A new book has been published on the history of hospitals in Birmingham. Chris Upton delves into its pages.
Birmingham, you may have noticed, has a very big new hospital, and the three giant towers of glass in Edgbaston proclaim the arrival of 21st-century medical care. I’m pleased to say that, as yet, I’ve had no reason to put it to the test.
What better time, then, for a new book to appear on the history of hospitals in the city?
Health Care in Birmingham - The Birmingham Teaching Hospitals 1779-1939 by Jonathan Reinarz (Boydell Press, 2009, £60) fills a surprising gap in the market. Although there have been individual studies of specific hospitals in recent years – I can remember one on the Children’s Hospital and another on the Orthopaedic – no-one had tackled the bigger picture.
Indeed, it’s been a long time since anyone ventured into the early history of health care in Birmingham. As Director of the Centre for the History of Medicine at the University of Birmingham, Reinarz is well-qualified to do so.
The opening date, and beginning of the study, is determined by the establishment of the General Hospital in 1779. Reinarz shows that Birmingham was among the last of the major English towns to found such a ‘voluntary hospital’, relying entirely on charitable support. Bristol had had one for more than 40 years by then.
The reason, I would argue, for Birmingham’s tardiness in this respect was that it already had a hospital – or rather, an infirmary attached to the workhouse – and that, in the eyes of many, was perfectly adequate for the time being.
Set up in the 1740s and funded out of the rates, the workhouse infirmary in Lichfield Street supplied health care to all who were unable to afford the private alternative. So, what became one of the great Midland hospitals, the General was not welcomed with open arms by all. There were plenty of charitable causes to support without introducing yet another.
Yet the General Hospital, initially in Summer Lane and later in Steelhouse Lane, soon embedded itself in the life of the town, culturally as well as medically. About 200 patients were treated in its first three months of operation (and operations). The £2,000 a year it cost to run the hospital was found partly out of donations and sponsorship, and partly from the huge music festivals held every three years in the Town Hall.
Without the assistance of Messrs Mendelssohn, Gounod, Elgar and Dvorak, the financial situation might have been very different. As Reinarz shows, the 1830 festival alone raised almost £6,000 for hospital funds, repairs and expansion.
Reinarz also provides a very useful “walk through” the Summer Lane building, an unusual addition to the formal history of the institution.
The funding model set out by the General Hospital became the norm for the other specialist hospitals which followed. Charitable donors, in proportion to the size of their annual contributions, received tickets to give to “deserving” cases.
For factory owners it became the easiest way to provide health care for their employees, especially given the regularity with which limbs were torn off and eyes removed by machinery.
If Birmingham was slow off the mark with the General Hospital, it was decidedly ahead of the game when it came to its first specialist hospital.
The Orthopaedic Hospital was founded in New Street in 1817, and was, as Reinarz points out, one of the first such hospitals in Europe. We, at least, would call it the Orthopaedic. At its opening it was known as “The Institution for the Cure of Bodily Deformity”. In the 19th Century they told it as they saw it.
It was a sound decision. By the early 1800s Birmingham was becoming very anxious indeed about what factory work was doing to the body, particularly of the young. And this was not a medical problem that the quacks dispensing potions in the Bull Ring had any claim to cure. The expertise and treatment provided in New Street was invaluable.
The arrival of the new QE completes a circle of two centuries of medical care in the city, as charted by Reinarz. While we, like our ancestors in the 18th Century, are becoming used to the idea of one general hospital to cover all eventualities, the Victorians preferred to pick off their organs individually.
Over the space of 50 years or so specialist institutions were established in Birmingham to deal with eyes and limbs, ears and throats, teeth and skin, as well as hospitals that dealt with the ailments affecting women and children. Most of these grandly-built specialist hospitals have now become hotels, and the human body has been reunited.
From having just two hospitals at the close of the 18th Century, by the outbreak of the Second World War Birmingham had a couple of dozen.
And this even before the arrival of the NHS. Nor was medical care anything like as parochial as it had been in the earlier period. A number of the Birmingham hospitals became national institutions.
Reinarz describes how, from its beginnings in 1941, taking over the old Queen’s Hospital, the Accident Hospital became one of the two national centres for dealing with trauma. The Children’s Hospital (now occupying the former General Hospital premises in Steelhouse Lane) similarly takes in patients from far and wide.
Indeed, given the presence of wounded British soldiers at Selly Oak and now the QE, Birmingham’s hospitals probably receive more national attention now than they ever have. A remarkable transformation after such modest beginnings.