Bagthorpe Isolation Hospital

“Heathfield Hospital”


BOROUGH OF NOTTINGHAM

HEALTH COMMITTEE

REPORT


PRESENTED TO THE COUNCIL

1892/1893


The old Garden Hospital has ceased to be, its functions having been finally taken over by the new institute at Bagthorpe. It was burnt to the ground by the order of your Committee on December 11th 1892. The Garden Hospital was erected in 1871-72 for a smallpox epidemic of those years. For some years after its erection it was alternatively used for various epidemic diseases, but since 1885 it has been almost exclusively utilised for scarlet fever cases, an ever increasing proportion of which found their way into the hospital from this date until its final closure.


The percentage of cases removed in 1885 was 12%; during 1891 the percentage of removals was no less than 86%. Notwithstanding the poor accommodation of the Garden Hospital, and the drawbacks inseparable from temporary buildings of the character, it continued to grow in popularity year by year until its demolition. During the five years of its existence nearly 3,000 patients were accommodated within its walls. The case mortality among these patients varied from 2 to 3.5%. The cases mortality amongst patient’s nurses at home ranged from 5 to 9%.


The new hospital at Bagthorpe was completed at the beginning of July 1892 and formally opened by the Mayor on the 15th of that month. After this I was instructed to furnish the hospital, to obtain the services of a competent staff to carry on its work, and to draw up a code of rules regarding the conducting of officers, servants, patients, visitors, etc. All this was speedily affected, and by the beginning of October the institution was in full use. My own thanks and those of the town at large are due in no small degree to Miss Dickenson the Matron and Dr. Wynne, the Assistant Medical Officer, and other members of the staff, for their cordial and efficient co-operation in carrying on the work of the hospital. It is necessary to understand something of hospital administration, and to have seen the working of an institution less ably officered, in order to appreciate the value of their services. Perhaps the best testimony in favour of the hospital is the almost unanimous approval expressed by persons interested in the hospital management who have visited it since the opening, and among these have been a long train of critical deputations sent out by other large towns to study the subject of hospital isolation for infectious diseases.


The number of cases of scarlet fever treated in both the Garden and Bagthorpe Hospitals during 1891 was 902; of those 883 recovered, and 19 died. The deaths amounted to 2.1% of the cases.


The number of known cases treated at home was 124, and the deaths among them numbered nine, or 7.2%.


The mortality figures both for the hospital and home cases are almost identical with those of last year. Although the apparent death rate among the home cases is doubtless to some extent exaggerated by the fact that a few of them escaped notification, the huge discrepancy between the two rates cannot be explained away by such means.


Of the 771 scarlet fever cases removed to the hospital during the year, 11 or 14% were admitted on the day of rash and 720 or 93% within the first week from the onset of the disease. The average duration in hospital for the non-fatal cases was 53.1 days, or seven weeks and four days.


Section of a 1901 map showing the location of Bagthorpe Isolation Hospital with Bagthorpe Workhouse and Infirmary still under construction.


I have already demonstrated to the satisfaction of your Committee that hospital isolation, as now practised in this town, has the effect of diminishing the spread of infection through the agency of the persons isolated by more than 50%. The figures necessarily vary from to time, but this is the general result. Taking 100 primary hospital cases it is found that some 20 to 25% of additional cases occur in the houses from which they are removed within three weeks of their removal and after their return home – these last return cases constituting about one sixth of all. Nearly 60% of additional cases are the results of infected patients nursed at home. The cases and deaths occurring at various age periods will be found in the accompanying table. I may note in passing the frequent occurrence of malignant or intractable scarlet fever, as a direct death cause in the hospital. Several malignant cases have been sent in an almost dying state. Kidney failure and complications, fostered by injudicious treatment and exposure, are a far more frequent occurrence as death causes at home than in hospital





The following figures, having reference to scarlet fever, show at a glance how rapid has been the increase in the practice of isolation during the past few years.


* First year of compulsory notification.



The combined cost of the two hospitals for the year ending with March 31st 1892 is estimated by the Borough Accountant to be £4,156: £1,362 for the Garden Hospital, closed in October, 1892 and £2,794 for the Bagthorpe Isolation Hospital, fully opened at the beginning of that month [March 31st 1892]. The cost per bed per annum works out at about £26 and the cost per patient, with the average duration in hospital of seven weeks and four days at £4 10s. (£4.50p)


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Bagthorpe Isilation Hospital

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