Bagthorpe Isolation Hospital

“Heathfield Hospital”


BOROUGH OF NOTTINGHAM


REPORT OF THE HEALTH COMMITTEE

RECOMENDING THE ERECTION OF PERMANENT

HOSPITALS FOR INFECTIOUS DISEASES ON THE

BASFORD GLEBE LAND

_______________


To be presented to the Council at their Meting to be held on

Monday the 6th day of February, 1888

                                                                                               Johnson, Town Clerk


TO THE TOWN COUNCIL HEALTH COMMITTEE


Report: -


That on the occasion of the purchase of the Basford Glebe Land for the site of Hospitals for Infectious Diseases, your Committee undertook in the report presented by them to the Council in June 1885, that before erecting any buildings they would bring the matter again before the Council


Since that date several cases of smallpox have occurred from time to time, and it has been found necessary to provide temporary Hospitals on the Glebe Land for the accommodation of persons suffering from that disease.


No case of smallpox has been dealt with in the Garden Hospitals on Woodborough Road since the acquisition of the Glebe Land.


Your Committee have very recently been compelled, owing to a sudden outbreak of smallpox in the town, to erect a further hospital, with accommodation for some twenty beds, at a cost of about £750.


This was a matter of great urgency and did not admit of reference to the Council at the time, but your Committee now ask the Council to endorse their action in the matter and sanction the expenditure they have made.


During the past year scarlet fever has been rife in the town, although not amounting to an epidemic, and there have been as many as sixty cases in the garden hospitals at one time.


The Town Council, in view of the purchase of the Glebe Estate for a hospital site, have directed the Estates Committee to offer for sale the site of the present garden hospital, and the Committee has in fact disposed of a portion of the land, and as soon as the whole site is sold the buildings now used for the reception of cases of infectious diseases, other than smallpox will be removed.


Under the whole of the circumstances above detailed, the time has therefore, in the opinion of your Committee, now arrived for the erection of permanent hospitals on the Basford Glebe Lands.


Your Committee, together with the Borough Engineer and the Medical Officer of Health, have inspected several of the most recently and best appointed epidemic hospitals in the country, and the Borough Engineer after the experience gained by these visits has, by the direction of your Committee, prepared a plan showing the site selected and the general arrangements of the Buildings your Committee now propose to erect.


The Block plan accompanying this report shows the method in which the land is utilised and the position of the various ward blocks in relation to the administrative block. The site is chosen is almost at the extreme western end of the estate, and is near the point where the Great Northern railway to derby passes under the Hucknall Road. It has an area of 12 acres and closely joins the old Glebe Farm Buildings, a portion of which are now used as Temporary Hospitals.


The accommodation proposed to be provided in the New Hospital is as follows: -


Two Ward Blocks for Scarlet Fever .. 44.

Two ward Blocks for Smallpox  ..      44.

Isolation Block for Diphtheria and other

Infectious disease .. .. ..                    16

                                                                          Total .. .. .. 104

The proposed diseases to be provided for are scarlet fever and smallpox, but it is also necessary to have accommodation for cases of diphtheria and typhoid fever as well as for the isolation cases of measles which may arise among the scarlet fever patients. Fifteen years ago, when the population of this Borough was only 88,000, eighty beds were found necessary for smallpox patients only. As regards to scarlet fever, upwards of sixty patients were isolated at one time in the Garden Hospital in 1887, the annual total exceeding 250, although there was no epidemic. From those figures it will be evident that the number of beds proposed is far from being in excess of the requirements of the Borough, and would indeed need to be largely supplemented in case of epidemics.


In the report of the Local Government Board for 1880-1, it is recommended that the proportion of beds to population should be one to every thousand; estimating the present population of Nottingham 240,000, this would require the provision of a hospital of two hundred and forty beds. In no case has any town provided this accommodation. It appears that the method adopted in the towns where hospitals have recently been built, it to have one bed for every two thousand inhabitants, and if accommodation is required beyond that to fix tents up or temporary huts. At Newcastle-on-Tyne, where one of the most recent hospitals has been built, there are eighty-one beds provided, but there are fever and diphtheria cases only and not for the reception of smallpox cases. The population of Newcastle is about 159,000, and therefore, the hospital gives and accommodation of one bed for 1,806 people with smallpox cases excluded from the hospital. It appears to your Committee that it would not be wise to have less that the accommodation suggested, viz: 104 beds, bearing in mind that there are eighteen cases of smallpox in the hospital at a time which certainly cannot be termed a period of epidemic, and there have been upwards of sixty cases of scarlet fever in garden hospital at one time.


At Sheffield a hospital for a hundred beds is being solely for the reception of smallpox patients, and total capacity outlay on hospitals in that town including the new one now building will be about £40,000.


At Salford, which has a population of about 226,000, it, is proposed to build an epidemic hospital to contain about 150 beds.


It is difficult until working drawings are completed to furnish the Council with an accurate estimate of the cost of the proposed buildings. The cost of the hospitals visited by your Committee differed very greatly, ranging from £220 per bed at Coventry to upwards of £500 per bed at Ealing.


At Sheffield the cost was £309 per bed.

                               At Cheltenham                 £47       ..

                                At Newcastle                  £250     ..


All the costs quoted are exclusive of the cost of site.


Your Committee made very careful examination of the hospital at Newcastle, and were well satisfied with the general arrangements; the buildings are devoid of any general architectural display, and the work is of the plainest possible description. They consider that this hospital is one of the least expensive which can be built.


Pavilion style ward suitable for tuberculosis patients.


The proposed hospital, with 104 beds, at an estimated cost of £250 per bed, would involve an expenditure of £26,000. In order to check this price, the Borough Engineer has made an estimate of the various buildings required by “cubing up” and adding the estimated cost of the various appurtenant works, such as sewers, gas, water, levelling, planting, drainage and fencing the total amounts to £26,620, or £620 more than the cost as reckoned at the price per bed, ascertained from the experience of the Newcastle Hospital.


This estimate of £26,620 is based on the supposition that the most modern improvements will be used, especially as regards sanitary requirements, and that the general arrangements of the blocks in themselves, and also with reference to one another, will be such as will conclude to the efficient and economical working of the whole establishment.


It is not intended to erect the buildings with any attempt at architectural display, but to erect them upon the most economical lines, having regard to the condition that the workmanship must be of the best, and that the greatest consideration must be paid to all sanitary requirements and conditions.


Among the many suggestions your Committee have considered is one that the buildings should be of purely temporary nature.


In the Local Government Boards’ report of 1880-81, Dr. Thorne, was has visited the whole of the epidemic hospitals in the country, says that in the case of wooden hospitals they have been lined with match-boarding and the intervening space between that and the outside weather-boarding has been filled with sawdust.


It has been impossible to maintain in them sufficiently warm temperature. During the winter of 1880-81, in one of these wooden hospitals, even of good construction, it was found impossible, even by keeping large fires going during the day and night, to maintain the buildings in use at a proper temperature: indeed in one of the wards the temperature near one of the beds was found to have fallen below 32’ Fahrenheit, thus rendering it unsafe for the reception of patients.


Having reference however to the experience which has been acquired, I cannot but conclude that, as regards permanent hospitals in this climate, wooden and iron buildings as ordinarily constructed are not as a rule well adapted to the purposes of wards.


That they can be constructed so as to ensure a reasonable and a fairly equable ward temperature, I doubt; but when so constructed, their original cost would probably not fall short of, if it did not indeed exceed that incurred in the erection of ordinary brick buildings; they would be less durable than these, and the cost of maintaining them in proper state of repair is undoubtedly greater than that needed for the maintenance of the more substantial structures.


Having regard to the desirability of securing surfaces which are easily kept free from dirt and infection, and which dry rapidly after being cleansed, it has appeared to me that wooden lined wards are not adapted to the varying needs of a permanent building.


On the other hand no information has been forthcoming during the course of my enquiry tending to show that wards composed of the more permanent materials, but which are well constructed, well ventilated, and well administrated, became in the process of time less fitted for the reception of the sick than when they were erected.


Ward used for the Isolation of smallpox patients


A view from the back of the above ward. Note, the viewing platforms. You couldn’t visit your relative only go and look at them



As regards the cost of temporary hospitals, the one in the workhouse garden which was built for eighty beds, cost including fittings is about £66 per bed. The temporary ward just built at the Glebe Farm cost £40 per bed, exclusive of fittings and sundry appurtenances; with fittings it would cost about £60 per bed.


In considering the difference in cost between permanent buildings and temporary buildings, it must be born in mind that the term temporary buildings usually applies to the ward blocks only, and that the following buildings forming the general administrative departments, together with certain other appurtenant works, should certainly be of a permanent character.


           Administrative Block

 Entrance Lodge.

 Laundry, including Chimney, and Laundry Machine.

 Stables, Van and Ambulance.

 Mortuary and Post-Mortem Room.

 Heating Apparatus.

 Boundary Wall next to Hucknall Road.

 Wooden fence to separate Fever Blocks from Smallpox Wards.

 Entrance Gates.

 Drainage.

 Levelling, turfing and general laying out.

 Forming roads, drives and walks.

 Planting a belt of trees.

 Gas and Water supplies.

 Covered Corridors to communicate between the Administrative Block.

 And the Wards.

 

 The cost of the whole of these works would amount to about £11,870


The Headquarters and Central Administrative Quarters to the Bagthorpe Isolation Hospital.


It should be mentioned that your Committee have not come to any definite conclusion as regards the Covered Corridors but it appears to them that it is absolutely necessary that they should be provided as it is a somewhat dangerous practice for nurses and servants to walk a distance of 200 yards in open space in the open air in all weathers; the cost of corridors has therefore been included in the estimate, and your committee will give the matter their careful consideration, and if considered unnecessary will strike out of the scheme.


There is then left the sum of £14,750 as the cost of the five blocks, or a net sum of £141 per bed for the erection of the blocks alone. Assuming that the idea was entertained of having temporary wooden hospitals, and that they cost only £60 per bed, there would be a present saving of say £8,510, but it must be remembered that the life of a temporary building would only be fifteen to twenty years at the outside, and there must be also taken into account the annual cost of repairs which for buildings of this nature is very great.


The popular noting, however, in Advising or suggesting the adoption of temporary buildings is that they may be burnt at certain periods after epidemics, so as to remove chances of infection. It is difficult to see how this could be carried out, as the Scarlet Fever Blocks would practically be always in use, and smallpox appears to pay the town a visit every eight or ten years.


Following this process through for a term of say twenty years, and presuming that the smallpox wards are destroyed by fire after every epidemic, say every ten years, and that the fever blocks are destroyed every five years, this system would cost as follows.


                                           Smallpox Wards, 44 beds times 2 times 5 =                £5,280

                                           Diphtheria and Fever Blocks, 60 times 4 times 60 =   £14,400

                                                                                                                          _______

                                                                                                                           £19,680


The cost is estimated at £60 per bed, namely £40 for buildings, and £20 for fittings; it is as necessary to burn the one as the other. So that if this scheme were adopted, there would be an expenditure of nearly £20,000 in twenty years, or an average of £1,000 per annum for maintaining the blocks, irrespective of the amount of repairs which would be required to buildings of this nature in the period of ten years and five years respectively, whereas for an expenditure of £8,5000 more than the first cost of temporary buildings, there could be provided permanent buildings having all modern requirements, and fulfilling the conditions laid down by the Medical Staff and the Architect of the Local Government Board, whose knowledge of the subject is without question.


Again, if temporary hospitals are built, apart from any ideas of destroying them by fire at certain periods, the repairs would amount to a very serious item and in fifteen years the average annual amount spent on repairs would exceed the interest on the difference between the cost of temporary and permanent buildings. Whereas the latter would cost nothing for repairs to the actual structure the repairs would simply be for painting and sundry repairs to the roads and walks.


Your Committee believe that the scheme they would in the end prove the most economical and advantageous to the town, and would enable them to entirely abandon the Garden Hospital, which appears to be viewed with such suspicion by the neighbouring occupiers and owners of property.


Your Committee have already marked out the site on the ground and the same is now being enclosed by a belt of trees and shrubs, to screen and protect the hospitals from the adjoining land, railway and road, and to shelter them from the north and east.


Your Committee have no hesitation in recommending the Council to approve the plan of the site and buildings, laid down before them, as they consider the arrangements should carry out all the latest requirements in institutions of this kind. They, therefore ask the Coucil to authorise them, when the detailed plans of the whole of the buildings and works now being prepared by the Borough Engineer are completed and approved by your Committee, to obtain and accept tenders for the carry out of the works.


The Remains of Bagthorpe Isolation Hospital (Heathfield Hospital) as seen from an aerial photograph taken in 1983.


As already reported to the Council by the estates Committee it was to devote the proceeds of the sale of the present Garden Hospital towards the erection of the new hospital, but the Lords Commissioners of Her Majesty’s Treasury refuse to giver their sanction to this course, other than by way of a loan, to be repaid in a short period of time, and as your Committee are of the opinion that this would be less advantageous to the Corporation than raising the sum required in the ordinary way, under the statutory powers possessed by the Corporation, they ask the Council to direct the Finance Committee to raise the necessary funds in such a manner as they shall deem most expedient.


                                                                                                                            Dated this 27th day of January, 1888

    

                                                                                                                                                      WILLIAM FORD

   

                                                                                                                                                                    Chairman


Bagthorpe Isilation Hospital

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