A brief history of healthcare provision in London



Initially established in converted private houses containing the wards, a Board Room and typically a chapel, voluntary general hospitals continued to expand, moving into purpose-built premises when finances allowed.  Ventilation and sanitation were improved, with separate buildings housing the kitchen and laundry.

The oldest voluntary general hospital in London was the Westminster Hospital, established in 1720.  Guy's Hospital opened in 1721 (built opposite St Thomas's Hospital by the wish of its founder), St George's Hospital (after a schism with the Westminster Hospital) in 1733, the London Hospital in 1740 and the Middlesex Hospital in 1745.

By the mid 19th century the 'pavilion' plan for new hospitals had become popular.  The main ward blocks (pavilions) were linked to the central administration building by corridors, with sanitary facilities located in towers or annexes.  The long wards were sometimes known as Nightingale wards, named after Florence Nightingale, a prominent campaigner for better hygiene and healthcare.  Variants on the pavilion plan included the radical cruciform building of University College Hospital and the circular wards of the New End Hospital.  Nurses' Homes began to be built on hospital sites, providing more secure accommodation so as to attract a better class of woman to the nursing profession.

Most patients admitted to general hospitals had acute disease; those with cancer or incurable afflictions were excluded.  Operations were performed relatively rarely until the introduction of anaesthesia in 1847.

As medical advanced were made, hospital design became increasingly complex to include new technologies, such as X-ray machines and darkrooms (after 1895).  Pathology laboratories also became a necessity.  The introduction of antisepsis and anaesthesia in the operating theatre enabled improvement in surgical treatment.  The larger general hospitals in central London developed medical colleges and became teaching hospitals and centres of scientific research.


The first hospital for poor foreigners in London was the French Protestant Hospital established in 1708 by the Huguenots in Victoria Park.  A German Hospital and Italian Hospital, and another French Hospital, were established later.

Jewish Hospitals opened in the East End of London (the last survivor was the London Jewish Hospital in Stepney Green), while various Catholic convents provided nursing care for convalescing patients or the terminally ill.

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Barry G, Carruthers LA 2005  A History of Britain's Hospitals.  Sussex, Book Guild Publishing.

Black N 2006  Walking London's Medical History.  London, Royal Society of Medicine Press.
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