A History of the Isle Of Wight Hospitals by E. F. Laidlaw

Royal Isle Of Wight County Hospital 1849 To 1992

On Tuesday, September 28th 1848, a general meeting of subscribers to the Royal I.o.W. Infirmary was held in Newport Town Hall; the Mayor of Newport, James Eldridge, was in the Chair, and he called upon Col. Harcourt, later M.P. for the Island in 1851-52, to read the draft of the proposed statutes of the Infirmary. These specified that the Management was to be in the hands of the Governors 'As qualified hereinafter'. The hospital was to be for the relief of the sick and disabled poor from all parts of the Island. Admission however would be dependent upon the patient procuring a letter of recommendation from a subscriber, except in the case of sudden accident or emergency - all such urgent cases would be received at any hour of the day or night.

The Management Committee was to be composed of twelve governors, with a Chairman; three were to retire each year, - but could be re-appointed. There were to be weekly meetings of the Committee and accounts were to be rendered monthly. The Committee would have the authority to discharge Matron or House Surgeon for misconduct and to appoint temporary officers in their place; that apart, control of the hospital was to be exclusively in the hands of the Governors, but the committee would submit their recommendations.

The Queen had already consented to be the Patron, - hence the justification for the Royal title; the President was Lord Yarborough.

The subscribers of 2 guineas became Governors for a year; and those of 20 guineas became life Governors. (We must remember that 2 guineas in those days was in terms of purchasing power the equivalent of at least £100 now and 20 guineas, £1000.)

This was not, obviously, the first meeting intending to plan the hospital; much had already been done and there had been a committee which had met probably on at least half a dozen occasions and which had produced the draft. But it does seem to have been the first meeting which is recorded in the archives of the hospital. There had been meetings certainly in 1845 and 1847 when much of the preliminary planning had been settled. By April 1847, Thomas Hellyer of Ryde had been appointed Honorary Architect and was made a life Governor. He had submitted a design for a 20 bedded hospital which had been accepted and was estimated to cost £1,630-11s-6d. Messrs Jolliffe had been appointed builders, and J. Percival Esq. of Woodlands, Treasurer. It was estimated that the cost of running the hospital would be £300 per 10 beds per annum.

Among the pioneers of these earlier meetings were Rev. W. Spencer Phillips, Rector of Newchurch, and a surgeon, Mr. A.T.S. Dodd. Newchurch in those days was a parish which stretched from shore to shore and included Ryde and Ventnor; but the Rector had realised that a large part of his flock lived in Ryde, and Ryde was chosen as the most suitable site for a hospital since it was said to be within 12 miles of four fifths of the Islands population (which must still be the case) and was also suitable for hot and cold sea baths. At the meeting in 1845, £400 had already been subscribed and by 1847 £1250; land for the hospital had been made available by Miss Player and Miss Brigstocke who provided it at a nominal rent for 99 years; later, about the turn of the century, extended to 999 years.

Among the conditions laid down in the draft now read, it was required that the House Surgeon and Matron, and nurses and servants, all of whom would be resident 'Shall be unmarried, or in such circumstances as not to be inconvenienced with the care of a family'. And that patients 'Such as are discharged, cured or relieved, shall be enjoined by the Committee to return thanks in their respective places of worship, and also to the persons who recommended them to the Infirmary; forboth of which purposes printed papers shall be delivered to them'. There were to be strictly no gratuities - on pain of immediate discharge if a patient, or dismissal if on the staff. More suggestive of modern times perhaps were the conditions that all complaints were to be notified to the Committee; and visitors wishing to inspect the Infirmary might do so at appointed times.

There might need to be a waiting list for admissions. The House Surgeon might reject unsuitable patients, informing the subscriber by letter; after a patient had been in the hospital for three months the Committee might discharge him or her unless the Medical Officer desired otherwise; in which case a further letter of recommendation must be obtained. In the case of death, the subscriber or the patient's friends, or parish, were expected to pay the funeral expenses, which in no case should be more than 30s; the expenses of transport home must in the case of patients coming from a distance be provided by the subscriber. Any soldier admitted must have payment guaranteed by his officer. Patients discharged for irregularity should never be re-admitted unless by special consent of the Committee.

The first meeting of the Governors was held in October 1849 just a year or so after this inaugural meeting; with James Player Lind in the chair; the Vice-Presidents included Captain T.R. Brigstocke, John Hamborough and Sir William Oglander Bt. The Honorary Chaplain was the Rev. Laurence Tuttiett; Dr Martin of Ventnor was appointed Honorary Consultant Physician and Mr. Richard Bloxam, Consultant Surgeon; there were to be four Medical Officers, B. Barrow. R.W. Bloxam, Henry Phene and T. Bell-Salter. The Medical Officer on duty was an ex-officio member of the Committee. The House Surgeon who was also to serve as Secretary was appointed and the first Matron was a Miss Pascoe.

Several categories of patients were excluded, - not to be admitted; namely those with Consumption; Smallpox; Venereal Disease; Epilepsy; and the Itch; and also those considered incurable; the insane; those with inoperable cancer; women with advanced pregnancy; and children under seven.

The minutes of this meeting included a final sentence 'Of the several reports, six in all, which have been published and circulated with the respect to the progress of the Royal Isle of Wight Infirmary, the last, issued by the late Committee on January 1849 was the first which contained a Debtor and Creditor account and was therefore, - as such statements of accounts will afterwards appear annually, - styled the first "Annual Report". 'There was reference at this meeting to a grand bazaar held in aid of the Infirmary by invitation of Col. and Lady Catherine Harcourt at St. Claire (now the St. Claire Holiday Camp); this had been attended by the Queen and members of the Royal Family; it had produced £847 which was said to be far in excess of the most sanguine expectation; (£800 in 1913 would according to Whitakers Almanac have had approximately the purchasing power of £40,000 now; - how much more £800 might have been in 1849 I do not know, - but it was indeed an impressive sum).

The report included a long list of rules for the Medical Officers, the House Surgeon and for the Secretary, Treasurer, Chaplain, Matron, nurses and servants. The M.Os. were to attend in a rota, one at 9 o'clock and one at ten o'clock on Mondays, Tuesdays, Thursdays and Saturdays. No Medical Officer was to prescribe for or intermeddle (sic) with the patients of any other M.O. except by his desire. No one should be allowed to see the prescription, practice or operations of the Medical Officers without their consent. No 'capital operation' was to be performed except in urgent cases without a consultation of Medical Officers and a Medical Officer was to attend each weekly Committee meeting to receive and examine patients recommended and certify his opinion of the cases and take them under his care if admitted.

The House Surgeon was to have under his care all medical stores, surgical instruments and pharmaceutical apparatus; keep an inventory and see that they were kept in good condition; on no account to lend any without written order from an Honorary Medical Officer, and when lent, take care that they were returned as soon as possible and fit for use. He was not allowed to entertain any party either for pleasure or for any other purpose within the house. The Matron was to have the keys of the outer doors and to lock up every evening at nine in the winter and ten in the summer.

For the servants the first requirement was that 'They should behave with kindness to the patients and with civility and respect to the officers of the establishment'. Finally the patients were to 'Wash their hands and faces every morning; to be decent and regular in their conduct; and not to swear nor use any improper language'. It is easy for us to smile at these rules; perhaps however we should recognise that they reflected the principles and practices of the time, - and who shall say that those of our own time are any better.

The hospital opened on November 9th 1849, - this date was chosen being the birthday of the Prince of Wales. There were now 25 beds rather than 20, 5 being set aside for paying patients or other purposes; in the first year, - that is up to the presentation of the second Annual Report to the A.G.M. in 1850, there had been 83 in-patients and 37 out-patients; the number, especially of out-patients rose rapidly; 125 in-patients and 457 out-patients in 1850-51, and - to anticipate - after 25 years, in 1874-75 there were 293 in-patients and 1547 out-patients. Much happened during those 25 years and indeed afterwards; the minutes indicate the main concerns of the Committee, the Governors and Medical Officers, dealing chiefly with admissions and discharges, subscriptions and donations, governorships; collections in churches and elsewhere, appointments and changes of staff; day to day maintenance; catering and house keeping; and new buildings; and there was a variety of incidental matters, some of which may be of some interest and throw light upon the times. In 1850, a special meeting of Governors considered the admission of patients from the Middlesex Hospital for the purpose of sea bathing; this was to be allowed on payment of such sum as would fully cover all expenses and provided that 20 beds remained for Isle of Wight patients; in 1851 the occupation of Turnpike Cottage was considered, this was a cottage situated adjacent to the main entrance, as it then was, to the hospital, which became the exit for cars and other wheeled traffic. The cottage, I think, must have been demolished because a lodge was later built close to that site. In 1852 the creation of a Public House almost opposite the Infirmary was to be opposed by every means in the power of the Committee (in parenthesis it seems fair to say that one is not aware of any adverse influence exerted by 'The London' on the hospital; possibly at times the juxta-position was, to some on both sides, convenient. The old London' of course is gone now replaced by the new one.

In 1855 six beds were set aside for soldiers invalided from the Crimean War; this was later increased to 12 (the Government to pay) and in that year the Chairman of the Governors wrote to the Master of the Workhouse in Newport asking if he could recommend a nurse for the female ward; in 1856 there was a problem about the admission of the wives and children of soldiers at Albany Barracks in Parkhurst, a problem which recurred several times over the years.

There were staff problems; the H.S. in post at the time of the opening was apparently not acceptable to the M.Os. and Governors; he left and a Mr. Billinghurst, or one of the Honorary M.Os., undertook to fulfil all H.S. duties for a month until someone else could be appointed; advertisements were placed in the Lancet and the Medical Times. In 1856 a disagreement between the Matron and the House Surgeon led to the latter resigning; in the following year Col. Harcourt reported to the Committee that he had encountered the Matron unfit forduty having over indulged herself; she resigned the next week.(Thiswasnot Miss Pascoe who had moved on earlier). In 1854 the advertisement for a House Surgeon offered the post to 'A legally qualified gentleman', - He would be required to act also as Secretary and to visit out-patients; (Home visiting seems to have been part of the House Surgeon's duties for several years to come, - even though he was the sole resident). In 1858 permission was given to George Dash, a porter (of whom more will be written later) to marry, provided that he lived at the lodge which was built for him; I Os-6d was allowed for his board and wages. In 1859 the offer of a pew to be reserved in the parish church for the Medical Officer was declined; the Committee felt that in future a difference of creed of the M.O. might make the arrangement objectionable.

In 1860 the porter, George Dash was given a key and a bell was fixed to ring in his lodge at night so that he could admit emergencies during the night. In 1868 there was debate about the admission of the wives and families of policemen on the Island, - it was felt that with a salary of £1 weekly and free accommodation and medical care that they would not qualify as poor people needing free hospital care; they could no doubt have been admitted but would have to go into the paying patients beds.

In trying to give an account of the hospital's history it seems best to deal with it under several headings although of course it developed as a whole and the different headings are closely inter-related; viz Buildings, Management, Staff and Finance.

Buildings

The earliest picture of the hospital about the time of its foundation shows the front recognisable with a main entrance looking East flanked by three tall windows on either side; a three storey building with the upper floor then having the appearance of attics with small windows; a ground plan about 1860 confirms this structure showing the main entrance connected with a cross corridor running from north to south with a set of rooms in the front and at the back. In 1851, however,Thomas Hellyer had added an Out-patients Department and a laundry and these also are shown on that plan; and about 1862 a lodge was built close to what is now the regular exit which must have involved the demolition of Turnpike Cottage.

In 1864 Mr. Barrow, one of the Honorary Surgeons, reported that the wards were overcrowded, each bed having only 720 cubic feet of space, whereas 1,000 cubic feet was considered desirable; he suggested that some beds should be moved upstairs. However, at the time, the Committee was already advising the Governors to enlarge the buildings, and had approved plans for this. Again the plans were due to Thomas Hellyer who remained the Honorary Architect for about four decades; these additional buildings increased the maximum number of beds to 38. In 1857 gas lighting for the hospital was considered and shortly afterwards was installed at a cost of £16.

In 1870 the Medical Officers urged better accommodation for fevers and stressed the need for the nurses and a laundry relating to such cases to be kept separate; under pressure from them, the Chairman, Major Augustus Leeds, informed the Committee that he had entered into an agreement with a Mr. Austin for the purchase of a separate house for the reception of fever patients.

The Chairman's action however was disputed, carried only by a small majority, but at the next meeting, a week later, rescinded and it was agreed that new wards should be built. At this time there was a Ryde Borough Council and it had created a sub-committee dealing with highways, gas and health and sanitary matters. This committee was interested in the provision of isolation wards for fevers and apparently would have undertaken part of the cost of patients admitted to such wards.

In January 1871 land was purchased for the new wards. The original plan seems to show the hospital grounds extending, as they now do, to the road immediately to the north of the hospital, Milligan Road then called Cemetery Road; but it seems that land for these wards which were to be built there had to be purchased by the Governors. It was suggested that these new wards should be a memorial to Sir John Simeon, and the Rev. Chisholm offered a subscription of up to £500 if this were agreed; however his family were unwilling to accept this form of memorial so that particular plan was abandoned; but the building of the wards was to go ahead.

In May of that year, 1871 the Sanitary Committee sought permission to build a temporary hospital in the grounds; but this was refused - it seems that it was to have been used for Smallpox.

The M.Os. were dissatisfied with the new wards when they were built. Mr. Barrow in particular who had persistently pressed for attention to drainage, ventilation and in general for a higher standard of accommodation, submitted his resignation in his displeasure but subsequently agreed to carry on; but he said that the wards were not as planned and the doctors with the support of J.B. Leeson Esq., M.D., F.R.C.P., F.R.S., of London complained that the design and ventilation of the wards was not satisfactory. The Architect submitted plans for enlargement and improvement of the wards and he also assured the Committee that the sanitation of the block was of the same pattern as that used in a series of well known buildings, mentioning the Radcliffe Infirmary at Oxford and the Institution of Mr. Eno the fruit salt manufacturer.

Meanwhile in 1874, Miss Lowther offered to raise £4,000 for a Childrens' Ward and Mr. Hellyer worked on a plan for this which the Committee asked the Governors to accept, and in 1877, Miss Milligan of East Ridge, Ryde proposed the erection of a convalescent home which was to be a memorial to her father and mother, - her father had fought in the Battle of Waterloo. This home was built and opened in 1881; Miss Milligan contributed in all about £5,500 towards its cost and endowment and its name is also associated with that of Marcus Lowther. It was known for a long time as the Milligan Convalescent Home or later as the Milligan Block and the institution was thereafter referred to as the Royal Isle of Wight Infirmary and Convalescent Home. It is of course the block lying to the West of the main hospital and opening onto West Street and it was connected to the main or central block of the hospital by a covered way and a flight of steps leading up to it; a memorial tablet is incorporated in the building and can still be seen above the entrance from West Street 'In Loving Memory of Robert and Elizabeth Milligan, this building is erected by their daughter Sophia Milligan 1880'.

The water supply to the hospital was derived at first from a well built close to what is now the main gateway which soon after the opening of the hospital had to be deepened but later the hospital went on to the main water supply. In those early times however George Dash had to pump water up into the storage tanks which would be presumably situated in the roof and which in the early days were of lead. These now, in 1881, were replaced by a galvanised iron and some years later the lead pipe supplying the tank was also replaced by a steel one.

Meanwhile in 1882 the roof of the original second floor was raised making the accommodation suitable for patients' wards; Mr. Barrow, now a member of the Committee and recently Mayor of Ryde after his retirement from the staff, asked for a communication between the fever wards and the main hospital; Mr. Hellyer indicated that he was planning a covered way and other modifications. A larger operating room was needed and a year or so later a new wing containing a sitting-room and three bedrooms for nurses as well as this operating room was built and also a new kitchen range and larder and a new ward with six beds for women together with a nurses' room and an enlarged dispensary and four additional bathrooms; by 1892 there were 50 beds plus 10 for fevers and 10 in the Convalescent Home; fire precautions were introduced with a hand engine which could be pulled along corridors and canvas shutes from the windows of the wards. (One hopes that patients never had to descend by these shutes). The need for more accommodation was persistent and about this time there was a project for a nurses' institution to be built in proximity to the hospital and Charles Seely M.P. offered £500 for this; but this plan did not come to fruition; it seems that the terms of the lease of the land did not allow such building on the hospital site and adjacent land was not found suitable. In 1894 plans for more accommodation for nurses and servants and for a lift were submitted; for the first time, the Architect now was not Thomas Hellyer who died that year; but by the next year, these things had been provided together with a new Consulting Room and a cabin for the porter within the building; and a new hot water system. Telephones were installed in 1898.

The most important and best known of the new buildings was to come in 1896 and the following years. Princess Henry of Battenberg, better known on the Island as Princess Beatrice, became Governor of the Island and President of the hospital in succession to her late husband who had died in Africa, in 1895; she supported the project to build a Childress' Ward and expressed 'The earnest desire that it may be carried out as a memorial of Her Majesty's reign of 60 years'. The next year, 1897, she laid the foundation stone, albeit there was some concern about the diminution of (financial) support, and an interest free loan of £300 from E. Sweetman Esq., a member of the Committee was accepted.

The ward was designed by Messrs Young & Hall of Southampton Street, Bloomsbury, and built by Charles Langdon of Ryde. The opening by the Queen herself was on Friday July 19th 1899.

At 5.30 p.m. on that day, - half an hour before the time of the opening ceremony, - Princess Beatrice unveiled a bust of Queen Victoria, mounted above the ward and sculpted by E. Onslow-Forbes, R.A.; under it was the inscription 'Built and endowed as the Isle of Wight's commemoration of Queen Victoria's Diamond Jubilee. "She wrought her people lasting good".

The Queen's procession came into Ryde by Queen's Road and proceeded by John Street, the High Street, and Swanmore Road, and entered the hospital grounds by the new gate, where a Guard of Honour was drawn up; nurses and patients were assembled on the verandah in front of the hospital with the Matron, Miss Pinchard; and below the new ward were the boys from the Isle of Wight College. The Queen arrived at two minutes past 6.00 p.m. A short service was conducted by the Bishop, and the Queen, remaining in her coach, was then handed a silver disk which she pressed, thereby opening the doors of the ward. The following day, Princess Beatrice accepted the ward on behalf of the Governors from the Commemoration Committee.

The Queen paid one more visit to the hospital in February 1900; it is said to have been one of the latest of her public engagements and was less than a year before her death. This seems to have been a quiet and unpublicised visit, and I cannot find any mention of it in the CountyPress; it was reported in The Times that the Queen had visited Queen Victoria Ward for Children at the R IoW C H; she was accompanied by Princess Henry of Battenberg and Princess Victoria of Schleswig-Holstein, and others, and was met and conducted to the ward by Dr A. Davey, the Rev. W. Welby, and Miss Skid, the Matron; there she distributed toys to the children. She returned from Osborne to Windsor shortly after this visit.

In 1903 a report was asked for from an independent Architect, T.W. Cutler, F.R.I.B.A. andwhen received must have caused some concern to the Committee, being rather highly critical. He said that the wards were divided into small rooms with the ventilation shared and heating inadequate; the theatre, kitchens, water closets and washrooms were in general bad; nurses' rooms lacked storage space; there was no cellar for wine and beer; no servants' hall; no porter's sitting-room; no Secretary's office; no visitors' waiting room; and no adequate system of ventilation and heating; no fire escape; and drainage was of doubtful efficiency. About the same time a Professor Colefield gave a report in which he considered that improved sanitation was absolutely necessary.

The Committee accepted Cutler's comments and a building sub-committee was formed and after discussions recommended Cutler's plans to the Committee. These involved the building of a 'sanitary tower', with some re-arrangement of the ground floor and the drainage; the provision of a fire escape; and the creation of a new Out-patient Department, with consulting rooms for physician and surgeon, a dispensary, a covered waiting porch and an Out-patient hall; above these were to be the new isolation wards for men and women with nurses' changing rooms and their duty room, and a bathroom with a mobile bath which could, it appears, be wheeled from one room to another; the buildings also included a new mortuary and a post-mortem room, a chapel of rest and a small room set aside for pathological investigations; this last was soon improved with the help of a donation from the Dowager Lady Calthorpe.

The contract for this work went to Henry Curtis of Southampton and the cost was about £5,000 but of this, Mrs. Hathway of Quarrhurst gave the money for the Out-patient hall in memory of her husband who had been a member of the Committee for some years; and the cost of the fire escape was provided by Mrs. Pakenham-Mahon who later made other and larger gifts; the cost also was in part defrayed by the proceeds from the bazaar organised by Mr. and Mrs. Maybrick which raised £918.

The new buildings were opened in 1907 by Princess Beatrice.

The next addition was a new operating theatre together with an anaesthetic room, sterilising room and changing rooms for the nurses and doctors. Half the cost for this, £500, was available from an anonymous gift through Mr. A. Banks, one of the surgeons to the hospital at the time; and about £300 was derived from a memorial fund for the late Dr Groves; he had specified that this money was to go to the creation in particular of the sterilising and anaesthetic rooms.

A memorial to King Edward VII was to be the modernisation of the main block of the hospital or such portion of it as subscriptions might allow; but at first it was felt that a nurses' wing of 12 beds was needed and would be part of the eventual plan. It might be expected that the Great War would have put a close to any building during those years - 1914 to 1919; but a new Eye Ward, doubtless planned earlier was opened in 1914 - and was regarded as a memorial to King Edward VII; and about the same time an electric lift was installed and an X-ray room built on; the former was a gift from the Mayor and Mayoress of Ryde, and the X-ray apparatus given by Mrs. Dobie of Ryde, was said to be one of the best and most up-to-date in any provincial hospital.

Some years before this building the Committee seeking more accommodation had reviewed the use of the Milligan Convalescent Home. The fact was that it was substantially under-used and in 1909 plans were produced to restrict the convalescent accommodation to two double bedrooms on the upper floor together with sitting-rooms for men and ladies, and to use the lower floor to provide a committee room, a secretary's office, a nurses' sitting-room and dining-rooms and bedrooms for a Superintendent Nurse and for three maids.

This allowed some re-arrangement in the centre block and gave rooms there for an Assistant House Surgeon, for the hall porter and a servants' dining room.

The Committee's objective now was to provide two large wards either by re-modelling of the centre block or by additional building; the first of these was named 'In loving memory of Captain R.H. Harington' by his widow in May 1915. He had been a member of the Committee; the ward was dedicated by the Bishop of Southampton on December 2nd 1915.

The next important addition was Wyndham Cottle Ward built in 1921-22 to the design of Mr. Oatley by Messrs Ball & Sons, the result of a legacy from Dr Wyndham Cottle who had been an honorary member of the consulting medical staff for some years. This ward was opened by Princess Beatrice on July 27th 1922. There is a note in the minutes that while this work was going on it, presumably, involved the closure of some staff bedrooms and five maids were lodged out in the London Hotel opposite the hospital at a charge of 5s each per week.

The two large wards on the ground floor were thus provided. Cottle Ward forming a wing which to some degree counterbalanced Victoria Ward on the other side. Until further building occurred this left a flat roof on top of Cottle Ward and here for a time a tent obtained from Messrs Selfridges was erected so that patients could lie out in it in favourable weather.

Further plans were now made for the reconstruction of the main part of the hospital in 1925. The first work was an enlargement of the kitchen which was carried out by Messrs Seely and Paget Architects; in 1928 a bigger reconstruction was planned and was to include six private wards in one block; a room for the medical staff; a second theatre for septic cases; a day room on each floor for the patients; and a small ward on each floor for noisy or very difficult cases; also a reception hall with a telephone box, and a separate room for electrotherapeutics and massage; and re-adaptation of the isolation wards.

This planning involved some dispute in the committees. Stanley Hall, F.R.I.B.A. was the Architect first invited to submit a plan; but his first scheme costing about £50,000 was. far beyond what the Committee could contemplate; he produced a modified plan costing about £15,000 but it seems that this involved converting Victoria Ward into an X-ray Department and building a new childrens' ward above Cottle Ward; and this plan was approved by the Building Committee and passed, but subsequently with representations from the Medical Committee the Chairman decided to disregard this vote and those plans were abandoned. This led to the resignation from the Building Committee of Miss Calthorpe and her brother, Admiral Calthorpe who felt that, as the original vote had been unanimous in favour of the plans, it was improper now to disregard it; the Chairman could only reply that he felt that he was acting in the interests of the hospital. The implication presumably was that the original decision had been hasty and made without full consideration. Both remained members of the General Committee and indeed rendered many future services to the hospital.

New plans were provided by Seely & Paget and were carried out involving an enlargement of the X-ray Department and a new ward over Cottle Ward, the funds for which had been obtained mainly by Miss Calthorpe who had collected £1,064 from the ladies of the Island and also £352 from Island children, made up of two miles of pennies; she had also obtained ten thousand bricks and ten tons of cement from a Mr. Saunders and two thousand bricks from the Carisbrooke Brick Company. The ward was named in recognition of her services and the furniture for the ward was provided by Admiral Calthorpe.

Seely & Paget somehow managed to find rooms in the centre block for 12 nurses' bedrooms and for maids on the upper floor and they also remodelled the isolation ward. The new buildings were opened by Princess Beatrice on August 13th 1931.

This reconstruction must have also involved the formation of Elizabeth Ward, named - for Princess Elizabeth, opposite Calthorpe Ward and approximately over Harington Ward. It was not until 1937 that, on the decision of the Medical Committee, the two wards on the ground floor, Harington and Cottle were designated as medical wards and the first floor pair, Calthorpe and Elizabeth as surgical. Meanwhile further buildings and reconstruction had created another ward on the second floor which was opened by Princess Beatrice also in 1937 and named after her. This ward being on the upper floor and close to the theatre was intended from the start for surgical patients and it came to be used exclusively for orthopaedic cases.

Two more important additions were to be built before the outbreak of war. A new Pathological Laboratory just inside the wall separating the grounds from Swanmore Road was built and opened in 1937 and of course this, after enlargement, remained the hospital laboratory right up to the time of the closure of the hospital.

The other important building was the King George V Nurses' Home in Adelaide Place built after much debate about costs by Messrs Rice of Brighton to the design of Seely & Paget at a cost of about £20,000, the land having been purchased for £1,600; the original estimate had been for 18,000 to £9,000 and when tenders for the first design were submitted they were between £22,000 and £24,000; this increase, - worthy perhaps of later times - caused the Committee much concern and some members not surprisingly felt that they had been misled. The Building Committee with Sir Henry Sweetman in the chair in particular had discussions with the Architect and eventually a modified plan was accepted for some thousands of pounds less than the original. The opening of this home was planned for September 9th 1939 but was overtaken by events and the President was pleased to postpone the opening sine die; the house of course was already in use by then.

Up to this time the Out-patient and Casualty Departments had shared the same accommodation; this was becoming increasingly unsatisfactory and more so as the years went by so that two or three years before the war, there was talk of separating the two but nothing could be done at that time and the Committee had to temporise by re-arranging the available space and creating a small accessory theatre for dealing with surgical casualties; at one time the sister's office of the childrens' ward adjacent, or nearly so, to the Casualty Department was taken over for casualties and in 1942 a bedroom in the childrens' ward had to be refitted as an office for the almoner. At the other end of the hospital, earlier on, a temporary bathroom for resident nurses had been squeezed in under the main staircase, and by the end of the war more rooms in the convalescent home had been taken over for offices.

Management

Lord Yarborough was the first President and after his death in 1862 Lord Heytesbury became President until 1891; he was succeeded by Prince Henry of Battenberg and after his death in 1896 Princess Beatrice, Princess Henry of Battenberg, succeeded him as the Governor of the Island and President of the hospital until her own death in 1944.

The Committee of Management continued its weekly meetings right up until 1930. It must have been the organisation which ran the hospital although of course it made its annual report to the Governors who had their say at the Annual General Meeting and at occasional special meetings requested by the Committee. The Governors also elected members to the Committee; after a time however the Committee members and Vice Presidents came to include the Mayors of Ryde and Newport, the Arch-Deacon of the Island, the Chairman of the County Council after 1890, and the Member of Parliament. Very often retired honorary medical officers were also appointed to the Committee.

The early statutes mentioned that all complaints were to be referred to the Committee - an attitude which might be approved nowadays, but it is doubtful whether the manner of dealing with the complaints, in some cases at least, would have found favour in modern eyes; in 1875, it was reported that a Mrs. Maynard had remarked in the presence of two patients that it-was a pity that patients were discharged before they were cured. A motion was carried in the Committee, unanimously, that Mrs. Maynard be not allowed to enter the Infirmary for any purpose; a copy to be sent to Mrs. Maynard. Later she offered an explanation of her remark (the explanation is not quoted), but the Committee regretted that in the interest of the institution, they adhered to their resolution. After further exchange, she explained that all she had done was to tell a patient who was about to discharge himself against advice that it was a great pity that he should go out before he was cured. However, there was no further action!

In 1881 the British Medical Association held its annual conference in Ryde under the Presidency of Benjamin Barrow formerly a Honorary Surgeon and now a member of the Committee and recently Mayor of Ryde; during this time, August 13th to 18th, the Infirmary and Convalescent Home were opened to members of the B.M.A. on presentation of their cards.

In 1889 Queen Victoria visited the hospital accompanied by her oldest daughter, the Dowager Empress of Germany, Prince Henry of Battenberg and the Princesses Sophia and Margarethe of Prussia. After this visit, the Queen sent the hospital seven framed pictures commemorating it; one wonders what has become of them. It was also after this visit that at the Queen's wish the name was changed to the Royal Isle of Wight Infirmary and County Hospital; it was in 1906 that it was decreed the title should no longer include the word infirmary.

The introduction of the Convalescent Home in 1878 had required new regulations. The home was to have a lady Superintendent who later served as Assistant Matron to the hospital and stood in for the Matron during holidays. The House Surgeon was in medical charge and was authorised to decide the diet and presumably any medication of each inmate; the Medical Committee considered that he should attend inmates, and because of the extra work imposed upon him, lie should be paid not less that £20 a year out of the accounts of the home. Persons with pulmonary consumption or other disease in advanced state; those requiring medical and nursing treatment; those of unsound mind or liable to fits; or recovering from contagious disease; or who had not been vaccinated, should, according to the Medical Committee, be excluded; also those under eight years of age and those in an advanced state of pregnancy. These recommendations were accepted by the Committee save that they did not exclude those in an advance state of pregnancy; also they decided not to raise the House Surgeon's salary deeming that his work would not be increased; later it was decreed that the House Surgeon need not visit the home daily but need only come in response to a call and that he should consult with the appropriate honorary staff whenever necessary.

There was, I think, never a chapel in the hospital but services were held in the Infirmary and from time to time a room was set aside for the use of the Chaplain; in 1886 there was a minute that a patient had been admonished by the Chairman for failing to attend divine service. In that same year the Committee appointed four ladies to visit the hospital; they should go round the wards and talk to the patients but should not read to them or pray with them.

The Committee did have to restrain the activities of the Gospel Readers who were excessively persistent in their efforts to preach to the patients. In 1886 also the Committee decided that for the first time the buildings and contents should be insured, - the main building for £2,400, the fever wards for £400, and the lodge for f160; the contents of these three components for £600, £100 and £40 respectively.

There was continuing difficulty in accommodating nurses and in 1888 the use of a small ward for a nurses' bedroom was debated; an alternative was to employ nurses from a nursing institute in George Street, Ryde; it was thought better and cheaper to accommodate their own nurses in the hospital.

As mentioned earlier it seems that from the start the House Surgeon visited patients in their homes; presumably, these visits were limited to Ryde and its immediate environs. Now it was understood that visits were to cease; this supposed decision provoked a very vigorous protest from the Clergy of the Island who asserted that the 'Custom of visiting out-patients unable to attend the hospital is in the nature of a contract since congregations subscribe to the hospital; and it has been an accepted custom since the foundation'. The Committee agreed to receive a deputation of Clergy to consider the matter and they assured the deputation that the House Surgeon would continue to visit old patients when directed by the honorary staff to do so; it seems that those who were elderly and those that were too ill to attend as out-patients benefitted from this service. I have found no indication when these visits to out-patients ceased; the work within the hospital was steadily increasing in all directions, the numbers of beds and bed occupancy, the operations, the attendance of out-patients and the numbers of casualties all rose from year to year; the House Surgeon must have been a very busy man and one supposes that the visits gradually declined; certainly they cannot have been continued after the introduction of Lloyd George's National Insurance Act of 1912.

The rules of the hospital were revised about the turn of the century; I have not been able to find any copy of these revised rules but a later revision in 1930 implies that for the most part they were then left unchanged. Among other arrangements there was to be an election committee for the appointment of honorary medical staff, composed of the acting honorary medical staff, the elected members of the General Committee and up to ten Governors. The House Surgeon was not to be entitled to a holiday unless he was re-appointed after a year's work; if absent for any other reason he must himself appoint a locum tenens acceptable to the honorary staff, at his own expense; it is fair to add that long before 1930 more generous arrangements were sometimes made for holidays. Honorary surgeons were to retire at the age of 60; other doctors at the age of 65. There was a further entry about the duties of the House Surgeon in 1920; he or she must be present at all operations; in the absence of a pathologist he must keep the post-mortem room in good order and must order or make the necessary post-mortem examinations; he must keep an inventory of all instruments and keep the medical notes in safe custody and in such a way that they could be readily available when required; he must never leave the hospital before 1 p.m. Some years prior to this entry the House Surgeon had given a course of lectures to nurses; he or she had to inform the Committee of these lectures and he was paid £10 for the course. Later, lectures were taken over by the honorary medical staff and the care of patients' notes was passed on to the ward sisters. The Committee might refuse admission for a patient and it might order a patient to be discharged unless the medical staff requested otherwise. The list of patients now excluded was simplified; the insane, epileptics, and those who would not benefit were not to be admitted; clearly this left the matter in the hands of the medical staff. The door to the Out-patient Department was to be open from 7 a.m. to 7 p.m.

An assistant House Surgeon was first appointed at a salary of £60 per annum in 1909; he or she was required to be competent as an anaesthetist and at X-ray work; regrettably the House Surgeon and the first Assistant H.S. working together did not get on well, and after the House Surgeon failed to attend at an operation, where he was required, he was asked to leave; the assistant also left without completing his term and no further appointment of ail assistant was made until very much later, in the 1930s. Advertisements after this time usually specified that candidates for the post of H.S. should be competent anaesthetists and at X-ray work!

There were some less serious matters to be considered; the Secretary of the Royal National Hospital, Mr. de Vine, sought the Committee's co-operation in amateur theatricals, - the profits to be shared; this was agreed. The nursessuggested that a tennis court might be provided in the grounds of the convalescent home; this could not be managed, but the Chairman presented the nurses with a badminton set. The Committee joined with the British Hospital Association in asking the Post Master General to provide a free telephone service for hospitals; they also sought freedom from legacy duty. (No marks for guessing the answer to these requests). In 1923 the Committee offered to pay the annual subscription of 8s-6d for any nurses who wished to join the Ryde Sports Club, 15 of them did so.

About 1918 the conversion of the convalescent home into a nurses' home was suggested, - some rooms were still urgently needed, and by 1923 with an increase in the number of probationer nurses this was brought about.

When the use of wireless in hospital was first discussed, it was decided that it should on no account be installed; this was in 1924, but within that year the County Press had offered a set free for the use of patients and by 1926 wireless for patients was conceded; headphones were to be used except in the childrens' ward. In 1932 wireless was available in all wards and Col. Murray, a Committee member, was asked to supervise the hospital wireless installation and service.

Lady life Governors were asked in 1921 to set up a committee to assist in organising working parties, entertainments, collections and fund-raising. A needlework group was established mainly by Miss Calthorpe, and over several years made large contributions to the hospital producing over two thousand articles in four years.

In 1925 the medical staff recommended that no smoking should be allowed in the hospital except at Christmas; this recommendation was repeated a few years later; in 1933 however it was agreed that limited smoking, namely from 1.00 to 1.45 p.m. and between 7.00 and 8.00 p.m. would be allowed; the ward sister had authority to disallow it if necessary and she was to keep a supply of tobacco under lock and key.

Out-patients and their accompanying supporters sometimes then, as later, had long waits in the Out-patient Department; the Committee found in 1925 that it could not supply refreshments but it authorised those waiting to bring food with them; in 1932 the womens' section of Toc H offered to provide a canteen, but it seems that soon after that, a local catering firm took over the service.

The special departments began to appear early in the century. The X-ray Department, the Ear, Nose and Throat Department and Eye Department about 1904; a Venereal Disease Clinic came in 1917, and Orthopaedic and Genito-Urinary Clinics in 1930.

In 1912 the comment was made that the National Insurance Act meant that a large class of patients, hitherto unable to pay for treatment at home, and thus obliged to come for treatment to the hospital, would now be entitled to treatment and consultation at home. This, it was thought, might necessitate new regulations about admissions and treatment but I can find no record of any such rules and admission by letter of recommendation continued for more than twenty years to come.

In 1914 a motor ambulance was provided. Before this, from 1885 a spring van had been available for patients too ill to come otherwise; the cost of the horse and the driver at that time had to be defrayed by the patient or a friend. No charge was made for the motor ambulance when it was introduced but those who could afford it, or who had friends who could afford it, were expected to contribute.

In 1926 there was a visit from the Prince of Wales on his way to Ventnor to open the Lampard-Green Nurses' Home at the R.N.H.; during which he made a presentation to the retiring Chairman, Mr. Blair Cochrane.(See Picture)

In December 1926 a surprising minute was written when the Chairman ruled - in reply to an enquiry by Mr. (later Sir Henry) Sweetman, 'Since patients were admitted with the approval of the Committee, members had the right to make enquiries as to the nature of the disease specified on the medical certificate of the letter of recommendation'. This ruling seems to indicate, if taken literally, that any or all of the Committee had the right to be informed of the diagnosis of any or all of the patients admitted. I find it difficult to believe that this was what was intended, and I feel no doubt that the medical staff, - both resident and honorary visiting - would have explained to any committee member who sought information the nature of confidence. It is well known of course that the diagnosis in many patients on admission is known to their friends, their families and sometimes indeed the public, but to have the right to demand the information on the medical certificate is a different matter; what led to or what was behind the original enquiry one can only speculate.

The following year the Chairman reported that he had been invited to take part in the management of an institution formerly known as the childrens' hostel, - now apparently called Ryde Hospital or possibly Ryde Hospital for Women and Children. He told the Committee he had replied that he regretted he could not recognise any hospital other than the Royal County Hospital although he was in sympathy with the idea of a childrens' hostel.

This 'Hostel for Ailing Children' was established at Southlands in Park Road and was active between 1921 - 1929 superintended by Miss Friend, it seems that it was supported largely by a grant from the Ministry of Health; that patients came from all parts of England; that the hospital would accept chronic cases unsuitable for a general hospital, and that there was a charge of 12s-a week; Lady Simeon had been interested in it and had sought the co-operation of the County Hospital. In February 1929 a letter came from the children hospital; its committee had found themselves unable to maintain it and offered the County Hospital two hundred guineas to take it over. A sub committee was appointed to consider this offer but were unable to recommend it and it was declined.

It has been mentioned that weekly committee meetings continued right up to 1930. It was then that a House Committee was formed which was to me weekly and the General Management Committee met thereafter just once a month. The House Committee received notice of such things as admission and discharges of the week and they dealt with appointments of domestic staff, minor repairs or requisitions, etc.; often the meeting was attended only by two or three members; the monthly committee meetings continued to deal with the main running of the hospital and as before any major items of building, expenditure, etc. were referred to the Annual General Meeting of Governors.

At a meeting on December 30th 1930 it was commented that H.R.H Princess Beatrice, the President had not visited the hospital for some time, and it was said that she was somewhat out of sympathy with the hospital because hey had not undertaken training for V.A.D. nurses; it was now agreed that sub training should be introduced and the President opened the new buildings in 1931.

It was not until the time of the Second World War that a trained or qualified almoner was appointed; but in 1923 a Mr. A. Wilson, who had been appointed as a collector some time before, took on the role of almoner and was asked to carry on in accordance with the instructions used at Portsmouth Royal Hospital; he received at first a salary of £70 but this was increased later up to £200 yearly; among his activities, with the blessing of the Committee, he organised the all Island annual whist championship which for many years made a useful and quite considerable contribution of a few hundred pounds each year to the hospital funds.

It was in 1937 after the new Beatrice Ward had been opened by the Presiders with the relief of congestion in the male wards that the medical and surgical wards were separated. The wards on the ground floor were hereafter medical and those on the first and second floor surgical - including the ophthalmic and orthopaedic wards.

It was in this year also that a second House Surgeon was finally added to the establishment; his salary was £130 yearly, the H.S. at this time having £200 a year; and in 1939 just before the war, the second House Surgeon was 'converted' into a House Physician, and so things remained for many years.

On August 30th 1939 several patients were discharged in order that some beds should be available for anticipated casualties in the presumptive crisis. This was criticised in the Committee, but Dr Stratton, speaking presumably on behalf of all the honorary medical officers, said that it had been considered that an emergency was already there, and he had decided and acted to the best of his ability; those who remember the times may feel that he was justified; evacuees were already coming across from Portsmouth and sand bags were being filled; however at that time, there as elsewhere, there was no flood of casualties and by mid September the hospital was full again.

With the onset of war of course the hospital became part of the Emergency Medical Service as did all others, but it does not seem to have made very much immediate difference to the running of the hospital. Shortages of staff - domestic staff, nursing staff and doctors were of course a problem there during the war.

In 1942, Ryde House was taken over by agreement for the use of patients suitable for transfer from the hospital, or possibly by direct admission; the medical staff, Dr Dockray in particular, thought this preferable to the possibility of Island patients having to be moved to some more or less distant place on the mainland. However, Ryde House was not in use for very long, - being closed in 1944; but in that year also Mr. G.R. Brigstocke offered the hospital the use of St. Vincent's Home as a convalescent home for the hospital, in memory of his two sons. This offer was accepted. However, as things turned out the hospital did not find a use for a convalescent home of this type; there was a suggestion that it should be used for staff accommodation but this was not in accordance with the terms on which it had been offered and by agreement in 1947 the association was discontinued; St. Vincent's of course subsequently came a residential home for ex-service men.

Maintenance and standards must have been difficult during the war and in February 1945 it was reported that the childrens' ward was unfit to receive patients, and Dr Fairley, the County Medical Officer, was asked to arrange for children to be admitted to Scio House in Shanklin until Victoria Ward could be made ready again.

About this time, Mr. Gordon who had served the hospital as Secretary for 45 years was due to resign; he was given a part-time nominal appointment as Honorary Supervisor of Accounts to enable him to complete 50 years of service.

The committee meeting on August 15th 1945, V.J. Day, faced plenty of problems. Catering costs were rising steeply and there was some dissatisfaction with food and feeding; a new kitchen superintendent was appointed and produced an improved service but she left to go abroad after only about one year; extensive re-planning and re-equipment of the kitchen was discussed in 1947; it is worth mentioning that, at this time, pig-swill was still collected from the kitchen and sold locally, the contract being worth £60 a year. Accommodation for both patients, nurses and domestic staff was a continuing problem and the difficulty of obtaining equipment and materials compounded it in those early years, as will be well remembered by those who can recall the times of austerity. Elizabeth and Mary and Cottle Wards all needed extensive repair and re-fitting; work was needed to provide a better Out-patient Department and to improve the casualty arrangements.

During these years also the decision was taken to abandon the internal laundry and a contract was made with the Vectis Laundry and was considered to be no more expensive than re-equipping the hospital laundry would have been.

Having filled all the available space on its original site, the hospital now looked for houses in nearby Partlands Avenue. The first house to be taken on lease, the Towers, served as a preliminary training school for nurses and provided at first accommodation for nine student nurses and for a sister tutor, assistant matron and two domestic workers. The Victor Nursing home at that time occupying some houses in Partlands Avenue was considered for private accommodation; however this did not come about and it was now that the private wards were established in what had formerly been the isolation block overlying the Casualty Department; the Chairman, Aubrey Wickham died in 1947 and the refurbished wing providing seven, or ultimately nine single wards, was named in his memory the Aubrey Wickham wing. Some of the domestic staff were again housed in the London Inn and two ward sisters were allowed to live out receiving an allowance of £100 a year for this.

Staff

The sources of information - chiefly the minutes of weekly, monthly or annual meetings of committees and Governors do not give much detail of the nursing staff and the servants who keep all hospitals running. However, they did receive some consideration and at the very start in 1849, a week's diet allowance was set down for the servants, all of whom were of course resident.

They were to have:-

• Bread and flour 1 gallon
• Beer 7 pints
• Butter 1/2 lb
• Sugar 1/2 lb
• Cheese 1/2 lb
• Meat 7 lb
• Tea 2 1/2 oz
• Milk 2 1/2 pints
• Vegetables twice daily

So foodwise they did not do so badly. The Matron was in charge of the nursing staff, but there is little to be found about their numbers although there is mention from time to time of appointments, resignations and occasional dismissals. In 1875, the accounts show that five nurses received £4.10s each quarter, £18 a year; at this stage, the Matron whose salary had varied between £10 and £30 yearly was up to £40 a year and the H.S. £50; house maids had £3 a quarter, laundress£3.10s, and cook £5.

By 1881, there were five nurses and two house maids; the complement of patients would then have been about 30 plus 10 for the fever beds; extra nurses were appointed when there were epidemics. By 1885, the total expenditure on servants wages was E305.1 Os in the year; the 'servants' perhaps included house maids, porters, a dispenser (who was also a porter) and nurses. The dispenser at that time had 25s a week - £65 a year; if the remaining staff had an average wage of £20 a year, this would allow about a dozen staff of all categories.

Nurses in those early days of course had no particular training, though presumably they received some instructions from the Matron. In 1863 there was a note that no nurse had been available to attend to a man admitted in the night with a fractured skull; the House Surgeon was instructed to ensure that the Matron was always informed of such admissions.

The career of one hospital servant, George Dash, was so remarkable as surely to merit a paragraph. He was born in London in 1824; both his parents died before he was thirteen and in 1837 he came to Newport to live with his uncle. Soon after this, he joined the Royal Navy, but was invalided out in 1845. He was appointed as gardener and porter to the hospital before it opened in 1847-48 and among his duties in the early years, he pumped up the water from the well near the front gate to the tank in the roof twice daily; this heavy work, it was said, led to a marked muscular development and he was accustomed to arrying patients whenever necessary. In 1858 he was given permission to marry provided that he lived in the lodge which was built for him. In 1860 a bell was fixed to ring in his home from the main door or gate at night, - so his job included that of night porter. In 1867, the Chairman informed his Committee that the porter (George Dash) was in the habit of extracting teeth and dressing wounds in the absence of the House Surgeon. The Committee resolved that he should not act in this capacity except in the presence of the House Surgeon, and in 1873, he was prohibited altogether from these functions. The problem of dental extraction was partly solved, when the Chairman informed the Committee that he had had a letter from a Mr. Harington 'Declaring his willingness to extract all the teeth sent to him by the Infirmary'.

Later George Dash took on the job of dispenser, and it was at his suggestion that the dispenser's salary was increased to £65 a year; later again the Committee decided that the House Surgeon was the man who had legal responsibility for running the dispensary. In 1898, the minutes state that 'George Dash, an old and respected servant of the hospital, was to act in future only as general porter and not as dispenser.' A lady was appointed to be Dispenser and Secretary and clearly George Dash had been doing the job for about 15 years. By 1900 he had more or less given up regular work but he lived in the lodge with his wife and was always pleased to help any of the staff in any way he could and he kept the front of the hospital tidy. He had three married daughters and in 1919 was a widower. He finally retired and left his lodge which was then taken over to provide nursing accommodation. He went to live with one of his three married daughters in Carisbrooke having served the hospital for over 70 years. He died in 1923 and was buried in Ryde Cemetery. Through his executor and eldest son-in-law the hospital received a bequest of £25 from him.

By the end of the century, nursing had become a profession and nurse training something of a reality. In 1888 on the initiative of one of the Honorary Medical Officers of the day - Dr Davey - a course of lectures for nurses was started, and in the same year the Matron was authorised to choose nurses' uniform dresses; much later in 1920, the Committee minuted the need to increase the number of probationers (as student nurses were then called) from 16 to 20, since the hospital had become a recognised training school for nurses, - in order to give nurses 'the requisite time for study so that they might pass the rather difficult examinations which were necessary to increase the staff'; later again the Committee decided to offer six prizes for nurses who achieved examinational success.

In January 1889 a nurse wished to leave the service of the hospital because she could earn more, £25 a year, in private work than she got at the hospital, - £22 a year; she was told to go and get it. In 1890 it was agreed that the Honorary Medical Officers might 'borrow' a nurse from the hospital for private nursing, if and so long as she was not needed in the hospital; she was to return on the Matron's request and was to be paid for her private work by the Medical Officer.

In March 1892 the Committee purchased a book of tickets for ozone baths for the use of the nursing staff!

The services of trained nurses outside the hospital, i.e. in the district and the community were becoming called for, and a motion was carried that 'The Isle of Wight should provide trained nurses in the community and a building should be put up for the purpose (presumably for training nurses and perhaps for administering the service) but the hospital funds should not be used for this purpose'.

The nurses were hard pressed in those days at times; in 1908 there were two children in the infectious diseases ward with Scarlet Fever; the nurse looking after them had no time off day or night; the Matron, asked for help, sent a maid who had recently had Scarlet Fever.

After the X-ray Department came into use the radiographer was under the supervision of the Matron, and the Matron herself, at her own request, was authorised to receive instruction in radiography and to travel to London for the purpose.

A night sister (Miss C. Elgar) was appointed in 1911 at a salary of £28 a year. Nurses were difficult to recruit in the years before the First World War; and the probationers' salary which had been at £8 a year was raised to £12 for the second year and £l8 for the third year; this shortage being the case, it was perhaps rather surprising that the Committee refused to allow Lady Baird's Red Cross nurses to attend on the wards; a further request for this was rejected by the Medical Officers in 1913; however by 1915 it was agreed that the Red Cross nurses working in nearby Haslewood should come for instruction and to help in the ward work, four at a time, and under the orders of the Matron. In 1918 a shortage of nurses called for closure of Harington Ward and the private wards temporarily and this recurred the next winter; but a round robin from the probationer nurses asking the Committee for a rise in salary was rejected, - they were told that such applications might come only through the Matron.

The House Surgeon usually, as now, held his appointment for six months or a year and right up until the end of the century he functioned also as Secretary. His secretarial duties ended in 1898 when the newly appointed dispenser also took over secretarial duties; save that he still had to attend the committee meetings and keep the minute book; in 1896 the medical staff had complained that the House Surgeon had to spend too much time in his secretarial work. I think that with the appointment of a full-time secretary he finally ceased to have any duties in that respect.

The Honorary Medical Staff of course gave their services; and as the hospital increased in size and numbers of beds the work must have taken up an increasing amount of their time; in return they were presumably entitled to treat their private patients in the few beds reserved for such paying patients. These were never numerous and right up to the time of the Health Service, and indeed so long after that as the hospital provided any private beds, it was always accepted that any emergency case could, if necessary, be admitted to one of the private beds. In 1878 Dr Broom-Pinniger was granted the use of a room in the hospital for the annual meeting of the Isle of Wight Medico-Chirurgical Society. The Honorary Medical Officers were mostly doctors practising in Ryde, although certainly several came from other parts of the Island; at the very start Mr. Bloxam came from Newport and Dr Martin from Ventnor; and later certainly Dr Waterworth and Dr Stratton of Newport were among the staff.

I should mention here Dr A. Wade a House Surgeon who remained in post throughout the First World War; junior staff residents were difficult to come by at that time, and the Committee recorded their gratitude to him for staying on. Another House Surgeon who became a senior member of the staff was Dr Horsbrugh who took on the job of Honorary Pathologist for a time before he was followed by Dr Firman-Edwards in 1921. He, Dr Horsbrugh, had the golfing distinction of having done the longest ever hole in two, at the fifteenth hole at Manchester, - 504 yards! I do not know whether this is still a record.

I have already referred to the earliest record of dental work in the hospital; in November 1878, the name of the Dental Surgeon to the hospital - Mr. Canter - was included in the list of Honorary Medical Staff and soon-after the turn of the century there were two dentists on the staff, one slightly confusingly, was a Mr. W.G. Daish; the second one was Mr. W. Griffin who was appointed to the post in 1903 and after the retirement of Mr. Daish he carried on alone; he served the hospital for 30 years retiring in 1933; in retirement he was a famous gardener and walker and lived to be 100.

At the very beginning there was reference to a laboratory but there was no indication of any pathological work until after the turn of the century at which time the new buildings designed by T.W. Cutler included a pathological laboratory; this was renovated or improved and equipped with the help of the Dowager Lady Calthorpe as already indicated. In 1913 new equipment was available and some sort of pathological service could be offered not merely to the hospital but to doctors on the Island; and a list of investigations was issued:-

• Identification of organisms other than Tubercle Bacilli 2/-
• Examination of Sputum 2/-
• Blood Count 3/-
• Widal reaction 2/6d
• Throat swab 2/-
• Cutting and mounting specimens 5/- to 6/-
• Examination of urine 2/6d

Dr Firman-Edwards continued as Honorary Pathologist until 1938, - though in the meantime he had also been for a while Medical Officer of Health for Ryde and in 1937 together with John Dockray he became an Honorary Physician. By 1938 pathology investigations had become more frequent and numerous and a more extensive service was needed. At this juncture, Dr Thornton and Dr Darmady, Pathologists at Salisbury offered to undertake the work and to visit regularly provided that a new laboratory was built; this was done, - the low building close to the Swanmore Road entrance was put up for £800 and after additions and alterations served this purpose up to the time of the closure of the hospital. One of the two Honorary Pathologists visited the hospital regularly each week and it was agreed that they would give their services but would undertake work privately referred to them by doctors on the Island; a trained technician, or later several technicians, worked in the laboratory and the service continued through the war; soon after the end of the war Dr Thornton retired when new arrangements were made at the start of the National Health Service.

The medical officers in 1928 asked for the appointment of a salaried part-time anaesthetist and Dr Agnes Bryce-Smith was appointed and served the hospital for two years; after that it was decided that the anaesthetists should be members of the honorary medical staff and appointments were made from 1931; while preparing this book I had the opportunity of speaking to Dr Sutherland who died in 1993; she told me that she was the first honorary anaesthetist to be appointed, in 1933, but according to the minutes there were others before her including Dr Collie who retired from the job in 1931; Mr. O'Donoghue and Mr. Liesching both worked as honorary anaesthetists for a period. Dr Sutherland continued in the services of the hospital until 1945 and after that in general practice until 1959.

In the years between the wars, many of the House Surgeons were lady doctors and several of them were re-appointed for a second or even a third spell and received the approbation of the Committee. In 1927 it was minuted that Dr Bonhote, a lady doctor, had given a blood transfusion to a young patient and was considered to have saved his life thereby and the Committee recorded their appreciation. The implication was that she had given a transfusion of her own blood. Afterthat the medical officers recommended that a list of donors should be prepared and later the Red Cross Service took over the administration of blood transfusion, until later again it was organised from Portsmouth.

The first X-ray Department was opened in 1904 and a new X-ray room was built shortly before the First World War. The radiographer at that time had a salary of £40 a year and was, as mentioned, under the supervision of the Matron. In 1913 diagnostic X-rays were recorded in 96 cases; 'high frequency treatment' was given to 139 patients. Dr Burrell was the first radiologist to be appointed. In 1936 a new department for radium treatment was opened and was served by a visiting consultant who came monthly from Southampton.

An Ophthalmic service was recommended in 1896 and a clinic was opened soon after that. Mr. May was the first eye surgeon appointed to the hospital early in the century. An Ear, Nose and Throat Department started in 1922; Dr Stuart was the first visiting ENT surgeon.

Infectious diseases were, especially up to the time in the 1890s when infectious diseases hospitals came into being, a continuing preoccupation of the medical officers. Cholera, Smallpox and Scarlet Fever were ones most frequently mentioned and all hospitals tried to avoid ever dealing with Smallpox. Before the hospital was opened there was an epidemic of Cholera in Newport and an offer was made for the use of the hospital wards for patients from Newport and was gratefully accepted by the Board of Guardians who offered to furnish presumably temporary wards that were needed; however I could find no evidence that this offer was actually taken up. In 1866 the medical officers at the request of the Committee presented recommendations for action in case of an epidemic of cholera:-

• 1. All available beds to be appropriated (presumably this implied that other admissions should be postponed sine die).
• 2. Patients to be kept separate and to have separate attendants.
• 3. The cheapest available bedding to be used so that it could be destroyed after use.

A few years later in 1870 the medical officers were urging better accommodation for fevers and stressing the need for the nurses and the laundry to be kept separate; the Sanitary Committee of the Ryde Borough Council was involved in the provision of accommodation for infectious diseases and apparently agreed to pay part of the expenses of the patients. In May of 1871 this Sanitary Committee apparently sought permission to build a temporary hospital in the grounds of the Ryde Infirmary; this was declined, - it seems that it was to be used for Smallpox. During that decade also, there was some dispute between the Ryde Borough Council and the hospital about admission of patients with Scarlet Fever and some exchanges between the Ryde Medical Officer of Health and the Hospital Committee and medical officers; it appears that there was at that time a borough hospital to which at least some patients with infectious diseases would be admitted; although the Ryde Isolation Hospital, off Rosemary Lane, was certainly not built until late in the 1880s.

It is appropriate to mention here, that in 1873 Mr. B. Barrow finally resigned. He had been a medical officer since the opening of the hospital twenty-four years earlier. His resignation was accepted 'With great regret and a deep sense of obligation', and in March 1874 he accepted the post of Honorary Consulting Surgeon; his criticisms did not end with that. He became a member of the Committee and in 1875 he was complaining of the filthy state of the wards, lobbies, sculleries and Out-patient Department. He went on to become the Mayor of Ryde and in 1881 President of the British Medical Association, as already mentioned.

Debate about the use of the fever wards continued; they were, one supposes, often empty and it was obviously tempting to use them for much needed staff accommodation or later to house the patients from the general wards when they were over-filled; in 1893 the Committee wished to close the fever wards, and it was specified that cases of Cholera should not be admitted; the closed wards were re-opened in 1894 and doctors were notified that a charge of one guinea weekly would be made for domestic patients. The next year, a minute in July said that there was no accommodation available in either the general or fever wards. Finally in 1907 or possibly earlier, it was decreed that the isolation wards were intended only for hospital in-patients who happened to develop infectious fevers while in hospital. By that time of course there were isolation hospitals available in Ryde, Sandown and Shanklin, and Ventnor; when new demands imposed further strain upon the accommodation in 1914, it was specified that infectious cases arising in the hospital might be transferred to the isolation hospital at Smallbrook, the County Hospital would in that case pay something for the use of the beds.

Medical staff and nurses were not the only ones who were at times busy and hard pressed. In 1926 in proposal of the need for upgrading or renewal of the kitchen, it was noted that one cook and one maid had to provide six staff breakfasts between 7 a.m. and 9 a.m. (patients' breakfasts were cooked by the night nurses); nurses' dinners; dinner for the maids and for the House Surgeon; hot dinners at night for the Matron, House Surgeon, night nurses and paying patients; supper for the nurses and servants; all this, in addition presumably, to the regular dinners and suppers for the patients.

Finances

Finding enough money to keep the hospital running and to enlarge and improve it as seen desirable or necessary was from the start a persistent problem. In the hospital's whole independent life of 99 years, there was only just one spell of a few years when income exceeded expenditure. The hospital had not been going very long before a committee or sub-committee was formedto consider means of economising.

In the very early years collectors were appointed in the principle towns on the Island: unpaid but authorised to keep 10% of what they collected. Also, when servants, male or female, were admitted, their employers were expected to pay, 1/6d daily.

The quarterly expenditure between 1852 and 1865 naturally varied, but it generally kept at around an average figure of £230 ± £30; in 1865 it rose to £274; thus in the first ten years or so the expenses were kept within £1,000 p.a.

In 1875, with the increase in beds, it had gone up to £450 a quarter. During these years and for some time afterwards the accounts as presented included a House Surgeon's account and a Matron's account. The former dealt with instruments and thermometers; drugs; wines and spirits; stationery; printing; disinfecting apparatus; incidentals; and, rather surprisingly, tithes; it is perhaps surprising also to find that wines and spirits under this heading constituted often up to 10% of the House Surgeon's account; malt liquors appeared in the general account for provisions and were presumably regarded as part of the regular food, perhaps for servants rather than patients, while wines and spirits were regarded as medicinal. Altogether in the first quarter of 1875 the House Surgeon's account came to £45-11s. The Matron's incidentals came to £26-6s; salaries were:-

• H.S. - £12-10-0
• Matron - £10-0-0
• Dispenser - 11 guineas
• Five Nurses, each at - £4-10-0
• A house maid - £3-0-0
• Laundress - £3-10-0

In the way of food, meat for the quarter cost £97-16; ale and porter - £19-13; milk and eggs - £26-17; potatoes and vegetables - £8-13; groceries - £46; fish and essence of meat - £3-14. In some years there is a heading for bread and flour, but not in this particular one. Presumably it is included in groceries. Coal and wood came to £30; gas - £13-13; the chimney sweep - £4-6; and incidentals £2-12; general expenses including payments to the painter, decorator, draper, ironmonger, upholsterer and builder - £29. Electricity of course would not yet have been installed, and the entry for the sweep reminds us that all the wards as well as staff rooms, etc. must have been heated by coal and wood.

Major Leeds, the Chairman commented in 1880 that after 30 years the endowment funds of the hospital were only £10,000; by 1888, including £5,500 from Miss Milligan for the convalescent home, they had reached £23,842. In 1890 the Treasurer was in difficulties; a street collection, presumably a forerunner of the hospital flag day, produced £166; in 1894 a Samaritan fund was initiated to provide artificial limbs and other surgical appliances. In 1900, 25 years after the previous figures, the total expenditure was £4,163; provisions cost £1,324; surgery and dispensary £398 (of which f41 was on wines and spirits); domestic £470 including coal £197 and gas £ 135; establishment charge £132; rent £28-15; salaries (including the HS and his locum and some petty cash payments) £78; Matron £45; sub matron £20; nurses collectively £210; extra nurses £82; servants £29; the Secretary £37-10; and the Chaplain £30.

Income this year came from:- annual subscriptions - £840; donations - £227; Hospital Sunday Association - £29; work people's contributions - £159; congregational collections -;£111; entertainments - £86; miscellaneous - £11. Investments yielded £10; interest on deposits - £9; and the sale of dripping and waste paper - £3-14. Ordinary income was £2,825-13; extraordinary legacies of £1,824 brought the total up to £4,650. Gifts mentioned this year included games and toys; linen; clothes and bedding; books and journals; the harvest festival - flowers, fruit and eggs; also framed pictures; a box of cigars; linoleum for the hall and stairs and teak for flooring. In this year there were 474 in-patients; 1360 out-patients; 195 operations; there were 78 residents in the convalescent home.

By 1913, the year immediately before the First World War there was urgent need for more income; of course during the war as would be expected expenditure increased and each year the gap between income and expenses rose. It was commented in 1919 that it was impossible to maintain the hospital on less than £6,000 yearly - ten years earlier £3,600 had sufficed; renewals and repairs needed had accumulated during the war; by 1920 the excess of expenditure over income reached nearly £2,000 and it was feared that the voluntary system might soon come to an end; in 1920 there was an appeal for wage earners to increase their contributions; it was mentioned that many patients had been glad to make donations.

In 1925, regulations for private patients were issued; the charge was 4 guineas weekly for a shared ward, 6 guineas for a single ward; the accommodation was available for Isle of Wight residents requiring surgery; rooms could not be reserved more than 36 hours before admission; patients must conform to the ordinary hospital rules; emergency admissions could seek advice from outside specialists with the consent of the Medical Officer on duty; the hospital was not responsible for providing any special equipment needed; and no special nurses or nursing would be available. At another time it was mentioned that alcoholic drinks were to be paid for by the patients, except for brandy!

In 1926, the Prudential Assurance Co. offered a donation of £20 per annum; it had to be explained that this was not sufficient to endow a bed, the minimum for which was £150; but a small plaque was allowed.

There had been many substantial bequests and donations apart from those already mentioned. By 1908 five beds had been endowed for f 1,000 each and six cots similarly and during the war there was a legacy of £3,000 from Miss E.H. Mortimer.

Nevertheless, by 1932 it was averred that the hospital's capital reserve was almost exhausted and various emergency measures were recommended:-

• 1. The almoner (Mr. Wilson) should ensure that there was no exploitation of services in out-patients and should seek voluntary contributions.
• 2. Prescriptions for insured persons should be provided by chemists rather than from the hospital dispensary.
• 3. Appeals for annual subscription and more voluntary subscriptions for non-insured patients should be made.
• 4. The possibility of tax rebate on subscriptions guaranteed for seven years (the modern covenanting).
• 5. The next year a charge of one shilling was to be made for each X-ray examination.
• 6. Finally, a new contributory scheme was to be considered.

It was this contributory scheme, which was said to be widely used elsewhere, and which was master-minded by Aubrey Wickham, then the Treasurer who later became Chairman, which proved, it seems, the salvation of the hospital. The scheme was introduced after consultation with representatives, especially from Oxford. It called for regular small contributions from all those in the area served by the hospital who were considered financially able to pay; the rate was 3d a week for a married couple with children under 14; for children aged 14 to 19 an extra penny a week; for a single person tuppence a week. No charge was asked for from old age pensioners or from the 'necessitous poor'; those liable for subscriptions were married couples with more than £5 weekly, or single persons with more than £4 weekly.

Benefits from treatment were to be available after subscriptions had been paid for six months - the benefits of course being free inpatient or out-patient treatment. Those who were outside the scheme or had not contributed for six months were expected to pay for their treatment according to their income.

This scheme must have involved a great deal of office work and required much publicity; but it seems to have been an immediate and outstanding success. During the year 26,000 members had joined; 44 local committees had been set up to support the scheme, a number which must surely have covered every town and village on the Island; and a number of employers had undertaken to deduct contributions from their employees (one hopes and assumes with their consent). Cowes alone remained outside the scheme, - presumably because with the Frank James Hospital they felt they could fairly do so. The scheme produced £8,096 in the first year, 1935, and in that year income exceeded expenditure by £3,800. (Besides the sum from the contributory scheme, ordinary income would of course have included some other items such as payment from private patients and for children referred by the Education Department; interest on investments; and donations and bequests). Letters of recommendation after 85 years were discontinued and used no more; anyone receiving treatment who was not already a contributor was expected to become so if they could afford it. Expenses were paid for contributors who had to go into other hospitals; money arising in this way was paid out to the Isle of Wight County Council for patients in Newport Hospital, to the Arthur Webster Hospital and Scio House in Shanklin, to the Royal Southants Hospital and to some London hospitals.

Inevitably the relief was temporary. The next few years and the war, brought a fresh rise in costs, - drugs for example increased in price from £691 in 1936 to £1,660 in 1940. The drug commonly known as M.B.693 had cost the hospital £60 that year. In 1941 the subscription rate was increase to 5d weekly for man and wife and children up to 14; and old age pensioners were asked to pay a penny a week. At this time under the scheme payment was made to St. Mary's Hospital, Newport at the rate of 6 shillings weekly for abnormal midwifery cases; 15 shillings weekly for acute cases up to ten weeks and 15 shillings weekly for chronic cases up to six weeks; the implication being that chronic cases were properly the business of St. Mary's. During the war the income level at which contributions were expected was raised from £260 to £420 per year. A legacy from Miss Cross in 1942 of £4,238 went towards the extinction of the outstanding debt on the nurses' home.

During the years of the E.M.S., the Ministry had, - sometimes belatedly, - made substantial contributions to the hospital's running expenses. After the war the contributory scheme was continued and many worked hard to promote it and to keep the hospital's finances in hand, but now it was a losing battle; by the middle of 1946 the overdraft was increasing by £1,000 a month. A special appeal for £50,000 was launched, the retired assistant matron, Mrs. Scrimshaw and other nursing staff organising activities among others; out-patients were asked to pay for some of the expensive drugs, - insulin, penicillin and liver extracts. In 1947 the Chairman of the Finance Committee visited the Ministry of Health and it was agreed that the Ministry would contribute £10,000 towards the hospital. This must have been almost on the eve of the N.H.S.

Over the years a great many voluntary efforts were made and it seems fair that these should be recorded. In 1868 and years after amateur theatricals often brought in several pounds. In 1900 Lady Eleanor Cochrane organised and carried through a house to house collection on the Island. More than £700 was collected. In the same year Colonel Gardiner's blind sheep dog 'Blind Jo' collected on the golf links. In 1901 a mother's cot was named after Mrs. Morgan who had collected or given £300. In 1913 Alexandra Day collections, which will be well within the memory of some, were instituted and named after Alexandra, the Queen Mother widow of Kind Edward VII. In 1910 the Matron was given permission to hold a 'Pound Day'. The idea was that gifts of a pound of something or other should be brought to the hospital and the first 'Pound Day' produced 601b of tea, 121b of biscuits, 341b of sugar, 101b of cocoa, 81b of coffee, 401b of soap, 601b of jam, 61b of butter and also 22 bottles of port and £6-11-6d in money. It must have been considered a great success. In 1916 the Mayor gave the hospital the takings from the bathing huts at Ryde, £40 odd which he rounded up to £50. In 1928 a bazaar raised £1,450 for the reconstruction fund: in 1929 the Matron introduced 'a birthday fund'; the idea of this was that on an individual's birthday he or she should make a donation to the hospital.

In 1931 the hospital was the subject of the B.B.C.'s week's good cause and in the same year Sister Scrimshaw with other sisters and nurses undertook to arrange fund-raising concerts throughout the Island; and in 1933 the H.S.A. undertook to contribute for each of its members six shillings daily if they were an in-patient, and three for an out-patient attendance, and 10-6d for an X-ray.

In the same year the Chairman himself collected £507 towards the new X-ray equipment. Before this, round about the turn of the century 'Promenade' concerts had been held at St. Clare, and Calico Balls were held annually; the title of these suggests that they were in marquees, but in fact they were, on occasions anyhow, in the town hall. These contributions and no doubt many others, often small or even trivial in amount, nevertheless collectively added up to a substantial sum, and perhaps more important than that must have helped to engender the mutual regard between the hospital and the population of the Island and of Ryde in particular. It is of course such feelings that lead to the bitter protests when ultimately the time for closure comes.