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THE WORKHOUSE AND HOSPITAL

AT HILLINGDON (Middlesex.)

1744 – 1967

by

Howard Wingfield F.I.B.M.S., D.M.S.

The Hillingdon Hospital NHS Trust May 2003

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FOREWORD

This publication documents the history of The Hillingdon Hospital near Uxbridge in Middlesex and its Workhouse origins. It is an update of my booklet printed in 1995 “A Brief History of The Hillingdon Hospital 1744 to 1967”. As previously, I have tried to bring together a story that tells of the development of a small parish workhouse to become a large hospital that today provides a wide range of modern healthcare services to it’s local community. I would not have been able to do this without the help of the many people who have kindly given or loaned me documents, photographs, letters etc. To all of you, my heartfelt thanks. Howard Wingfield

This booklet is printed solely as an educational resource. It is published on a strictly “not-for profit” basis and must not be sold or otherwise used for gain. Voluntary donations to trust funds or charities associated with The Hillingdon Hospital NHS Trust to benefit the patients it serves are always received with gratitude.

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INDEX Page TIMELINE 5

PART I

HILLINGDON AND UXBRIDGE UNION WORKHOUSES CHAPTER 1. THE OLD POOR LAW 8 CHAPTER 2. HILLINGDON PARISH WORKHOUSE 12

1744 – 1833

CHAPTER 3. “TAKING” THE WORKHOUSE 16 CHAPTER 4. THE NEW POOR LAW 19 CHAPTER 5. UXBRIDGE UNION WORKHOUSE 24

1834 – 1930 CHAPTER 6. THE WORKHOUSE INSTITUTION – 38

AN OVERVIEW

PART II

HILLINGDON HOSPITAL CHAPTER 7. HILLINGDON COUNTY HOSPITAL 40

1930 – 1933

CHAPTER 8. THE COTTAGE HOSPITALS 56 CHAPTER 9. HILLINGDON HOSPITAL 1939 – 1945 59

CHAPTER 10. BABIES, “BUGS” and BOMBS 62

CHAPTER 11. HILLINGDON HOSPITAL 1946 –1967 67

REFERENCES

APPENDIX

TEXT OF THE ADDRESS GIVEN BY DR. C.G. BARNES AT THE MEMORIAL SERVICE 10TH NOVEMBER 1965 TO COMMEMORATE THE LIFE AND WORK OF DR. ARKLAY STEEL.

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ILLUSTRATIONS Figure Page 1. Opening Part of the 1601 Poor Law Act. 9 2. Map of Hillingdon 1786 13 3. Inventory of Hillingdon Workhouse 1796 14 4. Document Establishing a Select Vestry for Hillingdon 1833 18 5. Certificate of Suspension of Settlement Act Removal Order, 23

Hillingdon 1833 6. Uxbridge Parish Workhouse 24 7. Ruislip Workhouse 25 8. Conveyance Document for the transfer of Hillingdon Parish 27

Workhouse buildings to the Guardians of the Uxbridge Union 9. Advertisement for Sale of Hayes Workhouse 1837 29 10. Map showing Uxbridge Union Workhouse, Hillingdon 1881 31 11. Advertisement for Tenders to Supply Uxbridge Union Workhouse 1846 33 12. Uxbridge Union Workhouse about 1930 with Chapel in the Background 37 13. Map showing Uxbridge Union Workhouse, Hillingdon 1932 40 14. Aerial View (Looking North) of Hillingdon Hospital about 1930 41 15. Main Entrance of Hillingdon Hospital about 1930 42 16. Hillingdon Hospital sometime in the early 20th Century 43 17. Robert “Jock” Rutherford. 44

Medical Superintendent Hillingdon Hospital 1929-33 18. X-Ray Equipment about 1930 48 19. Hillingdon Union Hospital Drug Formulary 1925 49 20. Linen Room Hillingdon Hospital about 1935 50 21. Hillingdon Hospital Ambulance about 1935 51 22. Boiler House Chimney Hillingdon Hospital about 1935 53 23. Senior Staff Hillingdon Hospital about 1935 54 24. Uxbridge Market House 1936 Decorated for Coronation of King George VI 55 25. Uxbridge Cottage Hospital about 1930 57 26. Interior of Uxbridge Cottage Hospital about 1930 57 27. Bomb Damage Hillingdon Hospital October 1940 59 28. Maternity Ward Damaged by Bombing October 1940 60 29. Dr. Beavan, Dr. Bray and Mr. Stevenson in 1968 64 30. North Lodge, Hillingdon Hospital 64 31. Scientific Publication by Dr. John Bray 65 32. Christmas Show Programme 1946 67 33. Press Cutting 1946 68 34. Christmas in the Ward at Hillingdon Hospital about 1945 69 35. National Health Service Leaflets 1948 70 36. Demolition of Workhouse Buildings about 1970 71 37. H.R.H. the Duchess of Kent 1960 72 38. New Maternity Unit Hillingdon Hospital in 1960 73 39. “The Furze” building at Hillingdon Hospital about 1960 74 40. Dr. Arklay Steel “Cutting the First Sod” Hillingdon Hospital January 1963 75 41. Portrait of Dr. Arklay Steel by Patrick Phillips R.A. 77 42. Aerial View of Hillingdon Hospital in 1966 78 43. Hillingdon Hospital in 1967 79 44. Part of the Pathology Laboratory at Hillingdon Hospital in 1967 79

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TIMELINE 1598 Acte for the Reliefe of the Poore required churchwardens and four Overseers

in each parish to: • Set children and poor to work • Relieve the impotent • Bind out pauper children as apprentices • Tax ‘every inhabitant and occupier of lands’ in the parish for the above

purposes.

1601 Acte for the Reliefe of the Poore consolidated and replaced a variety of previous poor law and aimed at:

• Establishment of parochial responsibility, with churchwardens or overseers allocating relief

• Suppression of begging • Provision of work • Use of County Houses of Correction for vagrants • Setting to work and apprenticeship of children.

1662 The Settlement Act (An Act for the Better Relief of the Poor of this Kingdom)

stipulated that newcomers to a parish “like to be chargeable” could be removed upon the orders of two Justices of the Peace if a complaint was made against them within 40 days of arrival, provided they had not rented a house worth at least £10 a year.

1697 Act for Supplying some Defects in the Laws for the Relief of the Poor

stipulated: • Newcomers with certificates to be removed only when chargeable • Those receiving relief to wear identifying badges • Fines for those who refuse to take pauper apprentices.

1723 Knatchbull’s Act (The Workhouse Test Act) enabled workhouses to be set up by

parishes either singly, or in combination with neighbouring parishes. In addition, relief was to be offered only to those willing to enter the workhouse.

1744 Hillingdon Vestry decided to build a Workhouse. 1747 Hillingdon Parish Workhouse built at Colham Green. 1782 Gilbert’s Act (For the Better Relief and Employment of the Poor)

Authorised parishes to unite and set up a common workhouse controlled by a Board of Guardians appointed by JPs.

1795 Speenhamland System. Named after a Berkshire parish where magistrates decided to

supplement wages from the poor rate on a scale that varied according to the price of bread and number of children.

1796 Inventory of Hillingdon Workhouse valued the furniture, fixtures, bed linen and

table linen at £155 19s 8d.

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1816 The stethoscope was invented. 1819 Sturges Bourn’s Act (To Amend the Laws for the Relief of the Poor)

Allowed parishes to appoint Select Vestries to scrutinize relief giving. 1832 Royal Commission on the Poor Laws established. 1834 Report of the Royal Commission published in March Poor Law Amendment Act received Royal Assent on August 14th. Poor Law Commissioners sworn in on August 23rd. The main points of The Act were:

• Parishes were to join together to form Poor Law Unions • Boards of Guardians were to take charge in each Union and build

Workhouses • Central Poor Law Commission set up in London to supervise. • Workhouse life was made disciplined so that “scroungers” did not enter the

Workhouse just to obtain food and shelter • Families in Workhouses were split up. • Outdoor relief would be given only to the sick, infirm and those over 60

years of age. Outdoor relief for the able-bodied abolished. 1835 Uxbridge Poor Law Union formed. First meeting of the Board of Guardians held

30th June. 1837 –1839 Oliver Twist by Charles Dickens first published in monthly instalments. 1838 Uxbridge Union Workhouse built on the site of Hillingdon Workhouse. 1844 Second Poor Law Amendment Act. Improved numerous details of the 1834 Act. 1845 Andover Workhouse Scandal where conditions were so bad that inmates were shown to

be fighting over scraps of rotten meat left on bones they were set to crush. 1846 Ether first used as an anaesthetic. 1847 Poor Law Board replaced the Poor Law Commission. 1853 The hypodermic syringe was invented. 1865 Joseph Lister introduced antiseptic principles. 1870 Education Act introduced compulsory elementary education administered by local school

boards.

1871 Local Government Board replaced Poor Law Board. 1875 Public Health Act set up nationwide system of rural and urban sanitary authorities.

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1882 Robert Koch discovered the cause of tuberculosis.

1895 X-rays first used. 1901 ABO blood groups described. 1902 Education Act replaced School Boards by Local Education Authorities and raised

school-leaving age to 14.

1906 Education (Provision of Meals) Act. Gave free meals for poor children. 1907 Education (Administrative Provisions) Act. Introduced medical inspections for school

children. 1908 Children’s Act. Gave local authorities new powers to keep poor children out of the

workhouse. 1908 Age Pensions Act. First state pensions given to those over 70. 1905-1909 Royal Commission on the Poor Laws. Criticised current operation of the law

but members were divided on how to reform. 1909 Trade Boards Act introduced minimum wages in certain industries.

1909 Old Age Pension was introduced. 1911 Unemployment Insurance and Health Insurance began in limited form. 1913 Workhouse now referred to as Poor Law Institution in official documents. 1919 Ministry of Health replaced Local Government Board. 1929 Local Government Act abolished all Poor Law Authorities and transferred their

responsibilities for “public assistance” to local councils. 1930 Hillingdon County Hospital & Infirmary formed under the control of Middlesex

County Council. Took over the Uxbridge Union Workhouse buildings. 1939 –40 During World War II. The Hillingdon Hospital expanded greatly in size. 1941 Penicillin first became available. 1948 The National Health Service came into force on 5th July. 1967 The New Hillingdon Hospital opened

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PART I

HILLINGDON AND UXBRIDGE UNION WORKHOUSES

CHAPTER 1.

THE OLD POOR LAW The history of English poor law may, for convenience, be divided into the Old Poor Law and New Poor Law periods, the separation being the passing of the Poor Law Amendment Act of 1834. In this chapter I have set out a brief chronological summary of poor law history up to the passing of the 1834 Act. I hope this will assist the reader who is unfamiliar with such history to appreciate more fully the events that took place in Hillingdon and how they were part of the ‘big picture’. In 1598 an Acte for the Reliefe of the Poore required every parish to appoint Overseers of the Poor who were responsible for finding work for the unemployed and setting up parish-houses for those incapable of supporting themselves. A further refining Acte for the Reliefe of the Poore of 1601 is often cited as the foundation of the Old Poor Law period. The 1601 Act placed an obligation on each parish to relieve the aged and helpless, bring up children in habits of industry and to provide work for all those capable of it who were lacking their usual trade. The main objectives were:

• The establishment of the parish as the administrative unit responsible for poor relief, with churchwardens or parish overseers collecting poor-rates and allocating relief.

• The provision of materials such as flax, hemp and wool to provide work for the able-bodied poor.

• The setting to work and apprenticeship of children. • The relief of the ‘impotent’ poor – the old, the blind, the lame and so on.

This could include the provision of ‘houses of dwelling’ – almshouse or poorhouse rather than workhouses.

The collection of the poor rates was done by parish overseers who were unpaid and elected annually by the parish vestry. The poor-rates were dispensed to the needy of the parish, usually in the form of bread or money. The 1601 Act empowered parish overseers to raise money from the inhabitants of the parish, according to their ability to pay. The poor-rate was originally a form of local income tax, but over time evolved into the rating system – a property tax based on the value of real estate. In general, the tenant of a property rather than its owner paid the poor-rate. Failure to pay the poor-rate would result in a summons to appear before a Justice of the Peace who could impose a fine or the seizure of property, or even prison.

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Figure 1 Opening Part of the 1601 Poor Law Act

The Elizabethans assumed that the settled poor would accept such work and relief as the parish provided; it was not expected that the offer of work in their own homes or a Parish House, would be felt harsh and punitive. One of the aims of the law was to prevent the poor becoming detached from their place of origin and to discourage vagrancy. (1) Legislation of 1607 set up County Houses of Correction where work was given as relief to the unemployed at the local rates of pay and where work could be enforced on the idle and vagabond, but the element of punishment soon became stronger and the House became an early form of gaol, quite separate from the Workhouse. (1) Further laws were passed under which “by parochial taxation, the parish officers are directed to provide competent sums of money for and towards the necessary relief of the lame, impotent, old blind and such others among them being poor and not able to work”. (2) Until 1697 the Laws of Settlement forbade any poor person to leave his own parish but an Act of that year allowed him to do so if he had a certificate signed by a Justice by which his parish agreed to take him back if he became a charge on the poor rates of another parish. This led to frequent difficulties and disputes as harassed overseers and constables sought to get rid of stray paupers and fix responsibility for them on to some other parish. 3 The 1697 Act tried to draw a line between paupers and the rest of the poor, requiring the former to wear on their right shoulders a large “P” with the first letter of the parish, but this practice of “badging the poor” was abandoned in many parishes.

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The Settlement Act of 1662 allowed for the removal from a parish (generally back to their parish of birth) of newcomers whom local justices deemed “likely to be chargeable” to the parish poor rates. Settlement could be acquired in various ways, for example by renting a property worth at least £10 a year, but this was well beyond the means of an average labourer. Another means of qualifying for settlement in a new parish was by being in continuous employment for at least a year. To prevent this, hirings were often for a period 364 days, rather than a full year. (41) The Workhouse Test Act (Knatchbull’s Act) of 1723 enabled workhouses to be set up by parishes, either singly or in combination with neighbouring parishes. The Act was also the origin of the so-called workhouse test – that the prospect of workhouse should act as a deterrent and that relief would only be available to those who were desperate enough to accept it regime. (41) By 1732, following Knatchbull’s Act, it is estimated that about 700 workhouses were in operation. Parliamentary reports in 1776-7 list a total of almost 2,000 parish workhouses in operation in England and Wales – approximately one parish in seven. (41) By the 1780’s the Elizabethan system of poor relief had begun to break down. Many agricultural labourers were experiencing great poverty and the overseers were often unable to help them. The Government decided to provide more outdoor relief through Gilbert’s Act of 1782 in which:

• Guardians of the Poor were appointed to distribute poor relief in place of the Overseers

• The Guardians had the power to work with other parishes if they wished by forming poorhouse unions

• Paupers were divided into two groups, the able-bodied (to be looked after by outdoor relief) and the infirm (to be housed in the poorhouse). (4)

The Act aimed to organize poor relief on a county basis with each county being divided into large districts corresponding to Hundreds) an old administrative unit within a county) or other large group of parishes. Such unions of parishes could set up a common workhouse although this was to be for the benefit only of the old, the sick and infirm, and orphan children. Able-bodied paupers were not to be admitted but found employment near their own homes, with land-owners, farmers and other employers receiving allowances to bring wages up to subsistence levels. (41) Poor harvests in the mid-1790’s and sharp rises in food prices meant that many farm workers, particularly those in the South of England, were not earning enough to keep themselves and their families. In 1795 a group of magistrates and guardians of the poor met at Speenhamland near Newbury. They worked out a system whereby a farm worker’s weekly wage was supplemented on a scale, which would vary with the price of bread and the size of his family

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Although it had its origins in the 1782 Act, the growing practice around this time of supplementing low wages from the poor rate became known as the Speenhamland System. This was taking place when the previous settled society was breaking up. In the early 18th century each parish was a fixed and stable community. Everything possible was done to prevent the movement of population and to preserve the settled, static nature of society. By 1788, John Howlett was speaking of agricultural labourers who “…ranged from parish to parish and from county to county unthinking of and undeterred by the laws of settlement.” For the landless labourer there was nothing to fall back on except parish relief. The total reliance of the poor on money wages meant that any rise in the price of bread would drive more and more people to seek relief just when it cost most to provide it. (3) The Sturges Bourne’s Act of 1819, in an effort to improve the administration of poor relief (and reduce costs) allowed parishes to appoint small committees, or select vestries, to scrutinize the giving of relief. In addition, to help the unpaid parish overseer with the growing administrative burden, a salaried assistant overseer could be appointed. (41) By the late 1820s there was growing dissatisfaction with the whole system of poor relief, particularly from the well represented land-owning classes who bore the brunt of the growing poor-rate burden. There was also growing unrest amongst the poor, particularly in areas, which even led to rioting, notably from those who identified themselves as supporters of “Captain Swing”. In 1832 the Government appointed a Royal Commission to review the Poor Law under the chairmanship of the Bishop of London. It conducted a detailed survey of the state of poor law administration and prepared a report. This was largely the work of two of the Commissioners, Nassau Senior and Edwin Chadwick. The report took the view that poverty was essentially caused by the indigence of individuals rather than economic and social conditions. Thus, the pauper claimed relief regardless of his merits; large families got most, which encouraged improvident marriages; women claimed relief for bastards, which encouraged immorality; labourers had no incentive to work; employers kept wages artificially low as workers were subsidized from the poor rate. (41) In summary, prior to 1834 the prime responsibility for poor relief lay with the parish.

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CHAPTER 2.

HILLINGDON PARISH WORKHOUSE 1744 - 1833

A meeting of Hillingdon Vestry in 1744 resolved “To pull down the Parish Houses adjoining to St. John’s Churchyard and the material employed in the building of a Workhouse.” The Parish (Church) House was a familiar institution in Elizabethan days. It was essentially a parish room built and maintained by the community and in it was held various parochial festivities such as the “Church” or “Whitsun Ale”. The ale for these feasts was usually brewed in the Church Houses. Possibly these Church Houses had been used for this purpose and as the “Church Ales” lost favour with the authorities, owing to various abuses, the house was no longer of great use to the village. (2) In Hillingdon, The choice of location for the new Workhouse was not straightforward. According to the local historian De Salis, a number of sites were considered: The first was upon Hillingdon Heath at a place called Hobby’s Corner, “provided the consent of the Lord of the Manor and Sir William Irby could be obtained.” Sir William refused. The Workhouse was then to be built on “Peal Heath” (later Pield Heath) “near the conduit, if Sir William Irby and Mr. Clarke consent, if not at Colham Green, near the Fox Pond.” By 1747 a site near Colham Green had been chosen and the Workhouse built. The Workhouse comprised 9 rooms, a kitchen, dining room, brew house, outbuildings and hospital room. The cost of the building was £457 1s 9d and the money was raised by a voluntary rate and by using £200 left to the parish by Henry Pagett (Paget), 1st Earl of Uxbridge, who died in 1743. (The tomb of the Earl is a notable feature in the Parish Church of St. John, Hillingdon.) By 1768 a workroom equipped with tools and spinning wheels had been added to the Hillingdon Workhouse and in 1774 there were 58 paupers in the workhouse. In 1796 there were 65 inmates in the Hillingdon Workhouse and on 27th and 28th October of that year Thomas Haynes made an Inventory of the furniture, fixtures, and effects. (Figure 3) This valued the “Furniture, fixtures, bed linnen, table linnen” at £155 19s 8d and “wearing apparrell” at £54 17s 3d.

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Figure 2 Map of Hillingdon 1786

(Reproduction by Motco Enterprises Ltd. Ref: www.motco.com)

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Figure 3 Inventory of Hillingdon Workhouse 1796

(Hillingdon Libraries)

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In 1809 the Vestry passed a resolution that “No contract shall hereafter be entered into with any person who shall not agree to reside wholly in the house.” The enforcement of this rule resulted in a change of management the following year when at a Vestry held on May 1st 1810 “It was submitted to the Vestry whether Mr. Newman under the circumstance of the several years he has been governor of the Workhouse, and is allowed proper maintenance of the poor, with his present proposal of £1,005, be preferable to MR. Holmes (who has not been engaged in such an undertaking) at his proposal of £890. The former (Mr. Newman) agreeing that one of his family shall constantly reside in the workhouse, and he and his wife occasionally attending, particularly himself on Saturday. And the latter (Mr. Holmes) agreeing to constantly reside in the workhouse with his wife …it was agreed that Mr. Holmes proposal be accepted.” (2) By 1810 rooms for cobblers and weavers had been added, also a schoolroom for pauper children. In 1830 the Workhouse was enlarged to provide separate accommodation for male and female paupers. In 1833 it was decided that contracts be entered into for any articles supplied to the Workhouse which exceeded a value of £5. Local tradesmen wrote to the vestry offering to supply the Workhouse and quoted their prices for various articles for the following month. Several letters were sent to the Vestry and these contracts were put in: “Mr. Henry Hull - Gurnsdale Malt 7/9 Best Good Hops 1/5lb. Mr. Edward Brown - Malt 7/6 Hops 1/6 Mr. Baynham - Soaps best equal proportions subject to duty while 6/8 Mr. Hetherington - Bacon best Waterford 3/4 per stone Rice patna 28/- per cwt. Salt Butter 74/- per cwt. 8d lb. Cheese 50/- per cwt. (5)

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CHAPTER 3.

“TAKING” THE WORKHOUSE

In the reign of George I a system of “farming” the poor was introduced. Parish officials were authorised “…for the greater ease of parishes in the relief of the poor, …to contract with any persons for the lodging, keeping, maintaining and employing all such poor in their respective parishes, town ships or places, as shall desire to receive relief.” This system appears to have been introduced into Hillingdon in 1758. In order to ensure the proper treatment of the inmates it was provided by the Vestry that “6 men be chosen out of the Parish to see that the poor are used well, and to go to the House every day at any hour the person pleases”. (2) The first person to “take” the Workhouse was John Hill, who “… did promise to keep and maintain the poor in the Workhouse of this parish, and all persons becoming chargeable to the parish, and to pay all other expenses as is usual for the Overseers to pay, except law suits, for one whole year, commencing from Lady Day next to Lady Day following, for the sum of £300, and to find them in the Workhouse in clothing of all sorts, woolen and linen, and to leave things in the House as good as they are found”. The advantage to John Hill was, that in addition to whatever he could save for himself out of the £300 allowed by the parish for maintenance, he could keep for his own benefit any profit arising from the work of the inmates. (2) John Hill, who “took” the Workhouse in 1758, kept it for ten years, at which time Mr. William Horseman succeeded him. The subsequent holders of the Workhouse, with the sums apportioned for the maintenance of the poor, were as follows: William Horseman 1768 £300 Joseph Jeffery 1774 £340 Richard Butler 1775 £330 S. Bradley 1778 £280 Richard Butler 1779 £340 Thomas Richards 1782 £350 Francis Lycett 1783 £365 Elizabeth Lycett 1793 £380 Thomas Haynes 1796 2s 6d weekly John Brown 1800 £550 Thomas Newman 1804 The terms on which Newman took the Workhouse are not mentioned. Probably they were the same as those agreed to by John Brown. Newman’s yearly tenancy was continued until 1809 when “…taking into account the present advanced price of provisions” he agreed to “maintain the poor for one year at the sum of £950.”

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However, the Vestry were not completely satisfied with the feeding of the poor and resolved “That it appears to the Vestry that the poor are not supplied with good and wholesome beer, for that 5 bushels of malt are only allowed for each brewing of 36 gallons of ale and 110 of small beer, and when it is considered that the greatest part of the poor people are infirm men and women nearly worn out with old age who stand in need of a more comfortable beverage, this Vestry are of the opinion that all future contracts ought to specify the quality of beer (as to the quantity of the malt to be allowed) which the poor are to be supplied with.” This was unanimously agreed. (2

An Account of a Village Soup Shop at Iver in the County of Bucks.

“In October 1796, a village soup shop was set up at Iver, in the county of Buckingham. The most proper person that occurred for the purpose, was the wife of Richard Learner, an industrious man, who had lost a leg by an accident in the course of his labour; and who, notwithstanding that disadvantage had brought up a large family decently and creditably, without parochial relief. - She was an industrious and notable woman, and had lived in a family as a kitchen maid. She attended, by desire, several times to see the soup made, which she afterwards took home for the use of her own family. She was then informed, that if she could make the same kind of soup twice a week during the winter, it would be a benefit to her poor neighbours, and a considerable advantage to herself; that she should be furnished with the receipt, and the necessary utensils and materials to set up her shop; which consisted of a tin pot that contained four gallons, and a bushel of split pease; and that we would purchase of her tickets, or give orders for soup, for her poor neighbours at threepence a quart; besides recommending to others, to purchase of her similar tickets for other poor persons, whom they wished to be of use to.

The advantages, which this proposal held out to her, were these; that the soup, which she sold at three-pence a quart, she could make for half that money: that therefore if she could get by the tickets, and by chance customers, a sale of only eight gallons a week (which was about her average) her profit, without interrupting any of her other work, would be very little less than four shillings a week; besides the comfort, of which she seemed fully to feel the benefit, but which it was much easier for her to enjoy than describe, of being in the midst of a cook shop.

What happened in the present case, is what will hardly ever fail to happen in similar cases: there were few poor families in the parish, but what, placed on some list or other, received a good meal, to take home twice or oftener each week, to their houses. The following is a copy of the memorandum made for the subscribers.

The pease soup to be continued twice a week from 12 November to 12 May. Every subscriber, of one shilling per week, may recommend 4 persons, or families, who shall be entitled to a quart of soup a week, and so in proportion whether more or less; or may direct the distribution of the like quantity of four quarts, as they shall think fit.

N.B. - The soup may be purchased or ordered for any poor family at three-pence a quart, or three-halfpence a pint.

From: The Reports of the Society for Bettering the Condition and Increasing the Comforts of the Poor. Vol 1 1798

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Figure 4 Document Establishing a Select Vestry for Hillingdon 1833

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CHAPTER 4.

THE NEW POOR LAW As in Chapter 1 for the period of the so-called Old Poor Laws, this chapter gives a brief overview of the national context prior to and beyond the passing of the Poor Law Amendment Act of 1834. The execution of the 1834 Act had a significant impact on the small Hillingdon Parish Workhouse. As the chosen location for the newly formed Uxbridge Union Workhouse it was greatly enlarged. The subsequent transition of the institution to become a hospital occurred in many places throughout England and Wales and many of our current hospitals, including such notables as The Hammersmith Hospital and Charing Cross Hospital, are located on former workhouse sites. While Britain was fighting wars against France (1793 – 1815) the poor rate rose sharply. At the end of the war people hoped that things would improve but there was a depression in industry and agriculture. Thousands of workers lost their jobs. The amount of money spent on poor relief rose from some £2 million in 1795 to over £7million in 1818.

Uxbridge 1827

“When we view with surprise the decay of a once flourishing and busy town. When we witness its streets neglected, it’s pavements dangerous, it’s market-house dilapidated, it’s sewers choked up, it’s workhouse miserable, it’s cottages falling to decay, and no spirit of improvement, no keeping pace with the progressive change of time and manners, we are naturally led to examine into primary causes. Our forefathers passed their happy hours in industry and usefulness, divided the bounties of heaven with their poorer neighbours and reserved the poor houses for the reception of the aged, the infirm or the cripple, who were unable to work for their daily support. But that golden age is gone. The workhouses are filled with sturdy paupers and beggars parade the town in formidable array; poachers infest the land and thieves stalk abroad to the terror of the inhabitants. Not a day passes but you witness scenes revolting to human nature; not a night But some larder or hen roost falls prey to the spoiler.” Dr. Beasley

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In 1830 riots and disturbances broke out among workers in the south of England, the worst riots taking place in areas where the relief given to the poor was greatest. Locally, on 1st December 1830, labourers at Iver and Shredding Green went armed with cudgels and compelled householders to give them food, drink and money. On the 29th November 1830, in the Flackwell Heath and Wooburn areas of the Wye Valley near High Wycombe, a mob caused serious disturbances and destroyed the machinery of several paper mills. Subsequently 44 of the rioters were sentenced to death by hanging for their part in the riot. These sentences were later commuted and most were transported to Tasmania. (6) Some argued that if the labourer were driven back into employment by the threat of the workhouse his sense of social deference would be restored. The Government set up a Royal Commission under Edwin Chadwick and Nassau Senior to investigate the working of the Poor Law. They reported in 1834 and Parliament passed the Poor Law Amendment Act based on their findings. The Poor Law Amendment Act of 1834 aimed to deter the able-bodied but provide a refuge for the ailing and helpless. It was based on the belief that the deserving and undeserving poor could be distinguished by a simple test: anyone prepared to accept relief in the repellant workhouse must be lacking the moral determination to survive outside it. The other guiding principles of the new regime was that of “less eligibility” namely that conditions in the workhouse should never be better than those of “an independent labourer of the lowest class”. The main terms of the Act were:

• Parishes were to join together to form Poor Law Unions, with some 640 Poor Law Unions set up over the country. In each Union, Boards of Guardians were to take charge of poor relief and build workhouses. A central Poor Law Commission of three persons was set up in London to inspect poor relief and supervise local officials. The local Boards would pay officials to look after the poor.

• Workhouse life was made disciplines as a matter of policy so that “scroungers” did not enter the workhouse just to obtain food and shelter.

• Families in workhouses were split up, husbands and wives to have separate rooms, children separated from parents.

• Outdoor relief would be given only to the sick, infirm and those over 60 years of age. Outdoor relief for the able-bodied was to be abolished. (4)

Workhouses were intended to replace all other forms of relief, e.g. by stimulating thrifty habits to provide for sickness, bereavement and old age. It was intended that outdoor relief (payments in money or goods to those outside the workhouse) would end within two years. In fact this was very much wishful thinking and the large bulk of poor law expenditure continued to be on outdoor relief.

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A Bastardy Clause in the new Act made all illegitimate children the sole responsibility of their mothers until they were 16 years old. If mothers of bastard children were unable to support themselves and their offspring they would have to enter the workhouse; the putative father became free of any legal responsibility for his illegitimate offspring. Not only did this remove the not infrequent problem of disputed fatherhood, but it was envisaged that the measure would discourage women from entering into profligate relationships. Perhaps unsurprisingly, this was a highly controversial measure and was overturned in a subsequent Act in 1844 which enabled an unmarried mother to apply for an affiliation order against the father for maintenance of the mother and child, regardless of whether she was in receipt of poor relief. (41) The passing of the Poor Law Amendment Act meant that the Vestry lost much of its control over the administration of poor relief which had been an important part of its duties. Parishes were grouped into Unions and placed under the authority of elected Boards of Guardians, with the Poor law Commissioners in London in charge of the administration as a whole. The Poor Law Commission, who administered the new system, consisted of three Commissioners in London. The working and implementation of the 1834 Act was put into practice by means of a large volume of orders and regulations that specified every aspect of the operation of a Union and its workhouse. The 1834 Act received much criticism, including even The Times which on 30th April 1834 (prior to its enactment) claimed the bill would “disgrace the statute-book”. Within weeks of it’s opening, the master of the first new workhouse built under the new law, at Abingdon, was the subject of a murder attempt. In the north of England an Anti Poor Law movement took hold. In places such as Huddersfield its supporters even included members of the Board of Guardians. At the heart of opposition to the new law was the hardship,and brutality it engendered. In 1841, G.R. Wythen Baxter published his famous The Book of the Bastiles – a somewhat lurid compilation of newspaper reports, court proceedings, correspondence and so on, which graphically illustrated some of the horror stories relating to the new law. In Huddersfield there was a public outcry in 1848 at conditions in the township workhouse. Conditions were appallingly cramped and unhygienic, with up to 10 children sharing a bed. The inmates’ diet was miserable, even by workhouse standards. Conditions in the infirmary were even worse – a living patient occupied the same bed with a corpse for a considerable period after death, and the sick were left unwashed for days on end. (41) The most notorious scandal was at Andover Workhouse in 1845 where conditions were so bad that inmates were scavenging decaying meat from the bones they were set to crush to make fertiliser.

22

In 1847, following the Andover scandal an other bad publicity, reports of internal quarrels and divisions, together with a desire by government to make the poor law administration more directly accountable to parliament, the Poor Law Commission was abolished and replaced by a new Poor Law Board. In 1871 this was, in turn, succeeded by the Local Government Board. By the start of the twentieth century, change was in the air. Two factors contributed to this. The first was the election of a significant number of women as Guardians. The second, in 1892, was the lowering to £5 of the property rental value qualifying for Guardian election which enabled the election of working-class people as Board members. In December 1905 a second Royal Commission on the Poor Law and the Unemployed was appointed. Over the next four years it carried out the most extensive investigation since the Royal Commission of 1832. The Commission was split and its recommendations were published as: A Majority Report, endorsed by fourteen of its members, which recommended the creation of a new Poor Law authority in each county or county borough, together with the replacement of workhouses by more specialised institutions catering for separate inmates such as children, the old, the unemployed and the mentally ill. A Minority Report, signed by four members, was more radical and advocated the complete break-up of the Poor Laws and the transfer of functions to other authorities to provide care for various groups. Its emphasis was on the prevention of destitution rather than its relief. Although no new legislation directly resulted from the Commission’s work, a number of pieces of social legislation were enacted in its wake. January 1st 1909 saw the introduction of the Old Age Pension (5s a week for a single person, 7s.6d. for a married couple). In 1911 Unemployment Insurance and Health Insurance began in a limited form/. From 1913 onwards, the term “workhouse” was replaced by “poor law institution” in official documents. Neville Chamberlain, Health Minister in the 1925 Conservative government, believed that the poor law system needed reforming and in 1926 a Board of Guardians (Default) Act was passed which enabled the dismissal of a Board of Guardians and its replacement with government officials. This was followed by a further Poor Law Act in 1927. In 1928 Chamberlain introduced The Local Government Act. Essentially, this would abolish the Boards of Guardians and transfer all their powers and responsibilities to local Councils. The Act was passed on 27th March 1929 and came into effect on 1st April 1930. This supposedly marked the end of the 643 Boards of Guardians in England and Wales.

23

Although the workhouse was officially no more, many institutions carried on into the 1930s virtually unaltered. Objections from Boards of Guardians and Councils meant that changes were very slow. Ultimately, the 1929 Act did not succeed in abolishing the Poor Law; it merely reformed how it was administered. Poor Law Institutions became Public Assistance Institutions and were controlled by a committee of “guardians”. However, physical conditions improved a little for inmates, the majority of whom continued to be the old, the mentally deficient, unmarried mothers, and vagrants. The National Health Service Act of 1946 came into force on 5th July 1948. Even the sweeping changes that came with this had less impact than might be imagined. Hospitals now came under the control of Hospital Management Committees under Regional Hospital Boards but many still carried the stigma from their workhouse days. (41)

Figure 5 Certificate of Suspension of Settlement Act Removal Order, Hillingdon 1833

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CHAPTER 5.

UXBRIDGE UNION WORKHOUSE 1834 – 1930 As a result of the Poor Law Amendment Act of 1834 ten parishes in West Middlesex were merged to form the Uxbridge Poor Law Union, administered by a Board of Guardians. In June 1836 Uxbridge with the 9 adjoining parishes of Hillingdon, Harefield, Ruislip, Ickenham, Cowley, West Drayton, Hayes, Northolt and Norwood containing 26,020 acres were constituted into a parochial union. The total population of these parishes in 1831 had been 12,663 of whom 3,482 belonged to Uxbridge. Union areas were usually centred on market towns and if near the borders they may have included parishes from two or more counties. The choice of Uxbridge Union was probably because it had a market house of its own and was in a commanding position as regards the other parishes. The first meeting of the Board of Guardians was held on 30th June 1836 at the Hillingdon Workhouse and thereafter they were held every Friday beginning 8th July at the White Horse Inn. (7)

Figure 6 Uxbridge Parish Workhouse

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Figure 7 Ruislip Workhouse

The newly formed Board of Guardians divided the Union into four medical districts: Hillingdon & West Drayton Norwood, Hayes and Northolt Harefield and Uxbridge Ruislip, Ickenham and Cowley For which they required four medical officers. Various Boards of guardians were pressed by the Poor Law Commissioners “…to resort to the expedient of putting up publicly to tender the @contract@ to supply medical aid to the sick poor, in order to give work to the doctor who would, like the contractor for bread, quote the lowest price.” (8) In Uxbridge, the Medical Officer was paid approximately £50 in return for attending the paupers and all midwifery cases. Paupers entering the Workhouse were to be examined before admission in order to ascertain whether they had smallpox or had been vaccinated.

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One of the first actions of the Guardians was to set up a committee to investigate the workhouse accommodation for each parish in the Union. In order to help the committee in its enquiries specific questions were set down to be answered: “Is there a Workhouse? Is there any land attached to it? If any, how much and of what value? What is its capacity of receiving paupers? What are the numbers of paupers now in the Workhouse? Distinguishing their age and sex? What is their moral condition? Have the paupers been generally healthy? Is the Workhouse the property of the parish or private property? Is the situation of the Workhouse healthy?” (9) A second committee was set up to see what repairs and alterations were necessary to the Hillingdon Workhouse so that it could contain 150 paupers. They were also to report upon the state of the families who were already residing there. A valuation was made of the Hillingdon Workhouse with yard, outbuildings, garden and land by Mr. Trumper for the Union and Mr. Heron for the parish. The Guardians were prepared to buy the site but a directive from the Poor Law Commissioners persuaded them to pay an annual rent of £65 instead. While plans were made for one central workhouse, temporary arrangements had to be made for all paupers within the Union eligible for indoor relief. Ruislip Workhouse was used to receive the 18 indoor paupers from Norwood and all paupers from the parishes of Harefield, Ruislip, Ickenham, Northolt and the township of Uxbridge. The 25 paupers already resident in Uxbridge Workhouse were to go to the old Hillingdon Workhouse where 6 paupers from West Drayton and 12 from Hayes joined them.

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Figure 8 Conveyance Document for the transfer of Hillingdon Parish

Workhouse buildings to the Guardians of the Uxbridge Union

28

Mr. Charles Parker made plans for the enlargement of Hillingdon Workhouse to hold 170 paupers but the Guardians later decided that “… in consequence of the plans and specifications prepared by Mr. Parker for converting the Hillingdon Poorhouse into a Poorhouse for this Union being on too expensive a scale, this Board does not feel authorized to act thereon.” (10) However, at the same time, they decided to build a new Workhouse at Hillingdon instead of using the existing one. “The Guardians of this Union are desirous of obtaining plans, specifications and estimates for a Workhouse to be build so as to comply with the latest recommendations of the Poor law Commissioners in the parish of Hillingdon to hold 200 persons and to be capable of being enlarged with convenience at any future time.” (10) The plan of a Mr. Thorold was accepted as well as his additional plan for enlarging the new workhouse to hold 300 paupers. Although the Guardians were anxious to keep costs low, they were also concerned with the appearance of the new building and instructed Mr. Thorold, the architect, to “… divest the Building of the Prison like appearance which those structures too commonly assume.” (11) The importance of this directive is shown quite clearly when the Guardians explain why the resolution was made: “The Guardians are induced to place this Resolution on their Records because they think it is unnecessary and if unnecessary not justifiable to make the confinement in the Asylum of the Unfortunate and Distressed as vigorous and painful as that which is suffered by Criminals in the Jails and Prisons of the State.” (11) In 1837 steps were taken to buy the Hillingdon Workhouse garden and appurtenances from the parish for £300 and also an allotment of about 4 acres from the Trustees of the Poor Ground for £600. Several tenders were submitted for the building of the Workhouse:

“Mr. Hollis of Windsor £4,890 Mr. Henry Morton of Uxbridge £4,460

Mr. Humphreys of London £4,600 Mr. Bishop of London £4,680 Mr. Shoppee of Uxbridge £4,884 Mr. Carter of Paddington £5,590 Messrs. Grissell & Pelo of London £4,650” (12) The Guardians chose Mr. Morton to build the new Workhouse.

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Figure 9 Advertisement for Sale of Hayes Workhouse 1837

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By 1840 the Poor Law Commissioners had promoted much new building. 271 Unions had plans for new workhouses, 85 more had hired or converted old ones, 34 had bought suitable buildings, and 24 had substantially converted old buildings. This was a great expense by the standards of the time. 16 Unions were spending up to £2,000 63 between £2,000 and £4,000 84 between £4,000 and £6,000 69 between £6,000 and £8,000 29 between £8,000 and £10,000

Six other Unions were spending even more. Some of the money came from treasury loans but mostly the Unions borrowed from the insurance companies on the security of the poor rates. Workhouses did not have an edifying reputation, but insurance companies knew that this type of public investment was a safe haven for their funds. (1) When the Board of Guardians was planning the new Union Workhouse the building committee suggested they adopt a system of heating with hot water. The idea was approved and the Guardians decided “… that the hot water apparatus with large pipes as recommended by the building committee be adopted and that the following rooms be warmed with hot water as also recommended by the committee. The Dining Hall, Waiting Room, Probationary and Receiving Wards, The Day Rooms, The Schoolroom and Infants School Room.” (17) Whilst the building was being constructed, a Major Stuart proposed that an additional building be erected at the northeast end of the Union Workhouse to be used as an infirmary “… for persons ill of Contagious Disorders.” (13) This was put to the vote and rejected. However, it was decided to retain part of the old Hillingdon Workhouse for conversion into an infirmary at a cost of not more than £20. It is likely that the site of the new workhouse was almost adjacent to the old one, particularly as the Guardians had bought the old workhouse garden. The building materials of the old workhouse not required for the infirmary were sold by auction for £223. 11s 6d.

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Figure 10 Map showing Uxbridge Union Workhouse, Hillingdon 1881

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One of the recommendations put forward by the Poor Law Commissioners was that supplies to parishes should be by tender and contract. (The Uxbridge overseers had adopted this suggestion in 1833). The Board of Guardians gave its Provision Committee the authority to advertise for tenders to supply the Union with bread, meat and other articles of consumption. The following tenders were accepted and contracts drawn up: “Mr. Goring’s tender to supply the Workhouse with Beef, Mutton, Suet and Meat for the Governor’s Table at 3d per stone and legs and shins per set at 7/- was accepted. Mr. William Child’s tender to supply Bread at 5d the 4lb. Loaf and flour at 15/- per cwt. was accepted. Mr. Gilby’s tender to supply Good Bacon at 50/-, Cheese 40/-, Simple Gloster 54/-, Good Butter 90/-, Yellow Soap46/-, Rice East India 15/-, Raw Sugar at 70/- all per cwt., Oatmeal at 2d and Good Canton Tea at 4/- per lb. and Candles at 5/6d per dozen, was accepted.” (14) A contract was also drawn up to supply the Workhouse with milk: “Resolved that the offer of Mr. Betteridge to supply Milk at Hillingdon Workhouse till Ladyday next at 9d per gallon be accepted.” (15) A close check was kept on the running of the Workhouse and a visiting committee of two members was appointed each month. The union also purchased a weighing machine from the parish of Hayes and probably used it to check the weight of supplies. On one of their visits the committee found that Mr. Gilby, one of the contractors, “… had in an invoice of goods delivered at the Workhouse charged a Side of bacon as weighing 73.5 lbs which in point of fact did not weigh more than 63.5 lbs and that this was done under the pretext of the Master having been furnished with other bacon for his own table.” (15) The Guardians wrote to Mr. Gilby expressing their displeasure and asking for an explanation. The Master of Hillingdon Workhouse, Francis Weedon, who was probably involved in the deception, was also severely reprimanded for his improper conduct in the transaction. However, at a meeting the Guardians agreed “… that there was no dishonest intention on his part or on the part of Mr. Gilby.” (16) There was a general attempt to introduce some consistency in the supply of food. A committee was set up to prepare a diet for the Hillingdon and Ruislip Workhouses. Their suggestions were supported by the rest of the Board and sent to the Poor Law Commissioners in London for approval.

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Figure 11 Advertisement for Tenders to Supply Uxbridge Union Workhouse 1846

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Individual needs were taken into account; the aged and infirm were allowed 1 ounce tea, 9 ounces sugar and 7 ounces of butter per week as well as their regular allowance. The Guardians were more generous to the Master and Matron of each Workhouse allowing them ½ lb fresh butter, 1 lb lump sugar ½ lb coffee or green tea per week. On special occasions such as Christmas Day and Queen Victoria’s Coronation Day the paupers had roast beef, plum pudding and a pint of ale each for dinner. (7)

Dietary of Uxbrige Union Workhouse 1836

Able-Bodied Men & Women: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Daily: Bread (oz) 12 13 12 13 12 13 13 Breakfast: Gruel (Pints) 1.5 1.5 1.5 1.5 1.5 1.5 1.5 (Bacon) Dinner: Beef (oz) 6 - 5 - 6 - - Potatoes (oz) 8 - 8 - 8 - - Soup (Pints) - 1.5 - 1.5 - - 1.5 Suet Pudding (oz) - - - - - 14 - Supper: Cheese (oz) - 2 - - - 2 - Butter (oz) - - - 2 - - 2 Broth (Pints) 1 - 1 - 1 - 1

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Allotment of Childrens’ Hours Uxbridge Union Workhouse

(March 1840)

Winter (29th Sept. to 25th March)

Hours Meals & Play Work Instruction

7.00 – 8.00 1 8.00 – 10.00 2 10.00 – 12.00 2 12.00 - 2.00 2 2.00 - 3.00 1 3.00 - 4.30 1.5 4.30 - 5.30 1 5.30 - 6.00 0.5 6.00 - 7.00 1 7.00 - 8.00 1 Totals 5 3.5 4.5

Summer (25th March to 29th Sept.)

Hours Meals & Play Work Instruction

6.00 – 7.00 1 7.00 – 10.00 3 10.00 – 12.00 2 12.00 - 2.00 2 2.00 - 3.30 1.5 3.30 - 4.30 1 4.30 - 5.30 1 5.30 - 6.00 0.5 6.00 - 7.00 1 7.00 - 8.00 1

Totals 5 4.5 4.5

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While the new Workhouse was being built the Guardians turned their attention toward the provision of furniture and equipment. Whereas Uxbridge Workhouse had catered for an average of 30 paupers, the new was to hold 300. The masters of the two Workhouses in temporary use were asked to give an account of all the beds they had. There is little evidence to suggest what sleeping accommodation was available before 1834, although Mr. Kee, Master of Uxbridge Workhouse, was allowed £3 “… for repairing beds in the Casual Room.” (18) The Guardians were probably hoping to save money by using some of the old beds for they decided to advertise for a total of 120 bedsteads; 39 for men, 26 for boys, 14 for girls, 35 for women and 6 for infants. Later they were able to make a list of the items of bedding required: “ 30 single feather beds 20 double feather beds 70 flock beds 50 feather bolsters 70 flock bolsters 120 mattresses of cocoanut fibre 120 pairs of blankets] 120 woolen rugs Hessian sheeting not less than 1200 yards.” (19) The new Union Workhouse was ready some time after March 1838 for the Guardians resolved “… that the inmates of the Ruislip Workhouse be removed to the new Union Workhouse during the next week.” (20) About 1875 a workhouse chapel was erected and in 1907 further extensions were opened – a female infirmary and other buildings.

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Figure 12 Uxbridge Union Workhouse about 1930 with Chapel in the Background

In 1891 it was reported that: The Union Workhouse contained 170 inmates. The Board of Guardians meets every Friday at the Union House. The officers were as follows; Rev. Beilby Porteus Hodgson, Chairman John Beck, Vice-chairman William Weekley, Master Mrs. Weekley, Matron Thomas Hirst, Schoolmaster Ann Allshorn, Schoolmistress Francis Stockwell, Relieving Officer Charles Woodbridge, Clerk to the Guardians and Assessment Committee

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CHAPTER 6.

THE WORKHOUSE INSTITUTION – AN OVERVIEW

Today, the workhouse remains a symbol of an institution dedicated to inhumanity, even cruelty, to those unfortunates who became its inmates. This notion influenced, no doubt, by reading Oliver Twist. It is undoubtedly true that these were dreadful places. However, in the 19th century the view of many was that the workhouse was the answer to the problem of caring for those unable to care for themselves. At the same time, its function was to deter those who would otherwise be idle and dissolute. Reverend J.T. Becher described this philosophy, in his words the “Antipauper System”, in 1828 as follows: “The advantages resulting from workhouses arise, not from keeping the poor in the workhouse, but from keeping them out of it, by making the inferior classes feel how demoralizing and degrading is the compulsory relief drawn from the parish. When the poor of the parish are discontented we offer them an order for admission into the workhouse, and we hear no more complaint. Males, females, and children are separated from each other on admission. The apparel of the poor is purified, ticketed, and deposited in the care of the Master. They are then dressed in the clothing of The Workhouse until their discharge, when they resume their own clothes. Paupers, except the very aged and infirm, wear clogs with wooden soles, instead of shoes. These are more economical; they are of very little use if carried away; and if tendered for sale, excite suspicion. They do not injure even the tender feet of children. Proceed to our workhouse. Observe the decency, cleanliness, and comfort, pervading every part; you will not then hesitate to pronounce every such establishment an Hospital for the Infirm, an Asylum for the Aged, a School for the Young, but a Terror to the Idle and Dissolute.” (42) The view of a contemporary historian, with a particular interest in this subject, may be of value in looking back at this period in the history of Hillingdon Hospital: “For many years workhouses had to combine the functions of schools, asylums, hospitals and old people’s homes, as well as being the last refuge for the homeless and unemployed. It cannot be claimed that these duties were always effectively performed, but it was the workhouse that provided the experience of managing the more specialised state institutions of today. The workhouse was the first national experiment in institutional care; many mistakes were made, and both deliberate and unintentional cruelties were perpetrated, but in trying to remedy these the state was led into creating the specialised institutions, which eventually replaced the workhouse. The New Poor Law of 1834 made the workhouse a place of unresolvable tension, as all its critics have noted. How could an institution simultaneously deter the able-bodied poor while acting as a humane refuge for the ailing and helpless?

39

The law was based on a hard belief that the deserving poor could be distinguished from each other by a simple test: anyone who accepted relief in the repellant workhouse must be lacking the moral determination to survive outside it. During a century of increasing prosperity, this notion wavered and changed, though it never disappeared. The categories of “deserving” gradually widened and were removed from the workhouse. Separate schools, separate hospitals, asylums for lunatics, old-age pensions, health and unemployment insurance, successively peeled layer after layer of the “deserving” away from the workhouse.” (1) What is certain is, that without the creation of the Workhouse at Hillingdon it is unlikely that a hospital would have developed on the site and be present today.

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PART II

HILLINGDON HOSPITAL

CHAPTER 7

HILLINGDON COUNTY HOSPITAL 1930 – 1933

In 1929 the Local Government Act abolished Boards of Guardians and their functions were transferred to County Councils. In 1930 Middlesex County Council took over the old Workhouse and began to develop it as Hillingdon County Hospital and Infirmary.

Figure 13 Map showing Uxbridge Union Workhouse, Hillingdon 1932

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Figure 14 Aerial View (Looking North) of Hillingdon Hospital about 1930

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Figure 15 Main Entrance of Hillingdon Hospital about 1930

The Hospital Report for the year 1930 was for “Hillingdon Institution”, which was describes an “… a hospital maintained under the Poor Law Act as defined in the Public Assistance Order, 1930.” The hospital had 227 beds (100 for men, 121 for women and 6 for children) for “… sick, maternity and mental cases.” The total number of admissions was 463; of which 31 were maternity cases (35 live births) and 48 surgical operations under general anaesthetic were performed. Out-patient services were minimal; the Report stated This Hospital is in the process of development, and at the moment there is no Out-patient Department. Provisions are being made for emergency treatment. Continuation treatment is too a small extent being practiced. Up to 1st November 1930 the medical care of the patients was under the control of a part time officer also in general practice. 2 new wards with accommodation for 62 erected by the late Guardians are being equipped but there is no accommodation for the nursing staff which will be required before these can be utilized.” (21)

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Figure 16 Hillingdon Hospital sometime in the early 20th Century

(Hillingdon Libraries) Dr. R.G. Macbeth who was appointed Assistant Medical Officer on 1st December 1930 has since given a vivid account of the hospital at this time: “ The hospital had been a poor law infirmary and had recently been taken over by Middlesex County Council, which planned to upgrade it into an acute hospital to serve the Uxbridge area. Robert Rutherford, a surgeon known as “Jock”, was the resident medical officer, and he needed an assistant. Jock was a fiery Scot who had been in the Black Watch in the 1914-18 war. He was quite a character, but his varied life had not made him one to suffer fools gladly. He was appointed resident medical officer to Hillingdon County Hospital in 1929, and became its Medical Superintendent in 1931.” (22)

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Figure 17 Robert “Jock” Rutherford

Medical Superintendent Hillingdon Hospital 1929-33 Dr. Macbeth goes on to tell: “It was really an old style workhouse with two so called acute wards for those inmates or tramps who needed temporary care. In the acute ward for women were beds for maternity cases, and also a labour room. The two of us had 300 beds to look after.” (Note: The Hospital Report 1930 gives this as 227 beds) “ The hospital was also a “place of safety” for young women who were presumed to be of doubtful mental stability, and it provided a nursery for their offspring. All patients were admitted on the direction of the relieving officer – a lay member of the County Council – we had to admit whomever he sent in.

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There was also a new and well-equipped block of two wards with day rooms and side wards which had been built by the Guardians of the old infirmary, but we were initially, at least, not allowed to use them. Finally there were four padded cells, because acutely mentally ill patients were sent in by the relieving officer at any time of day or night. We had to get a magistrate to see these people within two days of their arrival, and then they could be sent to an asylum. Luckily the owner of a private mental institution nearby was also a magistrate, and he readily advised us.” (22) (Note: The magistrate owner of the mental institution was Mr. John Stillwell, sometime chairman of Middlesex County Council, who was part-owner of the local asylum at Moorcroft House. He lived in the house named The Furze from 1916 to 1931. (23) “Before Jock was appointed the hospital had been looked after by a local general practitioner who came in once a day or if specifically summoned. The master of the workhouse was in charge of the administration and his wife was called the matron. There was also a sister in charge, ward sisters, and an elementary nursing staff of young girls, mainly from Wales and Ireland.” (22) (Note: The Resident Medical Officer’s Report No.1 1930 stated: “Nursing Staff; this is largely untaught from the medical Officer’s point of view, being unaware of the requisites for many simple bed-side examinations. The remedy is the appointment of a Sister with wide general hospital training to act as Sister Tutor. As far as I can see the actual nursing of the patient is carried out on efficient lines.” “There was a dispensary under the care of a qualified pharmacist, but no laboratory or pathology staff. Our operating theatre had floorboards and a blocked up fireplace on one side. Instruments were boiled up between cases in a fish kettle in the sluice room across the corridor.” (Note: The Resident Medical Officer’s Report No.1 1930 detailed: “May I draw your attention to the fact that instruments are being sterilized by means of a naked gas burner in the actual operating room. This does not allow of consecutive operations being carried on, as an ether-laden atmosphere may cause a disastrous explosion. There is a spare bathroom immediately opposite which could be converted into a sterilizing room, not only avoiding this danger but adding considerably to the efficient running of the Theatre. A steam sterilising system will no doubt be found necessary. No accommodation for sterilising materials is provided in the new building and it is proposed to make use of a gas point in the kitchen and here I should make haste to say that the steriliser will quite frequently boil dry and be burnt out; the nurse is not yet born that can keep a constantly boiling vessel full, to say nothing of enormous gas bills. There is the initial heavy expense for plant, but upkeep, given the right installation, is nil.” “On my arrival Jock told me all of this, explaining that his job was to oversee the gradual development of the hospital, but it was clear that his idea if gradualness differed from that of the council, and as a surgeon he was less interested in other aspects of medicine.

46

His first ploy, after he had settled in, was to tell local general practitioners that after 1 January 1931 we could admit any of their patients. This was a godsend to the doctors, who never knew where to send their emergencies. St. Mary’s was our nearest teaching hospital, but it almost always had to refuse their requests.” (22)

During the year 1931, the work of the hospital increased under the direction of Dr. Rutherford. The Hospital Reports of that year were divided into two parts: The first, for Hillingdon County Hospital (A General Hospital maintained under the Local Government Acts or the Public Health Acts) showed a total of 84 beds (34 men, 33 women and 17 children). Compared with the Report for the previous year the same numbers of medical and surgical adult beds existed but those for children had risen from 6 to 17. However, the 143 beds for chronic sick men and women recorded in 1930 were now categorized as part of Hillingdon Institution.

THE TRAMPS’ PARADE

“Perhaps our most interesting job was the daily tramps’ parade at 9.am. A young German woman arrived one summer afternoon on a bicycle.

She was accompanied by a shepherd dog and carried in her bicycle basket an accordion and a monkey. The dog was no problem because the workhouse had kennels for the dogs of tramps, but the labour master on duty was puzzled about how to deal; with and categorise the monkey. In the end it was registered as an accompanying child under the name of “Jacko Schmidt”. The young woman was making her way by singing and playing in pubs – The dog protected her and “Jacko” collected the money.” From: Macbeth R.G. Hillingdon County Hospital 1930-33.

British Medical Journal 18th Dec. 1993)

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Hospital outpatient work had begun, 788 patients being seen during the year. The nature of these was: “This department deals solely with the following classes;

1. Former in-patients who either attend for dressings or special treatments. 2. Casual sick. 3. Inmates of the House section. 4. Cases referred on a doctor’s written recommendation for opinion through the

Receiving Officers.” (24) The second part was for Hillingdon Institution (An Institution maintained under the Poor Law Act). This recorded a total of 143 beds (54 men, 53 women, 36 children). Of these, 50 beds for men and 49 for women were for the chronic sick and 4 for each were for “mental” patients. (25) Dr. Macbeth remembered: “As the hospital’s availability increased so did the pressure on our acute beds. It then became necessary to transfer longer-term medical patients to the Infirmary. This the patients did not like, so Jock decreed that the Infirmary wards be known as convalescent wards.” He further observed: “Jock’s ploy of making friends with the local general practitioners soon made it possible for him to go to his committee with figures which finally persuaded them to allow us to open the new wards that had previously been under wraps. We had meanwhile been allowed a second Assistant Medical Officer to look after the medical patients.” (22)

The growth of the hospital during the year 1931 brought with it an increase in the administrative workload for Dr. Rutherford. Some of the wide range of issues that required attention, and form the embryo of a modern hospital service, may be seen in the various Superintendent’s Reports for the year. For example: X-Ray Services; “Since the inception of this Department in the beginning of February 1931, upwards of 50 Radiographic investigations have been undertaken. Each Film is written up, indexed and filed and the report incorporated in the patients notes ready for immediate reference. The X-Ray tube, which cost £40 was accidentally broken by a head on collision in the Theatre, this damage is covered by Insurance. The Solus Electrical Company replaced this with commendable speed but one feels that such accidents should be provided for in the future.” (April 1931)

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Figure 18 X-Ray Equipment about 1930

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Dispensary and Pathology;

Figure 19 Hillingdon Union Hospital Drug Formulary 1925

“Owing to increased work difficulty is experienced in storing drugs etc., as there is a large unoccupied floor space in the Pharmaceutical department, permission is asked to have a central fixture installed; not only would this serve the purpose of storage but the top of the fixture could be used as a laboratory bench for routine laboratory investigations; the bench part would be fitted with sinks and gas points and beneath would be spacious cupboards; there is ample room for a fixture 9’ X 4’ and it could be so constructed as to be mobile in case of another part of the Hospital being allowed for dispensary purposes.” (March 1931) “Laboratory Bench: The estimated price of £64 has been exceeded by approximately £7. The representative of Messrs. Baird and Tatlock was interviewed and it was pointed out that if they insisted on this surcharge we would insist on certain points of their signed contract which although of very minor importance to us would cause them considerable expense to adjust. Moreover their surcharge did not seem reasonable and lay in an error of their estimating surveyor. Hey have elected not to insist on the surcharge.”

(June 1931)

“Owing to the great increase of work in this Department permission is asked to employ a pupil under the instruction of the Dispenser. This pupil would eventually sit for the Pharmaceutical qualifying examination after 3 years instruction here and the service of such a person would become increasingly valuable and release the head of the

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Department for important and minute duties in which, at the moment, he occupies himself until 10 or 11 p.m. each day although nominally his duties end at 6 p.m. Such a pupil usually receives a remuneration of 5/- weekly and holds the requisite matriculation required by the Pharmaceutical Society.” (April 1931) Nursing: “Organisation of dances and games is being attempted and it is proposed that the nurses hold a dance in the home once a month to which they can invite their friends; they can finance this to a certain extent by a capital levy, but it is felt that if some form of wireless gramophone were installed, the services of an orchestra could be dispensed with and much expense saved.” (February 1931) “All members of the staff feel honoured that their high standard of work should be deemed of such a high order that the County Medical Officer of Health felt justified in approaching the general Nursing Council to approve of the Hillingdon County Hospital as a full training school for nurses. The request was granted.” (December 1931)

Figure 20 Linen Room Hillingdon Hospital about 1935

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Clinical Activity: “The working the wards is particularly heavy just now, both on the Medical and Surgical side. On the surgical side this month has been unique in that it has marked in the history of the Hospital:

a) The removal of the first Appendix b) The first dissection of Tonsils c) The making of the first plaster bed for tuberculosis of the spinal column..”

(February 1931)

Figure 21 Hillingdon Hospital Ambulance about 1935

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Personnel: “Will the Committee consider granting Dr. R.G. Macbeth leave for the purpose of being married on September 12th 1931. A period of three weeks is requested. A locum would be required.” (July 1931) (Note: Dr. Macbeth subsequently reminisced: “While earning the princely salary of £400 a year I was able to live out in a rented bungalow in Copperfield Avenue, and to get married in 1931.” (22) In 1932 there was continuing rapid expansion of the hospital. The total number of beds increased to 140 (49 men, 66 women, 25 children). Similarly, outpatient activity increased, a total of 1,959 persons were seen with 6,113 attendances. For the first time, Casualty patients are recorded as attending. (26) Once again the growth of the hospital and its activity required the administrative attention of Dr. Rutherford the Medical Superintendent. Some further examples from the Superintendent’s Reports for the year, and replies from the Southern House Committee, include: Pharmacy: “It is submitted for consideration that it is advisable to increase the salary of Mr. D. Pritchard, the Hospital pharmacist. He is very anxious to get married and settle down and feels that he cannot do it on the present pay. He is more than Hospital pharmacist, as he does much of the bacteriological and biochemical routine work. Last year he carried out 460 such investigations.” (December 1932) (“Decided to recommend the County Council to grant this officer the sum of £25 per annum in addition to his salary scale in respect of pathological work carried out by him.” (January 1933) Nursing: “Would the Committee consider the laying down of tennis courts? The existing courts are in a very bad condition; the one behind the Nurses Home is not of regulation size and slopes towards the road. The other court has an extremely bad surface and at the best cannot be played on during many months of the year, owing to the softness of the ground.” (March 1932) Operating Theatre: “Owing to the weak state of the wooden flooring in the room used as a Theatre it was my opinion on taking over as Resident Medical Officer that a standard operating table with its accessories would be too heavy for safe working. Now that the Old Hospital Block is in process of renovation and that sound concrete floors are being laid, I advise that a modern operating table with its accessories should be installed. The present table now in use is not an operating table but a minor dressing table which has been in use many years and cannot be adapted to serve the various manipulations required in major surgery.” (April 1932)

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Figure 22 Boiler House Chimney Hillingdon Hospital about 1935

Personnel: “It is requested that three electric fires be put in the Medical Superintendent’s House:-

1. In the dining room 2. In the bedroom 3. In the nursery” (December 1932)

(“The Committee considered that the Medical Superintendent should supply his own electric fires if he requires them.” (January 1933) Similarly, the Hospital Matron, Miss. Hagarty, found it necessary to resolve problems associated with the growth of the hospital and its nursing staff. In particular, the question of accommodation. She noted in her Reports: “It is becoming a very difficult matter to find accommodation for the rapidly increasing staff. The Nurses’ Home is taxed to the utmost and many Nurses are sharing bedrooms which were originally meant for one only. In addition, they are being housed in the sidewards of the Hospital and one half of the Isolation Block – quarters which are badly

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needed for patients. So far, the system of “sleeping out” of nurses has proved satisfactory and many rooms could be obtained quite near the Hospital at the same cost. To relieve the congestion etc. it would be necessary to find rooms for25-30 nurses.” (March 1932) “The arrangements made within the last six months has proved very satisfactory and has eased the situation considerably. At the present time 34 nurses are “sleeping out” in rooms which I have obtained near the Hospital. The sum paid for each Nurse is 7/6d per week and with one or two exceptions . all nurses appear very comfortable and happy. I inspect every room before sending the nurses out and occasionally pay surprise visits.” (December 1932) In 1933 Dr. Rutherford, the Medical Superintendent, resigned. Dr. Macbeth recalls: “Jock had a row with his committee about the planning of the new operating theatre. The committee preferred the county architect’s design to his own, and Jock resigned on the spot. He claimed that “some greengrocer on the committee then got up and said, I beg to second that.” Jock had wanted the hospital committee of the county council to run before it could walk, and I regret to think that they were glad when he went.” (22)

Figure 23 Senior Staff Hillingdon Hospital about 1935

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Figure 24 Uxbridge Market House 1936. Decorated for Coronation of King George VI

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CHAPTER 8

THE COTTAGE HOSPITALS It is generally accepted that Albert C. Napper, a surgeon, established the first cottage hospital in England at Cranleigh in Surrey in 1859. Napper did this with the assistance of the local rector, Archdeacon J. Sapte, who donated rent-free a small cottage which originally housed six beds as well as an operating room. It is believed the gift was prompted by an emergency when the rector, out riding, heard of a serious accident where the victim was taken to a local cottage. He met Dr. Napper and the village policeman who were just about to amputate the man’s leg on the kitchen table. Apparently, the local druggist, who was to have been the anaesthetist, had fainted and was useless. This incident made an impression on both Dr. Napper and Archdeacon Sapte. By 1895 there were over 600 of these hospitals in England. No longer did country people need to be transported to the larger cities for treatment. Local doctors were able to practice medicine more effectively. The profession of country doctors grew in prestige as they performed surgery and practiced more complicated medicine in these rural hospitals. In 1958 The Uxbridge Group of Hospitals comprised: 36 Hillingdon Hospital of 621 beds together with the following satellite hospitals:- Uxbridge & District Cottage Hospital of 27 beds. After the advent of Florence Nightingale and her popular nursing expedition during the Crimean War, wealthy ladies developed philanthropic interests in medicine. In Uxbridge, one of these was Miss. Laura Cox, daughter of a local banker and landowner. Through her diligent efforts the original Hillingdon and Uxbridge Cottage Hospital was established in 1869. The Cox family donated two small cottages in Park Road, Uxbridge. The hospital moved to a larger property in Park Road in 1879 and then to Harefield Road in 1914. Along with Lord and Lady Hillingdon and Lady Essex, the Cox family equipped and staffed the hospital, accepting complete financial responsibility until the onset of World War I at which time the family moved to the south of England. The local townspeople then began to take over the duties and maintenance of their mow “community hospital” under the leadership of a few prominent citizens. Imaginative self-imposed taxes were established to maintain the everyday expenses of the institution. Every citizen contributed a share, about a penny a week. Great community pride developed from such responsible local control. After World War I two new wings were added, one in 1925 and the other in 1929. On November 19th 1931 a grand opening ceremony was held. (37)

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Figure 25 Uxbridge Cottage Hospital about 1930

Figure 26 Interior of Uxbridge Cottage Hospital about 1930

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(A notable patient of Uxbridge Cottage hospital was the author George Orwell, who taught at Fray’s College School in Harefield Road for two terms in 1934 during which time he contracted pneumonia.) Hayes Cottage Hospital of 36 beds. This cottage hospital was developed into a G.P. medical unit. Patient accommodation was extended in 1952. Harlington, Harmondsworth & Cranford Cottage Hospital of 14 beds. This hospital was erected as a joint venture of the three parishes in 1884. The Regional Board converted it in 1948 to a G.P. maternity unit. The hospital was closed in 1974. Mount Pleasant Hospital of 59 beds. The former Southall Isolation Hospital, renamed Mount Pleasant in September 1948. When taken over the North West Metropolitan Region Hospital Board put in hand a scheme for converting it to a hospital for diseases of the chest. Extensive works were carried out involving conversion of air-raid shelters into day rooms etc. and conversion of a garage block to provide operating theatres and X-ray Department. Later, in 1952-53, a complete new ward block of 29 beds was added. Later, because of the decline in demand for beds for tuberculosis patients, the hospital was adapted for use as a geriatric unit. St. John’s Hospital of 28 beds. The former Uxbridge Isolation Hospital, renamed St. John’s in 1949 because it was in the parish of St. John’s Hillingdon. Southall-Norwood Hospital of 28 beds. Former cottage hospital functioning as an acute general hospital. Uxbridge Country Hospital of 51 beds. Situated at Harefield Place which was acquired by Middlesex County Council for use as a pre-convalescent and post-maternity annexe of Hillingdon Hospital. Uxbridge Chest Clinic Situated in the Middlesex County Council local office building in High Street, Uxbridge.

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CHAPTER 9

HILLINGDON HOSPITAL 1939 – 1945

The outbreak of World War II brought a stop to plans to build a permanent replacement of the hospital to a halt. However, the onset of war brought a rapid extension of the hospital with the erection of temporary hutted annexe wards through the Emergency Medical Service. In June 1940 it was reported that “300 extra beds under the Government emergency scheme for wartime casualties are to be provided” and it was further reported in 1941 that 400 beds were completed. In October 1940 a bomb fell between two ward blocks causing extensive damage, particularly to the maternity ward. Fortunately, the only casualties were two nurses who were only slightly injured.

Figure 27 Bomb Damage Hillingdon Hospital October 1940

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Figure 28 Maternity Ward Damaged by Bombing October 1940

Completion of work on three additional Ministry ward hutments was completed in 1941 bringing the total bed complement to 867. The Medical Superintendent, Dr W. Arklay Steel, reported: “Although the hospital has gained considerably in bed accommodation, it has to be stressed with unremitting monotony that the essential services have not shown a corresponding expansion in structural development and must continue to labour under a very severe and continually testing handicap: without the establishment of adequate services further organization and development of the hospital cannot be carried much further. (27) In 1942 he further reported “As the war becomes more prolonged the greater become the difficulties and embarrassments affecting the hospital and the more recessive the means to provide a remedy.” (28)

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By 1943 the total number of beds has risen to 913 and the hospital treated 12,301 In-patients and 19,640 Outpatients. The pressure of working in inadequate temporary buildings was now of great concern and Dr. Arklay Steel commented: “As the war proceeds and the demands for post-war building increases, the promises already stressed before the war, and by the war, have been extended far into the future following the end of hostilities. Members of the community working even under ideal conditions are now showing signs of the effects brought about by the stress and strains of this war, and in a hospital such as this where conditions are far from ideal the effects of the prolongation of the war must be more evident, without any evidence of self-pitying or persecuted attitude being adopted.” (29) In 1944 there were somewhat fewer In-patients treated. This was because of the need to evacuate beds “… because of the dangers from fly-bombs and later rockets.” Two days after D-Day the hospital received its first casualties – probably among the first to be flown direct from France to this country. It was further reported, “Numerous casualties from fly-bombs and rockets were dealt with in the latter half of the year. To many, the fly-bombs provided the greatest dangers and most unhappy incidents of the many experienced during the war. With the flying bombs and rockets were increased the anxieties of being able to provide bed accommodation for big numbers of casualties and the possibility that, by their numbers, the organization and system of admissions would have been overwhelmed. By luck and little provision, this fear was never experienced, but with little to show for it.” (30) In 1945 a number of structural developments were completed but these were regarded as less than satisfactory: “Owing to the deplorable working conditions existing in the Maternity Department, the Ministry of Health had in 1944 sanctioned additional Labour Wards and Nurseries to be erected. These were completed in March 1945 and put in use straight away. Regarded as an emergency measure, the buildings had to conform to Ministry specification, with the result that, while providing additional floor space, the overall finish and appearance is extremely crude. All piping is uncovered, sterilising plant is open to the corridors, which are themselves cluttered with trolleys, tables and apparatus, for which there is no alternative storage or siting. So much is bad and open to criticism that it suffices now to record again the unsatisfactory state of the whole department and express the hope that sanction will be given soon to the building of a department which can be properly planned and organized.” (31)

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CHAPTER 10

BABIES, “BUGS” and BOMBS!

The discovery at Hillingdon Hospital of pathogenic E. coli as a cause of infantile gastroenteritis

In the early 1940s Dr. John Bray, then consultant pathologist, was the first to show convincing proof that certain strains of the bacteria now named E. coli were pathogenic and caused infantile gastroenteritis. This work took place in the Pathology Laboratory, then situated in the building called “North Lodge In 1968 Dr. Bray was invited to unveil a plaque commemorating his important discovery which was made with the collaboration of his paediatric consultant colleague Dr. Beavan. The work was conducted at a time of great adversity including the area outside the laboratory suffering extensive bomb damage in October 1940. Extracts of a vivid account of the finding, in Dr.Bray’s own words, are given below. “When I first came to Hillingdon Hospital from the Postgraduate Medical School as an Emergency Medical Service pathologist in 1939, one of my tasks was to perform necropsy examinations. It was supposed at the time that there would be a large number of bombing casualties. These fortunately did not materialise, but I soon found that there were very large numbers indeed of bottle-fed babies among my subjects. These children had died of gastroenteritis, or to give the disease two other names it went by – summer diarrhoea or cholera infantum. Cholera was a better name because, as in the tropical disease, many of the children apparently not in danger one minute were, in an hour or two more, in extremis. The first culture plate that I picked up from the laboratory bench from a case of gastroenteritis and which showed apparently normal flora, had a strong smell, but one sniff and the smell had vanished. It was extremely evanescent, but it was there! Well, from then on we started smelling our culture plates, Stevie and I (Mr. John Stevenson, tireless, most friendly and very expert technician from the Postgraduate Medical School, without whom this work could not have been done). We had rows of these culture plates on the laboratory bench which we used to sniff in turn and then mark as plus or This is not a reflection on the hospital at the time, because the causation of the disease and of its high infectivity was completely unknown, even though research had been done since the time of Pasteur , indeed also by Pasteur himself. Like many of my bacteriological predecessors, I became interested in the problem and I began doing bacteriological work on these cases. The bacteriology was negative: all that was found was the normal Bacterium coli that appears on every culture plate of a faecal specimen. There were no dysentery bacilli, no salmonellae, no consistent findings of any significance. There was little from a pathologist’s viewpoint to explain the death of these children.

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One day something happened. Dr. Beavan came into the laboratory, as he very often did, and said, "You know, I can spot these cases of gastroenteritis as soon as I go into the baby’s cubicle". They have a funny smell”. I do not think that anything further was said at the time, but this was the first clue I had been waiting for. At about this time I took down to the children’s wards two culture plates, one of Proteus, a common intestinal bacterium which has a strong smell, and one of the Bacterium coli “smellers”, as we used to call them. I handed them to the ward sister, one after the other, and asked her to smell them. With the Proteus she said, “Yes, a nasty smell, like glue”, but when she smelt the other she exclaimed “Why, that smells just like Baby W……!” I said, “Sister, it is W……; it is the culture from W……”. It was at that moment that I knew the problem had been solved. But of course you can’t make a diagnosis on a smell, and an evanescent one at that. Something more than that was needed, something to give these suspicious but absolutely harmless looking germs an identity of their own. It was necessary to make an antiserum and to determine whether these germs were antigenically homogenous, in other words, whether they were chemically similar or whether they belonged to a hotchpotch of different types. We wanted to know whether the germs from the cases of gastroenteritis all reacted to the same antiserum and to prove that the germs got from normal children and adults did not so react. At this time we had no rabbits at the hospital. All this research was being done on what has been called a “string and plasticine” basis, but I did have some rabbits at my home near Windsor. One of these pets was called into service and he received an injection into his ear vein of the W…… culture. From “Snowy’s” blood an antiserum to the germ was thus made. I should say that this rabbit did not seem to mind about the procedure at all and, in fact, lived as a pet to a happy old age. The next step was to see how different cultures, from cases of gastroenteritis and normal subjects, reacted with the rabbit antiserum; whether they agglutinated or not. This work took a long time, it was spread over a period of about four years and often the results were quite exasperating. The test sometimes failed to show the hoped for results, or else the supposed malefactors were found in apparently healthy children, or again were not isolated from cases thought by the clinicians to have the disease. On several occasions I felt with despair that I was deluding myself and was not on the right track at all. However, in the end, all these setbacks were to be explained. The apparently normal children who had the germ turned out either to have had the disease earlier in a milder form and had recovered, or else later they actually came down with the disease and became ill. The cases where the germ was not found were only suffering from uninfectious digestive disturbances, which had been mistakenly diagnosed. “ From: Bray’s discovery of pathogenic Esch. coli as a cause of infantile gastroenteritis Archives of Disease in Childhood 1973 Vol. 48 p 923.

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Figure 29 Dr. Beavan, Dr. Bray and Mr. Stevenson in 1968

Figure 30 North Lodge, Hillingdon Hospital

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Figure 31 Scientific Publication by Dr. John Bray

(Journal of Pathology & Bacteriology V 75. p. 239)

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The ending of World War II brought a feeling of relief and sense of deliverance. The gratitude of the Medical Director, Dr. Arklay Steel, was expressed as follows: “There is no doubt that civilians bore much of the prolonged dangers of the war, and it now seems fitting to place on record the high standard of work, loyalty and powers of endurance and tolerance shown by all members of the staff who, by their efforts, have enabled the hospital to be so well sustained during the many trials experienced during the war. To so many on whom the work of the hospital was so dependent it is impossible to pay individual testimony, but to all form their great help, co-operation and magnificent achievements, this acknowledgement and expression of gratitude is made.” 31 The end of the war brought with it new difficulties for the hospital, in particular the shortage of nursing staff which, by July, became so acute that it was necessary to close two wards and an operating theatre. It was hoped this would be a temporary measure but at the year-end it was reported that there was little evidence of recruitment of nurses improving to allow of the wards re-opening.

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CHAPTER 11

HILLINGDON HOSPITAL 1946 –1967

In 1946 the urgent requirement of priority being given to complete plans initiated before the war for the building of better accommodation at the hospital was vigorously put forward. A report describing the “deplorable conditions under which many of the staff had to work for want of better accommodation” was sent, not only to the County Council, but also to the Minister of Health and the Ministers of Air, Civil Aviation and of Works. This had the effect of instituting consultations between the different Ministers and the Council, with the purpose of agreeing that building would proceed as soon as conditions allowed. (32) The recruitment of nurses continued to be a problem and the consequent closure of three wards and an operating theatre greatly hampered the surgical work of the hospital. The nursing shortage was not unique to Hillingdon, 813 beds were closed throughout Middlesex for the lack of staff. (33) The continuing need to improve the accommodation of the hospital was pursued. It is reported that approval had been given for initial works to commence in 1948, with other schemes to follow on “as national conditions allow”. The Regional Authorities had agreed that the main part of the hospital should be built on the Furze site. The Ministries of Air and Civil Aviation had approved the scheme of building to a height of 150 ft. The delay in building was attributed to stronger claims than the hospital for the allocation of steel. (34)

Figure 32 Christmas Show Programme 1946

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Figure 33 Press Cutting 1946

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Figure 34 Christmas in the Ward at Hillingdon Hospital about 1945

1947 was the last year of the hospital while under the authority of the Middlesex County Council. Dr. Arklay Steel took the opportunity to make the following observations in his characteristic forthright manner: “The war shattered all dreams and plans of the future, delayed the building of a new hospital for far too many years, prevented re-organisation of every kind but provided experience from which much profit can be gained in hospital construction and administration in the future.” He went on to opinion: “In the past there was a will to work and a spirit of service which contributed much to the excellent and happy atmosphere which prevailed in many hospitals prior to the war. There is a tendency for this spirit today to be replaced by resentment of authority in any form, prominence and favour sought by personal aggrandisement and a contempt and disregard for discipline practised and unfortunately encouraged by all and sundry. Too much emphasis is being laid on the conditions of service before willingness for service is shown. All these characteristics are inimical to the co-operation and common purpose required and expected in hospitals.

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Redundancies of staff are beginning to appear and the dependency on at least one other to complete the work previously done by one, is becoming evident. If efficiency is not increased and proof of lowered individual output is shown, justification for such numbers of staff will be untenable. Reluctance of staffs to engage in duties entailing work in the evening and during weekends is being shown. What has elsewhere been aptly referred to as the “Fetish of Perpetual Expansion” applied to departments in hospital is rife throughout the country and there is no doubt that a sane approach must soon be made to the subject to prevent extravagance of plans and staffs beyond the needs of immediate necessity.” (34)

The introduction of the National Health Service took place from 5th July 1948 and management of the hospital transferred from Middlesex county Council to the Uxbridge Group Hospital Management Committee under the North West Metropolitan Regional Hospital Board.

Figure 35 National Health Service Leaflets 1948

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The total number of beds for the year was 785. This reduction on the previous year was because the continuing poor recruitment of nurses prevented the re-opening of wards. Once more, Dr. Arklay Steel took the opportunity to draw attention to the need for rebuilding of the hospital, which largely comprised temporary hutted accommodation, saying: “The records of our pleas for permanent hospital buildings are contained in past reports, and from the priority given to this hospital by Middlesex, the Gray Topping Report, and the Ministry of Health, it is hoped that this priority will be retained and that the Regional Board will ensure that these past promises are fulfilled as soon as ever conditions allow.” He also expressed his concerns for the future, including his opinion that: “The frugality which characterized the economy of hospitals of the past already shows signs of changing to improvident expenditure and hospital finance if encouraged in this impetus, will soon helter skelter out of control.” (35) In 1949 new accommodation was provided for the Catering Department and the Nurses’ Home kitchen was enlarged. On 20th July 1951 a new Doctors’ Hostel was opened and on 12th December of that year Her Royal Highness the Duchess of Kent opened a 150-room extension to the Nurses’ Home.

Figure 36 Demolition of Workhouse Buildings about 1970

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In April 1953 transfer of the Administrative Offices of the Uxbridge Hospitals Group Management Committee to The Furze took place. In 1957 The Ministry of Health sanctioned the first stage of rebuilding of the hospital to comprise 210 beds and supporting services for a hospital of 800 beds. On 5th July 1960 Her Royal Highness the Duchess of Kent opened the new Maternity Wing at Hillingdon Hospital.

Figure 37 H.R.H. the Duchess of Kent 1960

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Figure 38 New Maternity Unit Hillingdon Hospital in 1960

In the same year difficulties were again experienced in the recruitment of sufficient staff, especially nurses, and a number of measures were introduced to improve recruitment including arrangements for a number of girls from the German Federal Republic to be recruited as nursing auxillaries. The Group Office was moved from The Furze to the hospital and the Finance Department was moved to “Merchiston”, a house on the north of the site. This enabled plans to be drawn up to adapt The Furze as a nurse-teaching unit, for which the King Edward Hospital Fund for London made a grant of £3,500. (38) On 1st March 1961 Miss. M.M. Edwards, Director of Nursing King Edward Hospital Fund, formally opened The Furze as the new School of Nursing.

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Figure 39 “The Furze” building at Hillingdon Hospital about 1960

In July 1962, at a meeting of the Regional Board and Management Committee, discussions were held on the implications of the Government’s 10-year hospital plan for England & Wales. The main points were:

a) It was planned to develop Hillingdon Hospital to a total of 834 beds including the Maternity Wing and proposed small geriatric and psychiatric units.

b) Although Stage I of the re-building was to include only seven of the new acute

wards it would provide all the facilities for the rest of the 834 bedded hospital, together with a boiler house and workshop scheme to be built near the water tower on the main site.

c) Because of financial limitations the Regional Board did not expect to be able

to start building the second stage of the new hospital until 1970.

d) The Management Committee recommended the following additional schemes at Hillingdon Hospital: Extension of the nurses home accommodation and building of doctors’ and sisters’ flats as well as further works at the satellite hospitals. (39)

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There were continuing difficulties in the recruitment of staff, particularly nurses. The Medical Director, Dr. Arklay Steel, considered that “The work of Miss. Roker, the Matron, in exploring every avenue in the recruitment of nurses had been immediately offset by recent alterations in the service conditions of nursing personnel.” He considered “A reduction in working hours from 48 a week was never sought by responsible members of the profession nor was an increase in holiday leave. Had an adequate increase in salary been given, without alteration of hours or leave, much of the present day anxiety would have been avoided.” (40) The Turf Cutting Ceremony for the new hospital took place on 11th January 1963. Dr. Arklay Steel was invited to cut the first sod in view of his long association with the hospital and his participation in its re-planning

Figure 40 Dr. Arklay Steel “Cutting the First Sod” Hillingdon Hospital January 1963

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Work began during the year on construction of a pilot Central Sterile Supplies Department adjacent to the Maternity Wing. This was to allow experience to be gained in C.S.S.D. techniques before the full-scale department was brought into use in the new hospital. (39) Dr. Arklay Steel, in noting that his report as medical Director would be the last in such a form, took the opportunity to review the hospital’s statistics since 1934 when such figures were first reliably available. He considered such a review “…may serve as a record of the change which has taken place in the function and character of the buildings and of the progress and developments in the face of every adversity which has transformed a relative workhouse to one of the busiest general hospitals in the British Isles.” He further commented “Many of the older members of staff may not see the completion of the buildings which were originally planned for this Hospital, but the extensions have reached a stage in building which reveals the promise of a very magnificent hospital in the future.” There is a particularly sad irony in this statement because Dr. Arklay Steel, who had done so much to realize the vision of a new hospital over so many years, died before the opening of the new hospital in 1967. Dr. Arklay Steel also place a responsibility on his successors by saying “It is hoped that younger generations of staff will not take such conditions for granted but will work assiduously in upholding and furthering the reputation of the Hospital and work with a will to ensure the completion of Phases I and III.” (39) Uxbridge Group Management Committee changed its name to the Hillingdon Hospitals Group Management Committee from 1st April 1965. Dr. Arklay Steel retired on 10th February 1965. Sadly, he died on 18th October of the same year. A memorial Service was held at Hillingdon parish church on 10th November 1965 at which Dr. C.G. Barnes, Consultant Physician, at the invitation of Mrs. Steel, gave the Address. (The text of this Address is reproduced here as an Appendix) His colleagues commissioned a portrait of Dr. Arklay Steel, by Patrick Phillips.

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Figure 41 Portrait of Dr. Arklay Steel by Patrick Phillips R.A.

On 10th January 1967 Sir Arnold France KCB permanent Secretary of the Ministry of Health opened the new Hillingdon Hospital.

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Figure 42 Aerial View of Hillingdon Hospital in 1966

The £3.2million building provided seven new wards each of thirty beds comprising six four-bedded and six single rooms. Piped oxygen and vacuum was available throughout. In addition, there was an Out-Patient Department on two floors; an Accident & Emergency Department with twin theatre suite, recovery and observation wards; an X-Ray Department with eight diagnostic rooms and dark room; Physiotherapy and Occupational Therapy Units with gymnasium and hydrotherapy pool; Pharmacy, Pathology and Dental departments. The building also provided central Kitchens and dining room, a Chapel and Central Sterile Service Supply Department. The new boiler-house complex on the north site incorporated new incineration plant.

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Figure 43 Hillingdon Hospital in 1967

Figure 44 Part of the Pathology Laboratory at Hillingdon Hospital in 1967

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Described at the time as one of the finest new hospital developments in the country the opening of what was intended a phase one of a three phase development was, according to the chairman of the Regional Board, “a great occasion”. After so many years of set-backs and disappointments this impressive new building stood, not only as a valuable addition to the hospital, but as testimony to those who over some 200 years had served the community through the history of both workhouse and Hospital.

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REFERENCES

1. Crowther M.A. The Workhouse System 1834-1929. Methuen 1981 2. De Salis R. Hillingdon Through Eleven Centuries. 1926 3. Jarret D. Britain 1688-1915 Longmans 1966 4. Mason S. Social & Economic History. Macmillan Education 1988 5. Minutes of the Select Vestry 14th May 1833 6. Chambers J. Buckinghamshire Machine Breakers. Chambers 1991 7. Harrod S.E. The Poor Law in Uxbridge 1770-1841 1970 8. Webb S.R. English Poor Law History 9. Minute Book of the Uxbridge Union 8th July 1836 10. Ibid 26th August 1836 11. Ibid 9th December 1836 12. Ibid 12th May 1837 13. Ibid 1st September 1837 14. Ibid 19th August 1836 15. Ibid 21st October 1836 16. Ibid 20th September 1836 17. Ibid 21st July 1837 18. Minutes of the Select Vestry 4th September 1827 19. Minute Book of the Uxbridge Union 25th August 1837 20. Ibid 20th March 1838 21. Hillingdon Hospital County Hospital & Infirmary Reports 1930-31 22. Macbeth R.G. Hillingdon County Hospital B.M.J. 307;1621 1993 23. James A.H. Personal communication 24. Hillingdon County Hospital Annual Report 1932 25. Hillingdon Infirmary Annual Report 1931 26. Hillingdon County Hospital Annual Report 1932 27. Ibid 1941 28. Ibid 1942 29. Ibid 1943 30. Ibid 1944 31. Ibid 1945 32. Ibid 1946 33. Middlesex Advertiser & Gazette 8th November 1946 34. Hillingdon County Hospital Annual Report 1947 35. Hillingdon Hospital Annual Report 1948 36. The First Ten Years 1948-1958. Uxbridge Group Hospitals Management Committee 1958 37. Kennery C.L. Sealed in Time R.T. Image 3;18 1990 38. Uxbridge Group Hospitals Annual Report 1959-60 39. Ibid 1962-63 40. Hillingdon Hospital Medical Director’s Annual Report 1962 41. Higginbotham P. The Workhouse http://www.workhouses.com 42. Becher J.T. The Antipauper System 1828, 2nd edition 1834

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APPENDIX

TEXT OF THE ADDRESS GIVEN BY DR. C.G. BARNES AT THE MEMORIAL SERVICE 10TH NOVEMBER 1965 TO COMMEMORATE THE LIFE AND WORK

OF DR. ARKLAY STEEL

The year 1934 was an important year for Hillingdon Hospital. About that time the County Council of Middlesex had started to develop large general hospitals at strategic points in its territory and this was later to become the pattern for other administrations to follow. Hillingdon was chosen to become one of those major hospitals and in preparation for this, in 1934, WILLIAM ARKLAY STEEL was appointed Medical Superintendent – or Medical Director as he was later to be called. It was a shrewd choice. The man appointed was expected not only to raise the standard of clinical practice in the hospital by his own work and by that of the colleagues whom he would attract around him but, in addition, to undertake the administration of a rapidly developing hospital service and to co-operate in the planning of a complete new hospital and Arklay Steel was well fitted to do all of this. As a clinician he was reliable and competent rather than brilliant but what he lacked in flair and virtuosity he made up in meticulous care and very hard work. He continued with his clinical duties until a few months before his retirement in February 1965, and over the years there must have been thousands of men and women in this neighbourhood who owed a debt of gratitude to Dr. Steel, not only for the skilful treatment he gave them but also for the kindness and encouragement which they received from him during their illness. But in spite of this it is not as a surgeon that Dr. Steel will be best remembered. He had another gift which, as it developed, was to overshadow his clinical contribution to the hospital. This was his remarkable gift for personal relationships from which, of course, sprang his great success as a Medical Administrator. Anyone who met Dr. Steel knew at once that here was a sincere and dedicated man from whom there would be no double-dealing; one felt at once that he was genuine. He for his part was a very shrewd judge of character. He was quick to assess the worth of the people he met and his assessment was very wise. I was always glad when he was going to sit on an Appointments Committee with me because he was able to see beyond the awkwardness and nervousness of the candidates to the true value underneath, and at such times his advice was invaluable. And whenever any man or woman was appointed to the hospital he trusted them completely. He assumes as a matter of course that anybody appointed to work in the hospital was going to serve it loyally and dutifully as he did himself; and so, almost invariably, it proved to be. With the coming of the National Hospital Service the number of people employed in Hillingdon Hospital increased out of all recognition, but it never outgrew Dr. Steel’s belief that anybody who worked in the hospital, in however a humble job, was sharing with him in a worthwhile venture and was, therefore, entitled to his respect and courtesy.

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Dr. Steel had a very nice sense of humour, usually quiet, occasionally robust, and this, of course, helped a great deal in his good relationships with all the departments of the hospital and helped to smooth the difficulties which inevitably arose from time to time in medical administration. Occasionally there were disagreements between him and his staff over major matters of policy or minor matters of detail. I think this was inevitable; Dr. Steel did not want round him nothing but “yes-men and women” and so he was neither surprised nor annoyed when one of them said “no” – provided they did not say it out of pure selfishness. So from time to time there were disagreements, sometimes brisk but rarely bitter or prolonged. It was not easy to feel angry for long with someone who was always very mindful of his neighbours’ needs and was going to put these needs and the needs of the hospital before either your convenience or his own. Arklay Steel was a wonderfully loyal colleague and he was genuinely delighted when any member of the staff obtained some academic or other distinction which he felt brought credit to themselves and to the hospital. During his career at Hillingdon Dr. Steel was always greatly worried about the New Hospital for he was thwarted in every effort he made to get the new buildings under construction. There were always excuses put forward. There were rumours of war, and shortly afterwards war in fact. There were financial crises, not once or twice. There were changes in central administration and changes in Government, and then all the plans got out of date and he had to start them over again. But he had been promised a hospital. Dr. steel did not break his promises and he saw no reason why other people should be allowed to break theirs, and so he fought on year after year until by his determination and pertinacity he had that promise transformed at first into plans on the drawing board and then, years later when his time of retirement was drawing very close, into bricks and mortar an cement. This is not the time to tell of his immense labours in that Sisyphean task. He was really the author of the New Hospital – and indeed as the years went by and he busied himself over the details of its design he came to know them inside out so that by the time the New Hospital actually began to take shape he was in effect not only its author but also its architect. It is very sad that he did not live to see the opening of the New Hospital. He would have been so proud of it and it would have been so fitting that he should have been upon the platform on that occasion. But within a few months of his retirement the illness, which had been stalking him, moved closer to him very quickly and he himself knew that he had not long ahead. Those who were privileged to help during that time found, as they expected, that during his illness he never relinquished his sense of humour and that there was no trace of self-pity in Arklay Steel. He who was so warm with sympathy when any of his staff was in trouble had little to offer himself when the time came. And so he died; and I think that on the day when that became known there were many, many people in Hillingdon and round about who felt a sense of personal sadness, and for those people who knew him best and who worked most closely with him the sadness went very deep indeed. But sadness, although justified, must not get out of hand and we who are met here today to say “goodbye” to him are united not in sadness but in gratitude. Gratitude for the life and good example of Arklay Steel, gratitude that, at a time when Hillingdon Hospital

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stood poised for a great leap forward, God set at its head a man of integrity, of strong determination and of great kindness. Future generations will have their memorial of Dr. Steel secure in the fine buildings of the Hospital which he helped to create. We in this generation have this memory even more secure for it has its roots deep in the affection and respect of all who shared the fun of working with him.”