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A century of community health care
This page was kindly provided by the Bourne Hall
Museum , The Museum has a permanent collection and also mounts exhibitions
on specific aspects of life in the past. They welcome enquiries about places
in the Borough, which should be addressed to the Curator, Bourne Hall Museum,
Ewell, KT17 1UF.
This page is sponsored by
which carries on the excellent traditions of the Old
Cottage Hospital
and offers day surgery of all kinds to the highest modern standards
The Health of Epsom: Caring for the Sick
In 1909 an open meeting was held at the Public Hall in Epsom to discuss
the Reverend Northey’s proposal that ‘it is most desirable in the interests
of the working classes of this town that a Dispensary should be founded
as soon as possible’. Within three months there was a committee formed in
the hope that ‘skilled medical advice and attendance must be brought within
the reach of the poorest inhabitants’. The Epsom Town Provident Dispensary
had two departments in additon to the medical one: these were Midwifery
(run by its own Ladies Committee) and Dentistry. Premises were taken in
Ashley Road. Four local chemists were asked to give a tender for dispensing
medicines, of whom only Mr. Ingham responded. He was able to supply a fully
qualified dispenser at a shilling an hour, as well as providing drugs to
the Dispensary at wholesale prices.
The Dispensary served working men, their wives and children. To qualify,
you had to be unable to afford medical services, and to live within a mile
of the Spread Eagle crossroads. 1½d had to be paid in every week (a farthing
less for children), and members had to be of good health when they joined
the scheme. To stop the sick from taking advantage of it, no-one was entitled
to attendance or medicines until a month after they joined. The Dispensary
was open during weekdays for an hour in the morning and evening, and on
Sunday in the afternoon. Patients had to bring clean medicine bottles when
they attended, or buy new ones. There was a certified midwife, but she was
only allowed to attend the wives of members. 17/6d was charged for the first
confinement - to be paid in advance - with a reduction for later ones. Allowance
was made to pay for this by instalments, but it must nevertheless have been
a heavy burden on working class families. The doctor could be called in,
for free, at the midwife’s discretion. Dental work consisted only of extracting
teeth, and offering advice. Pulling a tooth cost 2/6d with an anaesthetic,
6d without - many people must have decided to economise and go on with the
pain. Mouthwash was available from the Dispensary on the dentist’s prescription.
The Epsom Nursing Association was founded in 1887 ‘to provide skilled nursing
for the sick poor at their own homes’, with a local GP, Dr. Coltart, as
President. The District Nurse, Miss Rae, lived in East Street, from which
in her first year she made 2,573 visits to treat illnesses ranging from
pneumonia to fractured limbs. Only under exceptional circumstances was Miss
Rae to be called out in the night; it was expected that she would make her
visits in daytime. She was to see to the comfort of patients, as well as
their satisfactory sanitary arrangements, and to give instructions about
how they should be treated before her return. She could not attend at childbirths
without express permission.
After the first year of the Association, Dr. Coltart was able to report
that ‘it was with much pleasure that he could speak in the highest terms
of the manner in which that work was carried on and the blessing it was
to the poor sick’. He ‘thoroughly appreciated the excellent nursing and
attention given to them by Miss Rae’. The service was funded by donations
from the local gentry - with the Earl and Countess of Rosebery at the head
of the list. Grateful poor users of the service had also contributed 25/-.
Some firms and people made offers of help in kind - Harsant, the chemist,
had supplied dressings at cost price, and Arthur Ebbutt, who ran a painting
and decorating firm, had supplied a noticeboard for the District Nurse’s
doorway. Dorsets, the ironmongers, contributed a hip bath. One gift of a
bath chair was specially singled out for mention, as it enabled a woman
to go out of doors for the first time in two years. By 1895 the number of
visits had increased to 4,194, and there had been several cases of meningitis
and typhoid. Two years later the Association engaged a fever nurse, who
would provide a separate service in the case of epidemics; this was part
of a general scare, for at the same time the Epsom ratepayers association
was urging the public to be vaccinated against smallpox. London was so near,
and easily accessible, that the spread of contagious diseases was to be
feared.
The Health of Epsom: From Workhouse to Hospital
Plans were being made as early as 1836 to provide Epsom with a central Workhouse.
The old parish poor house was to be pulled down, and a new structure built
for £4,800 to hold 300 people. This was more than three times as many as
had been accomodated before. A week later, seventeen tenders had been received.
Land at the back of the old poor house, off Dorking Road, was bought for
£900, and John Trower was appointed as Master at £40 a year. His daughter
was appointed Matron, but it was not thought necessary to provide her with
a salary. After the plans had been changed, a second contract was put out
to tender and won by Butchers of Guildford. The Building Committee were
keen to see an infirmary supplied beside the Workhouse itself, kept separate
for the control of infection, but still inside the high boundary walls.
Within three years Katherine Gritten had been appointed as assistant nurse
on £12 10/- a year; then at last the inmates of the old poor house infirmary
were moved into the new premises.
Soon after the new Workhouse was built, the town’s medical officer had to
complain about a sewer outside the gates which smelt so strongly that it
was harming the inhabitants.It was covered over - using pauper labour. Later
on, the Board of Health prepared plans for draining the house: but the water
company would not lay on water to flush the drains. In the winter of 1849,
at a time of great sickness in the Workhouse, the drains were improved.
An extra ration of bread (four ounces) was given to adults, and the children
received more beer, costed at 1/- a gallon. When William Dorling, the local
printer, became Chairman of the Board he ordered four hot water baths to
be installed, plus an extra one for patients with the itch. Six tin basins
were supplied for the boys to wash in, and the hot water supply to the infirmary,
which had broken down long before, was mended. Plans were made to replace
the infirmary as part of the rebuilding of the Workhouse in 1851. Finally
in 1882 the Board decided to build a new infirmary, with 120 beds, at the
same time erecting a porter’s lodge on the Dorking road on the site of the
old town pound.
On St. Lukes Day in 1936 - the feast day of the patron saint of doctors
- a crisis was reported at the Cottage Hospital. Starting with only eight
beds, it had now grown to forty, and still there was not room enough. Beds
were having to be put out on the balcony, and funds were quite inadequate
to meet demand. the committee had certainly tried. Every house in Epsom
had a Penny A Week box, from which collections were made twice a year. A
private insurance fund had reduced some of the bills. Only three years earlier,
the whole town had joined in Hospital Carnival Week to raise money. There
had been a Carnival King and Queen, a ball at the Capitol Cinema, a baby
show, and a Donkey Derby. Still there were too many patients, not enough
money. The Urban District Council said it was the County Council’s responsibility.
And the County Council responded by enlarging the only building they had,
the Workhouse in Dorking Road.
By the War this building had a new name and a new image as Epsom Main Hospital.
In 1941 a new nurses’ home and a Maternity Unit were added. The Nursing
School was amongst the first in the country to teach the syllabus recommended
by the General Nursing Council, and to include obstetric nursing. The Outpatient
and Casualty Unit, opened in 1955 at a cost of £400,000, had all the latest
equipment. Ten years later the Hospital had annexes for the elderly at Cuddington,
Ewell Park and Shabden Park Hospitals, as well as the Schiff Home for the
recovery of post-operative patients. There were now 120 nurses in training.
In 1965/6 the running costs went over a million for the first time. Next
year saw the construction of a new block, containing 180 beds and new operating
theatres. The old Hospital Chapel was demolished, and services were held
in Mary Ward. In 1972 the last building of the old workhouse was demolished.
This was the Oaks, an old peoples home and geriatric ward. It was replaced
by a psychiatric and alcoholic unit costing £656,000. The programme of demolition
and development has continued through into the 1990s with the loss and replacement
of the old nurses’ home on the Woodcote Green Road side.
The Health of Epsom: Fever and Contagion
Epsom ratepayers were shocked to hear of the unsanitary nature of their
town in 1849. A public report, which led to calls for the creation of a
Local Board of Health, found the town to be full of uncovered drains, with
many wells dug next to cesspits. The average life expectancy in the town
had sunk as low as 40, largely due to the unrestricted building of shoddy
and crowded houses. ‘Continued fever... of a severe character’ prevailed
everywhere - scarlet fever in Church Street, and typhoid at the Workhouse.
Already, in the first quarter of the year, 47 cases of scarlet fever had
been reported at the Workhouse, and the doctor from the infirmary there
had attended a further 17 in the town. On Epsom Common and Clay Hill, despite
the apparently healthy situation in the open air, there were many more cases
caused by the inadequate drainage of the impermeable subsoil and the lack
of an independent water supply.
Gradually traditional measures, such as fumigating the streets after Derby
Week to dispel the infectious influence of the visiting crowds, were replaced
by a more scientific system. Smallpox was much feared, and by the 1860s
it was possible to take official steps against its spread. Mark Bristow
of Epsom was proceeded against for exposing the illness in the street. In
1862 a cottage in the Workhouse grounds, known as the Pest House, was used
to isolate those with smallpox. This was not enough: there were several
more local outbreaks of the disease, and by 1881 the need for an isolation
hospital had become clear. A house near Banstead station, owned by the railway
company, was chosen as the appropriate site. This continued for many years,
and was the forerunner of the present hospital there, but it was too small.
Cases were having to be sent as far away as Highgate, with a fee of £5 to
be paid by the doctor each time before they could be admitted. By the 1890s,
an Isolation or Infectious Hospital was built in Hook Road, on what is now
Tomlin Court. During the scarlet fever epidemic of 1897, when there were
proposals to close the schools, this building was seriously overcrowded.
Up to fourteen cases a week were being diagnosed and sent here for treatment.
In the late eighteenth century, Epsom was no longer a busy Spa town but
a quiet home out of London for professional men. Many schoolmasters and
clergy took up residence, as did doctors. One of these was involved in a
tragic accident in 1826, when the Dorking coach overturned in Ewell’s High
Street and injured a young woman called Catherine Bailey. No medical help
was available in Ewell, and a boy was sent to Epsom to summon a doctor:
however, as it was April 1st the lad’s story was dismissed as an April Fools
joke, and by the time that the mistake had been sorted out, Bailey was dead.
Victorian Epsom supported three doctors - Dr. Jones who had been there since
the 1840s, Dr, William Daniel who had arrived in 1864, and Dr. Willliam
Coltart who came ten years later. They ran practices and held surgeries
in their own homes, and patients relied on the appearance of the house to
give some idea of the doctor’s success. Daniel lived at Silver Birches,
an eighteenth-century town house which was also run as a private mental
home. Coltart lived at Tower House in Ashley Road, where the School of Art
is now. In 1885 they were joined by Dr. Alexander, who at first took premises
nearby in Hope Lodge, but afterwards moved to a house further down Church
Street called Beechwood. In a society dominated, as Victorian Epsom was,
by a few prominent citizens, it paid for a doctor to move in the right circles.
An imposing house mattered, as did membership of the right groups - doctors
were prominent in the founding of the Epsom Golf Club. 1918 saw the first
joint practice, between young Drs. Daniel and Coltart, with a Dr. Thornley.
In this way the family tradition of the first Epsom GPs was carried on.
Drs. Alexander and Joslin formed a combined practice in the next year. Doctors
in a joint practice did not share premises, but continued working from their
own homes: they co-operated by supporting each other in off-duty periods.
These arrangements could be very long-lasting, and two joint practices which
were formed in the last century are still working today.
The Health of Epsom: Life as a Doctor
John Propert was born in 1793 and left school at the age of fifteen to serve
in the army during the Napoleonic campaigns. After a few years as an ensign
he left the service and had to find a new trade: as he had no private income,
he started as the pupil of a doctor in Cardigan. Though he liked to call
himself ‘the poor Welsh apothecary’, he rose quickly in this new profession,
and by 1848 was distinguished enough to become a trustee of the Medical
Protection Society. This was an unwise move, as the Society collapsed shortly
afterwards, and Propert had to pay many of its debts from his own purse.
His experiences had given him a lasting sympathy for doctors in financial
distress, and he conceived the idea of building a Medical Benevolent College.
By 1853 land had been purchased at a cost of £1,300. Building the College
would cost a further £33,000, £300 of which went to the architect.
Prince Albert, accompanied dutifully by the Prince of Wales (the future
Edward VII) opened the College in June 1855. (He was to have laid the foundation
stone, but was confined to the Palace at the time - with measles). It housed
a hundred pensioners, who had to be either duly qualified medical men or
their widows (over fifty years old). There was also a school for two hundred
boys, who were the sons of medical men. Within a few years Propert’s institution
had changed its character. The school was doing well, but the provision
for poor doctors was proving controversial. The living conditions at the
Medical Benevolent College were very basic, considering the expenditure
involved. In 1861, when 26 cases of scarlet fever had been reported, it
was found that there were only two baths in the whole school. One parent
received a letter from the President assuring him, on the basis of fifty
years experience, that there was no link between cesspools and disease.
Many critics also questioned the need to spend money on such elaborate premises,
when it could have been distributed directly as annuities to those in need.
Meanwhile, at the Workhouse, other critics complained against the effects
of giving money directly to those in need, rather than housing them in elaborate
premises. It seems that middle class and working class poverty were judged
very differently in Victorian Epsom. List of photographs in the original
exhibition:
- Christmas 1955, and the Mayor visits the childrens ward
- The badge of Epsom School of Nursing
- The new Out-Patients Department, opened in 1955
- Learning to be nurses in a practical classroom
- Gloucester Ward in the early 60s
- Rosebery Ward in the early 60s
- Elizabeth Ward in the early 60s
- The nurses’ lounge in the Nursing Home, 1960s
- The operating theatre in the early 60s
- Epsom’s midwifery training course
- The Oaks old peoples home, once the Workhouse
- The Hospital and old Workhouse in 1955
- The Isolation Hospital in Hook Road
- Wells next to cesspits behind the Albion, 1849
- John Propert, founder of Epsom College
- The entrance gates of Epsom College
- Dr. E. Daniel
- Dr. Alexander
- Dr. Coltart
- The elder Dr. Daniel
- A nurse’s uniform of the 1890s
- Bramble Walk in the undrained Common
- Epsom’s original poor house, off Dorking Road
- The Town Pump was half the town’s water supply
- The Golf Club - a place to meet your doctor
- Weatherboarded housing was cheap and unhealthy
- The Reverend Northey
- Dr. Daniel’s house at Silver Birches in Church Street
- Harsant & Lee, the chemists - still unchanged today
This page (and others)kindly provided by the Bourne
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