The humble beginnings of the Western General Hospital!

2018 is a very special year for the Western General Hospital as it celebrates its 150th anniversary! In this blog our Access Officer Louise looks at the origins of this century and a half old hospital.

The Western General has its roots in the 18th century. St Cuthbert’s Poorhouse opened in 1761 to serve the parish, however by 1865, alongside a growing dissatisfaction with the general standard of poor relief in the country, the poorhouses of the City, the Canongate, and St Cuthbert’s, were reviewed by the City’s Medical Officer. Sir Henry Littlejohn found the poorhouses of the city to be in a derelict state and proposed a controversial plan to merge the existing poorhouses to create a new and larger building. His plans were rejected and an argument for a separate poorhouse for St Cuthbert's found support. The result was the opening of the Craigleith Hospital and Poorhouse in 1868.

Craigleith Hospital and its grounds (GD28/8/1)

The building served the poor of the local parish for over four decades until 1914 when the outbreak of the First World War saw it transformed into the 2nd Scottish General Hospital. The poorhouse patients were subsequently transferred to Craiglockhart Hospital, and Craigleith became dedicated to caring for sick and wounded British service men. To cope with its new role as a Military Hospital the building saw a number of transformations and extensions with the building of a large operating theatre and recreational hut.

Craigleith Operating Theatre c.1914-1918 (GD28/8/1)

After the war ended Craigleith returned to its role as a Poor Law Hospital in 1919 and it is between then and 1939 that the origins of the Western General Hospital began. In 1928 Craigleith started being used for general hospital purposes, and after the passing of the Local Government (Scotland) Act in 1929 the Parish Councils were abolished. The hospital was then taken over by the Public Health Committee on 16 May 1930. Craigleith, Pilton and Seafield Hospitals were then renamed to Western General, Northern General, and Eastern General Hospitals in 1932 under the new banner of Municipal General Hospitals.

Preparations were then made to expand the hospital as it began to admit medical and surgical patients, as well as children. New departments were opened for a variety of different treatments including massage, dentistry, and urology, the entire drainage system was renewed, and in stark contrast to its days as a Poor Law Hospitals, patients who were able to were expected to pay for their time in the hospital.

Annual Report of the Public Health Departments and various Sub-Department for the year 1932 (GD28/7/2)

Since its beginnings as a Poor Law Hospital, the Western General has survived two world wars, enjoyed the benefits that were brought by the introduction of the National Health Service, and developed into a hospital that now hosts a number of specialist units. In the coming months we will be bringing your more blogs relating to the the history and achievements of the hospital.

To mark the anniversary here in LHSA we are working on a collection of oral histories from staff who have worked at the Western General Hospital. Our archivist Louise Williams has already recorded a number of interviews and a team of enthusiastic volunteers have been tasked with cataloguing and part transcribing the recordings. For more information on this check out our last blog! You will also hear more from our volunteers and the project in the coming months, but in the meantime take a look at what other 150th celebrations are happening by visiting: https://westerngeneral150.blog/

Voices in the corridors...

This week, Archivist Louise has been creating some new content for the archive...

Back in 2011, I took a vocational course run by the University of Dundee called Sound and Vision, about how to manage audio-visual media in the archive. Before I decided to train to be an archivist, I'd worked in the cinema sector for a number of years, and I went on the course being primarily interested in visual culture. However, a major part of the syllabus involved oral history - and soon learning about the methods of and reasons behind recording individuals' personal testimonies to keep for future generations became my favourite aspect of the course. We learnt the best methods of taking an oral history, how to produce a summary of it for potential users, and how to transcribe it to make it even more accessible (the last part is a labour of love and takes hours upon hours!)

Whereas we do hold some film archives here at LHSA (like this 1930s' film of the Royal Infirmary of Edinburgh, for example), an increasing part of my job recently has involved adding to the archive with oral testimony from those who've been closely involved in healthcare in our region in the recent past. For example, I'm currently interviewing former members of (then) Lothian Health Board staff about the challenges of fighting the 1980s HIV epidemic in Edinburgh  - we have 13 interviews to date, and more in the pipeline for the coming months.

I've also been using my oral history training in a project to celebrate the 150th birthday of the Western General Hospital, of which I'm sure you'll hear more this year. Although the Western only acquired its current name when the local authority took over the running of the old poor law infirmaries from 1930, its history as a hospital goes back to 1868, when St Cuthbert's Poorhouse relocated to the site from its former home at the West End of Princes Street.

The Clock Tower building of the Western General Hospital, when it served as a military hospital during the First World War (GD8/8/1)

As part of the commemoration of this long history, LHSA has been asked to record memories of medical staff who have worked at the Western General Hospital, in the form of longer oral history interviews to be kept in the archive. Some of the interviews have taken place here at the Main Library, but last week I was lucky enough to visit the Western on a beautiful summer day to conduct interviews with former staff who had been part of the hospital's recent past.

One of the many lions represented in the older buildings at the Western General Hospital, taken on my visit last week.

One of my interviewees, David Boyd, is a ninety-three-year-old retired Consultant. He has worked at the Western for several stints in his career - from a student rotation in 1948, to a Registrar post in the Endocrine and Metabolic Unit from 1959 and as a Consultant in General Medicine by the 1970s. Mr Boyd's interest in general medicine means that he has had a long and varied career, covering many different specialisms, geographical locations (even Glasgow!) and has worked with some of Edinburgh's most notable medical names.

For example, in the 1950s, Mr Boyd held a Registrar post in respiratory medicine, working with Professor (later Sir) John Crofton, who pioneered the 'Edinburgh method' of treatment of tuberculosis, pairing a combination of drugs with active monitoring, which at last offered an effective cure for the disease. He describes his time working with Crofton in this excerpt.

We'll be arranging to record more interview through the rest of this commemorative year, and we're hoping to enlist the help of some volunteers from our well-established programme to catalogue the interviews and transcribe some of the key sections. As our volunteers uncover the stories about the people who have made the Western General Hospital over the years, keep your eyes (and ears!) on the blog to learn more!

New devices. New data?

LHSA is a member of the Health Archives and Records Group (HARG, https://healtharchives.co.uk/), which is a forum for bringing together people who have a research interest in, or are responsible for, health records. Over the last couple of years HARG has been reinvigorated by a dynamic committee that has been providing a programme of events to explore relevant issues in the care and use of health records.

Last week, Ruth went to HARG’s most recent session, a workshop on wearable medical devices and the data generated by them. (And to prove it here’s a photo from the day taken by our colleague Clare, who organised the event, Ruth’s on the right, talking to the the woman in green!)

The day included a number of shorter presentations with a longer discussion session in the morning and afternoon. The speakers were from a wide range of backgrounds (and this diversity was evident in the attendees too): information governance professionals, developers of wearable medical devices, clinicians, researchers using data from wearables and, of course, those responsible for archive collections.  

This is a new and constantly evolving area with people regularly using wearables now, from Fitbits for fun through to clinical devices to monitor conditions. Much of the day helped those attending understand what is currently available in terms of wearable medical devices and looked at the importance of the individual knowing what data about them is being generated and how it is being used to ensure the users’ ongoing confidence. Several papers demonstrated how much benefit can be derived from appropriate use of these devices in terms of adherence to treatment/exercise regimes, and that this then translates into fewer and/or quicker appointments with clinicians, and more sustained positive outcomes for the patient. So that continued confidence in the device, and the use of the data it creates, is crucial.

But from an archival point of view, the papers that looked at the kind of data that is being collected, whether and how it can be shared and used ethically, and how to ensure the data is authentic and has the right information associated with it to be meaningful were particularly relevant. The final paper of the morning looked at these issues in detail and was the basis of the subsequent discussion session which looked at the technology, the policies, the people and the training that should be considered in this context. Does the device measure what you want it to measure? Will the data be accessible for as long as it needs to be? Does the policy generated around the use of wearable medical devices establish who is responsible for the data and for how long? In terms of the people involved, we looked at what the users of wearables need to be able to use the devices effectively and to understand what data will be collected and how it will be used, with training being a strong aspect of this.

It was a really informative day, but perhaps more importantly it was a thought-provoking one. What information on wearable medical devices should be preserved in the archive: how are we going to capture this emerging and growing facet of 21^st-century healthcare?

HARG will be providing the slides from the presentations, and a report that will give an overview, on their website in due course. We will be contributing ourselves to the next HARG event, with Louise presenting on our case note catalogue and describing the methodology used.