First image retrieved and enhanced by the author. Other historic images kindly supplied by the Museum & Archives Service, Great Ormond Street Hospital for Children, NHS Trust. Many thanks to hospital archivist and curator Nicholas Baldwin, both for these two images and for extra information about the present south wing building and web resources. Colour photograph by the author. [Click on the images for larger pictures. You may use the first one and the colour photograph without prior permission for any scholarly or educational purpose as long as you (1) credit the source and (2) link your document to the Victorian Web or cite it in a print one.]

The London Hospital for Sick Children, Great Ormond Street, London WCI. E. M. Barry (1830-1880). 1875. Since demolished. Source: Walford 564. This picturesque brick building with terracotta decoration had flanking corner towers topped by octagonal turrets, dormers with pointed roofs, and round arched windows, in a loosely Flemish Gothic style. It was the first purpose-built children's hospital in the country. Its history up to this point speaks volumes, both about attitudes towards childhood in the Victorian period, and the passion and energy of leading Victorian reformists and health care professionals.

The Early Years

England had a poor record in this area. In France, the L'Hôpital des Enfants Malades had been founded in Paris as long ago as 1676, and Charles Dickens ran an article in his weekly magazine Household Words pointing out that many other cities of the world, from Berlin to Constantinople, had such facilities too (see Morley, "Drooping Buds," 45). But in the middle of the nineteenth century, most English people still seemed to think that, at this early stage of life at least, nature should be allowed to take its course. Of the 50,000 or so people dying annually in the capital at that time, 21,000 were children less than ten years old. Yet a survey taken in 1843 showed that only 26 out of 2,363 patients currently hospitalised in London fell into that age group (see Weinreb et al. 344). The article in Household Words, on which Dickens clearly collaborated with his then staff writer Henry Morley (see Kosky 161), expressed outrage at this: "What should we say of a rose-tree in which one bud out of every three dropped to the soil dead? We should not say that this was natural to roses." The same article indicates the underlying problem here by citing a "want of sanitary discipline" (45). After all, it was mainly the poor children, the children in the slums, who were being allowed to die in such numbers.

For children like these there was no adequate health care. Their parents, even if they were responsible and devoted, could afford neither a physician nor a nurse. Their only recourse was a dispensary. Such dispensaries were "a cross between a pharmacy and a hospital outpatients’ department" ("Complete History"): in Our Mutual Friend, Dickens refers to one of these as a "doctor's shop" (305). Dr Charles West (1816-1898), was the son of a Baptist minister, with a strong sense of vocation. He had completed his medical studies in Europe, and had served for several years at the Universal Dispensary in Waterloo, just to the south of Waterloo Bridge. He knew that more could and should be done. Already recognised as an authority on paediatrics, he was a "prolific writer on medical subjects," and "[o]ne of the finest public speakers of his generation" (Coley). In 1851 was at last able to set up a dedicated children's hospital in residential premises in Great Ormond Street, Holborn.

The beginnings of this "pioneer of English children's hospitals" are outlined in Henry C. Burdett's four-volume compendium, Hospitals and Asylums of the World (1891-93). At the very earliest stage the hospital was housed in no. 49 Great Ormond Street, on the corner of Powis Place. As Burdett explains, this "was the dwelling of Dr. Meade, the court physician of the early part of the last century," so it was old and elegant, with "painted ceilings ... panelled walls, and marble floors" (241). It sounds grand, but it was simply not spacious enough. In 1854, West himself wrote:

The poor now flock to it, sick children from all parts of London are brought to it. The out-patients in the first year were 1252, last year they were 9867, and nearly 60,000 have received relief since it was first opened. During the same time 2274 children have been admitted into the wards; the accommodation in which has been gradually increased from twenty, to thirty, and two years since, to forty-four beds. At this last number, however, it still remains stationary. Forty-four beds! when more than 21,000 children die every year in this metropolis under ten years of age; and when this mortality falls thrice as heavily on the poor as on the rich! (4-5)

Fund raising continued, with the issuing of "Drooping Buds" as a brochure in 1853 as part of the campaign. In 1855 the fledgling hospital received its first legacy. In 1858, it was able to acquire the neighbouring house, no. 48 Great Ormond Street.

A hospital ward in 1858, from an Illustrated Times of April 1858.

In the busy ward scene depicted above, Dr West and Dr Jenner are attending to their young patients. West, the chief founder of the hospital, stands just left of centre. He is examining a child's leg while two other little children, probably the girl's siblings, follow this proceeding rather anxiously. Dr William Jenner, who joined the hospital from the beginning, and would later become Physician-Extraordinary to the Queen (who also extended her patronage to the hospital), is shown in the left foreground, writing on a diet card. An older girl stands behind him ready with extra quills. Other children are playing, sitting at the big central table, or occupying their cots. While other mothers or visitors look on, or hang solicitously over the cots, a nurse spoon-feeds the child in the front right-hand corner, and a cot is being prepared for a new patient at the other end of the same row. Notice the Noah's Ark with its animals scattered in the centre of the foreground, and the plants on a shelf to the right. Like the lively little girl in her "go-cart" (see Miall 55), the Noah's Ark and the plants suggest hope and growth.

Considerable progress had been made. "So much good and wholesome work on behalf of childhood has been connected with the London Children's Hospital, since we first made its acquaintance, that we hardly know where to begin another report upon it," wrote Morley in All the Year Round, the successor to Household Words. This article, written soon after a Christmas visit in 1861, is entitled "Between the Cradle and the Grave," and here both the new nursery facilities and the wards are described in glowing terms. Dickens himself extolled the hospital in Our Mutual Friend, which came out in monthly instalments from 1864-65, and was his last completed novel. One of the novel's most touching episodes is when the little orphan Johnny Higden is taken to what is recognisably the same hospital. He arrives with his new toys, including a Noah's Ark, and these are arranged on "a little platform over his breast" (311), much like the ones shown on the right side of the Illustrated Times picture. Johnny is already at death's door when he is admitted: "'This should have been days ago. Too late!' says the doctor, shaking his head" (312). The message to readers is not to hesitate to take their children to this wonderful place while there is still a chance of saving them.

The New Hospital

Morley happens to mention in this article that there were "fifty sick children in the hospital" (455) when he visited, so it is clear that patient capacity remained more or less "stationary" into the 60s. However, with the support of patrons like him and Dickens, not to mention royalty, and powerful public figures like Lord Shaftesbury, Edwin Chadwick, Angela Burdett-Coutts, the numbers of subscribers to the struggling hospital increased. In 1875 there was a big leap forward when Barry's new building was opened near the original houses. It was truly state-of-the-art for that period, with "four new wards, a purpose-built operating theatre ... and a sophisticated under-floor heating system" ("Complete History"). Burdett describes it in more detail as:

a block of the single pavilion type (Class IA), with an isolated block at the north end. The pavilion block contains in the basement the out-patient department, a large portion of which is of one storey only, and is built out in front and back. Here also are the kitchen offices. The three upper floors contain the wards, with a chapel on the ground floor at the back. The latter is beautifully decorated and fitted up, and was a special gift from an anonymous donor [Barry's brother-in-law]. The isolated building at the north end contains servants' quarters, mortuary, chapel, post-mortem room, and museum in the basement, and isolation wards above.

The reference to a specific "pavilion type" plan here reminds us that since the 1860s new hospitals were being built in separate blocks linked by corridors, with space between them for good ventilation. By the 1900s, Lavinia Mitton explains, "the typical ward was a long, lofty room, the spaces between the large windows hung with pictures, with a floor of polished oak, elegant and easy to clean. Each side would have a row of beds, all the covers neat and tidy. Down the middle of the ward would be a long table with flowers, ferns and palms" (23). Interestingly enough, the ward pictured in the previous premises in 1858 already fits this description quite well, so Dr West's ideas as well as Barry's seem to have been in advance of the times.

An illustration of the chapel as first built by E. M. Barry, in The Builder of 4 November 1876, 1073. Its restoration at the end of the twentieth century was entirely faithful to the original.

The new hospital building could offer many more facilities. In his entry on it, for example, Burdett mentions isolation wards housed safely away from the general wards. This meant that children with contagious diseases could now be admitted. He adds that nos. 48 and 49 Great Ormond Street have themselves been replaced by a new building with "additional accommodation for out-patients, administration offices, and wards for about fifty additional beds" (241). This happened in the early 1880s, "in order to complete the rebuilding of the Hospital according to the original plan and design of Mr. Barry" (Walford 562). The whole complex was set in an area large and pleasant enough for it to be labelled, "The Hospital in the Garden" ("Complete History").

Late Victorian Rebuilding

Frontage of the 1893 building on Great Ormond Street, today's Paul O'Gorman Building. Barry's rather typically mid-Victorian structure has gone, but this sturdy late-Victorian frontage has been preserved despite further extension and rebuilding. It is of friendly red brick with subtler decorative features — stone balustrades and copings in a terracotta colour that blends with the brickwork, a rounded end and rectangular oriels — and has a contrasting and welcoming white stone portico. This was designed after Barry's death by his elder brother, Charles Barry Jnr (1823-1900).

Such was the clamour for beds, and such were the advances in treatment, that the original purpose-built hospital soon proved inadequate and outdated. It was demolished in the next major building programme, which was partly funded by money collected by children all over the country to commemorate the Queen's Golden Jubilee in 1887. All that is left of it now is the splendid chapel, which was moved in the late twentieth century to a new location on the ground floor of the present building. However, not only did Barry's brother carry on the family connection with the hospital, but this brother's son. yet another Charles, designed the hospital's now demolished Astor Out-Patient Wing, opened in 1908. His younger brother, the distinguished engineer Sir John Wolfe Barry [1836-1918, most famous for his work on Tower Bridge] was on the Hospital for Sick Children's Management Board" (Baldwin).

Dr West's legacy has proved even more lasting. Seen as "the father of British paediatrics" (Coley), he was a great-hearted man, as evidenced by his book for nurses at the hospital, How to Nurse Sick Children. This was first published anonymously in 1854, and radiates humanity. Particularly notable is the way he encourages the nurses to be patient with their charges, however fractious. He reminds them that the children's "cross and naughty tempers" will improve little by little as they recover and that, after all, "children's love is not hard to win, nor hard to keep" (18). In presenting nursing as a high calling, he reveals his own deep commitment to his calling, too. His aims had been to provide healthcare for children in poor families such as those in the nearby slums, and to facilitate pioneering research in the field of paediatrics, as well as to train specialised paediatric nurses. Today the hospital serves a much wider community, welcoming children who need highly specialised care not only from all over the country but from all over the world. West's other aims are also being fulfilled day by day, on a scale he could scarcely have imagined.

Related Material

Other Web Resources

References

Baldwin, Nicholas. Correspondence with the author.

Burdett, Henry C. Hospitals and Asylums of the World, Their Origins, History, Construction [etc.]. London: Churchill, 1891. Internet Archives. Web. 23February 2012.

Coley, N. G. "West, Charles (1816-1898)." Oxford Dictionary of National Biography. Online edition. Web. 23February 2012.

"Complete History of GOSH." Great Ormond Street Hospital for Children NHS Trust. Web. 23February 2012.

Dickens, Charles. Our Mutual Friend. Ware, Herts.:Wordsworth Classics, 1997. Print.

Kosky, Jules. Mutual Friends: Charles Dickens and Great Ormond Street Hospital for Children. London: Weidenfeld and Nicolson, 1989. Print.

Miall, Anthony and Peter. The Victorian Nursery Book. London: Spring Books, 1990. Print.

Mitton, Lavinia. The Victorian Hospital. Botley: Shire, 2008. Print.

Morley, Henry. "Between the Cradle and the Grave." All the Year Round, Vol. VI: 454-56. Internet Archives. Web. 23February 2012.

_____. "Drooping Buds" (with Dickens). Household Words, Vol. V: 45-48. Internet Archives. Web. 23February 2012.

Walford, Edward. Old and New London: A Narrative of Its History, Its People, and Its Places. Westminster and Western Suburbs. Vol. IV. Cassell, n.d. Internet Archives. Web. 23February 2012.

Weinreb, Ben, et al. The London Encyclopaedia. 3rd ed. London: Macmillan, 2008. Print.

West, Charles. How to Nurse Sick Children; Intended Specially as a Help to the Nurses at the Hospital for Sick Children. 2nd ed. London: Longman, 1860. Internet Archives. Web. 23February 2012.


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Last modified 23 February 2012