Crowded and dirty, European hospitals were seen as ‘gateways to death’ for much of their history. The fact that patients entering them were often required to pay a deposit in case of burial did not help make them more popular. Some English hospitals removed this clause in 1766, thereby offering their services to the public free of charge. Many, however, did not. St Bartholomew’s charged nearly £2 in the last decade of the 1700s. At provincial hospitals the charges were usually less then £1. The main expense of burial was the cost of a coffin and shroud. Some hospitals even possessed their own cemeteries. For those without this advantage, the main cost was transporting a body back to a patient’s parish of settlement, where it was buried.
Despite the introduction of burial money, most hospitals gave far more than they received. Many supplied patients with a change of clothes on admission. Hospitals in the 1700s often provided each inpatient with lace stockings. They also provided linen and three meals a day. Occasionally families were required to wash sheets and supplement meals by providing tea, sugar and butter. Rather than burying their patients, most hospital staff incurred additional costs when patients were discharged. Many paid for discharged patients to return to their communities. Some received additional financial support from hospital benevolent funds, which provided artificial limbs and even fresh milk to children. Even in the case of a patient’s death, sometimes the only person to attend the funeral was a member of the hospital staff.