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Erschienen in: Journal of Medicine and the Person 3/2013

01.12.2013 | Hospitals

Great Ormond Street Hospital for children

verfasst von: Nicholas J. Baldwin

Erschienen in: Journal of Medicine and the Person | Ausgabe 3/2013

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Excerpt

The Hospital for Sick Children opened on a very modest scale in a converted 18th century townhouse, no. 49 Great Ormond Street, in February 1852. Although specialist children’s hospitals had been founded in most major European countries since the Hôpital des enfants malades opened in Paris in 1802, the concept was regarded with suspicion in Britain, and prior to the Hospital’s opening the only specialist healthcare facilities for children in London and other major cities were a number of children’s dispensaries, offering basic medicines and doctor’s advice but without in-patient facilities. The Hospital’s principal founder, Dr. Charles West, was a ‘Physician Accoucheur’ (male midwife/gynaecologist) by training, and became interested in child health via women’s health. He had trained in France and Germany and been impressed by the children’s hospitals there. After working at Dublin’s maternity hospitals, he returned to London in the 1840s to work at the children’s dispensary in Waterloo Road. After several years failing to persuade their management to become a full children’s hospital, he decided that he would have to initiate such a project himself, and assembled a small committee of distinguished people in 1850 to establish the institution. West was ambitious to establish both a treatment and a research centre for children’s diseases, and a centre for developing the training of children’s nurses. The 1852 Hospital opened with two 10-bed wards, one for boys and one for girls, but there were so few in-patients initially that just one ward was shared by both sexes until April. The institution was a so-called Voluntary Hospital, and only open to the children of the poor (see Fig. 1). It was to be funded by subscriptions and donations, with those who gave over a certain amount made ‘Governors’ and allowed to nominate a fixed number of patients for admission each year. Charles West and Dr. (later Sir) William Jenner were the first doctors, with one surgeon and ten nurses. The Hospital was fortunate to gain celebrity support from an early stage, with Queen Victoria donating £100 at opening and Charles Dickens, then living nearby, publicising and justifying the new institution in an article in his journal ‘Household Words ‘in March 1852. In 1857 the new Hospital hit a financial crisis, but Dickens chaired the first of a series of Annual Dinners and gave public readings in aid of the Hospital during 1858, raising over £3,000 and enabling the Hospital to both survive and expand by purchasing the adjacent property at no. 48 Great Ormond Street. The early Hospital was a much more general children’s hospital than it is today, with most of the patients being very local. The range of treatment was very limited, but many would have benefited from being fed and washed properly for the first (and in many cases only) time in their lives. A ‘Country Branch’ for convalescent patients was acquired in 1869, the 17th century mansion of Cromwell House at Highgate, then on the edge of north London. By this time the main Hospital was under acute strain, with the converted houses unable to cope with increasing demand, and another fund raising campaign was initiated, resulting in the building of the first purpose-built Hospital block on the back gardens of the original houses. This was designed by Edward Barry, of the celebrated Victorian architectural dynasty; it had four large wards, an operating theatre for the first time (previously surgery had been done in the wards behind a curtain), a sophisticated Roman villa style under-floor heating system and an elaborate Chapel endowed by the architect’s cousin. In 1880 a separate ‘Isolation’ block for infectious diseases, with 4-bed wards, was added on the north side, and in 1893 another new block, still standing today, replaced the original houses on Great Ormond Street, containing three more large ward units, two medical, one surgical (see Fig. 2). The original Hospital policy was not to admit children with chronic conditions or certain infectious diseases, but this proved difficult to enforce. In the nineteenth century, patients were officially only admitted between the ages of 2 and 12 years, although the lower limit was widely ignored by the clinical staff, at times causing management tensions. By the end of the nineteenth century, the Hospital’s reputation as the leading institution of its kind in Britain and the British Empire was well established, although its finances remained fragile, and it now had competition from several other children’s hospitals that had opened in London since the 1860s. Many of the leading physicians and surgeons of the age worked at the hospital, and began to build the foundations of modern Paediatrics, including Samuel Gee, W. H. Dickinson, Sir Thomas Barlow, Walter Cheadle, Sir Archibald Garrod and F. E. Batten. In surgery the leading names were Sir Thomas Smith, John H. Morgan, Sir Charles Ballance and Sir William Arbuthnot Lane. Batten and Garrod’s contemporary George Frederic Still, on the staff from 1894 to 1926, was arguably the first full-time Paediatrician. A sizeable new Out-Patient Wing funded by newspaper magnate William Waldorf Astor opened in 1908. Into the twentieth century, technical and clinical advances began to accelerate, with the establishment of a radiography department in 1903, soon followed by a Bacteriology Laboratory. The Hospital’s innovative Pharmacist for 40 years, John Wicliffe Peck, had a major input into both of these, also patenting the first fireproof splints for children under the name ‘Pexuloid’ in 1913 and establishing a new splint shop at the hospital to manufacture them. The Hospital survived the First World War without damage, but came under further financial strain, and also employed female doctors for the first time in 1916, when many of the regular staff were on military service. By the 1920s, the Victorian buildings were becoming shabby and unable to cope with both the growing volume of patients and the evolving medical technologies. A major campaign was launched to completely rebuild the Hospital in a much more spacious open-plan manner on the nearby site of the Foundling Hospital, London’s famous orphanage which had closed in 1926. This did not come off due to the dire economic climate at the time, but parts of the scheme were built in more compact form to the north of the existing buildings in the 1930s, with a new Nurses’ Home block opening in 1934 and a new 10 storey clinical block in 1938, subsequently named the Southwood Building and still in use today. The fundraising for the new buildings resulted in the celebrated gift of the copyright of ‘Peter Pan’ to the hospital by its author J. M. Barrie. The original Hospital had been free to the children of the poor, but rising treatment costs and the easing of acute poverty with the beginnings of the modern Welfare State meant that a ‘pay what you can afford’ system developed, with an Almoner being appointed in 1909 to assess patient’s families’ ability to pay towards the costs of treatment. The new 1938 block also contained wards for fully fee-paying private patients for the first time. Another distinguished generation of physicians and surgeons joined the staff after World War I, including Hugh Thursfield, Robert Hutchison, Sir Lancelot Barrington-Ward and Australian-born Denis Browne, the first full-time Paediatric Surgeon and pioneer of neonatal surgery. A national professional body, the British Paediatric Association, was founded in 1928 by two of the Hospital’s leading physicians, Frederic Still and Donald Paterson, along with leading Newcastle Paediatrician and Community Child Health pioneer James Spence, who had also previously worked at Great Ormond Street.
Metadaten
Titel
Great Ormond Street Hospital for children
verfasst von
Nicholas J. Baldwin
Publikationsdatum
01.12.2013
Verlag
Springer Milan
Erschienen in
Journal of Medicine and the Person / Ausgabe 3/2013
Print ISSN: 2035-9411
Elektronische ISSN: 2036-3877
DOI
https://doi.org/10.1007/s12682-012-0134-x

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