Tales from the Archive (2): Miners and the Royal Infirmary of Edinburgh, 1900-1950

Patients and Funding at the Royal Infirmary of Edinburgh

The issue of how the Hospital would pay its ever-increasing costs was always pressing. The annual reports built a picture of the pressures it faced. During the period 1900-1950, ordinary expenditure always exceeded ordinary income. In 1900, ordinary income amounted to £30,009, whilst ordinary expenditure was £47,868. The report cites the cost of coal, lights, cleaning materials, ordinary repairs, wages, and the rising price of meat as reasons for the increase in expenditure.

As the prices rose, so too did the number of patients. In 1900, 8,914 new patients were admitted to the Hospital; the average number of patients in the Hospital on a given day was 701.

The annual report for 1939 specifically mentions the start of World War Two as contributing towards the large rise in the number of patients. It also cites the increase in the number of motor car accidents as a significant factor. By 1946, ordinary income had risen to £264,965 but expenditure was £350,108.

By the 1930s, the Royal Infirmary of Edinburgh was the largest voluntary hospital in Britain. Its policy of being ‘the Ever Open Door’ with medical need as the only criteria for entry, enabled it to appeal for voluntary contributions on the broadest possible basis. In fact, as early as 1900 the annual report noted that the Hospital was dependent to a large extent on annual income derived from contributions. Each parish in Edinburgh was listed individually and within this, each church, individual and firm which contributed £1 or more. Many wealthy benefactors left money to the Hospital in their wills and bed plaques were often commissioned to record this, or wards were sometimes named after particularly generous individuals.

To maintain this level of contribution, the Hospital had to have an organised system of raising money. As a result, in 1917 the League of Subscribers was instituted. At the same time, the area for collection was greatly extended with subscriptions from individual donors and parishes received from all over Scotland as well as England and Ireland.

The Miners

During the period from 9 May to 8 June 1928, 77 miners were admitted to the Hospital. Their admissions can be traced through the General Register of Patients. 21% were admitted due to accidents that had occurred in the mines; nearly two-thirds were diagnosed with chronic conditions. There were some admissions which cannot be categorised as either, such as typhoid.

Of those who were admitted with injuries, the most common were fractures and breakages of the tibia and fibula bones in the leg. This was followed by penetrating injuries to the eye and fractures of bones in the arm. There were also several injuries to the head, spine and ribs noted.

There was also a definite pattern in the types of chronic illness that the miners presented with.

These conditions are all associated with the bacterium H. Pylori; presumably contained in the dirt that they were inhaling.

If 77 miners were admitted to the hospital during one month, it is likely that up to 1,000 were admitted in one year. Given that the average cost per hospital bed per annum in 1928 was £149 18s 3d, the cost of the miners’ healthcare was not inconsiderable.

Royal Infirmary of Edinburgh, General Register of Patients, May 1928-Mar 1929 (LHB1/126/72).

The Hospital’s annual reports show that the miners were very generous in giving money to it. This was perhaps in recognition of the fact that many of them would require hospital treatment at some point in their lives. This generosity didn’t go unnoticed by the Hospital managers; in each annual report, they were singled out for praise. In the managers’ 1946 annual report, shortly before the Hospital was handed over to the NHS, the following comment appeared: “Many groups of employee contributors outside the membership of the League of Subscribers, including particularly the workers in the mines and the oilworks who have been so consistently loyal and generous in their support of the Royal Infirmary have again contributed in substantial measure”.

The money contributed by the miners was in addition to health insurance which the majority of miners had by the 1930s as a result of the 1911 Health Insurance Act. This covered the costs of their medical care. With one or two exceptions, the 77 miners admitted to the hospital in May-June 1928 were all members of an insurance scheme.

The connection with the miners continued beyond the establishment of the NHS in 1948. In the 1950s, miners were sent from the Royal Infirmary of Edinburgh to the Astley Ainslie Hospital, a rehabilitation hospital. It provided for those requiring longer care and supervision to fit them for a normal life.

The Astley Ainslie created a miniature mine within its grounds to rehabilitate miners. At this time, it was thought that as many as 1 in 4 miners were suffering from industrial injuries. The miniature mine enabled miners to regain their confidence and physical stamina and reacclimatise so they could return to work in the pits.  

After the introduction of the NHS, it was felt that the contributions from the miners should be commemorated with a plaque. It is slightly larger than the usual size, perhaps in recognition of the size of the contributions that the miners made from their own wages. Between the years of 1918 and 1948 (when the NHS started), the coal and shale workers had contributed over £408,000 to the Royal Infirmary of Edinburgh. In today’s money, that is approximately £11 million.

Photograph of the 'Narratives' opening (LHSA photographic collection).

This plaque is the centrepiece of the 'Narratives' installation at the Royal Infirmary of Edinburgh, on the first floor, north corridor between Wards 104 and 101. Links with the past are considered important at the hospital and although there is no direct link with the miners today, it was felt important to continue commemorating them and their efforts. 

LHSA Sources for Further Study

Royal Infirmary of Edinburgh (LHB1)

Astley Ainslie Hospital (LHB35)

Public Health Department of the City of Edinburgh (LHB16)

 

 

Spotlight On… (3): Class ticket signed by Joseph Lister, 1876

Below is a class ticket issued to Mr Thomas Preston Lewis and signed by Joseph Lister.

Class ticket signed by Joseph Lister, 1876 (GD1/3/4).

Joseph Lister (1827-1912) had become Professor of Clinical Surgery at the University of Edinburgh in 1869. He was given fifty beds to supervise at the Royal Infirmary which at that time was still at its site at the bottom of Infirmary Street. His research into the use of carbolic acid to prevent infection during surgery had already gained him a considerable reputation and he continued his pioneering work while in post. 

It is testimony to Lister’s popularity with his students that, on being offered a post at King’s College London, 700 of them signed a petition to encourage him to stay in Edinburgh. He chose to take up the new post, however, and the winter session 1876-1877, for which this class ticket was issued, was his last in Edinburgh.

Disability Livelihood and Employment (2): The Register of the Outdoor Blind

Content Warning: This blog post contains derogatory terminology that wouldn't be used in present-day records and can be distressing.

In his book Hearing Our History, Iain Hutchinson frames the concept of the ‘outdoor blind’ as the ‘people with sight loss who lived in the wider community rather than in institutions such as Edinburgh’s blind asylum’ (2015, p.1). These Registers listed blind men and women living in local communities, gave basic information about their work circumstances, and granted aid. Many people listed in the register were elderly and frail, whereas others were employed in some way.

Hutchinson explains that ‘the Society for the Outdoor Blind focussed on teaching people with sight loss to read raised type and this was primarily so that they might access religious works. The system of raised type that was promoted was the Moon system, although by the Edwardian period the society had also embraced braille and therefore offered instruction and library facilities in both methods of tactile print’ (2015, p.2). The image below shows a female register recording information concerning their age when sight was lost, the cause of the blindness, and their previous and present (at the time!) employment. While the Register shows numerous gaps, it still provides a sense of the wide range of occupations women held before and after they lost sight.

The Register of the Outdoor Blind, 1903-1910 (GD52/9).

Some of the occupations mentioned in the volume before women lost sight were servant, Bible woman, sewer, nurse, mission worker, dressmaker, charwoman (a dated term for a female cleaner), chemical worker, kept house, book sewer, poor house matron, school pupil, and mill worker; whereas the terminology or jobs listed after losing sight offer an apparent contrast in most instances: unable, knitting, unemployed, infirm, keeps house, none, labourer, small shop, bedridden, helps in house, mangle turner, on street. There is also a mention of a woman who worked as a music teacher.

Occupations performed by men covered the whole spectrum of trades and traditional jobs. Before losing sight, some of their professions were hawker (a door-to-door seller), collector, clerk, carpenter, plumber, mechanic, baker, jeweller, shoemaker, labourer, tailor… It very much covers the whole spectrum of traditional trades. While the job or terms listed after they lost sight are radically different and include hawker, on street, selling tea, not able, unable, nothing, street reader, mattress maker, bakers shop, infirm, sells fish, musician, pedlar (a dated term for a travelling salesperson), sells tea, piano tuner, street music, unemployed.

Instructions for filling out the Register of the Outdoor Blind, from the Royal National Institute of Blind People collection (GD52/9).

Interestingly, tea sellers and mangle turners were approved in Edwardian Edinburgh, whilst street musicians were not. People who earned a living ‘on the street’ were considered to not be engaging in a respectable form of ‘self-help’. Neither were musicians or oratory readers of raised type. Musicians would perform on the street, in public houses or music halls, all of which were places that didn’t present the image of blind people that the missionaries to the outdoor blind sought. On the other hand, music teachers, piano tuners, and organists were highly regarded. The first two could end up working in the homes of respectable middle-class families, whereas the latter would perform in places of worship. Some people underwent drastic career changes. Knitting was the main employment for women, whereas a high number of men worked as hawkers with different levels of success. Selling tea was the most remunerative option. For instance, there is evidence of a tea seller who was a miner prior to losing his sight. While he was widely respected for his ability to develop his business, he earned considerably less than he had earned as a coal miner.

You can learn more about the Register of the Outdoor Blind here.

Conservation (1): What is conservation?

In this new series, we will explore the importance of conservation work for LHSA collections. From the very basics of what 'conservation' entails in an archival context to examining some significant case studies from recent years, we will show you some of the work that takes place behind the scenes and that is essential to grant access to collection items.

 

What is Conservation?

Conservation aims to stabilise the condition of, and limit any further damage and deterioration to, a given object whilst working ethically to provide the best treatment possible. It can be broadly divided into two interrelated categories. Interventive conservation involves treatment to address the chemical and physical effects of damage and deterioration, cleaning and tear repair, whereas preventive conservation includes the provision of proper storage and monitoring and control of the environment. Conservation seeks to ensure long-term preservation and, in the case of LHSA, to enable continued safe access to a historically, socially and medically important collection.

LHSA's Preservation and Conservation Programme

LHSA aims to undertake collection-wide preventive conservation strategies, coupled with interventive conservation treatment of individual items or series as necessary in order to address the preservation and conservation needs of the collections. Core work funded from the annual budget is coupled with externally-funded projects and the programme is formalised in the LHSA Preservation and Conservation Policy. Please contact us if you'd like to consult the full policy, or for any further information.

LHSA has played a key role in developing the University of Edinburgh's Disaster Response and Recovery Plan for its rare/unique collections. The Plan covers LHSA material and ensures that we offer best-practice collection care. An edited version of the Plan (with all sensitive data redacted) is available here.

Pile of paperclips.

Core Conservation

LHSA has spent years establishing a conservation profile and now has an active programme of preservation and conservation work funded by the annual budget. This ranges from surveys to determine the condition of all or parts of the collections to preventive conservation measures to stabilise and, where possible, improve the climate in which the collections are housed; for example, environmental monitoring and re-housing. Interventive treatment of individual items is also undertaken as necessary. For example, conserving bound volumes and architectural plans. Supplementary work includes photographic and written documentation, writing applications for external funding, and disseminating the results of LHSA's core and project work via presentations, publications, workshops and tours.

Access to the collections is also supported through the preservation and conservation programme. Examples include the provision of guidelines and training on handling, the production of surrogates or substitutes as necessary, and the preparation and installation of exhibitions.

Surface cleaning using an eraser and a natural hair brush.

Core conservation work may be undertaken in-house or contracted-out to specialist commercial companies depending on the material nature and quantity of items to be treated, the treatment required and the availability of funds from the annual budget.

Conservation Projects

LHSA is committed to generating project funding to supplement core conservation work. In recent years, grants have been secured from the Wellcome Trust, the National Archives of Scotland, and the National Manuscripts Conservation Trust. Awards have ranged from £649 to part-fund the conservation of four handmade Clennell booklets and £1,100 to treat indexes to the Royal Infirmary of Edinburgh general register of patients to £120,000 to preserve twentieth-century folder-based medical case notes. Work may also be undertaken by project staff specially recruited or contracted-out to specialist commercial companies as appropriate.

 

Royal Infirmary of Edinburgh Indexes to the General Registers before treatment.

 

All core preservation and conservation work as well as projects are governed by the LHSA Preservation and Conservation Policy and adhere to professional standards and best practice for both treatment and documentation.

LHSA gratefully acknowledges the support it has received from external funders.

Spotlight On… (2): Bruntsfield Hospital

Bruntsfield Hospital had its origins in the Edinburgh Provident Dispensary for Women and Children. It was founded by Sophia Jex-Blake at 73 Grove Street in September 1878 to provide medical care for women in an environment staffed solely by female doctors and nurses. A successful campaign in the 1950s ensured that this ethos was upheld despite the Department of Health for Scotland's wish to appoint male doctors.

 73 Grove Street Dispensary (LHB8/17/1(ii).

When the Dispensary moved to 6 Grove Street in 1885, it was able to provide six beds for women requiring hospital treatment, and the institution changed its name to the Edinburgh Hospital and Dispensary for Women and Children. In 1899, when Sophia Jex-Blake retired and left Edinburgh, the hospital's Executive Committee acquired her home, Bruntsfield Lodge.

After alterations, the lodge provided 18 beds as a small general hospital for women: it gradually expanded and its bed complement reached 72. In 1910, after a number of years of cooperation between the staff of the two institutions, Bruntsfield Hospital amalgamated with Elsie Inglis' Hospice in the High Street. Medical, surgical and gynaecological work was done at Bruntsfield, while obstetric and infant work was carried out at the Hospice. Like the Hospice, Bruntsfield Hospital retained its own dispensary and its own name.

Bruntsfield Hospital (LHB7/17/1(x).

Both Bruntsfield Hospital and the Elsie Inglis Memorial Maternity Hospital were closely connected with Edinburgh's best known medical women. They originated from the wishes of Sophia Jex-Blake and Elsie Inglis to provide medical care for women, while at the same time offering practical experience to young female doctors. Jex-Blake (1840-1912) was one of the first female medical students at Edinburgh University and campaigned for women to be allowed to train in hospitals, successfully obtaining the right for them to receive clinical training at Leith Hospital in 1886. In setting up Bruntsfield Hospital, she was able to ensure medical training for female doctors whilst at the same time providing much needed hospital care for women.

Portrait of Sophia Jex-Blake (LHB8/17/1(i)).

Bruntsfield Hospital amalgamated with the Elsie Inglis Hospital in 1910. From 1948, the Bruntsfield became part of Edinburgh Southern Hospitals group under South Eastern Regional Hospital Board. The hospital remained open until 1989.

Tales from the Archive (1): The story of the ‘Sick Kids’ Hospital

“the mortality which takes place among children, and in particular among the children of the poorer classes, calls for an immediate effort to alleviate so much suffering and avert so great a loss of life; and that for this purpose it is necessary that a suitable hospital be provided in some salubrious locality in or near Edinburgh.”

The Royal Edinburgh Hospital for Sick Children is celebrating its 165th anniversary this year. The mission of the hospital fulfilled the wishes of its founders, who were moved by the plight of sick children in mid-nineteenth century Edinburgh. The above statement of intent appears in the minutes of the Promoters for a Hospital for Sick Children in April 1859. The group formed in response to a series of letters published in the Scotsman in early 1859, which called for the establishment of a hospital where children could be treated separately from adults. Like the Royal Infirmary of Edinburgh, it was to be a voluntary hospital, financed through philanthropy and by attracting subscriptions from private donors and organisations. The promoters set about securing funding for the hospital, appointing staff and finding suitable premises. By the end of 1859, a house at 7 Lauriston Lane had been leased and was furnished with eight iron beds measuring five feet long by three feet, two inches wide, and four measuring four feet long by two feet, three inches wide. The first patient, Mary Sutherland aged 1 ¼ years was admitted on 15th February 1860 suffering from dentition of bronchitis (bronchitis brought on by teething). She was discharged and recovered on 18th October.

Extract from Register of In-patients showing Mary Sutherland's admission (LHB5/5/1).

Meadowside House

It quickly became apparent that the Lauriston Lane building could not accommodate the numbers of children requiring treatment and, in 1861, the Contributors drew up plans to acquire larger premises which would include more beds and a separate fever ward. They instituted a building fund for which all sorts of fundraising initiatives were created; the Ladies’ Committee held a bazaar over five nights which added £1,300 to the appeal and Dinah Craik, the “accomplished authoress of John Halifax, Gentleman” lent her support which drew in many donations. As a result, Meadowside House was purchased and refurbished for the sum of £5,500. It opened in 1863 and, granted royal patronage by Queen Victoria, became the Royal Edinburgh Hospital for Sick Children (REHSC). It had 40 beds and the separate fever ward that had been hoped for. A further 30 beds were added with the addition of a new wing in 1870.

 

Royal Edinburgh for Hospital for Sick Children, Sciennes Road, c. 1950 (P/PL5/004).

Ward at Plewlands House, c. 1890 (P/PL5/001).

Plewlands House & Sciennes Road

As the demand continued to grow, and an outbreak of typhoid fever within the hospital affected several members of staff and caused the death of a nurse, new premises were once again sought. The Directors decided to move the hospital to other premises while Meadowside House was thoroughly examined. They managed to secure the lease of Morningside College at Plewlands, where all the patients were moved to in 1890 whilst a new, permanent site could be found.

By the 1890s, the hospital had a large network of contributors throughout Scotland and received subscriptions in the region of £7,000 to £8,000 each year. Companies, churches, and individuals all gave money whilst charity events such as dances and concerts continued to be held for the cause. In 1895, the former hospital premises at Sciennes Road were purpose built at a cost of nearly £50,000 and opened by Princess Beatrice.

 

Achievements

Dr Joseph Bell, on whom Sherlock Holmes was modelled, was the first surgeon to be appointed at the hospital in 1887 and remained there until he retired. He provided a new dimension to the hospital where previously there had been no surgical department. By 1892, the surgical wards were full of children injured in cart and tram accidents, but the largest number were treated as the result of joint disease, especially of the spine and hip.

The REHSC established a Department of Medical Electricity in 1897, only two years after the discovery of X-rays. In 1913, the Department for the Diseases of Ear, Nose and Throat in Childhood was opened, the only such ward in Britain at that time. Throughout its history it has had strong ties with the University of Edinburgh, working to develop the field of paediatrics and training students in this discipline. After the arrival of the NHS, the hospital continued to innovate: a new Ear, Nose and Throat operating theatre was built, the Department of Psychological Medicine was established and advances were seen in anaesthesia, transfusion and burns treatment. These innovations continued: in the 2000s, it installed a hi-tech baby pod (the first of its kind in Scotland) and was the first in Europe to fit a hi-tech operating system that allows more keyhole surgery.

The Future

The hospital moved from Sciennes to a new building at Little France, next to the Royal Infirmary of Edinburgh, in July 2020, with all services transferred there by March 2021. On 5th July 2023, HRH The Princess Royal officially opened the RHCYP. There, it benefits from the most up-to-date technology, and the proximity of world-class facilities at the Royal Infirmary. After 165 years, the vision of the founders continues to flourish: a hospital providing the best care for the city’s sick children, and those from further afield.

 

LHSA Sources on the Royal Edinburgh Hospital for Sick Children

The following collections are recommended for research into the REHSC using LHSA material:

Royal Edinburgh Hospital for Sick Children 

Spotlight On… (1): Stories from the Craigleith Hospital Chronicle

The Craigleith Hospital Chronicle is a rich resource of articles, poetry, drawings and photographs reflecting the aspirations of those who fought in the First World War. It contains stories on a wide variety of topics and rarely misses an opportunity to add propaganda value.

LHSA has a collection of 13 issues of this military magazine, unfortunately not a complete run. It was produced by the Second Scottish General Hospital, Craigleith during the years of the Great War. Staff and patients submitted articles, stories and poems on many different topics. Many provide a valuable insight into life as a soldier, patient or member of hospital staff at this time.

The Craigleith Hospital Chronicle, Volume One, No.2 (LHSA Ref: GD1/82/1) is the first in LHSA's collection, articles include: "Duties of a Ward Orderly", "An Impression of the Belgian Wounded" [arriving at the hospital in October 1914], "Christmas Day in Hospital"; and a poem entitled "A Private's Alphabet", the first lines of which are repeated below:

"A is the Army, to which we belong;

B is the Battle, we wage against wrong.

C is the Cause we are all fighting for;

D are the Devils who started this war..."

 

 ‘Craigleith Hospital Chronicle’ magazine (GD1/82).

Craigleith Poorhouse was founded in 1868 and served the St Cuthbert's district of Edinburgh. It included an Infirmary for the care of sick paupers. In 1914, the Poorhouse was taken over as a military hospital and renamed the Second Scottish General Hospital, Craigleith. The Poorhouse returned to its former function in 1919, and in 1929 it became the Western General Hospital.

An article in volume 1 number 5 from April 1915, ‘Lighthouses in War Time’, describes the war from the point of view of lighthouse keepers and sailors. It explains that in autumn 1914 the command was given, ‘lights out on the east coast’. This may have baffled enemy movements by night but it also added anxiety, delay and danger to allied merchant ships’ sailings.

According to the article, some mail boats had changed their sailing times to complete voyages during daylight. Also included is a story in which the crew of an Orkney vessel found they were being tailed by a German submarine. The captain of the ship decided that the submarine meant no harm but was merely following them to gain a safe passage through the Pentland Firth. The article then claims that the ‘wily Orkneyman…led his unwelcome follower a wild dance across the shoals and shallows’ until the submarine ran aground!

Moving onto the work of the lighthouse men, the article states that although the lights are not lit, the machinery is continually oiled, cleaned and ready for use. Therefore, their work is constant and essential. It informs the reader that ‘with the least encouragement’ many of ‘these brave fellows would gladly don khaki’, but the best way they can serve king and country is to persevere with their present work.

‘Craigleith Hospital Chronicle’, Volume One, Number Five, April 1915 (GD1/82/3).

An interesting feature of the writing style is how it describes lighthouse keepers and sailors as masters of their craft. Adjectives such as patient, painstaking, steady, reliable and nimble paint the character of men who do their job very well, while the phrase ‘handy with a boat’ and ‘as clever with their hands as jolly tars’ emphasises how skilful they need to be. It also mentions their ‘cheery philosophy’, showing that despite their isolation they remain steadfast. By creating a sense that all people in Britain and its allied countries, no matter what they were doing, were diligently working towards a common cause, the hospital magazines would have attempted to build up the morale of soldiers who may have had to spend months recovering and inactive.

The publication is an invaluable account that delves into the personal experiences of those involved in such a convoluted event.