Posts Tagged 'Location Location'

Location, Location 5

The story of Bethlem’s four sites having been told in earlier posts to this thread, the Archivist now turns his attention to the siting of the other hospitals for which the Archives & Museum holds records: Croydon Mental Hospital this month, and the Maudsley Hospital in November.

Until 1903, Croydon Council fulfilled the statutory responsibility, imposed on all local authorities by successive Lunacy Acts, of care for the ‘pauper lunatics’ of the Borough by arranging for their residence elsewhere – notably Cane Hill Asylum, Fisherton House near Salisbury and the Isle of Wight Asylum. Toward the end of the nineteenth century, however, the Council brought forward plans to build an asylum of its own, and bought a seventy-acre acre site for the purpose in Warlingham, six miles south of Croydon.

The Hospital’s first Medical Superintendent was appointed in March 1902, before any patients had been admitted and while building work was still underway, and visited the site regularly to advise the architects “on all details affecting the future working of the Institution, such as the position of telephones, electric bells, tell-tale clocks, disinfector, fire alarms, operating theatre, screens in the corridors, hatchways to the various stores, covering up of all obvious points of suspension…that would act as a help and incentive to suicide”.1

The buildings, according to the Hospital’s first annual report, were “of the plainest and simplest character, all superfluous ornament having been avoided and every part having been treated with a view to economy”.2 The Superintendent noted that the removal of tree stumps and brushwood by the unemployed of Croydon during the winter of 1902-03 “proved a great blessing as regards the aspect and view of the whole Institution” as well as having allowed for “a larger cricket and recreation field, and more land for farm purposes”.3 At that time, 38 acres of land were given over to the cultivation of produce such as potatoes, cabbages and strawberries.4 In this way (and in several others), a self-sustaining element was introduced into hospital life from the outset.

A history of Croydon Mental Hospital (renamed Warlingham Park in 1937) will not be attempted here; for those who are interested, an outline may be found within the Archives & Museum’s This is Your Hospital web resource. Having opened in 1903, the Hospital was closed in 1999. By that time, Croydon’s mental health services had been subsumed into those run by Bethlem and the Maudsley Hospitals. All Warlingham Park’s buildings (save only its distinctive clock tower) were subsequently demolished and the site redeveloped for suburban housing.

1 Croydon Mental Hospital, Warlingham, Surrey: First Report of the Visiting Committee (1904), p. 21

2 ibid. p. 12

3 ibid. p. 22

4 ibid. p. 31

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The Clocktower in 2013

Location, Location 4

By the start of the twentieth century, “Bethlem was a respectable and neatly gardened enclave in the midst of poverty, overcrowding and traffic congestion”, according to its published history, albeit one with an old-fashioned layout, unsatisfactory sanitary arrangements and an expensive maintenance bill. In the 1920s the Hospital’s Governors concluded that “for a hospital for the educated middle classes Southwark was not an ideal location”, and began looking for an alternative.1 They duly found one, a 334 acre country house estate that straddled the boundary between Croydon and Beckenham, Kent that had remained unsold at auction in 1920. The land was obtained via a second exchange of the 999-year leasehold which was originally granted by the City of London in 1674 in respect of the Hospital’s Moorfields site, and transferred to Southwark in 1815. There a new hospital was built according to the ‘villa system’ pioneered on the Continent, with separate blocks for “administration, occupational therapy, refractory patients, convalescent patients, treatment and research, along with a nurses’ home, chapel, reception hospital, mortuary, workshops and a laundry”.2
In anticipation of the move, the hospital magazine Under the Dome (soon to be restyled Orchard Leaves) devoted space in several issues to depicting the new site in Elysian terms. In 1928, for example, it published an imaginary letter of a patient to his wife dated May 2000, which began:
“When I arrived here yesterday, I found that I was just in time to wash and dress for dinner… The fare here is pretty good, but the oysters were not quite up to the mark, and the butler had not iced the champagne in just that way, you know, Clara, in which one expects it to be. All went well during the evening, except that the only bath salts they had here consisted of Parma Violet, and you know how I have always used Rose at home… Each bed has its own wireless set, but I am asking for an extension from mine to be put in my own bathroom here, as I hate to miss anything.”
The perceived advantages of the Hospital’s new situation were, however, parodied by Samuel Beckett in his satirical novel, Murphy.
“The Magdalen Mental Mercyseat [Beckett’s fictional version of Bethlem] lay a little way out of town, ideally situated in its own grounds on the boundary of two counties. In order to die in the one sheriffalty rather than in the other some patients had merely to move up, or be moved up, a little in the bed. This sometimes proved a great convenience.”3
In the event, the fact that Bethlem’s grounds were bisected by the boundary between Beckenham (subsumed into the London Borough of Bromley in 1965) and Croydon proved an administrative headache in circumstances that required the attention of a coroner. At the time of the relocation, it also led to some purposeful lobbying of the Postmaster General on the part of Bethlem’s Governors, anxious to ensure that the Hospital was given a postal address in ‘respectable’ Beckenham rather than in Croydon. The Governors duly got their way, but it was not until the 1990s that the borough boundary was redrawn to take the entirety of the site into Bromley and in, terms of mental health service provision, the Hospital’s present links with Croydon are as strong as, if not stronger than, those it maintains with Bromley.
1 Jonathan Andrews et al, The History of Bethlem (London, 1997), pp. 546-547.
2ibid., pp. 549-550.
3 Samuel Beckett, Murphy (Clader, London, 1993), p. 90.

 photo aerialview_zps03888ccb.jpgAerial view of Bethlem in 1948

Location, Location 3

At the start of the nineteenth century, Bethlem’s Governors began actively seeking new premises for the Hospital. By then, as previously noted on this thread, all the perceived advantages of the Moorfields building had been irredeemably compromised (along with the healthful purity of the Moorfields air). In requiring asylums to be built in “an Airy and Healthy Situation, with a good supply of Water”,1 the 1808 County Asylums Act followed contemporary medical opinion in placing a high premium on the siting of residential psychiatric facilities. The Governors’ relocation plans were not constrained by the Act, Bethlem being a private hospital, but they were infused by the Zeitgeist. Their first preference was for seven acres of high ground in Islington; but it proved impossible to interest the vendors in the transaction, which (since the Governors were tenants on a 999-lease on the Moorfields site) would involve the direct exchange of land, rather than of cash. They eventually settled upon a site south of the river in Southwark, a suburb which laboured under the disadvantage of being “swampy, overcrowded and predominantly poor”, but had the fact of its being City-owned and available to recommend it.2

In August 1815, Bethlem’s 122 patients were brought from the old hospital to the new in a succession of hired Hackney cabs. In their first winter, they must have been exposed to rather too much air, since the building’s “system of warming by steam was installed only in the basement storey and the windows in the upper storeys were either exposed to the full blast of cold air or were completely darkened” by being shuttered.3 Moreover, this was, in all likelihood, air of the wrong sort, Southwark at that time sharing with Lambeth the highest number of smoke-consuming furnaces in London.4 Though at first a somewhat mealy-mouthed defence of this system of open ventilation (“for obviating the disagreeable effluvias to which, as Dr Latham has observed, is peculiar to all Madhouses”5) was offered, the windows were glazed, and amendments made to the heating system, in 1816.6

The Hospital’s maintenance of a convalescent department in rural Surrey (within the grounds of King Edward’s School Witley, which shared its governance with Bethlem, and had been recently moved there from central London) between 1870 and 1929 is evidence that its immediate environs in Southwark were not proving to be sufficiently therapeutic. There is little doubt that “beautiful Witley” exercised a beneficial effect on the minds of a good many of Bethlem’s patients over these years. However, Bethlem’s Governors had no intention of turning their backs on London, having stubbornly resisted pressure brought to bear on them throughout the 1860s to relocate to the countryside.7 When another move finally did take place, some sixty years later, it was to a suburban site no more than ten miles from Charing Cross. As is well known, the old hospital was then given over to the use of the Imperial War Museum. “It is perhaps appropriate”, wrote a London County Council surveyor of the 1950s, “that a building occupied for so many years by men and women of unsound mind should now be used to house exhibits of that major insanity of our own time”.8

1 Kathleen Jones, Asylums and After: A Revised History of the Mental Health Services from the early 18th century to the 1990s (London, 1993), p. 37.

2 Jonathan Andrews et al, The History of Bethlem (London, 1997), p. 403.

3 Ida Darlington, The Survey of London: St George’s Fields, volume xxv (London, 1955), p. 78.

4 Jonathan Andrews et al, The History of Bethlem (London, 1997), p. 403.

5 Minutes of Evidence taken before the Committee on the State of the Madhouses, 1815-1816, p. 194.

6 Robert Howard, ‘A lesson from the history of psychiatry: competitive tendering for services and defective central heating systems in Georgian New Bethlem’, Psychiatric Bulletin (1991), pp. 566-568.

7 Jonathan Andrews et al, The History of Bethlem (London, 1997), pp. 498-502.

8 Ida Darlington, The Survey of London: St George’s Fields, volume xxv (London, 1955), p. 80.

 photo Bethlemc1900_zpsc5480152.jpg

Location, Location 2

Whereas “old Bethlem was built over a regularly blocked common sewer”, as we reported on this thread in January, new Bethlem (built in 1676 half a mile to the west at Moorfields, on the south side of what is now Finsbury Circus) “suffered from subsidence upon the site of the old city ditch, used as a dump for rubbish and waste”.1 Yet this unpromising fact was invisible to the building’s first admirers. Robert Hooke’s Bethlem Hospital at Moorfields was “London’s first great public construction in half a century [after the Royal Exchange and the Custom House]… surpassing the other two in size, stylishness, ornament and, not least, superb siting”, 2 the Moorfields area then being known for the relatively pure (and, it was supposed, restorative) quality of its air. It was built on a strip of land 740 feet wide and 80 feet deep, which Bethlem’s Governors had secured on a 999-year lease at a nominal rent from the City of London. “Most fundamental to understanding” its architectural grandeur, according to the historian Christine Stevenson, “is the [Bethlem] Governors’ conception of Hooke’s building as the home of an ancient Christian charity, one all the more noble because [it was thought that] its recipients could not be grateful nor, indeed, comprehend the nobility of the building”.3 The irony of this was not lost on seventeenth century commentators, one of whom wrote cynically:
“Bedlam is a pleasant Place, that it is, and abounds with Amusements; the first of which is the building so stately a Fabrick for Persons wholly unsensible of the Beauty and Use of it: the Outside is a perfect Mockery to the Inside, and Admits of two Amusing Queries, Whether the Persons that ordered the Building of it, or those that inhabit it, were the maddest?”4
However dramatic the siting of the building, however admirable its architectural aspirations, by the end of the eighteenth century considerations such as these had been overtaken by pressing engineering concerns. “Want of skill or attention are obvious in the carpentry of the walls and floors, below the roofs; there being no bond, or tyes, between the several parts, which should have been strongly connected”, wrote James Lewis, the Hospital’s Surveyor, in 1800 – or, as Christine Stevenson puts it, “Nothing aside from the tie-beams…actually joined the front to the back. No floor was level, no wall upright.”5 In the opinion of Lewis, “the present condition of the building is not in such a state as to warrant any other repair to be made thereto, than to preserve it…by such works as may be requisite…it is incurable.”6 With over 85% of their 999-year tenure remaining, Bethlem’s Governors were obliged to contemplate another move.
1 Jonathan Andrews et al, The History of Bethlem (Routledge, 1997), p. 206.
2ibid., pp. 230-231.
3ibid., p. 252.
4 …cited in ibid., p. 232.
5ibid., p. 252.
6 James Lewis, Report respecting the present state and condition of BethlemHospital (London, 1800).

 photo NewBedlaminMoorfieldsinnewbed_zps85671feb.jpg

Location, Location 1

Here is the first of six posts concerning the rationale behind the location of the hospitals for which the Archives & Museum holds records: Bethlem, the Maudsley and Warlingham Park Hospitals.
“The actual site” upon which Bethlem Hospital was originally founded, “now buried beneath the concrete horrors of Liverpool Street railway station, was never a very large one”, according to the medieval historian Nicholas Vincent, and its founders “would no doubt have been surprised to learn of the subsequent fate of their institution, intended in origin not as a mad-house but as…part of a wider movement in which the cathedral church of the Nativity at Bethlehem and its bishops sought land, alms and hospitality in western Europe”.1 Its location was not chosen with its later function as a hospital in mind, but instead was governed by the landholdings of Simon fitz Mary, sheriff of London. In 1247 he granted all the property which he held in the parish of St Botolph outside Bishopsgate to the visiting bishop of Bethlehem, “to found there a priory under the obedience of the church of Bethlehem, for the reception of the poor and of the bishop, canons, brothers and representatives of Bethlehem whenever they should choose to visit England”.2 By 1403, however, this religious community (which had been small from the outset, and by then was so tiny as to be practically unrecognisable as such) was playing host not to paupers or visitors but rather to the unwell, specifically “six insane men and three others who were sick”, according to the Porter’s visitation report of that year. In short, Bethlem’s location – like its transition from monastic house to hospital (in the medieval sense of that word, to which ‘almshouse’ is probably the nearest equivalent in meaning) – was “the product of pure chance”.3
Nevertheless, it turned out to be a felicitous one, at least for the majority of the 400 plus years the hospital stayed there. “It was…well-placed…beside the highway which linked the City with the Great North Road and ran on southwards to London Bridge…for the original purpose of offering a base and accommodation for members of the Order of Bethlem”, according to the hospital’s published history, as well as being “a good site for a hospital, as alms could be sought from passers-by” and “quite substantial sums to the income of the Hospital” could be solicited from intending visitors.4 On the downside, the hospital was “built over a regularly blocked common sewer”, and by 1674 it had become, in the words of its own Governors, “very old weake and ruinous, and too small and streight for keeping the greater number of Lunatikes as are therein at present”.5 Eventually these drawbacks precipitated a move away from the land originally given to the bishop of Bethlehem by Simon fitz Mary in hopes of ensuring “prayers for the sake of his own soul” (as well as currying favour with the King, a friend of the bishop).6 Yet, as its subsequent history would show, with this relocation Bethlem did not move far from the centre of the English imagination.

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1 Nicholas Vincent, ‘Goffredo de Prefetti and the Church of Bethlehem in England’, Journal of Ecclesiastical History, vol. 49, no. 2 (April 1998), pp. 213, 228.
2ibid., p. 224.
3 Jonathan Andrews et al, The History of Bethlem (Routledge, 1997), p. 80-82.
4ibid., p. 36.
5ibid., pp. 206, 233.
6 Nicholas Vincent, ‘Goffredo de Prefetti and the Church of Bethlehem in England’, Journal of Ecclesiastical History, vol. 49, no. 2 (April 1998), pp. 224-225.