Nottingham Hospitals Archives 2011
1902 - 1988
© Wellcome Images: Saxondale Hospital Nurses, circa 1920’s
The story of Saxondale Hospital began on Tuesday 25th July 1899 when a corner stone was laid by Lady Belper of Kingston-upon-Soar and was finally opened three years later on July 29, 1902 by Lady Elinor Denison and was the first hospital to put into practice the changing policies and philosophies of psychiatric care and establish early links with the community.
The hospital attractively located on a hill off the A52, eight miles from Nottingham and within walking distance of Saxondale Village and Radcliffe-on-Trent, once owned acres of farmland. It kept its own livestock, ran a pasteurising unit and a bake house and generated its own electricity.
The original hospital can be traced back as far as 1810 when an institution was established at Sneinton. Before the County Asylum Act of 1808, "pauper lunatics were found to be chained in the cellars of garrets and workhouses, fastened to the leg of the table, tied to a post in an outhouse or perhaps shut up in an in uninhabited ruin."
Nottingham's asylum, later split into Saxondale, Mapperley and Coppice Hospitals, was the first that came under the Acts non-deterrent treatment.
It was not until 1839 when John Conolly preached a "non-restraint system" that such developments were generally put into practice.
The original silent at Sneinton, funded by the county, the town and voluntary subscribers, costs less than £20,000 and had 60 patients. By 1839, nearly £40,000 had been spent on the building and its protectors and doctors were exceptional because they were genuinely concerned about the hygiene and general running of the asylum. And Dr Storer, its chairman and originator, was keen to back one of the first attempts in the county to treat patients as human beings.
The Lunatics Act of 1845 marked an era of reform. The old physical methods of bleeding, purging, leg locks and straitjackets were discredited and progress began to be made in the education and rehabilitation mentally ill. The Lunacy (Consolidation) Act, 1890, according to many commentators was a considerable setback to advancement. By 1900, there were 77 public asylums in England, and most of them with about 1,000 patients – and the age of enlightenment still to penetrate their foreboding walls.
It was in this uncompromising period that Saxondale, built at a cost of £147,000 opened its gates in 1902 to provide accommodation for 452 patients. In 1913 a further £529,000 was spent extending the main block for another 148 patients.
The general rules for the management of the Notts County Asylum – as it was known – make revealing reading today. "An ample supply of books, newspaper and cheap publications of a cheerful nature shall be provided and maintained in every ward, and be always accessible to the patients.
"No stranger or visitor except the Committee of Visitors, or the Commissioners in Lunacy, or the Lord Chancellor's Visitors, shall be admitted into any part of the asylum accompanied by patients, or be shown through the asylum, without leave from the superintendent.
In some aspects, though, the rules seem enlightened for the times. Relatives were able to visit for a couple of hours on Wednesday or Saturday afternoon and patients, with the superintendent’s permission, were allowed to take walks in the grounds and could be granted home visits for up to four days.
The 1920s were turbulent times. Nurses staged a "sit in" in protest in 1922 after being sacked for refusing to work a 66 hour week.
They barricaded themselves in the wards and continued to carry out their usual duties of dressing, washing and feeding patients.
After three days they were evicted by force including nearly 100 police and bailiffs who use crowbars to breakdown doors and barricades.
While police and strikers waged hand-to-hand conflict, patients ran amok smashing furniture and hospital equipment, during the four-hour battle.
Ejected but not dejected, was the front-page headline in the official magazine of the National Asylum Workers Union. Recalling the events at the confederations diamond jubilee dinner, general secretary Frank Lynch said: "It was a black day which almost bankrupted the union, but its overall lesson – that patient's welfare and safety must be a nurse’s first consideration – as it is true today as it was all those years ago."
Gradually things returned to normal and in 1930 Parliamentary sanction was given for the hospital to admit patients without certification – a big step forward.
Adapted from: Saxondale Hospital: The Way Forward, June 1985
During the interwar years Saxondale expanded considerably with the building of two villa blocks in 1932 for 50 female patients each and a 50 place nurse’s home. Another villa for 50 patients was added in 1937.
The shortage of nurses led to the closure of the female ward in 1946 and overcrowding was a great problem. But the appointment of Dr James S. McGregor as medical superintendent led to many advances. The hospital changed its name from the Radcliffe Mental Hospital in 1947 and an "open door" policy was instituted. A ladies hairdresser and occupational therapist was added to the hospital staff, together with the third assistant medical officer, ophthalmologist and pharmacist. By 1952 the Visiting Governor of the Board of Control were able to report: "Until a few years ago it was unfortunately the case that this hospital was among the least progressive and worst equipped in the country. Today it is beyond question a first-class hospital."
What sparked the change? Psychology made rapid strides after the Second World War. The possibility of the mentally ill living in the community was first fostered. From 1955 new tranquillisers and later anti-depressants and other psychotropic drugs were introduced.
The arrival of the National Health Service saw many new departments established that Saxondale including X-Ray (1951), Occupational Therapy (from 1950), a Patients Canteen (1952), and operating theatre and Insulin Treatment Unit (from 1953), a branch of the County Library (1956), an Industrial Therapy Unit (starting with just six patients in 1960), Chiropody (1970) and many more.
The 1959 Mental Health Act put an end to legal formalities for admission. Progress was also made in reducing patient numbers (in 1949 the hospital had over 1,000 patients), developing outpatient services and encouraging early treatment.
Coinciding with the liberating force of the 1959 Act, Saxondale's entrance was improved, the unsightly brick piers were removed and, symbolically, there was no gateway but an open way. At this time, the first two parties of 50 patients enjoyed a fortnight's holiday in Skegness.
J. S. McGregor, something of a visionary, wrote in a local magazine in 1962: "When the Hospital plan for England and Wales was drawn up it was considered that the development of the hospital would be complimentary with the developments of the services for care in the community. This is a feature which I regard great importance and there is no doubt that the local authority staff establishment will have to be increased very considerably before even a beginning can be made on real community care.
"It is unfortunately true that there is a marked tendency for Government, when a plan has been committed to paper, to consider the achievement has already been reached. But I have no doubt that many patients could be treated in the general hospital..."
Dr McGregor advocated the therapeutic value of setting up the printing department. This grew rapidly and was soon producing stationery, memos, letterheads, order pads, bound books and record sheets for the community as well as hospital services in the region.
Mixed occupational therapy began ten years after the creation of the Industrial Therapy Unit, which achieved great success, completing contracts for a dozen or more firms. Perhaps most remarkable was the packing of sterile supplies, which grew into a major unit within its own buildings, providing a service for Nottingham hospitals and health centres at Radcliffe, Bingham and Cotgrave.
The opening of the day hospital and the formation in 1976 of its first group home – where people who had been in patients Saxondale for many years are now living independently – went a long way towards fulfilling that objective.
© Wellcome Images: Saxondale Hospital Nurses, circa 1920’s
1984 – 1988
The Closure of Saxondale Hospital
The proposal to close Saxondale Hospital was not a new idea. As long ago as 1961-2, the then Health Minister Enoch Powell produced a ten-year policy document declaring that large mental illness hospitals, such as Saxondale, should be phased out.
Ever since that time, Saxondale's long-term future had been thrown into doubt. The intention was to provide a better service for the mentally ill. Most people consulted by the government said that providing treatment in District General Hospitals and caring for patients within the community offer the real prospect of improvement.
This view was, of course, not universally shared. But it was believed that Nottingham adopted a sound and sensible approach for securing suitable results from the DHSS policy. Indeed the district was at the forefront of new, exciting developments projects, such as community mental health centres. It was seen as a model of good practice by MIND – the National Mental Health Organisation.
One of the reasons for care in the community is that one in six people need psychiatric help at some stage in their life. Yet most mental health lasts only a short time and can be best treated in areas where patients lived and belonged rather than in remote institutions.
The plan to close Saxondale Hospital was only one feature of a review of mental illness services of the early 1980s. A significant increase in community provision was envisaged for long stay patients that were affected by the closure of large institutions. It was believed that such patients would benefit by having the opportunity to live as normal life as possible within the community and would have the support from professional staff to enable them to do this.
This type of service for long stay patients at Saxondale gradually evolved and developed over a seven to eight year period. Various groups, after a period of intensive rehabilitation were able to be discharged to the community to live in small family sized units called Group Homes.
It was appreciated that this arrangement did not suit every long-term patient, which is why the patients were carefully selected and underwent a lengthy period of training.
Saxondale was for many years the main psychiatric hospital for the whole of the county population, excluding the city. When the Central Nottinghamshire and Bassetlaw became self-sufficient in terms of hospital beds for the mentally ill, Saxondale Hospital became too large for the resident population that it was built to serve.
The 1959 Mental Health Act laid a duty upon County Council Social Services Departments to provide hostels for the mentally ill, who needed help and supervision in their day-to-day living but no longer required the full resources of a psychiatric hospital.
Such facilities existed for some time in the Mansfield area, managed by the County Council and it was envisaged that this type of care would be extended. Also, significant changes in the pattern of services stemmed from the opening in 1984 of new acute mental illness units based at Nottingham's Queens Medical Centre swiftly followed by Bassetlaw Health Authority, which covered the Worksop and Retford areas, by the opening a mental illness unit at the new Kilton District General Hospital in October 1984. Some patients, who originated from Bassetlaw but were receiving treatment at Saxondale Hospital were transferred to the new unit in the same month signalling the end of acute admissions to Saxondale.
The planned closure of Saxondale Hospital envisaged further concentration of services on the Mapperley, Queens Medical Centre, General and Highbury Hospital sites. The remaining patients, mostly elderly, and therefore could not be relocated into the community were transferred to upgraded accommodation At the General and Highbury Hospitals, which enabled all Nottingham beds to close at Saxondale in 1988.