British patients’ experiences of hospitalisation
Visitor staffs from three London hospitals, 1801-1870
Writers of history often focus on the doctors and nurses who ran the hospitals. There is another group whose experience of hospitals it is important to explore and which is surprisingly often overlooked: the patients. In Britain the experience of the hospital patient has changed dramatically over time.
Hospital - a place to avoid
In the 1700s hospitals in Britain were places to avoid. They were ‘gateways to death’, dens of infection, entered only by the desperate and destitute. The fact that patients had to pay a deposit on admission - to cover burial costs - probably did little to make them more popular. Patients who could not afford this money still found it difficult to resist admission, as there were few other options for medical care. The view of hospitals as places of last resort fuelled repeated efforts over the centuries to clean them up and improve patients’ chances of recovery.
Visitors to hospitals
Perhaps no-one did more to draw attention to the poor conditions than the philanthropist John Howard, who toured hospitals throughout Europe in the 1770s and 1780s in an effort to improve hygiene and administration. Alongside Howard’s efforts, visits from other individuals were equally important to the wellbeing of hospitalised patients. Families and friends may not have improved hospital conditions, but they often made them more tolerable. Following Howard’s tour of European hospitals, visitors were variously welcomed or prohibited, but almost always the time they could spend at the hospital was restricted.
Supplies given to patients
Many hospitals supplied patients with a change of clothes on admission - in the 1700s they 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.
Patients actually spent the majority of time in hospital by themselves or with only other patients for company. Occasionally they were visited by medical staff, usually nurses. Just as often, from the ancient to the modern period, they were attended by religious figures, or simply listened to sermons and prayers in hospital chapels, often from their beds.
Visitors have always been important to the running of hospitals - but their activities have always been controlled. Subscribers alternately visited the hospitals they supported to ensure against funds being spent unwisely and patients mistreated. Friends and families of patients at English voluntary hospitals in the 1700s and 1800s not only provided patients with support, but many brought food and clean linen.
The presence of visitors has often been grounds for complaint. Visiting days were noisy events, and the admission of outsiders also brought unwelcome items, such as liquor, sweets for young patients and dirt, into hospital wards. By the 1880s, in an age of germ theory, visitors were also seen to bring disease into the hospital environment. As a result visiting became even more regulated, largely in efforts to prevent infection. Most hospitals in the 1800s began to restrict the numbers of visitors per patient, the length of visits and the frequency of visiting days. This was most noticeable in children’s hospitals, where visiting in the early 1900s became severely restricted.
John Bowlby - relaxed visiting regulations
Since the 1960s and 1970s visiting regulations have again been relaxed, largely due to the work of the psychiatrist and psychoanalyst John Bowlby. Family visits are now regarded as important to the psychological health of the patient.
Related Themes and Topics
G Mooney and J Reinarz (eds), Permeable Walls: Historical Perspectives on Hospital and Asylum Visiting (Amsterdam: Rodopi, 2009)
G Risse, Hospital Life in Enlightenment Scotland: Care and teaching at the Royal Infirmary of Edinburgh (Cambridge: Cambridge University Press, 1986)