A History of the Isle Of Wight Hospitals by E. F. Laidlaw
When the Isle of Wight became a separate county in 1890, it ceased to have any proprietary rights in the Hampshire County Mental Hospital at Knowle; Isle of Wight patients such as were already there remained there for the time being, and others were sent; but the county had to pay for each patient, the fee decided by the Hampshire county, and it was known that Knowle Hospital was already overcrowded, and Hampshire county was anxious to take over the accommodation used by the Isle of Wight; some Isle of Wight patients of course were at the House of Industry as has already been explained.
A meeting was held in Newport Guild Hall on March 2nd 1892, Gen. the Right. Hon. Somerset I.G. Calthorpe, Chairman of the County Council presided; to consider establishing a mental hospital on the Island.
The first step was to get land; the Commission in Lunacy, - a national body, - had let it be known that about 50 acres would be required. They had enquired first of the Guardians of the possibility of purchasing land on the House of Industry site; but nothing came of this and other offers were invited. It is perhaps rather remarkable that no less than about a dozen different farms offered that amount of land, - including those at Parkhurst, Furzyhurst, Marvel, Longdown, Hale, Redway, Great and Little Pan, Merstone, Rookley Waightshale, Stoneshill and Whitecroft: after the committee had considered all these, the Commissioners in Lunacy were asked to look at two of them, Redway and Whitecroft; it was reckoned that accommodation would be needed for 250 'paupers' and for 30 private (paying) patients; and an administrative block, making a total population of 350. In August 1893, the Redway site was eliminated and in October the Whitecroft site was approved, on condition that it should also include the field known as Peddars Butts; the Bursar of Winchester College agreed to sell this latter for £650.
Architects were then invited to submit plans for buildings; a block system was required, each block to accommodate 50 patients and to be of two storeys; there was to be a laundry and administrative block to include accommodation for a Superintendent and for an unmarried Medical Officer; a dining hall for 200; six cottages for attendants; and later a chapel. A water tower would be needed and the wards and buildings were to be fitted for electric light. The winning design would carry with it the contract for the buildings; second, third and fourth prizes of £50, £30 and £20 were to be awarded for the runners up.
A visit was paid to the Hants County Mental Hospital at Knowle about this time. It had 461 men and 529 women patients, of this 69 men and 103 women were Islanders and chargeable to the Isle of Wight. Soon after this, the Hampshire County Council informed the Isle of Wight that their asylum was seriously overcrowded, and they hoped the Isle of Wight asylum would be ready for occupation in 1894; also that they were building a new block for idiot children, and would charge the Island two elevenths of the price of this.
After much consideration and correspondence, Mr. G.H. Howell was appointed to judge the plans and designs submitted, and he selected those of Mr. B. Jacobs of East Yorkshire. Controversy arose over the selection of the plans and the award of the contract. Before the building was even started a Visiting Committee was selected and appointed; the need and propriety of this was questioned and a legal opinion (given by Mr. Edward Bullen at some length) was that an asylum must by law have a Visiting Committee, - but a Visiting Committee was not obliged to have an asylum and would therefore properly be appointed in advance of the building. The land purchased was in excess of needs and the surplus was sold off to Mr. Ford at £1 an acre after his offer of ten shillings an acre had been declined.
Messrs Garlick and Horton of 43 Sloane Street, SW were the builders; bricks were made on site, - three and a half million of them; Swanage stone was also used, but when it was not available Bath stone was accepted instead, albeit aftermuch debate. A heating installation, by Henry Hope of Birmingham, cost £1,212 and an electric lighting plant, with its own generator, by Sheddon of Southampton cost £2,453. A clock with two dials and a ten hundred weight bell was supplied by John Smith. This clock, high up in the tower, was, and is, visible over a considerable extent of the Island: and the saying that someone is 'Under the Clock' as a euphemism for being in the Mental Hospital, has been familiar on the Island through this century.
Building proceeded slowly. It started early in 1894, - one report says in February, but the contract with the builder was sealed only on April 27th; in June 1895 it was reported that work had been delayed by four and a half months by inclement weather, by workman strikes, by shortage of workers, and by a fever epidemic; also the isolated position of the work was unpopular. Water supply became a problem. Newport Corporation had at the start offered ten thousand gallons a day subject to terms; but it was decided to sink a well and this was done to a depth of 74ft. with a bore hole below that to an additional 100ft.
The plans as agreed were to include a block for the sick and infirm; one for recent and acute cases; and one for epileptics; each of these three were to house 29 men and 41 women, a total of 210; a fourth block was to be for working, quiet and chronic patients with room for 13 men and 17 women, bringing the total to 240; it was anticipated that a further two blocks, each perhaps with accommodation for 55 patients, would raise the total to 350. In addition there were to be farm buildings, a cemetery and a mortuary.
Whitecroft Hospital thus differed from Ryde and St. Mary's in that it opened with most of its accommodation already nearly built and its final shape and plan more or less settled. Besides this, the staff were to be appointed by the time the hospital opened and it would be some time before there were any substantial changes in the staffing.
Knowle Hospital may surely be fairly looked upon as the parent of Whitecroft; the buildings of Whitecroft copied many features of those at Knowle; the first medical Superintendent appointed had been a Medical Officer at Knowle for some years before coming to Whitecroft and came direct from there; not only so, but both the head male and female attendants came from Knowle and so of course did many of the first batch of patients.
The hospital, although large by Island standards, was much smaller than many of the county asylums and because of this, the head male and female attendants, each of whom received £50 a year salary, living in, had to include in their duties those of the House Keeper, supervisor of the cooking, and in the case of the man, the work of patients employed in the workshops; he was also required to have aknowledge of music. Carpenters, tailors and fitters workshops were furnished before the hospital opened. Other staff besides these senior attendants included, for 80 men, three charge attendants, five under-attendants, and two night-attendants, their salaries being about £30 a year each with the charge attendants slightly higher; and for 120 ladies, four charge nurses at £20 to £22 a year, two night-nurses at the same salary and eight under-nurses at £17 to £20 a year. There was one laundry maid, three kitchen maids and one house maid. Attendants and nurses who held the Certificate of the Medico-Psychological Association were granted £1 a year extra. The cook had £25 to £30 a year and for the asylum band there was an allowance of £20 a year and uniforms. All staff of course lived in, and there was an allowance of £40 annually for books, papers, amusements and periodicals. The total cost of furnishing the hospital before it opened was £3,000.
Dr H. Shaw M.B. D.P.H. was the first Medical Superintendent; coming from Knowle he was appointed in August 1895 and actually started in September 1896; he had a salary of £350 with 'the usual allowances', living in; these would one supposes have included accommodation for himself and later for his family, possibly a board allowance, heating, lighting and some domestic assistance. He was authorised in February 1896 to appoint and discharge the hospital servants.
Workers in the Engineering Department and stokers, living in, received respectively tuppence and a penny a day.
There was no formal opening ceremony. The chairman of the County Council explained that he did not think such a ceremony appropriate.
Soon after the opening a private patient block was available with a billiard room. This was the block near the main gate separate from the rest of the hospital; later it became an admission ward, and was named Tennyson Ward.
The post of Assistant Medical Officer was advertised in June 1896 and was soon filled by Dr B. Taafe Trim who received £100 a year and all found, except for alcoholic drinks.
40 male patients, it is recorded, were transferred from Knowle on July 7th 1896, but temporary difficulties in water supply at the hospital and trouble in the crossing from Stokes Bay led to postponement of further transfers until September. The available accommodation was in excess of needs, and patients were accepted from other councils - 30 from the LCC and 8 from West Sussex.
At the end of the first year there were 220 patients, the numbers increased steadily and after another year there were 304.
In the first Annual Report by the Medical Superintendent, he indicated that a block to hold 50 private patients would soon be ready, and that a lodge, farm buildings and two cottages were under construction. Male patients worked on the land; two had 'escaped' but were soon brought back; there were weekly dances and occasional concerts. The cost per patient was twelve shillings weekly; this cost was actually to decline during the next few years to as low as ten shillings and threepence weekly. The accounts for the first year showed:-
- Salaries for officers £570
- Wages for attendants and others £563
- Provisions £1351
- Gas and water £855
- Surgery and dispensary £27
There was a deficit of £26 on the farm in the first year. One may note the low expenditure on alcoholic drinks, especially compared with, for example, the County Hospital and St. Mary's. The Commissioners had been pleased to learn that extended exercise beyond the grounds was afforded to the patients twice weekly weather permitting.
The water supply was a continuing problem in these early years and was, considered to be linked to the two cases of Typhoid Fever in the year 1896. 1897; a new well had been dug and two years later a bore hole had been driven down to 400ft. and later as deep as 525ft., which was found to suffice. At at early stage too a new boiler was required which weighed twenty tons, and must have provided a formidable problem for transport along the local highways and soon the electricity installation failed and another £750 had to be spent on it, but it still gave further trouble. The commissioners had asked for improved safety precautions, and implied the need for a chapel. The number of out-county patients, i.e., patients from the mainland, reached 81 during this year. It was a number which varied considerably, declining from this high level to no more than three in the years just before the war, but rising again after the end of the First World War. The charge for county patients at this stage was twelve shillings and threepence weekly and for out-county patients fourteen shillings; private patients whether Isle of Wight or mainland paid twenty-five shillings.
Visits were paid in these early years by deputations from the Boards of Governors of several other unions including those of Wandsworth and Clapham and also by the B.M.A. during a meeting in Portsmouth, and all of these generally approved of the hospital. It was noted that no restraint was used and only one patient was sedated.
The classification of mental diseases at this time is shown in the figures for 1899 of patients in the hospital:-
|Type of Illness
During these early years, and indeed for a long time thereafter, the farm in which some of the male residents worked - produced meat, poultry, eggs and vegetables in some quantity.
The Commissioners in lunacy paid yearly visits and made reports, sometimes a bit critical; thus in their report for 1904 they wrote 'We think it would be as well to encourage the male attendants to produce a general tidier appearance' and in 1913 they recommended an improvement in diet, - there should be a second (pudding) course at the main meal; a better allowance of meat in soup and pies, currently 2oz, and sometimes a cake for tea.
In the first year of the war Dr Shaw died; he had been at Whitecroft for nearly 20 years; he had married a few years earlier, I think in 1905. It was clear from the minutes that as Medical Superintendent he was very definitely in charge of the hospital, and answerable to the committee for all aspects of it; and one gets the impression that he was competent to manage it and had the trust and goodwill of the Committee.
Dr Peachell followed him but stayed for only about a year, moving to Dorset; the committee had declined to liberate him for enlistment, but had required him to decide how many male staff could be spared to join the forces.
He was followed by Dr Erskine who was to receive £400 a year rising to £500 by increments of £25 yearly; he also had his house, lighting, upkeep of the garden, and the privilege of purchasing from the hospital stores, worth £100; and he also received £50 a year as Medical Officer to the Mental Deficiency Committee. It was decided that he and his assistant were to have a month's holiday each during the year; there would be no locum tenens, but local practitioners would be asked to relieve. Later in the war, presumably when manpower was becoming a problem, the Board of Control suggested that one Medical Officer was sufficient and the Assistant, Dr Reardon, was allowed to go and work in another asylum, his wife being authorised to stay in her lodgings at Whitecroft. In 1917 the nurses appealed for one whole day a week off duty, but the Committee decided that this would have to wait until the end of the war.
In January 1919 there were 380 patients in the hospital, this number included 58 private patients; 38 'out-county' patients; and 7 service patients; most of the 'out-county' patients returned during the year to Portsmouth or Chichester and only one remained after that.
The Medical Superintendent reported in 1921 that there had been three cases of Typhoid Fever; one healthy infant had been born; four patients had escaped and been recaptured; he referred to the recommendations of the Conciliation Joint Committee of Mental Hospital Associates and National asylum workers; there had been agreement upon a 60 hour working week (five days of 12 hours and two days off each week) and some rise in weekly wages.
As Medical Officer to the Mental Deficiency Committee, the Superintendent reported difficulty in finding vacancies for the most severely afflicted mental defectives; they had to go either to a suitable guardian or to an asylum he visited these cases, accompanied by the senior female attendant.
During 1919, 445 patients received treatment; 380 had been on the registar on January 1st and 65 had been admitted; 75 were discharged; and 44 die of the 324 remaining, only 56 were over 65.
The annual reports indicate a steady evolution of the hospital; patients ~ were allowed out with friends at weekends, or were taken out by the staff; the kitchens were improved; the hospital was recognised as a training school for female and male nurses and a Sister Tutor was appointed; the staff had been increased - there were by 1925 five male charge nurses and 13 male attendants six female charge nurses and 29 other nurses, and 10 nurses were certified as Registered Mental Nurses.
Occupational classes had been started, directed by women under the Matron; the women taught handiwork such as raffia work, cane tray makink basket making and knitting. Men as before worked on the farm or in the tailor's or carpenter's shop or the Engineering Department. It was hoped to start an occupational class for men soon. In this year the total cost of wages and salaries was £8,150 and of provisions £4,580. The hospital kitchens had been improved and all food for private patients was now cooked in these kitchens, not inseparate kitchens in the private block; but a deputation from the Board of Guardians complained that the food there in the private block was never hot and advised some system of keeping it hot. The hospital now was overcrowded to the extent of 24 patients.
Throughout the late 1920s accommodation for mental defectives was a continual problem; Portsmouth and Southampton had been approached, but were unable to help; 10 cases were under supervision at the Brighton Guardianship Society, and 34 were at home under supervision, visited by Medical Officer and nurse; there were 26 patients at Parkhurst and 15 in institutions elsewhere, but such institutions would no longer be able to take new cases.
In 1930 there is mention of the Mental Deficiency Act which was said to indicate an expectation of 8 mental defectives per thousand population; at that time this would have given a total of 752 for the Island; the number ascertained was 195; the accommodation needed on the Island, reckoned at one per thousand population, would be 94; in fact it was 64. Of all those on the Island 41 were in institutions, 45 were under supervision, 11 under guardianship, 24 under voluntary supervision, 38 now at Parkhurst, i.e. St. Mary's and 16 at Whitecroft, but suitable for institutions which could give day and night care.
Dr Erskine had been Medical Superintendent from 1915 to 1932 and now he retired and his place was taken by Dr Charles Davies-Jones who came from Oxfordshire and a year later was joined by Dr A. Wood. It was at this stage that Whitecroft Hospital became known as a Mental Hospital and no longer as a Lunatic Asylum. Some out-patient work had already been established by Dr Erskine, who visited and advised on patients with General Practitioners; soon after he came, Dr Davies-Jones was able to initiate an Out-patient Clinic once a week at Ryde Hospital, and shortly before this he had a Mental Welfare Clinic which also became a Child Guidance service at County Hall. About this time also a small laboratory came into use in the hospital, and the private patient block was converted into an admission block. Other changes at the hospital were the switch over to main electricity supply and the introduction of a refrigerator in the kitchen.
Occupational centres were started in Newport and a year later in Ryde. There was an endeavour to make the wards more homely, to eliminate locked doors, and to encourage open air nursing on the verandas when the weather permitted. Entertainments for the patients were welcomed.
The Council planned to provide 100 places for mental defectives. The Superintendent's dominating interest was perhaps in the Mental Welfare Clinic. Mention is made in his report of prolonged depression and lassitude after influenza. There were serious epidemics of influenza in the 1930s, and those with long memories can easily recall the severe depression which sometimes followed the illness. Possibly this now would be called ME. A new Mental Welfare Clinic was opened at Northwood.
During this decade there was a steady increase in the proportion of temporary and voluntary patients admitted and treated. The number of patients rose to 390 and overcrowding of the hospital increased. The residents included 66 patients classified as mental defectives who were still in need of accommodation elsewhere. In 1937-38, 130 patients were admitted, 88 were discharged and 27 died (usually a large proportion of deaths were in patients over 70 years of age - about one half of them). A flat was now provided for a third Medical Officer and a nurses home, much needed, was planned; there were by now 23 male and 33 female nurses. The home was designed by the1 County Architect, Mr. Sydney Gregor, and accommodated 55 nurses; also a new hot water system was installed throughout the hospital. A holiday Camp at Brighstone for patients was considered to be an unqualified success. A social club for the staff was opened.
After the outbreak of war, the number of resident patients reached 400, and the recreation hall was fitted to take 40 male beds, and a sanitary annexe was constructed.
The accounts for this last year before the war may be of some interest.
|Other ('Out-county' Patients)
|Drugs & Appliances
|Clothing for Patients
|Clothing for Staff (Uniforms)
|Fuel, lighting, water & laundry