There were many signs of social conscience and philanthropic purpose in the eighteenth century and in Chester concern for the sick poor was reflected in the foundation of an infirmary in 1755 and the Ladies Benevolent Institution for home nursing and midwifery in 1798. As early as 1721 Peter Cotton, gentleman, bequeathed £100, the interest on which was to be disbursed annually by the Mayor and Justices of the Peace ‘in buying of Phisick or medicines for such poor people Inhabitants of the said City as they shall think most Objects of Charity and that shall most want the same either upon account of Sickness or in the Case of Surgery’ The Assembly accordingly ordered that Alderman Parker and Alderman Bolland should be employed as apothecary and surgeon to care for the poor as directed.
In 1753 Dr. William Stratford left £3300 ‘in case a County or General Hospital or Infirmary for the sick and lame poor be established in the City of Chester within three years after my death’. Three weeks after reporting this Adams Weekly Courant carried an advertisement that subscription lists were open. At a meeting for subscribers on 22nd April, 1755, a list of thirty-five persons was drawn-up, representing the local gentry, clergy and doctors and well-to-do tradesmen, any seven of whom could constitute a committee.
By June it was decided that part of the Charity oF Bluecoat School should be fitted up to serve until the completion of a new building and that certain of the subscribers should act in rotation on a weekly board. Six physicians’ and six surgeons were desired to attend the future patients—a number subsequently reduced to four in each case. In September it was reported that the upper part of the Charity School was ready for the reception of patients. Mr. Thomas Crane of Neston, who had been appointed Apothecary and Secretary at a salary of /330 per annum, was desired to visit the Liverpool and Manchester Infirmaries to see what would be necessary for fitting up an apothecary’s shop and laboratory. Other ppointments were made, including that of matron. Mrs. Jane Seward of Warrington was chosen from six other applicants to serve at a salary of £310 with such gratuity as the Board might think after the expiration of a year. All ‘servants in the house’ were to receive a weekly allowance ranging from seven shillings for the Secretary and his wife, and the matron to four shillings for the two women servants and the porter.
Provision for the reception of out-patients was made by November and the first physician and surgeon were asked to attend. It was ordered that three thousand forms of recommendation be printed. Subscribers of a guinea or more per year became governors and were allowed to recommend in and out-patients in proportion to their subscriptions. Meanwhile a committee, including four doctors, had viewed possible sites for the new building. Alter considering the Gorse Stacks and other waste land belonging to the city they found them unsuitable. They favoured a field on the east side of St. John’s Churchyard belonging to the Earl of Cholmondeley but apparently negotiations broke down and it was finally decided to use the present site. Unfortunately the Minute Book for the years covering the building of the Infirmary is missing and the first book ends with a tender for bricks and an order for £300 to be paid for the site of the intended building. By 1761 the new building was ready. In plan it was a quadrangle four storeys high and facing west with a central area fifty-four feet by forty-two giving light and air to the wards. The main wards which ran the whole length of the building on the north and south sides were originally designed to take twenty-four beds each. On the remaining sides were staircases, a chapel and four small rooms for staff. The hospital accommodated a hundred beds, affording about 1,000 cubic feet of air space per patient. Later, at the beginning of the nineteenth century the long wards came in for particular criticism because patients with various complaints, surgical and medical, and in varying conditions had been mixed indiscriminately. They were also said to facilitate the spread of infection. It may be that these conditions lasted longer than was desirable or necessary but, before coming to hasty conclusions about the eighteenth century hospital, one must remember the conditions obtaining in the period and respect what was achieved. Money from bequests and benefactions had to be invested to ensure a regular income and to provide a firm basis for the economy so efforts had to be made to meet running costs from subscriptions. This meant keeping the paid staff to a minimum and for a small staff long wards were a convenience. The patients were quite frequently unruly5 and it would have been difficult to supervise a number of small wards adequately. Nevertheless some division between the beds was attempted. In May 1770 it was ordered that partitions be prepared between the bedsteads in the new wards but by August 1771 the wood partitions were ordered to be removed and the beds divided by a piece of coarse home-made cloth in order to prevent the ‘buggs”. The patients were of course divided by sex and venereal patients were catered for in separate wards.
In July, 1771 the latter were ordered to be confined to their own wards and no person admitted to them without leave from the matron or apothecary. 5th August, 1756 William Hughes was ordered to be dismissed for irregularity, being accused of going into the Women’s Ward at unseasonable hours; Two patients were dismissed for irregularity in the following year. There are also instances of men patients dismissed for fighting. It was a hard drinking period and in March, 1757 it was ordered that, unless otherwise directed, no patient should be allowed more than two quarts of beer daily.
The Statutes of the Infirmary, drawn up in 1763, describe the administration which was in the hands of certain governors. All benefactors of twenty or more guineas were to be governors for life. All subscribers of two guineas per annum were to be governors during payment. The physicians and surgeons attending were to be governors and be able to vote at all boards, and the head of any township, corporate body or society subscribing two guineas per annum was to be a governor during payment. A general meeting of governors was to be held thrice yearly at stated times with power to appoint and remove officers. In May they were to elect a President and choose two treasurers, an under-treasurer and two auditors. There was also to be a weekly board of governors meeting every Tuesday at 11 a.m. at the Infirmary and responsible for appoi~ning two house visitors to serve weekly to inspect the same, and visiting apotheearies in monthly rotation.
A subscriber of one guinea a year was allowed to recommend one out-patient; a subscriber of two guineas one in-patient or two out-patients and so on in proportion to the subscription. No patient was to be admitted who could find his subsistence and pay for medicines.
From the beginning the Infirmary was administered with humanity. Thus one out-patient who came without, any accommendation being unfamiliar with the rules, was nevertheless admitted and, although a general board in January, 1757 desired persons recommending patients from distant places to send with them a deposit of money for the journey home as the expense was proving burdensome to the charity, yet it was resolved that Irish or foreign patients being in want when discharged should be provided with money for their voyage or journey home.It was thought that to supply themselves with common necessities they~ might otherwise be tempted to either steal or rob upon the highway which might in some measure be prevented by this timely assistance. The allowances were generous.
Thus a patient going to London received one pound six shillings, one going to Dublin five shillings, and another going to Caernarvon seven shillings and sixpence. There are a number of occasions while a soldier belonging to the garrison was being treated in the Infirmary, of the subsistence money paid to the hospital for him, or part of it, being allowed to his wife and family because of their distressed circumstances.
Similar consideration was shown to the staff. Mrs. Seward, the first matron, in December 1765 was allowed the expense of a nurse to attend her during an illness. In May, 1774 she was allowed leave to go the the country for the recovery of her health and later she was allowed to go to Dawpool for a week for the benefit of sea bathing. In January,1767, when Nurse Jones had desired to resign on account of her age and health, she was continued as an assistant to the other nurses and subsisted in the hospital.
The system was not too rigid to accept new ideas and the governors responsible for the administration showed interest in and a willingness to learn from other similar institutions. Chester Infirmary was, however, the first in the country to institute wards for the isolation of fever patients. This innovation was due to Dr.John Haygarth, who was appointed physician to the Infirmary in 1766. He later described how, in 1783, on looking out for proper accommodation he found the attic storey on the north unoccupied and merely a lumber room. It was 96 feet long by 21 feet broad and open to the roof whi~zh was 16 feet high. It was divided by a partition in the middle so forming two wards through which the air could freely circulate.6 Fevers, especially typhus and smallpox, had on occasion been epidemic in Chester, as in 1774. Haygarth estimated that out of a population of 4,713 only 1,060 had never had smallpox.7 On 15th June, 1784 it was ordered that the attic storey be immediately fitted up according to the physicians instructions for the reception of fever patients. The first, three women and a man, were admitted on 24th September. Every precaution was taken to isolate them and in March 1790, a sedan chair was ordered to be purchased to carry them into the infirmary. In October, 1791 it was ordered that the Fever Nurse be desired to keep in her own apartments in future and that everything necessary be taken up to her by one of the other nurses.
The policy was successful. The annual report states that, during the first year ‘thirty cases of fever were admitted, many of them in the most eminent danger, yet they all, except one, recovered.’ Nevertheless fever nursing was hazardous. ‘At the commencement of this institution, at Chester, apprehensions of the danger of infection were so prevalent that no nurse could be persuaded to attend the Fever wards. In these difficulties a surgical patient was prevailed on to undertake this office in the men’s ward. He caught the fever and died of it. When a proper nurse was procured she (Lowry Thomas) had the care of both wards for eleven years with only occasional assistance. During this period she was infected by the fever several times, and died of it in July, 1794, on the fifth attack, after a week’s illness.
The nurse who succedtled has twice caught the Fever, and was each time very ill of it, but otherwise enjoyed good health for four years. A night nurse. . .. caught the Fever. And other occasional nurses may probably have suffered infection, but as far as has come to my knowledge, these four are the only instances of infection communicated in the Fever Wards at Chester during a period of fourteen years and a half—from August, 1783, till March, 1798. Both these nurses (Lowry Thomas and Jane Bird) were susceptible to Fever. They both exposed themselves to infection without reserve, even more than was necessary and useful, especially the former.
Dr. Haygarth had already done much to stamp out casual smallpox by encouraging innoculation by means of a ‘society for promoting innoculation and preventing the casual Small Pox in Chester’ formed in March, 1778.
‘J.
Haygarth ‘A letter to Dr. Percival on the Prevention of Infectious Fevers’
(1801) quoted by John
Elliot, .4 Medical
Pioneer: Jo/In HavgarM of Chester, reprinted from the British Medical Journal,
February 1st,
1913.
J.
Haygarth. Paper read before the Royal Society in January, 1777, on the
population and diseases
of Chester in
1774, quoted ut supra.
‘J.
Hayg~r~h ‘A 1et~r t~ Pr. Percival on the Prevention of Infectious Fevers’
(1801), quoted by John
Elliot op. cit.
Another very useful step was taken in the same period. At a special general board on 22nd October, 1776, proposals were drawn up for saving persons from drowning. The governors offered to provide rewards, when ‘friends of the unfortunate objects’ were too poor to pay, of two guineas for anyone attempting a rescue and four guineas to the rescuer whenever a patient was restored to life. Instructions for life saving were to be published in the newspapers and books and other instruments, warm baths, fumigators, etc., were to be kept at selected houses on the River Dee and Canal for recovering the drowning. The physicians and surgeons of the Infirmary engaged themselves to give their services free. On the 8th August, 1780 three persons were rewarded for rescues.
At the time of the foundation of the Infirmary the status of the medical profession was low. Although Oxford, Cambridge and Edinburgh Universities awarded medical degrees, no legislation existed against unqualified practitioners. There was still considerable rivalry between specialists in different spheres of medicine.
In the middle ages and at the time of the renaissance the physician, the surgeon and the apothecary were quite distinct. The first of these were the physicians. The barber-surgeon gained status in 1540 after the union of the Barbers Company with the Guild of Surgeons to form the Barber-Surgeon Company. The early apothecary prepared medicines for the physician but did not himself prescribe them. At a still earlier date drugs ordered y a physician were supplied by the grocers until, in 1617, the apothecaries obtained a special charter. However this improvement in their position brought the displeasure of the physicians who saw in them potential rivals in practice. The striving of the apothecaries to improve their status is shown in Chester when, in 1725, they sought incorporation, having usually associated with the Company of. Mercers and Ironmongers. Their petition was rejected.9
Fortunately the general standing of all three representatives of the medical profession was improved by the granting of royal charters to the Colleges of Physicians and Surgeons and the founding of the Society of A~pothecades. Nevertheless these old rivalries were still reflected in relations between the three at the Infirmary.
In February, 1766 it was ordered that none but physicians prescribe internal medicine to any patient belonging to the Infirmary in any case whatsoever. If the urgency of the case required immediate prescription it was to be done by the apothecary of the Infirmary. In November, 1798 it was ordered that no-one be admitted a surgeon to the Infirmary who practiced pharmacy.
Usually qualification as an apothecary was by apprenticeship but opportunities for experience were growing. In 1774 Mr. Owen, the apothecary and secretary was granted leave to go to London to attend some lectures in his profession. It is interesting to note mention of attendance at lectures and courses in Mr. Connah’s reference~ for the post of apothecary and secretary in 1790. In January, 1801 a protest was raised against Mr. George Harrison, the secretary and apothecary, calling himself House Surgeon and Apothecary but it was decided that, in view of his position at the Infirmary and care of patients at the County Gaol, he might so describe himself. The medical side of the office increased. In May, 1812 he was allowed to attend midwifery cases at the Workhouse, Castle (Gaol), and Lying-in Institution and in cases of difficulty appre1~tices were allowed to attend although the permission was not to extend to general practice. From May, 1815 the Accountant acted as Secretary at the additional salary of £10 a year. The House Surgeon and Apothecary became in fact the Resident Medical Officer.
Although the House Apothecary had been allowed to advertise for an apprentice as early as 1756, other apprentices were not taken into the Infirmary for some dozen years because it was feared it would be prejudicial to the visiting surgeons. Care continued to be taken to define the scope of each branch of medicine. Thus in 1807 it was ordered that the Surgeons apprentices should on no account enter the apothecary’s shop but confine themselves to the surgery. Little information is given about their training but, in 1816, the House Apothecary was allowed the use of the Chapel Room for part of two evenings a week to have ‘Anatomical Converzationes’ with the pupils of the house. There are some indications of high spirits on tlte part of the apprentices and in the following year the Surgeons’ apprentices were enjoined not to deface the windows and walls or in any other way conduct themselves in an improper manner.
The nurses’ duties were laid down in the Statutes of 1763. They were to ‘obey the Matron as their mistress and to behave with tenderness to the patients and with civility and respect to strangers.’ On the whole the Infirmary was well served in the Eighteenth and nineteenth centuries. In 1840 the nurses were each presented with a sovereign ‘in consideration of their good conduct and temperate habits’. In 1756 the two nurses were each paid three pounds salary but in addition to this they received certain allowances and could apparently earn more if they did night duty for an vrder of 9th March had directed that such servants in the house, who chose to sit up with the patients were to be paid eightpence per night. In June, 1804 the nurses’ standing wages were ordered to be three shillings and tenpence per week or ten pounds per annum including tea. By 1862 upper nurses were re-ceiving fourteen pounds six shillings per annum and under nurses eleven pounds fourteen shillings. They received in addition twenty shillings a year beer money in lieu of the customary issue of beer or porter. In 1866 a further rise in wages took place in order to attract a better class of person. In one week of that year two nurses were sent to prison for stealing patients’ clothes and a third was dismissed for ‘grossly indecent conduct’. In the following year uniforms were introducedtO and the first mention of training for nurses occurs in the infirmary minutes.
How were the Infirmary’s finances organised? In 1755. correspondents were appointed to receive subscriptions and benefactions for establishing the Infirmary, “It was resolved ‘that the four head nurses each have caps of the pattern produced by the Matron also two cotton dresses and a blue merino dress. That the four tinder nurses have each caps and two cotton dresses, the dresses and caps to be the propcrty of the Institution.’ in Nantwich, Middlewich, Northwich, Knutsford, Congleton, Macclesfield, Altrincham, Stockport, Frodsham, Malpas, Sandbach, and circular letters were sent to clergymen in the county and the neighbouring counties of Wales desiring them to solicit subscriptions. The Infirmary relied on the subscribers to provide sufficient to cover1’tiie annual expenditure, and money from benefactions and bequests was invested, mainly in 3% consolidated annuities but also lent to the Commissioners of the Denbighshire and Wrexham Turnpike Trusts. By 1780 more than five thousand pounds was invested at 3%.
The Infirmary found itself in almost chronic financial difficulties and there were repeated appeals for increased subscriptions, particularly aimed at North Wales whence many of the patients came. Some idea of the proportions of subscriptions is given in the auditor’s report for the year ending 25th March, 1779.
Number of subscribers Amounts of annual
subs.
City of Chester
169
£298 4s.
County of Chester
43
£149 2s.
North Wales
28
£ 73 0s.
In other places
3
£ 5 5s.
One should compare with these figures, a statement, made in September, 1784, that two out of three patients were from North Wales.
Much difficulty arose in collecting arrears of subscription. In January, 1782 Mr. Robert Wilkinson was appointed to collect subscription at a salary of ten guineas a year and a travelling allowance. By March 1786 it was found necessary to sell £350 stock, which with collections from parishes in Wales was to be used to discharge money due to the Treasurer. It was ~strongly recommended to the General Board to adopt such regulations and restrictions that the annual expenses of the Charity in future may not exceed its income.’ Drastic steps were taken. In the same year the number of in-patients was cut to sixty, excepting casualties and urgent cases. By 1789 the number had been limited to fifty and further stock had to be sold to reimburse the Treasurer. In January, 1794 an accountant and collector of subscriptions was appointed at a salary of twenty pounds (~ 10 previously allowed and £9 1 Os from the salary of the Apothecary and Secretary) but still not enough could be raised by subscriptions. In October, 1801, the number of patients was cut to thirty, exclusive of fever patients. The number allowed fluctuated; by December, 1802 it was thirty-five, forty in 1804, forty-five in 1805. Most patients continued to come from outside Chester. In May, 1806, there were only two patients belonging to Chester in the Infirmary, one of whom was a fever patient paying weekly subsistence. A desperate appeal for subscriptions was made in March, 1807, lamenting that the Infirmary which could take up to a hundred patients was forced to ren~ain half empty and pointing to rising costs and prices.
Subsistence had to be paid by the parish and it had to be paid for soldiers admitted and for a few sailors. In December, 1800 ninepence halfpenny was paid for subsistence for soldiers. By April, 1795 every master of a family recommending a servant as a fever patient had to pay seven shillings and sixpence a week for the same. This was far from making the Infirmary self-supporting. As the eighteenth century progressed an increasing number of mining and other companies became subscribers as did more parishes. It was a useful form of insurance. An interesting entry occurs in September, 1791 that Joseph Barlow an in-patient, was a member of a club held at the Cross Foxes in Northgate Street and was allowed from it three shillings a week subsistence money. The Infirmary in the eighteenth century has tended to be judged by the criticisms levelled in the following century. Despite the problems of reconciling diminishing subscriptions with rising costs—they are said to have trebled in some thirty or forty years,—the Infirmary was administered with humanity and, not only endeavoured to keep abreast of modern medical trends, such as the installation of hot baths and remedial treatment by salt water bathing, but, actually pioneered the installation of fever wards, and by the use of innoêulation helped to check the spread of fever amongst the poor.
Between 1823 and 1829 a number of subscribers, led by Dr. George Cumming, one of the honorary physicians and governors of the Infirmary, made determined efforts for improvements. He prepared two papers to present to the committee for procuring information for extending the plan and improving the general economy of the Infirmary. The vigour of the campaign is shown by the following comments on the interpretation of the rules made in the first of these papers, in 1825. ‘Firstly that for nearly twenty years the Infirmary has been open for the reception of letters of recommendation not only on Tuesdays, but every day of the week, Sundays excepted. Secondly that the House Surgeon (who ought to be viewed in the light of the resident medical director of the Institution) is from necessity absent the greater part of the day, while visiting the out-patients in the City and Suburbs and in attending the City workhouse and County Gaol. Thirdly that a considerable majority of the out-pktients annually reported to be cured, relieved, &c., never come under the care of any Physician or Surgeon belonging to the Institution’.
Again, while admitting that the Fever and Magdalen patients were strictly confined to their respective compartments in the attic storey, and that there was a ward, in the same quarter for the reception of male patients with diseases of the eyes, he urged the division of different classes of patients in the long wards. In the second paper in 1830 he deals with the records of the Infirmary stating pungently the differences between the reports and the facts.
As a result, in 1830, the sum of £3,250 was spent on alterations and additions. The basement was divided up into laboratories, store rooms, domestic offices and small rooms intended for patients whom it was desirable to keep isolated. The ground floor was retained as office accommodation, board room, library, etc, hut rooms were set aside for a dispensary and baths were installed for the use of patients The long wards on the first and second floors were divided into two and new rooms and bathrooms for nurses were built around the central courtyard. The governors congratulated themselves that ‘the Chester Infirmary is now confessedly one of the most improved institutions as to plan in the country’. Dr. John Elliot, writing in 1912, stated, however, that the effect of this scheme was the ‘effectually blocking out sunshine and fresh air and necessitating acomplicated system of drainage under the building destined to become a fruitful source of trouble by-and-by. The consequences of these “improvements” has been that the wards are gloomy and ill-ventilated, the passages dark and difficult to clean, and what is left of the central area remains like a well into which sunshine never penetrated.”’
The newly organised dispensary was, however, a great benefit. Patients were divided into two classes; ordinary patients who attended personally, and home patients who were attended by a ‘visiting surgeon.’ This saved the Infirmary expense in enabling non-surgical cases to be treated at home.
The admission system was revised in 1838 and the number of recommendations allowed each governor was drastically curtailed. This caused so much dissatisfaction that it was conceded that additional in-patients would be allowed if their sponsors paid one shilling a day for their treatment and subsistence.
By 1856 the Infirmary was out of debt and had a small favourable balance, mainly due to a centenary fund in that year, but efforts continued to be made to raise the income from subscriptions. In 1859 the ‘Infirmary Field’ was purchased from the Ecclesiastical Commissioners to maintain an open area about the Infirmary for ‘sanitary and recreative purposes.’ Concern for fever cases was still felt and, in 1865, a legacy of five hundred pounds was left by Mrs. Henry Wood to provide a hospital for smallpox and other infectious diseases. Despite some local opposition prompted by fears for the health of the neighbourhood, work started two years later on the east side of the Infirmary. The cholera epidemic in 1867 si1enced the opposition and convinced people of the need for a fever hospital. It was completed in 1868 and of the one hundred and fifteen patients admitted to it in the following year, over half being typhus cases, only one died. It continued until the opening of the isolation hospital at Sealand Road by the Chester Corporation in 1899. In 1902 it was converted for use as a nurses home.
In 1882 a sanatorium was opened at Parkgate for convalescent men. After use as a Red Cross hospital in the 1914—l8 war, it was closed in 1923. In 1883 the adjoining house was purchased for the use of convalescent women and children.
In 1892 an important addition was made to the old Infirmary building when the Humberston Wing was built. Colonel Humberston, a Chairman of the Board of Management for twenty-five years, had left a legacy of five hundred pounds and this was used as the basis of a memorial fund for this purpose.
In 1903 the Out-Patients Department was enlarged and a new operating theatre built. The original furniture of the operating theatre had been extremely primitive ~ a wooden operating table, wooden instrument cupboard, wooden floor and a small basin with a single cold water tap.
“John Elliot (Ywster, reprinted from the British Medical Journal, June 8th, 1912, pp. 8, 9.
In 1865 a Committee of Inquiry warned the Governors that dilapidated furniture, partly decaying floors and skirtings, infested with vermin, would deter patients and £1,630 were spent in fumigation and improvements. In 1909 Sir Henry Burdett, editor of The Hospital, visited the Infirmary, and his criticisms of it as one hundred and fifty years old initiated extensive new improvements. The King Edward VII Memorial Fund opened in 1911 raised £31,000 by the end of the following year. Although the ‘Albert Wood Wing’ was opened by King George V and Queen Mary in 1914, on which occasion the King desired that the hospital should in future be known as ‘Chester Royal Infirmary,’ the new nurses home and out-patients’ department and the reconstruction of the old building as an administrative block were delayed by the outbreak of war and not completed until 1917. Many donations were made to the hospital in memory of those killed in battle. The ophthalmic wards were completed and a new operating theatre opened in memory of Lieutenant William Gladstone, Squire of Hawarden. Two wards were endowed as memorials to Harry Urmston Hayes and Captain Francis Rigby. Other bequests were made by Mrs. James Taylor, who provided a new operating theatre in memory of her husband one of the Infirmary’s honorary surgeons, and by Mr. George Barbour, Mr. F. Farrimond and Mr. E. Boden, after whom three of the new wards were named. The years immediately following the war brought the formation of orthopaedic, X-ray, and pathology departments, special provision for the treatment of venereal diseases, and the opening of a new children’s ward and an almoner’s department. The Humberston Wing was enlarged and reconstructed. Unfortunately further plans for extension and improvement were arrested by the outbreak~ of the second world war.
The Infirmary continued to struggle to match income with rising costs but was helped by voluntary efforts; by the institution of Hospital Sunday in 1871, by which all collections on one Sunday in the year were devoted to hospital funds; by the Working Men’s Hospital Saturday Association, whose donations of a penny a week had, by 1872, totalled over a thousand pounds; by the Chester Royal Infirmary Linen League founded in 1915 to provide sheets, blankets and linen; and by the Ladies’ District Association formed in 1921 with district collectors to endeavour to raise subscriptions and gifts. By 1931 it was found necessary to charge each patient part of the cost of treatment. Earlier in 1921 it had been found necessary to close the home visiting service provided by the dispensary.
Following the Local Government Act of 1929, which gave greater powers to local authorities in counties and county boroughs to provide hospital accommodation, representatives of Chester Corporation, the Royal Infirmary and the Chester Maternity Hospital met to survey local hospital services with a view to co-ordination. The whole structure, however, was revolutionised by the National Health Act of 1948 which instituted Regional Hospital Boards and Hospital Management committees and placed the Chester Royal Infirmary under the jurisdiction of Chester and District Hospital Management Committee.12
“My
thanks are due to the Chester and District Hospital Management Committee
and to Mrs. Maxwell
Davis for the loan
of the two papers by Dr. John Elliot.
RECORDS DEPOSITED AT THE CITY RECORD OFFICE, TowN HALL, CHESTER BY CHESTER
AND DISTRICT
HOSPITAL MANAGEMENT COMMITEE.
Minute
Books, 1755-1937, [gap 1758-63]
Resolutions
of the Board of Management, 1850-68
House
Visitors’ Books, 1802-1879
Registers
of Patients, 1755-63, 1772-78, 1782-92 [3 vols.]
Dr. P.
Jones’ Out-Patients’ Register
In-patients’
Register, C. 1914-16
Account
Books, 1806-20, 1831- , 1884-88
Minutes
of ‘Committee of Oeconomy’, 1801-6
Register
containing details of invested funds~ securities and assurance.
Register
of Documents (copies of bequests, agreements, etc.), 1851-
Book of
Newspaper cuttings, 1912-14
Miscellaneous
documents, agreements, etc., 1764, 1872-1947
PRINTED MATERIAL
Annual
Reports, 1856-1931, 1936-41, 1947
The Statutes
of the General Infirmary, at Chester, 1763, 1799. Th. Crane.
Rules
for the Government of the Infirmary at Chester, 1854
Minutes
of a Special Meeting of Governors, held 24th May, 1892, for revision of
the rules
Rules
and Standing Orders, 1938
Report
of the Committee appointed for the General Improvement of the Chester Infirmary
together with Mr. W. Cole’s Reports and Plans. 8th September, 1824
Contributions
submitted to the Committee appointed for procuring Information for extending
the Plan and Improving the General Economy. By a member of the Committee,
1825
Extracts
from the Records of the Chester Infirmary illustrative of the Necessity
of extending
the Plan and Improving the General Economy. By G. Gumming, M.D.
Plans
of Proposed New Wings and Alterations to Present Buildings and Nurses’
Home. 1st June,
1911. [Secretary’s copy with typed and written notes]
PRINTED MATERIAL RELATING TO THE HISTORY ox’ CHESTER ROYAL INP!RNARY
E.
M. SNEYD-KYNNERSLEY, Chester Royal Infirmary, 1912-1922 (Booklet published
1923).
GEORGE H. WEAVER, M.D., John Haygar~h, porlrail, lester and decendants,
(Reprint from the Bulletin
of the Society of Medical History of Chicago, January, 1933, Vol: IV. pp.
264-267).
MRS. ENID
M. MUMEORD, Chester Royal Infirmary, 1756-1956 (Published to mark bi-centenary).
Miscellaneous
plans, 1903-48
Photographs