatch Lunatic Asylum Established in the mid 19th century. Architect Samuel Whitfield Daulkes (1811-80).The first patients arrived in July 1851. The use of the word lunatic was not officially dropped until 1930. [1]
Bibliography
1. Andrew Roberts, Index of English and Welsh Lunatic Asylums and Mental Hospitals Based on a comprehensive survey in 1844, and extended to other asylums. 2. Steven Cherry, Medical Services and the Hospital in Britain, 1860-1939 (Cambridge University Press, 1996) 3. Roy Porter, Madness: A Brief History (Oxford University Press, 2003) 4. Jeremy Taylor, Hospital and Asylum Architecture in England, 1840-1914 (Mansell, 1991)