Conservation (8): Conservation of modern collections

It is often assumed that modern collections, such as LHSA's HIV/AIDS material, do not need conservation treatment. However, this material is still vulnerable to deterioration because of its inherent qualities or inappropriate storage methods upon accession. Often, modern collections in archives consist of unstable or low-quality materials, as they were not designed to last but sewere intended for practical and temporary use.

For example, modern paper made from low-quality materials may exhibit greater deterioration than an older paper object made with high-quality rag paper. Plastics formed 20 years ago may already be fading or becoming brittle, and modern materials such as VHS and audio tapes could be unreadable after just a few decades.

Problems can also arise with mixed media collections regarding how to store these items together in their original form without losing their meaning, while still adhering to conservation standards. Ethical issues also emerge, such as which items to retain and which can be disposed of. Questions about conserving modern materials will only grow as more modern ones are produced daily, making this a new and fascinating area.

Example of unsuitable housing of collection items upon accession.

Conservation of modern paper

Deterioration of modern paper

Often paper made in the past 50 years shows greater deterioration than papers made 500 years ago. For example, this newspaper page (right) found in the HIV/AIDS collection has discoloured and become brittle.

Paper deterioration can be caused by both internal and external factors.

Internal causes of paper deterioration

The raw materials and the manufacturing process of paper can cause degradation. 

Raw materials

In Europe, early papers were made from cotton, linen and hemp rags which were relatively stable and generally made good quality papers. However, as the demand for paper grew, papermakers began to use different materials and methods which resulted in lower quality sheets. In the 1840s, a method was developed for using ground wood pulp in the paper making process. This type of pulp contains lignin which is acidic and darkens on exposure to light.

The use of new materials, such as recycled fibres, optical brighteners and colourants and new manufacturing processes from the 1980s onwards has increased the types of paper available. However these processes and material all have an effect of the longevity of the paper and a paper conservator must be aware of the methods of production to successfully treat objects made from modern paper.

A newspaper that has discoloured over time, especially along the edges and folded areas.

Manufacturing process

Early papermaking was all carried out by hand, which resulted in a good quality strong sheet. However, it was a long and laborious process and many sought to mechanise the manufacturing procedure to increase production.

The first papermaking machine was invented in 1798 by Nicholas-Louis Robert. This mechanical pulping and formation resulted in shorter fibres and also unintentionally introduced metallic particles into the paper resulting in a weaker sheet.

Chemical pulping was introduced in 1854 by Hugh Burgers and Charles Watt. Chemical pulping removes lignin and does not cut up the fibres as much as mechanical pulping, resulting in a stronger paper.

From the mid-1970s thermomechanical pulping was widely used. This method uses heat and mechanical pulping to soften the wood chips used in paper making. Today, the sulphate process is most commonly used to produce paper. This is a chemical procedure in which wood chips are treated with sulphurous acid under high pressure to produce cellulose and extract lignin.

Alum rosin sizing was introduced in the early 18th century in an attempt to strengthen the paper; however, this sizing caused further acid to form within the paper. Wood pulp paper from before the 1980s also tends to be acidic due to the alum-rosin sizing used. The development of synthetic sizing in the 1980s enabled the production of paper with a neutral to slightly alkaline ph. This, combined with a calcium carbonate filler, acting as an alkaline reserve to prevent acid contamination from the environment, resulted in paper with better ageing characteristics than modern papers from the early 20th century.  

This resource by the Robert C. Williams Museum of Papermaking provides a good overview of the history of papermaking around the world: History of Papermaking Around the World

External causes of paper deterioration

Environmental conditions

Temperature: high temperatures increase chemical reactions. An increase of 10 degrees C doubles the reaction rate. Therefore, a cooler environment is preferred for paper collections.

Humidity: moisture in the air can also accelerate chemical reactions. High levels of humidity can aid mould growth and encourage pests. Equally, low levels can cause desiccation of the object and result in increased brittleness.

Fluctuation of these conditions causes the material to expand and contract. Over a long period of time, this can weaken the physical bonds within the paper and cause a loss of strength.

Pollutants

Gaseous pollutants can originate externally from industrial and vehicle fumes, or internally from common materials such as paint, plastics, cleaning supplies, and photocopiers. These pollutants, especially when combined with a humid atmosphere, can initiate chemical reactions that can result in paper degradation.

Light

The absorption of energy from light can trigger chemical reactions that degrade paper. UV light is particularly damaging as it has more energy than other longer wavelengths of light. Light can cause the lignin in paper to darken and cause inks and dyes to fade. Other forms of light such as direct sunlight and infra-red bulbs can also produce heat which again causes paper to degrade.

Handling and storage

In the HIV/AIDS collection, the majority of the damage to the paper documents is due to poor handling and storage during use, prior to accession. They were often used in offices and, as such, not handled with great care as they were just seen as ephemeral documents.

Paperclips and staples

Frequently, metallic paper clips or staples are used to hold loose sheets together; however, these can rust over time and cause planar distortion of the paper. These damaged areas now represent an area of weakness, which will be more susceptible to damage over time.

Creasing

Due to inappropriate storage and careless handling, papers can easily become creased. These creases weaken the paper fibres and may be more likely to tear in the future. This is often caused by inappropriate storage. For example, documents placed in a ring binder may exhibit tearing around the hole punches.

Tears

This is often caused by inappropriate storage. For example, documents placed in a ring binder may exhibit tearing around the punched holes.

 

Surface Dirt

Although it may seem innocuous, surface dirt can absorb pollutants from the atmosphere. These can then migrate into paper and increase the acidity of the paper. Surface dirt can also provide a food source for pests and encourage mould growth. Without appropriate storage, dirt can accumulate on the paper surface and result in paper degradation.

Conservation of modern paper

Surface Dirt 

Surface dirt has been removed using a chemical sponge. This method was chosen as it is quick and easy to prepare. It can also be used to target specific areas and is very effective at removing surface dirt

Removal of metal fasteners

In the HIV/AIDS collection, metallic fasteners such as paper clips and staples are frequently used to hold together loose sheets of paper. These items are all being removed to avoid the transfer of rust from the metallic fastener to the paper. Care must be taken to avoid the tearing of the paper during removal. 

Once these metallic fasteners have been removed, the nature of the object has been slightly changed and it may not be obvious that these items were previously held together. Therefore, simple paper tabs have been created to hold items that have had their metallic fasteners removed together. The number of metallic fasteners that have been removed has also been recorded so that the original appearance of the items can be recreated if necessary.

Creasing

Creasing has been reduced by gently rubbing the creased area with a bone folder over a piece of Bondina™. In some cases of extreme creasing, the paper has been carefully folded back on itself to help the fold lay flat. In most cases, the papers have been laid flat in the archival folders so that over time they will lay flat due to the weight of other paper items on top of them. In cases of extreme cockling, paper items have been placed in a press between layer of Bondina™ and blotter to reduce planar distortion.

Tear Repair

Tears have been repaired using Japanese paper and wheat starch paste.

Rehousing

All paper items are being rehoused into more suitable enclosures to provide better protection from mechanical damage and to avoid migration of acids from non archival storage methods.

Due to the size of the collection, it is not feasible to house each sheet individually. Instead, loose papers at a maximum depth of 2 cm are placed in triptych folders. These folders are then placed in acid free clam shell boxes.

Postcards from the Take Care HIV awareness campaign

The Take Care campaign in Lothian began in the late 1980s in response to the realisation that cases of HIV and AIDS in the area were four times the national average, affecting mainly young heterosexual people. The campaign aimed to raise awareness among all community members and involved advertising, events, and educational initiatives.

The postcards below display some of the images that were used in the campaign to portray the message of safe sex and 'taking care of the one you love'. The Take Care collection came to LHSA in 2000. It consists of administrative files, information packs, reports and research, advertising materials, postcards and posters, audiovisual items, and objects.

In 2015, resources for teachers in secondary schools and youth groups were introduced largely based on this collection. The resources focused on the Curriculum for Excellence framework. Each resource highlights specific items within the HIV/AIDS collection at LHSA. A fact sheet provides background information on the resources presented, along with suggested activities.

Take care of the one you love. Condoms can prevent.... (GD22/14/4/2/28).

Take Care of the One You Love, 1990s (GD22/14/4/3/1).

Do you come here often?, 1990s (GD22/14/4/1/2).

Lovely latex, 1990s (GD22/14/4/3/3).

If he’s half as big as he thinks he is….10.5 x 14.5 cm (GD22/14/4/5/14).

If they’re half as fashionable as they think they are…. 10.5 x 14.5 cm, 1990s (GD22/14/4/5/15).

You are the sunshine of my life, 1990s (GD22/14/4/3/8). 

Take Care when you xxxx, 1990s (GD22/14/4/3/11).

The Royal Edinburgh Hospital's Royal Charter

King George III granted a Royal Charter in 1807, establishing the Edinburgh Lunatic Asylum. The foundation stone of the original building was laid in 1809, and the first patient was admitted in 1813. The charter is in Latin and has the Great Seal of Scotland attached. LHSA created three posters capturing the Royal Charter in advance of the Hospital's bicentenary celebrations in 2009.

In 1792, Andrew Duncan initiated an appeal to establish an asylum in Edinburgh. Voluntary contributions were initially slow. However, a government grant of £2,000 in 1806 significantly increased the funds and allowed for the purchase of a villa and four acres of surrounding land in Morningside. Soon after, in the spring of 1807, a Royal charter or warrant granted by His Majesty King George the Third established the Edinburgh Lunatic Asylum (ELA) as a corporate body. The foundation stone of a building designed by architect Robert Reid was laid on 8 June 1809. ELA admitted its first patient on 19 July 1813.

Pages of the Royal Edinburgh Hospital's Royal Charter of Incorporation (LHB7/19/12/21).

As well as extending royal patronage, the warrant made ELA into a public body. This gave legal rights to use a common seal, to perpetual succession, to sue and be sued, to own lands, to lend money and to receive donations and legacies. It could also make bylaws, rules and regulations, provided they were consistent with the institution’s charitable purpose.

The warrant also specified how ELA was to be run. Twenty named extraordinary managers and twelve named ordinary managers were elected. They were drawn from the Edinburgh Town Council, the law, the University and the local medical profession. A governor and five deputy governors, along with four ordinary managers, could be chosen from among charitable contributors who had given £10 or more and who resided in or near Edinburgh.

Front and back image of the Great Seal (LHB7/19/12/21).

The warrant consists of four sheets of parchment folded to make eight pages. The text, in Latin, is inscribed onto each page except the last, which is blank. The Great Seal of Scotland is attached using intertwined silk threads. Its wax relief shows King George in military uniform, mounted on a rearing stallion and overlooking the City of Edinburgh. An idealised, but still identifiable, panorama of the Castle, the churches and tenement buildings of the Royal Mile and Salisbury Crags can just be made out behind the horse’s legs. 

In 1841, Queen Victoria allowed the prefix ‘Royal’ to be added and, ten years later, the name was officially changed to the Royal Edinburgh Asylum by a private Act of Parliament. In 1927 a new charter was obtained which changed it to the Royal Edinburgh Hospital for Mental and Nervous Disorders. Today it is simply known as the “Royal Edinburgh”. 

A new building, designed by William Burn, was added in 1842. Originally known as West House, it was later renamed after Dr William M’Kinnon, who served as the first Resident Physician from 1839 to 1846. Additional accommodation was added in 1894 when Craig House opened nearby. The original building, soon called East House, was eventually demolished. During the twentieth century, the site saw a series of outpatient and residential developments. The Royal Edinburgh Hospital was granted a Coat of Arms in 1959. 

Further resources

Poster 1: General information about the Charter and Seal

Poster 2: The Charter text in English

Poster 3: Images of the Charter and Seal

History of the NHS (2): The dawn of a new era

In 2008, a photographic exhibition by LHSA celebrated the 60^th anniversary of the National Health Service.

The National Health Service (NHS) was launched on 5th July 1948. It heralded a new era of health care for the UK. The main provision was for every man, woman and child to have access to a complete health service, regardless of who they were or where they came from. Medical care and treatment were to be free to all individuals, funded by central taxation.

Back cover of Royal Infirmary of Edinburgh League of Subscribers Annual Report, July 1948 (GD1/38/6).

Leith Day Nursery, South Fort Street, c.1950s (LHSA Photographic Collection) [Image reproduced by permission of The Scotsman Publications Ltd.]. The NHS strengthened and consolidated maternity and child welfare services, which were first established in Scotland at the turn of the century. As well as providing clinical care for expectant mums, babies and young children, it offered further assistance to mothers through ante-natal classes, health visitors, nurseries and play centres.

Sighthill Health Centre, c.1950s. Sighthill Health Centre opened in May 1953 and was the first of its kind in Scotland. Sighthill was chosen because it was a new housing area with a large population that was inadequately served by existing provision. he idea behind it was to create a facility for related health care services under one roof. The Centre housed GP consulting rooms, child welfare and school health services, an NHS dental surgery, a pharmacy and a physiotherapy department.

The NHS brought together a number of existing services which had begun many years before. It provided a uniform national structure that had previously involved voluntary, provident, private and government provision at the hospital and community levels. The main features were: regional hospital boards to co-ordinate hospital services; local health authorities to run community-based services and executive councils to administer GP, dental, chemist and eye services. The complete service offered by the NHS aimed to encompass all aspects of health care from the cradle to the grave. It also promoted good health and welfare in general.

National Health Service (Scotland) Act, 1947. The text reads, 'Chapter 27. An Act to provide for the establishment of a comprehensive health service in Scotland, and for purposes connected therewith. [21st May 1947.]'

Newspaper cartoon, c.1946 (LHSA Pamphlet Collection). This cartoon shows an elderly patient worrying about the potential effects of the new National Health Service. The British Medical Association agreed with the creation of the NHS in principle, but felt it was not properly consulted when the legislation was being developed.

People playing cards and dominos at Sighthill Health Centre, c.1950s [Image reproduced by permission of The Scotsman Publications Ltd.].

Before the NHS, citizens had to pay for medical advice and treatment. Many simply could not afford this. So calling out a doctor, or going to a hospital, often became a last resort, with the result that illnesses or injuries often went untreated altogether, or became more serious than they might have been. The NHS meant that people of all classes no longer had to worry about how they would pay. Care and treatment became a right, not a privilege.

Royal Edinburgh Maternity Hospital (Simpsons) Case Note, 1935 (LHB3 CC1/ 1935/1010). This image is taken from a patient case note and shows a husband and wife's pre-NHS insurance provision. The National Health Insurance Scheme was introduced as part of the National Insurance Act of 1911. It entitled the working man (and in some cases his family) to medical treatment, his wife to maternity care and offered him sickness benefit during periods of his incapacity for work. By the mid-1930s, all manual labourers earning no more than £250 a year were made compulsory members of the Scheme.

Nurse and patient in ambulance, 1942. Before 1948, the ambulance service in Scotland was supplied jointly by the St. Andrew's Ambulance Association and the British Red Cross Society, and funded by voluntary contributions. This joint service continued post-1948, the only change being that the costs were now met by the State.

School Dental Service, c.1950s. Dental check-ups and treatments were free under the early NHS, as were visits to a GP, eye tests and spectacles, hearing tests and hearing aids.

The first part of the exhibition focuses on aspects of pre-1948 health care and selected features of the NHS Scotland Act. The second part provides photographic snapshots of the many components of the service provided by the NHS in Edinburgh.

Royal Edinburgh Hospital Admission Register, 1920 (LHB7/35/12). These volumes recorded several patient details, including an individual's status as 'private' or 'pauper'. If private, the patient or their family would be charged an appropriate board rate. If a pauper, the state would pay the minimum for their care under the provisions of the Scottish Poor Law. Private patients in this psychiatric hospital were housed separately from paupers in finer surroundings and had access to many other privileges which paupers were excluded from.

The NHS has adapted and developed continuously since 1948. Almost immediately, it became apparent that the need for health care in Scotland (and the UK) was enormous and that the cost of meeting it was going to be far higher than previously estimated.

School Medical Service, diphtheria immunisation, 1953. In Scotland, the School Medical Service was established in 1908. For the next 40 years, it was administered and financed at a local level, often with very limited resources. With the coming of the NHS, medical services for school children became the responsibility of the State nationally. It soon began to offer vaccinations and immunisations to all children.

Royal Edinburgh Hospital Case Book, 1916 (LHB7/51/100). This image shows the higher annual board rate paid by this private patient. Despite staff working hard to improve the mental health of all patients, fundamental inequalities remained.

Many people today are quick to associate the NHS with waiting lists, prescription charges and so-called ‘postcode lotteries’. But we should never forget that the fundamental values behind the NHS still remain the same. Anyone who is sick or injured can go to a hospital or a doctor’s surgery and get the help that they need. This was not the case 60 years ago in Scotland and is unfortunately not so in many countries of the world today.

Hospital ward, East Fortune Hospital, 1953. East Fortune Hospital was a tuberculosis sanatorium which opened in 1922. It was converted for this purpose from a World War One naval airship station in Drem, East Lothian. From 1956, the hospital also began to care for children and adults with learning disabilities.

Audience receiving question cards at a health education meeting, New Victoria Cinema, 1947. Health education was not just for mothers and children. Public meetings held in cinemas were organised by the Edinburgh Public Health Department, now a fully integrated part of the NHS. Films were shown followed by question-and-answer sessions on a range of topics. For example, tuberculosis, venereal disease, hygiene and exercise. Anybody could attend without charge.

The 'Audience of 2000' leaving the New Victoria Cinema after a health education meeting focusing on tuberculosis, 13 March 1949 [Image reproduced by permission of The Scotsman Publications Ltd.].

Central Leith Health Campaign, 1955 [Image reproduced by permission of The Scotsman Publications Ltd.]. In the 1950s, Edinburgh worked hard to promote the fight against tuberculosis. The Central Leith Health Campaign of 1955 encouraged people to have their chest x-rayed to detect any signs of the disease. This was followed in 1958 by the Mass Radiography Campaign, which invited all citizens of Edinburgh over the age of 15 to have their chests x-rayed. A staggering 77% of the population took part.

Central Leith Health Campaign, 1955 [Image reproduced by permission of The Scotsman Publications Ltd.].

Window display at Woolwoths, Princes Street promoting 'Health Week', 1952 [Image reproduced by permission of The Scotsman Publications Ltd.]. Edinburgh's 'Health Week' ran from 10th to 18th May 1952 and employed the slogan 'Your Health is Edinburgh's Wealth'.

History of the NHS (1): A history of the NHS

As a result of the National Health Service (NHS) (Scotland) Act 1947, the NHS came into being on 5 July 1948. It aimed to meet all health needs free of direct charge to the citizen.

In the years immediately prior to its creation, Scotland had pioneered new forms of organised health care, such as the Highlands and Islands Medical Service (HIMS) (1913), and the Clyde Basin Experiment in Preventative Medicine (1941) which anticipated some of its provisions. Such factors combined with other features of Scottish society to create a national health service which was in many ways as distinctive as the Scottish medical culture which preceded it.

Before the NHS, Scottish healthcare combined elements of voluntary, municipal, provident, private, and government provision at both hospital and community levels. Subsequently, over four hundred hospitals, accommodating around sixty thousand patients, became Crown property and were formally vested in the Secretary of State for Scotland (SSS), operating through the Department of Health for Scotland (DHS). Five Regional Hospital Boards (RHBS) were established to oversee Scottish hospitals on a regional basis. This was achieved through eighty-five local Hospital Boards of Management (HBM). RHBs coordinated various aspects of hospital services, including specialists and diagnostic laboratories, as well as medical research. They also played a similar role in relation to ambulance services for hospitalised patients and blood transfusions, although both continued to be run on a voluntary basis. Hospitals in the Lothian region were managed by the South Eastern Regional Hospitals Board.

Pamphlet, Your Health Service: How it Will Work in Scotland, HMSO 1948 (GD1/112/1).

The DHS also assumed overall responsibility for twenty-five Local Health Authorities (LHA) which co-ordinated a variety of community based services, including maternity and child welfare, midwifery, immunisation, vaccination and other aspects of preventative medicine, health visiting, home nursing and mental deficiency. General practitioners (GP), dentists, chemists and opticians remained self-employed. However, the DHS set up Executive Councils (EC) to arrange payment for services for NHS patients. In addition, a Scottish Medical Practices Committee (SMPC) was set up to help co-ordinate the distribution of GPs nationally. Locally, doctors' views were also represented via Medical Committees (MC). The DHS placed great emphasis upon the future co-ordination of doctors' activities through Health Centres (HC) which would be concerned with health education as well as direct patient care.

 

The NHS in England and Wales

The administrative structure of the NHS in Scotland differed from that in England and Wales with respect to some of its arrangements:

• Teaching hospitals remained under the control of RHBs via Medical Education Committees (MEC). In England they were managed by Boards of Governors directly responsible to the Minister for Health.
• Boards of Governors of hospitals also controlled pre-NHS endowments, whereas in Scotland they were vested in RHBs and the Scottish Hospitals Endowments Research Trust (SHERT).
• As well as communicating with HBMs via RHBs only, the SSS was also responsible for the provision of HCs, whereas in England and Wales, this came under LHAs.
• The SSS also had equivalent responsibilities for the ambulance service, blood transfusion, and laboratory services, whereas in England and Wales it was LHAs, RHBs and the Ministry of Health (MH) respectively.
• HBMs were called Hospital Management Committees south of the border and had a different appointment mechanism.

Your Health Service leaflet, Pictorial plan of the new health service (GD1/112/1).

NHS re-organisation in Scotland

Since the inception of the NHS in 1948, a number of organisational changes in the structure of the service have taken place. The first of these administrative changes was introduced following the publication of the NHS (Scotland) Act 1972. It was decided that, in order to provide a more integrated health service, the 3-tiered system of administration should be abolished. This led to the Regional Hospital Boards (planning and development of hospitals services) and the Executive Councils (pharmaceutical and general medical, dental and ophthalmic services) being disbanded and responsibility for Community Health Services (welfare, preventative medicine and public health) removed from Local Authorities. Boards of Management, which had been responsible for the day-to-day management of hospitals, were also abolished under the new system.  Instead, 15 health boards acting on behalf of the Secretary of State for Scotland were established. Lothian Health Board (LHB) was made responsible for Midlothian, East Lothian and West Lothian. Within LHB, three Health Districts operated from 1975-1984: North Lothian District, South Lothian District and West Lothian District. The Common Services Agency managed ancillary services such as the ambulance service, blood transfusion service and health education programmes.

Further reforms followed the publication of the Griffiths Report in 1983 which recommended a move away from consensus management where responsibility was shared between doctors, nurses and administrators. This approach was seen to delay decisions and instead general managers were appointed with overall responsibility for the service. The district level of management of the NHS was eliminated in April 1984 in order to devolve responsibility for services to hospital groups of management. General managers were subsequently employed at unit level to further speed up the administrative process. Clinicians were more closely involved in the management process and units were now responsible for their own budgets.

The publication of the white paper "Working for Patients", January 1989 led to further changes in the health service. In order to provide a more efficient service, as much responsibility as possible was devolved to local level with hospitals now having the opportunity to apply for self-governing status as NHS Hospital Trusts. The role of the Health Boards was to set performance criteria, monitor the performance of the Health Service and evaluate its effectiveness. Lothian Health was responsible for assessing the needs of the local population and purchasing services from health care providers. The NHS hospitals were concerned with the day-to-day management of medical services. From 1992, the units of management were re-structured with the introduction of service units. Hospitals could now "opt out" and become self-governing hospital trusts.

 

Sources of reference

Committee of Enquiry into the Cost of the National Health Service: the National Health Service in Scotland: Memorandum by the Department of Health for Scotland DE22532/1/944 100 6/52R. DHS. June 1953

Committee of Enquiry into the Cost of the National Health Service: the National Health Service in Scotland: The main differences between the Service in Scotland and the Service in England DE 23172/1/351 35 8/53R. DHS. August 1953

Leathard, Audrey. Health care provision: past, present & future London: Chapman & Hall, 1990

Lothian Health Board circular: General Management in Lothian, May 1987

Main differences between the health services in Scotland and in England and Wales DHS. December 1956

The National Health Service in Scotland: notes for speakers DE 2175/1/284 25 2/53R. DHS. January 1953

Scottish Home & Health Department Circular no. 1983 (Gen)27 (LHB1/81/218: Reorganisation of NHS Jan 1980-83)

Williamson, Peter J. General management in the Scottish Health Service University of Aberdeen, 1990

Your National Health Service: how it will work in Scotland Edinburgh: HMSO, 1948