The Blackpool Sanatorium for Infectious Diseases and the History of the Health of Blackpool.

Edited and extended with a second part June 2024

With thanks to Robert Leach for the cover image.

Inflation figures on all amounts relate to 2023

Brief Summary;

The Sanatorium was first established in 1876 on a site adjoining the cemetery at Layton. It was a wooden building and, though described as having a brick foundation and a slate roof, its detailed construction is unknown. Of a Ducker (Doecker) design, it was a wooden hut of a proprietary German, self-assembly design and, in its less permanent condition, had its problems. Though this concept appeared ideal for non-permanent buildings for use in the field for military purposes, it would not be ideal, it seems, for any serious, permanent function as a municipal hospital. A slate roof would, no doubt, need a brick foundation and perhaps the erection of the Sanatorium in this way, in the newness of its concept, was a careful, or even clumsy, cross between permanence and cost. There was a working association between both the cemetery, next to which it was situated, and the hospital, as the Sanatorium, paid rent for a piece of cemetery land (for an undisclosed purpose – perhaps tenanted to the cemetery), and cemetery registrar John Wray had duties towards the hospital building as did the porter of the hospital, James Robinson, reciprocally towards the cemetery, under the direction, John Wray.

The creation of the hospital arose in the first instance from the growing, and legally defined, responsibilities of townships in the later 19^th century to provide hospital accommodation. As an Infectious Diseases Hospital, the Sanatorium had a controversial existence which continued after it had been superseded in 1891 by a more permanent and solidly brick built hospital further up New Road (to be renamed Talbot Road) to the west and which was demolished in 2007. The two hospitals however ran concurrently in function for a while, the original Sanatorium being used for small pox cases until the extensions to the more modern hospital were completed in 1904. The original hut continued with limited use as a hospital, though at least one attempted suicide was taken there to be dealt with, and the building was used later as a mortuary. While the graveyard eventually absorbed the original Sanatorium site, there is still a building in use as a mortuary on the 1910 OS map.

The stories of both hospitals, each preceding the construction of the town’s general, Victoria Hospital, reflect the continuing need to understand disease and its spread, and consequently the need to put into practice measures to prevent, at its worst, the epidemic experiences of the past. Costs had to be borne and legal requirements adhered to, and the medical profession, as well as those municipal representatives in the Council chambers responsible to the ratepayers, and the employed matron and porter on site, had to agree in important areas … and often they didn’t.

The controversy over vaccination and re-vaccination which was contended at the end of the nineteenth century in the age old combat against disease, re-emerges from time to time as different viruses have to be understood and dealt with, both by the medical profession and the local, municipal and national authorities, the latest being the covid pandemic of 2019 and its later variants.

Part 1

Late 1876 to 1900.

There were two sanatoriums – (sanatoria if preferred) –for infectious diseases in Blackpool. The first was constructed, or rather ‘hastily erected’ in 1876 and the second, more substantial, building erected in 1890 and functioning by July 1891. The two ran concurrently, in name and part-purpose for a while, until the eventual demolition of the first, and they echo the continuing struggle to understand disease, its causes, its means of spreading and its consequent control, as townships and populations grew during the later nineteenth century and beyond. This is Blackpool’s story up to the stabilising of the concept of a Sanatorium, in all of its often controversial need, function and physical structure, as the numerous contemporary newspapers reveal it.

On the 19^th May of 1871 the Blackpool Board of Health, with chairman, Dr Cocker, met at the Board Room on Market Street to form a Sanitary Committee ‘for the purpose of taking into consideration the advisability of providing a sanatorium, disinfecting rooms &c in connection with contagious diseases’. It appeared to be a topic with a high level of sensitivity and, while the motion was carried without the presence of the press who were asked to leave, it wasn’t a unanimous decision to consider further discussion to that end. There were those who didn’t consider a sanatorium necessary and those who considered that the presence of such an establishment in the town, with the unsavoury title of an ‘infectious diseases’ hospital, would lose the confidence of the visitors upon which its economy depended. These visitors who packed the boarding houses and hotels, might then be wary of coming to a disease infected coastline rather than the town with the reputation of being the healthiest watering place in the land.

However, some years later, those in favour of creating a sanatorium were given a legitimate boost by section 131 of the Public Health Act of 1875 which states, ‘Local authority may provide for the use of the inhabitants of the district, hospitals or temporary places for the reception of the sick.’ The Act also gave Local Authorities more obligation, and indeed powers, to devise necessary bye laws for the consideration of public health. This concerned, among many aspects of the basics in maintaining the health of a town, not only the provision of clean drinking water and the disposal of sewage, but also powers to prosecute and impose fines for breaches of the devised byelaws. While water had been piped from the Bowland Fells since the middle of the century, there were still parts of the town that relied on wells and these could, and did on occasion, become contaminated. There were numerous ash pits for burning rubbish and, while a basic sewerage system had been in place for some time, there were still cess pits and unconnected privies, and for the sewage that didn’t end up in Spen Dyke to eventually reach the sea, the controlled sewage from the sewerage system was deposited at low water mark to return to contaminate the beach and the edible mussel beds underneath the piers. There was too, the continuing question of the many private abattoirs as the blood, at one time before the middle of the century, ran in the streets, and the carcasses hung outside the shops meant that two people were not able to walk abreast. For the growing populations of towns, in order to maintain their health, research and development was in continuous need for the understanding and control of disease.

In the case of accident, before a general hospital was built in the expanding town of Blackpool, the injured would have to travel to Preston. A little later, as the result of the multiple traumas caused by the Poulton rail crash in 1893, the injured were sent to the already established cottage hospitals of Lytham and Fleetwood. It would take that tragic train crash in 1893 to move the authority to hurry forward from its procrastinations to create its first general hospital on Whitegate Drive. From 1876 onwards, the first place of provision to which to isolate the infectious sick, rather than accident or non-infectious conditions from the township, was then the Sanatorium which was established in the following year after the 1875 Act. It was however a pre-fabricated building, ingenious in its concept perhaps, yet not entirely suitable to function as a serious hospital, as it proved in time, and somewhat inconspicuously tucked away at a distance from the main town of Blackpool just outside the graveyard at Layton.

There was, in the beginning, no provision of access for paupers to the Sanatorium in the Act, though it seems that that ‘class’ of people were eventually accepted at the discretion of the local authority to provide a place for them. Those who could not afford a stay at the Sanatorium in Blackpool were left to be dealt with by the Poor Law system already in place and administered by the Fylde Union in Kirkham, and they would be sent to the Workhouse there. For those at the brink of starvation with no food for their children, there were the soup kitchens. By 1891, these were located at three places; the Assembly Rooms on Clifton Street, and on Dean Street and Chapel Street and accommodated over 1,000 needy people in total per day. The kitchens were supported by charitable donations run by members of the Council and there was sufficient funding at that time, it was agreed, at one of the regular meetings. However, in the continuous uncertainty of the availability of this funding, there were calls for the reduction of locations as well as the opening times of just a couple of hours per day at present. When the Church was asked to contribute to the fund, the Rev Wainwright was upset that charity should be considered a municipal responsibility and not the age old and naturally moral responsibility of the Church. If the lay members of the poverty relief group wanted money from the Church collection boxes, then it should admit members of the church onto its board, where seemingly they had been excluded. The problem was that the terms of dealing with a pauper were not always that clear and, in that lack of definition, it was equally unclear as to who should be responsible regarding admission to the Sanatorium. Soup kitchens of course were much easier and cheaper to arrange than medical care. In a meeting of the Fylde Board of Guardians in March of 1879, the case of a young girl in the service of Mr George Bonny was brought up. She had contracted one of the zymotic diseases, those seven deadly diseases of nineteenth century description, though which one was not specified and, as a consequence, a representative of the Fylde Board of Guardians had been contacted who then contacted the Fylde Board who equally did not know what to do. While the discussions as to whose responsibility was continued, she was taken to the Blackpool Sanatorium. A doctor had seen her but it was doubted that the doctor, as a private practitioner, had had any right to interfere in a public arena. It was assumed that her admittance to the Sanatorium had come from the Town Hall clerk at Blackpool. The Fylde Board then agreed to foot the bill, but only if the case of the girl could be proved to be a pauper case. Logical for the administration perhaps but not for those who rely on the system in place and most importantly for those who are ill, so the system was proved to be still in its early stages of development and, if it was regrettable, it still didn’t matter if such if people of reduced social importance were inescapably used as guinea pigs. The young girl was from Shropshire and, described as an orphan, had been only three weeks in service before she became ill. Perhaps she was truly an orphan, or perhaps also she had parents who could not afford to keep her and so she went into service as was the lot of those young girls and women who had no other choice but the streets, and which in some cases of service, proved to be not much better. There is no more information on the girl, whether she survived or succumbed to her illness and died an unloved and lonely death or, if she survived, then what became of her if she was to live the life of an unprivileged young woman at the end of the nineteenth century.

In a triage system that judged first the ability to pay, the question of who qualifies as a pauper or, more than that, who should take responsibility at that time could, and would, produce tragic results which would eventually be used in argument by the Fylde Union against both the status and the efficiency of the Blackpool Sanatorium.

With the creation of the Sanatorium, the urban Authority of Blackpool could reflect upon itself and be proud of the fact that it had been one of the first to take advantage of the Act. This was a fact later acknowledged by the Local Government at Westminster when it was brought into the argument over the complaints of the Fylde Rural Sanitary Authority that the Blackpool Urban Sanitary District was very much in need of a more efficient hospital for infectious diseases than the one it already boasted. The Fylde authority was looking legitimately to its own concerns, that it didn’t want pauper cases sent willy-nilly to the Workhouse which had its own accommodation restrictions regarding lack of space for infectious diseases. In that correspondence between the three parties, the Clerk of the Urban Authority of Blackpool, Henry Parrot May, could write in defence of his town’s responsibilities, ‘The Urban Authority of Blackpool was one of the first to take advantage of the Public Health Act of 1875. In 1876 they erected, upon the most improved principles, a hospital for the reception of persons suffering from infectious diseases and, since its erection, not only the poor, but the wealthy classes have gladly taken advantage of it.’ So there was some discretionary access the poor, the less well off, here it would seem but not for the paupers, those who had no means at all of paying. What he had failed to say was that the Sanatorium was a hastily constructed wooden hut mostly run by less qualified staff and administered by parties, both medical and civil, who were at loggerheads with each other. And of course in the beginning, and at the Council’s legitimate discretion according the Act, paupers did not have to be accepted, which did produce tragic results in at least one recorded instance.

The complaints of the Fylde Rural Authority weren’t however, without reason, as the death of Ellen Meredith reveals. The Medical Office of Health for Blackpool, Dr Leslie Jones, in stating that the cost of a stay at the isolation hospital was between £2 (£196.69; 2023) and £2 10s (£245.86) a week also states that the Blackpool Urban authority had passed a resolution not to take in paupers. ‘That being so’ he is quoted as stating, ‘the pauper patient was sent in a cab to Kirkham’, ie the Workhouse there. This complaint, referring to the death of Ellen Meredith, had arisen in the December 1878 when there had been a recent death of one of these ‘paupers’ at the Workhouse. It was an incident that the Fylde Authority found legitimate complaint in the inadequate provisions of the Sanatorium in Blackpool that the Blackpool Urban Sanitary District felt it could boast about, but when it was the Fylde that felt it had to subsidise its inadequacies. There was also an arrangement between the Workhouse and the Blackpool district to take in ‘imbeciles’, unless they were infectious, in which case, if they could pay, they might find accommodation at the Sanatorium, but it wasn’t specified as to their fate if they were also paupers when discussing the viability of constructing wards for infectious cases at the Kirkham Workhouse in 1885.

It does seem that a sanatorium was created with at least a little compromise as it consisted only of a wooden hut in the middle of nowhere in the remote fields of rural Layton in an area marked out for the new municipal cemetery, a cemetery which was also not considered necessary by some. Not a very salutary view through the window from the bed of a patient to see the graves, watch the burial procedures and listen to the solemn obsequies of the attending cleric, a viewpoint presented by those who would soon want the Sanatorium moved to a more suitable site and consist of a more substantial building, with pleasant, landscaped views more conducive to recovery. The dead did eventually take over the sanatorium site, though not in the fantasy of a zombie apocalypse but more at the hands of the living who buried them, as the cemetery expanded in leaps and bounds in line with an increasing population, and this first and controversial Sanatorium would eventually be taken down and replaced by that encroachment of graves, its function already replaced by a more substantial building a little further up New Road to the west. This new build would last for over a hundred years before its own demise in its demolition in 2007.

In March of 1877 it was resolved at a meeting of the Finance Committee that the Sanatorium Committee pay the Burial Board £5 (£481.59) per annum for use of the land in the cemetery grounds as its borders were contiguous with the cemetery and perhaps had a portion of shared land. It is not clear which piece of ground this referred to nor to its usage, but the longstanding Cemetery Registrar, John Wray, was required to do work on the Sanatorium building and the porter at the Sanatorium too, would be required to work ‘under the direction’ of the cemetery registrar when not required at the Sanatorium. So the two establishments perhaps had a kind of symbiotic relationship in some part. Indeed it could be cruelly surmised with a certain amount of contempt by those opposed, that the Sanatorium was there to provide corpses for the graveyard.

At the very beginning of the establishment of the Sanatorium, the question of how to accommodate pauper patients was discussed. Since everything had to be paid for and paupers couldn’t pay, how then did the both the morality and the responsibility settle in the hands of the municipal authority with a first call to the ratepayers. The first discussion didn’t take place immediately because the Mayor was indisposed, but the problem of finance would exist until resolved in 1912, largely by private national insurance schemes and by 1947 by a state controlled National Health Service until that too became less of an interest in its current concept, to those responsible for its administration. It was at this date too that the idea of constructing a meteorological observatory within the town was mooted, though no decision was evidently possible at the time and the matter was, perhaps conveniently, passed over to the responsibility of the town’s surveyor for discussion at a later date. The weather of course could, in its observation, statistically reveal the incidences of disease and thus assist in its control.

But this new Sanatorium itself had a bumpy start. Only the following year, in the August of 1877 the Matron of the Sanatorium, Mary Ann Priestly, resigned for an undisclosed reason, a fact read out in a letter to the Sanitary Committee meeting of that month. Her resignation was accepted and an advertisement was placed in the Blackpool Herald for a replacement. There are no plans seen to understand the construction of the building nor the provision of detail within, a structure which has been described in its early days as a wooden hut, but its later description as a Ducker hospital has enabled some idea of what it might have been like. It was also resolved at this meeting that the Matron’s role, perhaps in hindsight, had not been clearly defined and that a matron should be provided with a ‘pass book and that she enter all articles required for the Sanatorium in the same.’ So perhaps here again the organisation of the Sanatorium had not yet been established precisely and the Matron’s role was not clearly defined and represented a conflict of expectations and understanding between the medical profession and the non-medical administration that provided funding from the rates. The question of what cost to charge patients for the accommodation had still to be worked out and the August meeting of the Sanitary Committee it was decided that the matron should have that pass book in which the requirements of the Sanatorium could be written down and a weekly charge of 15s (£72.35p) per patient and 10s (£48.23p) for each servant of the rate-paying patient was established. Visitors would be charged £1 (£96.46). Any extras described as aerated waters fowls, fish and preserves would not be included and would have to be paid for, so it was a system of ‘work it out as we go along’ and the matron being in the middle of all this uncertainty perhaps had had enough and had found little option but to resign. At this August meeting the Town Clerk was instructed to chase a Mr Roberts Banks for £3 (£144.70) owed by him for the attendance of a servant during his three week stay. By the end of August the Town Clerk had proffered his resignation. Whether it was anything to do with the confused system that the Sanatorium appeared to represent, is unknown.

But maybe there was another reason for the matron’s resignation and departure. On 7^th September 1877 the Sanitary Committee resolved that a stove should be purchased for the Sanatorium and John Wray, in one of his obligations as cemetery registrar, was to be instructed to install it. Perhaps there was a September nip in the air already and the need for heating in the less substantial building that the isolation hospital appeared to be at the time, was considered not only desirable but essential. But anyone with as close an association with it as the matron would have been, would have been well aware of that. The days and the nights can be cool even in the Spring and Summer, but the winter months were approaching and, even if it could be assumed that this stove was a supplementary one, on the other hand, perhaps the lack of one in the first place might have encouraged the former matron to have resigned if such basic facilities were not available to her. Another reason maybe have been that the appointment of a suitably qualified matron was not the forte of the administrating authority at the time as it is later intimated in the appointment of a full qualified matron for the new and improved Sanatorium in 1905.

In March of 1878 the perennial question of what to do with paupers was on the agenda. Infections had to be isolated from the community but those who couldn’t pay constituted the problem of who should take responsibility. There were objections from the Workhouse at Kirkham run by the Fylde Board of Guardians, where the Blackpool Board felt they should be sent so they would not be a burden on the rates, and costs could be shunted over to the Poor Law. But it seemed that a compromise was reached in determining a responsibility. The Blackpool proposal to spread the cost between the two authorities in the case of paupers, appears to be that ordinary cases would be charged at 15s (£73.76) week and the more difficult, smallpox cases 21s (£103.26) for board alone, but this would exclude wines (!), medicines and medical attention, which might be expected to be borne by the Fylde Guardians via the Poor Law.

At the end of June in 1878 the Medical Officer of Health of Blackpool, Leslie H Jones, who had been in the post for five years by now and who had taken over the post from Dr P Hinks Bird, presented his report to the Lancashire and Cheshire branch of the British Medical Association, of which he was president for the year. Held at the Talbot Road Assembly Rooms, he talks about the renown of Blackpool as a health resort where, ‘As far back as a century ago Blackpool was celebrated for the longevity of its inhabitants and its restorative powers as a health resort.’ Quoting the historian, Hutton, Blackpool was a place to which you might be carried to or walk on crutches, but in both cases you would be able to walk back unaided after your stay. There was also the case of a totally blind man who, after bathing in salt water and drinking and treating his eyes with the same, in his six weeks’ stay in the town, found that his ailments had receded and his vision has somewhat miraculously returned. Such was the belief in the curative powers of sea water and a belief to which many a seaside holiday resort today owes its existence. I guess to his credit and that of the medical profession, Dr Jones was not taken in by miraculous cures but rather explained them away in the practical medical language of the day. Fresh air, and often clean drinking water were not available to all in the congested cities, so it not surprising that those few who were able to make the trip to the coast, felt better after indulging in both at the seaside for a short time. From that little fishing hamlet of ‘100 years ago’ where horses were evicted from their barns to create accommodation for visitors and its ‘200 yards of grassed promenade’ it was now an incorporated town of 15,000 inhabitants. From eulogising the nature of the town’s copious and high quality entertainments, Dr Jones then naturally concentrates on the importance of providing the necessary requirements to the health of a town. The main ingredients being a good supply of fresh drinking water, efficient drainage and a properly functioning sewerage system as well as a means of isolating those infectious diseases which potentially constituted the roots of fatal epidemic. The water was piped from the Bowland Fells and drunk unfiltered in many a household, and there had not been a single reported case of illness as a result from this source he claimed. About infectious diseases he suggested that a modification to the Sanatorium might be advisable to accommodate those visitors who, he finds, would be ‘glad to avail themselves of any means placed at their disposal for the removal of their sick relatives from crowded lodging houses.’ Sanitation was a perennial problem with new inventions and methods of dealing with it coming into play in the last part of the nineteenth century. It is interesting to note that regarding sewage disposal there were two outflow pipes at either end of the town, though a town at the time which did not include the districts of North or South Shores or Marton of the present town. Regarding this Dr Jones felt able to claim that, ‘Taking into consideration the great body of water which covers the sands twice in every twenty four hours, a more effective method of disposing of it is hard to imagine.’ A concept which in the progress of time would not be considered valid today with its greater volumes produced and the greater accumulated pollution resulting over time.

And then he goes on to say, after praising the provision of public baths in the town, for those ‘who are not strong enough to bear the shock of ordinary sea bathing on the sands,’ and that there is only one town other than Blackpool, ‘where measures have been adopted for providing every house with an abundant supply of sea water’. Physicians, he agrees with his audience of medical men, ‘know the value of a daily salt water bath for weakly, scrofulous children.’ His praise of Blackpool is easier to quote than precis or re-arrange and continues, ‘I desire finally, to call your attention to our promenade which if report says true, is unequalled in the kingdom; several yards in width, and presenting a level surface, composed of asphalte; it extends a distance of nearly three miles along the coast. It is impossible to exaggerate the great blessing this smooth road by the water’s edge is to invalids, more particularly to those suffering from spinal or uterine complaints for who the jarring of a drive on an ordinary path is so painful and injurious. Here they can enjoy the ride, along a perfectly smooth surface with the sea waves almost touching the wheels of their chairs.’ This statement provides a little insight into the real life experiences of those pictures of the sea side at the time in those old photographs. He goes on, ‘Generally speaking, convalescence form all acute diseases is so well known that I need not dwell upon it.’ For tuberculosis (as phthisis) the doctor claims that many lives had indeed been saved (including his own he claims) by a sea voyage and for that debilitating disease of infant children, tabes mesenterica, itself seemingly related to the tuberculosis bacteria via cow’s milk, Blackpool, as opposed to inland towns, provides a place where children can recover, ‘the abdomen gets smaller, the blood richer and the little patients thrive and grow.’ His description of chorea also has a successful cure at Blackpool for a 16 year old, ‘emanciated’ (emaciated) woman who arrived with no ‘purposive movement’ of her limbs or her tongue and could not speak and had to be carried everywhere. After six weeks of salt water treatment she was able to talk, eat dress and walk and recovered entirely. The point being as the doctor suggested, with all the various diseases which the 120 medical men present would have been entirely familiar with, it was that Blackpool did not have a miracle cure, but possessed the natural advantages of fresh air and provided further facilities away from the smoke ridden industrial towns where recovery was not possible. ‘To conclude then gentlemen, you can recommend Blackpool to your patients as a place where they will find a very equable climate (hotter than London he referred to earlier but without the factual proof, he admitted), extremely tonic air and a well-drained soil – where no matter how great the exhaustion to which sickness may have lowered them, they can avail themselves of the invigorating effects of sea water bathing, and gentle exercise along the coast – and where efficient means are provided for protecting them against insidious attacks from preventable disease – where varied amusements suitable to every taste afford healthy recreation and promote that diversion of thought and relaxation of the mind so valuable as aids in restoring health. Nor will you forget those subtler effects produced by the panoramic changes of scenery, unequalled in magnificence, displayed by the mighty ocean, when lost in all the glories of the setting sun, the wearied tenant forgets for a time the insecurity of its own, “frail dwelling place” and is drawn to thought of immortal life.’ His conclusion was greeted with great applause and while society has changed and medicine advanced in time up to today, the freshness of the air, the expanse of the ocean and the glories of the setting of the sun are now readily recorded in photograph or moving film, and are still relevant and important for all to enjoy today. So it seems that everyone was happy and the meeting broke up and the members visited the various attractions of Blackpool which included the Winter Gardens and Fernery, South Pier, Reads Baths and the Raikes Hall Gardens, concluding with a meal at the Baileys Hotel. Perhaps a good time to be a physician.

In his speech at the meeting, Dr Leslie Jones, referring to the siting of the Sanatorium as its main and vociferous proponent against opposition for its creation in the first place, describes it as having ‘been erected at a convenient distance from the town’, that is by the cemetery grounds a little to the north and east. Here it could be safely hidden well out of the way so that no-one could find fear in the fact that Blackpool could in any way be associated with infectious diseases such as the ever dreaded smallpox (of which there had been no reported cases in the town recently anyway).

Away from the meeting of medical men, in the November of 1878, the Blackpool Herald reports that ‘The Committee recommended that the Surveyor be instructed to repair the approach to the Sanatorium, and that the Matron at the Sanatorium have written instructions as to her duties.’ So it does seem that there is some confusion between what the Committee considers are the duties of the Matron and what the Matron, whoever she might be when appointed, considers to be her duties without interference. Also if the approach to the Sanatorium already needed repairing, it perhaps suggests that the building wasn’t given the highest of importance upon its construction.

The November of 1878 revealed the efforts of the Fylde Board of Guardians to reach an understanding with the Blackpool Corporation regarding ‘the occasional use’ of the Sanatorium for pauper fever patients, but at that time no reply had been received from Blackpool. Paupers were an element of controversy when payment for treatment was essential to keep the Sanatorium financially viable before a morally fairer system, acceptable to all, could be conceived and put in to practice. The December of 1878 revealed those differences between the Blackpool Urban District, the Fylde Rural Authority and the Local Government Board at Westminster when the Fylde Authority, with some justification, it seems, had written to the Government authority to complain about the inadequacies of the Blackpool Sanatorium. This initiated a series of letters in subsequent correspondence between the three parties. The case of the death at the Fylde Union Workhouse involved Ellen Meredith, a young, single girl without a home, and parents in Wrexham who could not be contacted, and who was living rent free, it seems, as an unpaid house servant, at an address in South Shore belonging to a Mr Wright and family. When it was evident that she had contracted a fever, Mr Wright contacted the health authority to remove her to the Sanatorium in Blackpool, but this was declined as she was considered a pauper and so had no means of paying and it seems that Mr Wright, who would be away from his premises out of town, was not willing, able or obliged to pay himself. Her condition deteriorated and the now dying girl was put in a cab and driven the nine miles along the bumpy, country roads to the Workhouse in Kirkham where she died, it would seem not long after her arrival. The Fylde Board complained that, ‘In this particular case it was anything but creditable to the Board of Guardians and to Blackpool that she had to be brought to Kirkham in a dying state.’ In the construction of the Sanatorium, the local authority had passed a resolution not to take in paupers since the cost of taking in a patient was between £2 and £2 10s (£196.69 – £245.86) a week, and that being the case, since the girl or her guardians couldn’t pay then it was natural process to send her to the Workhouse. By 1885 little had improved, in the report of the Fylde Board of Guardians in May of that year it is stated that they, ‘had arrangements with Blackpool to the effect that all cases in the Blackpool District including Marton, should go to the Sanatorium unless they were infectious. In that case they would have to come to the Workhouse.’ The ratepayers of Marton at the time were willing to amalgamate the district with Blackpool for a favourable rate but this didn’t happen till a long time afterwards.

At the same time, and with the inferred resentment of the Fylde in accepting cases from Blackpool when the town should be able to deal with them itself, there was ongoing discussion at the Fylde Union Workhouse, to create a separate, purpose built building or to extend the current building for the purposes of isolating infectious diseases. But to those with any sensitivity or responsibility in their occupations, it was considered grossly wrong for those in Blackpool to deny a place at the Blackpool Sanatorium to those who required it, whatever their financial status. Before a concept of a National Health Service, the cost of staying at the Sanatorium was considered steep, ‘even for the middle classes’ let alone the ‘pauper’ class and it was mooted that could not a lesser fee be payable and some kind of provision be made for those who had no means at all of paying? The case of Ellen Meredith had been brought up in this discussion at the meeting of the Committee of the Fylde Board of Guardians in November and prompted the query to the Board of Local Government in Westminster. The conflict in the question was whether Blackpool should, or would, be able to provide a hospital space for paupers in some form or other rather than relying on the Union Workhouse which claimed the town was quite evidently merely passing the buck while there was the concept of a provision in place in the existence of the Sanatorium.

The death of Ellen Meredith, a poor girl made famous only in the loneliness of her suffering and death, was brought up once more as the subject of this continuing complaint in the following January of 1879 when the Inspector of the Local Health Board complained strongly about the conditions that the Blackpool Urban Sanitary Authority allowed to prevail at the Sanatorium. A letter had been received from the Local Government Board referring to a complaint made by Mr Cane, the Inspector, that the Blackpool Sanatorium did not possess sufficient accommodation, and the building was kept at a cold temperature and it was queried whether it was fit for purpose. The letter advised the Blackpool authority to look more closely to its responsibilities regarding the isolation of infectious diseases. This was received with some surprise by the Sanitary Authority which claimed through the Town Clerk, Henry May, that should the need for more accommodation be deemed necessary then there was enough land owned by the Council on the present site to expand at will and the Blackpool Urban Authority was one of the first authorities to consider the seriousness and need for an isolation hospital in its construction in the first place. That was the retort of the Blackpool Town Clerk, preferring to smother the negative comments beneath a blanket of positive ones as the argument became a game of tennis in the apportioning of responsibilities. In the February of 1879, at a meeting of the Sanitary Improvement and Parliamentary Committee it was resolved that the Medical Officer of Health should be ’empowered to make such additions to the Sanatorium as he may deem necessary for disinfecting purposes.’ So the Sanatorium was evidently still in its early stages of concept and development. The Sanitary Committee still had its own direction despite all, but perhaps was aware that criticism was not too good for the town’s public image and felt that a little improvement should show on the records.

In April of 1879 Blackpool’s Chief Medical Officer, Dr Leslie Jones in his somewhat comprehensive report to the Local Government Board, in speaking of the many topics concerning the health of the 15,000 residents (and the several thousand visitors) of the town at that date, refers to death, differing between classes from upper class to paupers, states that there had been no cases of smallpox, measles, diphtheria, typhus, cholera or puerperal fever. Differentiating the paupers, there had been 40 cases of sickness one of scarlatina and six of enteric fever. These had been removed to the Workhouse where there had been four deaths, two from enteric fever and two from phthisis. Of the Sanatorium four cases of scarlatina had been admitted and all recovered, but of the two cases of enteric fever admitted both had died. It was thus demonstrated as being more beneficial to be admitted to the Sanatorium than to the Workhouse. Those who could afford the fees would perhaps have a better chance of surviving. As all things move naturally in cycles without intervention, we are once more in 2023 approaching a state of Health care in which affordability is more equal to recovery. The report, emphasised the importance of removing cases of infectious disease ‘not only from among the lower but also from among the upper and middle classes of residents and visitors.’ While social classes have been less distinct in 2023, it has been covid that has levelled them all in a contemporary sense and an isolation policy deemed paramount. If it is coughing and sneezing and leaving traces of virus on door handles and such common surfaces during covid which is the understanding of today, it was, added to the ignorance of such, often the overcrowded and inadequately ventilated dwelling and boarding houses in 1879 that would propagate infection. This was exacerbated at the end of the nineteenth century by things like the back up of sewage in the cellars due to the less developed sewerage provision, the non-standardisation of milk and butter production and the lack of provision of isolation and the piles of contaminated rubbish accumulated in the backyards of the built up areas with privies that needed emptying by the night soil men which the sewerage system of more perceivably healthy disposal had not yet reached.

In the general Council meeting of July 1879 it was pointed out that not a single infectious disease had been reported in the month and thus no admissions to the Sanatorium in the same period, so it is not known whether the matron got paid or whether the stipulation regarding non-payment for an empty hospital in the original advert had changed, or whether it was deemed necessary to appoint a matron until the hospital was occupied. It was resolved at this meeting that the Town Clerk, ‘be instructed to write to the medical men of the town, and request them, in case of their sending any patient to the Sanatorium, to send to the porter a certificate that such person is suffering from infectious diseases.’ So the relationship between the ‘medical men’ and the Sanatorium had not yet been clearly and properly established and was still being worked out.

It seems that a matron had not been appointed despite the 1878 advert and a further advert was inserted in the Blackpool Times in the May of 1880. By July, as the subsequent interviews had been undertaken it was decided to appoint Mr and Mrs Robinson as porter and matron of the Sanatorium and ‘in case they do not accept the appointment, that Mr and Mrs Fenton be appointed,’ so there was some doubt about the acceptability of the posts to the first potential appointees and a second line of defence was assured by providing a back-up. The tenure of the matron and porter or ‘master’, as the census return describes the post, of the Sanatorium would see the births of their daughter Edith and their son Herbert, who might have had the unique experience of being born at this earlier Sanatorium if born at home, which it is most probable that they were.

By July 1881 at a meeting of the Sanitary Improvement and Parliamentary Committee in the town, it was resolved that a new hospital be built next to the existing hospital (and ‘contiguous’ with it) and that it should not cost more than £500 (£50,230.69). In a later meeting in the month, on the 30^th, the Sanitary Committee, resolved that the erection of a new sanatorium be delayed until a little more research is undertaken and reference is made to other sanatoria to gather relevant information. It was estimated that the building would take five weeks to complete, but that the matter should rest until the end of the season. Five weeks in construction might seem rather a short duration for a building any more substantial than the current one, so that probably represented a mere extension of the standing wooden structure along the lines of the ‘Ducker principle’.

The existing plans did not have the approval of the whole Committee and nothing seems to have come of it at that stage. This appears to be next considered in the December of 1882 when it was suggested by this same committee to apply to the Local Government Board for plans and sections for a new hospital for Infectious Diseases.

1883 Dr Leslie Hudson Jones had resigned his position as Medical Officer of Health and the position was taken over by Dr Welch. Dr Jones had taken up a another post in Cheetham where he was to remain until his retirement in 1911. He had been a Conservative member of the first town council in 1876, representing the Claremont ward. On his resignation he sold his private practice, which he had been allowed to keep, as well earing earning his salary of £100 (£9,849.24) per annum to Dr George Kingsbury.

In March of 1884, while discussions via a sub-Committee to consider the creation of a Cottage Hospital were further deferred, there was also a resolution to transfer the water closet belonging to the house connected to the Sanatorium, which presumably referred to the Matron’s house, to a more suitable place. The Sanatorium Porter had submitted his report to the Sanitary Committee, and perhaps the question of the placement of the water closet was included in that and the committee felt obliged, in agreeing to do something about it. In July of 1884 at the meeting of the Sanitary Improvement and Parliamentary Committee, the salary of the porter and the matron, James and Elizabeth Robinson, of the Sanatorium was increased from 30s to 40s (£154.05-£205.34) a week. By 1884 a Cottage Hospital sub-Committee had been formed to look into the feasibility of creating a general hospital for the town. In a heated debate of July, the question of not only the cost of land to provide a hospital for the town was discussed but also its placement. There was less interest in using the cemetery ground where the existing Sanatorium was situated, and there was more interest in moving it south (from the current town centre hub of that time) to somewhere between Bloomfield Road and Whitegate Drive where land from a Mr Benson offering the land for £150.00 (£15,400.40) a statute acre was proposed, though it was considered that land could be bought cheaper. This site anyway was considered too far from the centre of the town and there was potential conflict with the medical profession of the town who would not want to send their patients that distance to a hospital (though it was also argued by the non-medical men that the doctors had carriages, and it would not take too long to move a patient to a site that was only a few minutes away in such a carriage anyway). The proposal for the new Sanatorium, or indeed for a cottage hospital, was that the cemetery being unsuitable as, in the words of Alderman Hall, ‘they wanted another site, not in the cemetery where everybody was interred, but in a place where they could go about and “see” the fresh air of Blackpool.’ It was evident at this time that, as well as the creation of a cottage hospital, a new Sanatorium was needed as both the site and the building itself was considered inadequate, though there didn’t seem to be the know-how, consensus or urgency at that time to create either a new site or new structure and the search for a suitable site continued to be a protracted one.

In 1885, at the Council meeting in June, while the question of selecting a site for a new Cottage Hospital was once more deferred, it was agreed that the chairman of the Sanitary Committee, Councillor Mycock, and the Medical Officer of Health should see to the provision of furniture as required by the Sanatorium. By 1886 the question of whether to site the new Cottage Hospital in the cemetery grounds was once more subject to controversy and heated debate. While the cemetery site was favoured by some, it was objected by others, the main reason being given that, in a practical sense, a sufficient fall for a sewerage system from the cemetery to the main sewer could not be achieved. If the Sanatorium could be accepted in its position by some, with all its evident inadequacies, then it was implied by others, at this time, that the running of the Sanatorium also could not be as efficient as it should be.

In April 1886 the report of the Medical Officer of Health, now Dr Henry Welch, published his extensive report in which he states that there was only a single case of smallpox in Blackpool and this was brought back from London by a schoolgirl at home for the holidays. She was sent to the Sanatorium where she was re-vaccinated and her family at home also vaccinated. There were 25 cases of Scarlet Fever and five of these were removed to the Sanatorium and the rest isolated at home where a thorough disinfection was carried out and written instructions left. As in the case of measles, the schools were warned of a possible outbreak. In this year there were only two deaths from scarlet fever as opposed to five in 1884. A single case of German measles (Rötheln) was identified and the patient sent to the Sanatorium. In all, cases dealt with by the Sanatorium, constituted the one smallpox, 5 scarlet fever, 7 enteric fever, a single measles and the one German measles. There were eight cases of diphtheria resulting in two deaths. At this time the inadequacy of the Sanatorium was shown up, when an empty school at Queenstown had to be brought into use to accommodate some cases as it was impossible to isolate two particular kinds of diseases at the same time at the Sanatorium. The rental cost of the school to accommodate six patients incurred a very heavy expensive outlay. In all, the medical officer’s annual report showed the reasons for much of the prevalent diseases were due to poor sanitation in the domestic environment, and revealed the medical profession’s attempts to understand and control the spread of these diseases by identifying the causes and dealing with the effects. In this report there is reference to the ‘new’ ambulance and while this turned out to be a rather basic and crude affair it was nevertheless welcomed in excuse, by its usefulness.

There is a rather, critical to sarcastic, comment about this ambulance in the Blackpool Herald of June 1888. It is described as being a rather ‘cosy carriage’ and ‘I’ (the reporter),’suppose the reason why a heavy draught horse is yoked to it and a man is put on the box to drive who is dressed in the picturesque garb of a navvy, is to impress upon the public the fact that cases of a dangerous character are being dealt with,’ as if to tell the world or just the densely packed streets of holidaymakers that the carriage and its passenger(s) were unclean. The origin of the report came from a member of the public on holiday who, in the busy street, asked what the unusual nature of the carriage with the heavy horse and the navvy clad driver (who would more than likely to be the porter of the hospital). The enquirer had to be informed that it was the hospital carriage which was moving an infectious case to the Sanatorium. The reporter then got up on a soap box in the columns of the newspaper to complain of the over obvious nature of the carriage in a busy street full of holiday makers, and the poor reputation that it could bring to the town as a health resort, which should represent a place to get rid of disease and ailments, not a place in which to contract them. It was not a good advert for the town for such a vehicle to be seen driven down the streets which were full of day trippers who, it is insinuated, in their alarm might flee to the railway station to make their way back home as quickly as possible.

In 1886 out of 187 cases reported in total from disease, there were recorded no deaths from smallpox but two each of measles, scarlet fever and diphtheria, 3 from enteric fever and 11 each from both whooping cough and diarrhoea. Whooping cough was a problem because it lay outside the known preventative measures in the understanding of sanitation. The classification of disease contained the seven principal zymotic deaths which are listed as smallpox, measles, scarlet fever, diphtheria, enteric (typhoid) fever, whooping cough and diarrhoea.

In April of 1886, and regarding the prevention of the spread of disease, other than coping with it as the infected person was sent to the Sanatorium, the Medical Inspector of the Local Government Board, Dr Page, had advised that all privies and common ash pits should be exchanged by water closets, and household refuse, as collected in bins, should be removed as both aspects were evident where cases of infectious disease were more numerous. Sewerage systems should also be sufficiently ventilated and regularly flushed. The discharge of sewage into Spen Dyke was considered a particular problem as this travelled through Blackpool and had its outlet by the promenade directly onto the beach. The question of a public slaughterhouse was on the agenda again in the July of 1886. There were many private slaughterhouses in the town which constituted a health hazard, and to regulate and focus the slaughter of animals within a single premises was deemed essential. There were 20 private slaughter houses in number according to the report of the Medical Officer of Health Dr Welch and these should be closed and the town provided with its own, public slaughter house. By July a slaughter house was in function near the gasworks but this meant that cattle had to be taken along the promenade from the railway yard and a more suitable site in New Road, (and owned by a Mrs Barber) opposite the Sanatorium was proposed as having the practical advantage of being next to the railway. In the report, the inadequacy of the Infectious Diseases hospital was also pointed out and the resolution of this should be considered as soon as possible. Discussions for the construction of a Cottage Hospital continued or, in the words of Alderman Cocker, the topic had since been ‘kicked about like football’ in the Council chambers. It had first been introduced in 1885 and the first site suggested in that year was as an extension within the Sanatorium grounds. The proposal in July of this year of 1886 was a site ‘on the southerly side of Dyke’s Lane’ owned by the Clifton Trustees after the previous suggestion of land ‘between Bloomfield and Whitegate Lane’ had been deemed too far from the centre of the town.

In this respect, by July 1886 the site of the ‘present Cottage Hospital’ be used for the erection of an ‘improved’ Cottage Hospital and plans for the same be approved. At the same Sanitary Committee meeting a Mrs Sharp was praised for her donation of 50 copies of the ‘London Weekly News’ to the Sanatorium. So it seems that the ‘cottage hospital referred to, if not mis-described, was the Sanatorium as the general ‘cottage hospital’, as the Victoria Hospital wasn’t opened until 1894. ‘Sanatorium’ as a descriptive word in its dictionary definition could refer (and was on occasion) to the hospital for infectious diseases, a general cottage hospital for accident or non-contagious illness, or the promenade of the town and the town itself each in their function as health giving or convalescent places.

Regarding infectious diseases, there are many tragic cases of deaths behind the closed doors of history that the individual human being has had to contend with in the normal course of a life. Occasionally a case, in the acute drama of its tragedy, can come to light via the newspapers and such a case occurred in the December of 1892 at Breedy Butts farm in Thornton and which continued to Breck Farm in Poulton in which a family were virtually wiped out by diphtheria. Of the Ashton family at Breedy Butts, first the parents had died, and then the children were taken to Breck farm in Poulton, the home of their grandfather, who had died the previous week. Some of these children also succumbed to the illness and died one by one, despite efforts at adoption from those compassionate enough to look after the surviving children for the short time they would be in their care. Three children survived at the time of the report though one was critically ill. It is not known what happened to the other two orphaned children or whether the critically ill child survived. In an attempt to understand and control the spread of the disease the Medical Officer of Health ordered an inspection of the two farmsteads and disconnected the milk supply, contaminated milk being a noted source of infection. Other cases of diphtheria in the district could be traced to Breedy Butts farm as the place of origin. And it is later noted and published that the farm is owned by a Mrs Hardman of South Shore in which case the Ashton family would be tenant farmers there. By January 27^th of 1893, as a real and practical tragedy of the epidemic, the farming equipment and produce was up for auction followed, a couple of days later, by the cattle and horses. The farm was taken over by a Mr Christopher Riley who made some improvement before moving in.

At this time too, in the April of 1886, it is recorded that the hospital had been occupied by patients during 251 days of the year at a cost of £27 14s 3d (over £2,899.52) while fees received from paying patients and from the Poor Law Guardians amounted to £42 12s 8d (a little more than £4,510.37.) It seems then that by this time, those who were not able to pay a part, or any part of the fees, necessary for a stay at the hospital could have access through the Poor Law system or maybe even the rates.

In the same month, and on a lighter note of April 1886, the Sanatorium porter Mr Robinson saw a couple swallows at the cemetery which was considered newsworthy enough to be included in the Blackpool Herald and the editor to remark, while understanding that it does not make a Summer, and perhaps with a little intended irony ‘Swallows it seems, know how to appreciate the cheerful surroundings of the town’s hospital,’ no doubt as they fly around the gravestones.

By the end of 1887 it was suggested by the Sanitary Committee that the plans for additional wards to be constructed on the east side of the present Sanatorium be approved. The Sanatorium however continued to be controversial, as it had been almost from the moment of its evidently somewhat hasty and somewhat perceivably ill-considered arrangement and construction.

In January 1888 at the council meeting to accept the resignation of William Jones as the Assistant Inspector of Nuisances and appoint in his place William Cardwell, currently Inspector of Buildings, it was also agreed to appoint Wilfrid Jones as a clerk to the Sanitary department at a wage of 5s (25p; £26.89) a week. On Thursday January 12^th 1888 however, the dominating question regarding the ongoing controversy over the status and siting of the Sanatorium came to a head. At a meeting of ratepayers which included many influential property owners and members of the church and medical profession, convened at the Prince of Wales Theatre in order to condemn the siting of the hastily constructed Sanatorium in its placement immediately adjacent to the cemetery grounds, and to the inadequate amount of £500 (£53,694.87) proposed to be spent on extending and improving the present building, described as a wooden hut and no more than a barn, while its facilities were not conducive to comfort or recovery of patients. Insufficient ‘to raise their drooping spirits’, as it was described in heated and sometimes mutually insulting exchanges across the room. It was also suggested that another site, were it to cost as much as £5,000 (£536,948.73), should be discussed by the Council and ratepayers as it could only be good for the town’s reputation as a health resort. The first to speak was the Rev Wayman followed by Rev Wainwright who were both strong in their condemnation of the present hospital and siting. Dr Wartenburg (the same Dr Wartenburg who had provided several magazines to the patients at the Sanatorium June 1886 and no doubt at other dates too) who followed, claimed that he visited a patient recently when the temperature was only 40 degrees (which if he is talking Fahrenheit, is only a little more than 4 degrees Celsius) and should not other suitable sites be considered? Better to have a hospital of which the town could be proud and the visitor confident, and that a proper facility would be available to them should they be unfortunate enough to fall ill. He claimed the currently considered site was eight feet below the present site and was not fit, it its marshy state, for a dwelling house nor a hospital. If any member of the Council in favour of the current site were themselves unfortunate enough to have to spend time in the hospital, they would come out after their stay and immediately propose the construction of a new hospital on an entirely different and more suitable site and find sufficient funds to do so.

While the cemetery was indeed a morbid place, it was nevertheless the only planted public open space in the town and, in its greenery and peacefulness, it was a magnet for many a quiet stroll or ‘promenade’ in the description of the day, in the town and indeed for visitors, and lauded even in the regional press of the nation. An extension to the argument was that the Council could not force anyone to go to the Sanatorium, even if they should make it more attractive for voluntary admission. The only powers it had were to compulsorily send those infected off a ship or from a common boarding house, but no legal powers to force anyone from a private dwelling to be admitted. Of 93 infectious diseases identified only 13 had been treated at the hospital, and those who declined a stay at the hospital stated the reason being that it was so close to the cemetery. The doctors of the town themselves had stopped sending patients there. It would be better to spend £3,000 (£322,169.24), as proposed costs differed in different viewpoints and understandings, on a new hospital on a new site where visitors could feel confident of the town as a notable health resort.

Ultimately it was decided to explore the viability of another site, as it was at last generally agreed among some parties that the present site was considered unsuitable. Since Alderman Grime was at the meeting, as editor of the newspaper he would have first-hand knowledge of proceedings and an editorial column of the Blackpool Herald of 20^th January, not only the siting next the cemetery but also the attitude of the Council to the Sanatorium was strongly called into question. The Sanatorium was a wooden hut, hurriedly built in a panic, next to the cemetery and the very fact that it was next to the cemetery made it a least desirable place for anyone suffering from serious diseases to feel comfortable within. While the Council in its desire to save money on the building and its facilities, the ratepayers would demand an improved structure or a different building in a more suitable setting. The Council would argue that £500 (£53,694.87) was sufficient for improvement and an extension to the present building, and to seek another site would mean buying up land at what was considered as large amounts of money ill spent. The need for the publicity of the town which wanted to regard itself as the healthiest place in the land, meant that anyone on the side of publicity alone, and to protect their own interests, would want a sanatorium with the title of an infectious diseases hospital to be set aside well out of the sight and sound of anyone wanting to visit the town. The conflict then was between the good name of the town, with those who felt a responsibility for maintaining that financially lucrative reputation, and the poor patient who succumbed to disease championed by those who had a compassion for the sick in a moral and a practical sense and with a profession or a vocation to tend to them.

The annual Council finance report of March this year of 1888 reveals the annual salaries of the Council employees. That of the Medical officer Dr Welch as £250, (£26,847.44), James and Elizabeth Robinson as the porter and matron of the Sanatorium with house, rates, coal and gas free, each as £104 (£11,168.53).

In August of 1888 when the rates for the Borough were determined, the costs for the Sanatorium included ‘materials and appliances’ were estimated at £210 (£22,551.85) and specific Sanatorium expense including a ‘new ducker’s hospital’. The cost of the new Sanatorium was given as between £3,000 and £4,000 (£322,169.24 – £429,558.98) as an estimated cost, but at this stage it wasn’t yet established to be included in the estimation of the levy of the rates for the following year. By June however, it had been decided to apply to the Local Government Board for sanction to borrow two amounts of £850 and £2,000 for a term of 30 years. Each amount respectively in today’s values of £91,416.82 and £215,098.40.

In September of 1888 at the Council meeting, it was resolved that the Medical Officer of Health and the Borough surveyor, along with the architectural departments get together to discuss the proposed Infectious Hospital building. It was resolved that the Borough Surveyor should be instructed to lay a drainage pipe from land east of the Sanatorium to take away the surface water. This is likely to refer to the proposed Sanatorium as there had been a complaint from local resident and property owner Mr Coulston, though it seems that there had been a drainage problem at the current Sanatorium from the beginning. Meanwhile also in the same September of 1888 the Sanitary Committee decided to distribute the purchases of provisions among several tradesmen for one week at a time, perhaps to get the best price from competition among them all. At the same meeting it was also decided to allow both the matron and the porter of the hospital a month’s holiday, though not specified in the report whether this be an annual entitlement or gardening leave, as talks about the proposed new hospital proceeded more positively. It is also alluded to the fact that there was not much to do at the Sanatorium ‘which speaks well for the sparse demands made on that establishment’ (Blackpool Herald 5^th October 1888). In the annual report of the Medical Officer of Health, he states that only 22 persons were admitted to the hospital in 1887 and the average stay was 29 days so evidently not a lot of work for either matron or porter to undertake.

In the January of 1889 there is a complaint to the editor of the Blackpool Herald regarding the general health of the town, about the smell arising from the carting of vegetable matter from the south to the north of the town. It was evidently the case that there was a great north/south divide between the wealthy south and the more impoverished north. Why should the north be afforded the discarded decaying organic matter of the south where the smells prevent the opening of windows? The correspondent cites a case where a whole family had to be taken to the Sanatorium suffering from scarlatina which, he claims, arose from the careless distribution of rotting organic matter to the district. While understanding that the Sanatorium is of inadequate size and hinting at complaint, he suggests that burning such rubbish in home fires could obviate the need to throw it out to rot on its own and, anyway, potato peelings especially make a good warm fire. In the case of a serious outbreak of smallpox in Yorkshire recently, very high prices were paid for shoe leather parings which when burnt gave off odorous fumes which were believed to be a disinfectant. The correspondent signs off as, ‘One Who Loves The Pure Fresh Air of Blackpool,’ who in the anonymity of the name is probably a male though could be female as less notice would probably have been taken of a female at the time if signed as a female.

In March of 1889, and perhaps as result of the strong and vociferous complaints in January, there was a Government Enquiry regarding an application for more borrowing powers for the Corporation, and held by a Local Government Board Inspector. Included in this was an amount of £3,860 (£409,813.91) for the construction of an Infectious Diseases Hospital. This amount included £850 (£91,281.28) for the purchase of land and the rest for the construction of the hospital and the laying out of the grounds etc. The need for the new hospital was justified by the fact that the current hospital was insufficient and could only accommodate a single disease at a time with any efficiency. It was disclosed at this point that for the last 12 to 18 months a separate building had been purchased by the Council to accommodate any extra need, and was used as a nurses’ home when vacant. This extra hospital, the location of which is not revealed, unless an extension to the Sanatorium by the graveyard, had been provided under the ‘Ducker principle’. This Ducker principle was that the building would have been in the nature of a pre-fabricated and, in some cases even portable, building and which could be erected without too much skill needed from the ‘flat pack’ principle. (Ref Historic hospitals which gives an excellent view into what the original sanatorium might have looked like).

As it had now been decided to build a new Sanatorium, the proposed purchase of the land for the new building from the Guardians of Bispham Endowed School would cost more specifically £788 8s 9d (a little more than £84,623.12) was discussed. The exact measurement of the plot of land is described as 2 acres, 2 roods and 20½ perches, obscure measurements which used to have a place on the back of school books of days gone by. The advantages of the site were that it was not too far from a central position for the town, was in a lightly populated area, and was near to both a water supply and sewerage facilities. The building would consist of an administrative block, two separate hospital buildings, one for ten beds and a double hospital ward for five beds with the ‘usual out buildings and ground with a fence round it’. The cost of the building would be £2,323 8s 6d (a little more than £246,631.53) and the grounds and fence etc. would make £3,000 (£318,508.22) a reasonably accurately estimated cost. The hospital would also contain a small dispensary for drugs. There was still objection to the cost from some quarters concerning the suitability of the land and the purchase price which some considered that another site could be bought for less, so the argument of the construction of the hospital on that site had never been a straightforward one and continued to be controversial. Some considered that the hospital would be too big for the size of the population of the town which was estimated at 20,000 at the time. And there were objections to the site from outside the Corporation as the Corporation received a solicitor’s letter threatening legal action against it by two private parties. In perhaps a nimby-pimby way, a Mrs Pickup and a Mr William Wildman complained of the construction of the hospital going ahead on that site which it can be assumed was close to their properties. Perhaps in the light of this, if the complaint was seen to be real and legitimate, the Council at the same time resolved to ‘remove any obstructions to the flow of sewage through the sewer manholes.’

But there were other issues away from the heated argument over the status of the infectious diseases hospital. In March of this year of 1889, the discussions concerning the health of the town were first about whether or not to contract out the removal of night soil at a cheaper rate than the Council could do it, but with the concern that it might not be done efficiently when the health and reputation of the town was at stake. Regarding then the Sanatorium, it had been further resolved to discard any proposal to extend the current Sanatorium and instead consider 2½ acres of land south of New Road and near Boon Ley (in Layton) which had been offered by the trustees of Bispham Endowed School at £300 (£32,216.92) an acre and would cost £850 (£91,281.28) for which a loan would need sanctioning. The total cost of the construction of the new Sanatorium, to include the provision of surrounding, boundary walls etc. should not exceed £2,000 (£214,779.49). In May, the Sanitary Committee resolved that the plans for the Infectious Diseases Hospital, submitted by the Medical Officer and the Borough Surveyor be approved. These plans consisted of an ‘administrative cottage, two pavilion hospital blocks, disinfecting room, wash-house, mortuary and ambulance shed.’ The site chosen was that earlier decided on New Road near Boon Ley and the cost was to be referred to the finance Committee for the purposes of sanctioning a loan of £3,000 (£322,169.24) to cover not only the construction of the hospital buildings but also roads, drainage, boundary walls, disinfecting apparatus and the planting of the grounds. A sub-Committee was authorised to inspect the plans and to make any adjustments considered necessary to the details. By October, the Charity Commission had given the governors of Bispham Endowed School the necessary permission to sell the land to Blackpool Corporation for the building of the Infectious Diseases Hospital.

The birth rate for the town with an estimated population of over 20,000 had lowered each year for a few years and in 1889 was at its lowest. The death rate was given as 15.6 per 1,000 and death by disease recorded as with whooping cough and diarrhoea showing a decrease, but from diphtheria and enteric a fever, an increase. The water supplied to consumers by the Fylde Water Company was of good quality but would need constant assessment to keep it clean. The rates levied for the coming year were set at 3½d in the pound which included a cost £272 (£28,920.96) for the Sanatorium staff and among other necessities for keeping the town clean and hygienic, and in order to save the streets being used as a place to relieve the bladder, £799.00 (£84,955.31) for urinals to include new ones at Central Beach.

In March of 1890 the problematical nature of the new site continued. At the meeting of the Sanitary Committee it was considered purchasing further land at the north east corner of the hospital site which belonged to Messrs. Cardwell and Coulston and which had been offered earlier before the present site had been purchased. It was proposed to buy this north east corner of New Road and Boon Hey Lane at a cost of £168 1s 6d ( a little more than £17,836.46), which contained Boon Hey Lane where it was also proposed to widen the road. This proposed purchase was subject to much heated discussion in the Council Chamber. Why all of a sudden it had been seen necessary to purchase the land now when it was not considered necessary before, and the proposed road to be constructed there would greatly benefit the sellers and their building estate on Boon Hey Lane more than the benefit to the hospital where a road would nevertheless be necessary. The motion, it seems was carried to purchase the land in the face of any objection given.

In June of this year at the town Hall of the North Western Branch of the Society of the Medical Officers of Health, the main subject was ‘The increase in Cancer and its causes.’ After the meeting the ‘gentlemen’ as described, as there were no women mentioned, made a visit to the new Sanatorium. In July of 1890, while the new hospital was being built, it was recommended that the Sanitary Committee should inspect the work in progress. There was also the continuing problem of Mr Eaves’ brickworks where bricks, naturally in the process of manufacture, were being burnt, and the smoke arising from this affected the health of the hospital. The land for this new hospital is close to that of William Eaves’ brickworks a little north over the railway (1901 OS map) and the Sanitary Committee resolved that, ‘if any bricks or tiles be burnt on land in close proximity to the hospital, legal proceedings will be instituted’. It seems that Mr Eaves had repeated the burning of bricks since the letter sent to him, and the Committee decided on a final warning. A similar problem would arise at the building of the new Council school at Revoe the following decade which was in close proximity to the brickworks of Cartmell Bros. The brickworks would be eventually bought out by the railway company and William Eaves moved his works to Marton, but before that, there was a compromise or a kiss and make-up between the Council William Eaves, builder of many a structure and an abundance of housing in the town including the new town hall, resigned his position as ward councillor so he could take on the contract for the Sanatorium which was then awarded to his firm.

On a different topic at the same meeting, it was suggested that an assistant to the matron at the Sanatorium be appointed for the summer. This is either for the currently active Sanatorium by the cemetery or in expectation of the opening and functioning of the new hospital.

In June of this year there is reference to the ‘new sanatorium’ in the brief report of a meeting of the North Western branch of the Medical Officers of Health who would visit this new sanatorium as part of the meeting, so it had been at least part built by then.

In the December of this year, the cost of its construction came up in a meeting of the Sanitary Committee. Here, two Council members were appointed as a sub-committee to arrange for the provision of furniture for the ‘new hospital’, with a view to a completion in sight and no doubt resulted in the advert above. Regarding the construction, there were questions in the Council Chamber later on regarding how much more cost over and above the loan of £3,850 (£408,752.22) that had already been set out by the Local Government Board, as if the cost was a sensitive subject and questions were not welcome by those present who were interested in answers. Land for the new Sanatorium had previously been offered by Councillor Cardwell at cost, but the profitability arising from this potential self-interest was equally questioned and equally denied in the chamber. There was an added problem that residents in nearby properties had no desire whatsoever to have a sanatorium on their doorstep and when building had commenced during the year, the Council received many threatening letters. But these came to nothing, and in December 1890, the Blackpool Herald of 24^th of the month reports that, ‘The furnishing of the of the new sanatorium was begun on Monday; and I understand that before long the handsome structure will be ready to fulfil its functions, though all the same I sincerely trust it will be a long time before it receives any occupants.’ And we all hope in the present day as the covid still lingers that it will at last recede and, like the hopes of the Blackpool Herald in its day, the current hospitals will not receive many more occupants from the virus. But the problems for the Sanatorium were not over as there was an (unidentified) ‘nuisance’ on land near the hospital, the responsibility of a Mr Wiggins to resolve and remove. The question of whether to engage an assistant to the matron at the currently working Sanatorium was referred to the Chairman and the Medical Officer of Health for a decision. So the question of the administrative structure of the Sanatorium was an ongoing feature of discussion.

In the December of 1890 the Council officially adopted the terms of the ‘Infectious Disease (Prevention) Act of that year, though two exceptions were specified, sections 22 and 23, and to come into operation on the first day of January 1891. On the 10^th April-1891 as the hospital drew closer to reality, an advert was placed in the wanted columns for a matron and a porter for the hospital.

As a direct quote from the Blackpool Herald of the 8^th May, the Sanitary Committee determined that, ‘On the 10^th of April this Committee determined that a trained hospital nurse, certificated preferred, as matron of the new sanatorium, be advertised for, at a salary of £30 (£3,149.29) per annum, board, washing and uniform provided; also a porter at 25s (£131.23) per week. The following are the respective duties of the matron and porter;-Matron: To undertake the nursing of all patients; to undertake the catering and general management of the Sanatorium; to carry out the instructions of the various doctors as to the treatment of their respective patients; to keep the registry of the entry and exit of each patient, and any other books as directed from time to time by the Sanitary Committee; to present monthly reports, including all house-keeping accounts, to the Sanitary Committee; to be responsible for the efficient maintenance of furniture, utensils and general stores; to engage and manage the servant or servants; to act under the Medical Officer of Health as to any special duties not here specified. Porter: To attend to the heating, lighting and cleaning of the buildings; to keep the grounds in order and to work the gardens efficiently; to carry out the disinfecting; to remove patients to the Sanatorium when so directed and keep the ambulance in order; to act generally under the orders of the matron and to execute any special instructions of the Medical Officer of Health; to keep all necessary books as directed by the Sanitary Committee or Medical Officer of Health from time to time’. ‘The Town clerk submitted 9 applications for the situation of nursing matron at the new sanatorium, and 5 applications for porter. On the 30^th the committee appointed Mrs Elizabeth Robinson the matron of the Sanatorium, and James Robinson porter, at the wages of 15s (75p) per week with board and washing provided.’ These two are thus transferred from the former Sanatorium by the cemetery and the Sanitary Committee perhaps playing safe by employing what they know as opposed to what they don’t know.

So it seems the Sanatorium was a step closer to opening and perhaps the 15s (75p) a week wage as opposed to the 25s (£1.25) advertised reflected the marital relationship of the two newly appointed personnel. In June the Sanatorium was complete and open for inspection by interested parties on application to the matron or to the medical officer Dr T W Butcher and would be pleased to accept donations as comforts for the patients.

The Matron having been appointed, one of her first duties regarding staff would appear to be the hiring of a general servant. However, it is not until the June of 1892 that it is briefly reported that it was considered necessary to appoint a permanent nurse.

The new Sanatorium is on the 1891 OS map and consists of four large buildings with a few trees haphazardly planted within the grounds. The original Sanatorium is shown outside the cemetery grounds to the north east of the cemetery, surrounded by trees. Boon Ley, in Queenstown at Layton, is described with further fact in Nick Moore’s extensive History of Blackpool as being bequeathed to Bispham Endowed in School by Henry Warbreck as early as 1687, and by 1890 perhaps some of the land had already been sold off. Boon Ley is later represented by St Joseph’s Road…and now lost in modern development. As the modern Devonshire Road was constructed and built up, the eastern side of the new Hospital would front this new road. The Blackpool Herald paid a visit to the new hospital, now open for inspection any week day between 2pm and 7pm in June 1891 and the reporter provided a favourable report. Here were two parts to it, the first complying with that laid out on the model principle designed by the Local Government Board and the second was constructed to the plans created by the Borough surveyor Mr Wolstenholme. The rooms were spacious and lofty and lit by the Wenham lamps, the floors of solid wood and the walls plastered (‘Parian cement’), the details being the work of the late Medical Officer of health, Dr Welch. The furnishings were deemed to be of the highest quality and provided by the Manchester firm of Kendal Milne and Co., and the reporter was not short in his praise for the Company. The beds were ‘models of compactness and suitability and furnished as they are with the best spring and hair mattrasses, feather pillows etc.’ and the bedside tables had been specially constructed with glass tops. The matron’s house ‘is also very nicely set up’ and arrangements had been made for the accommodation of friends and visitors. A particular point made as the new disinfecting technique used steam rather than gas and it is now ‘possible to disinfect feathers, furs, silks etc without the slightest damage’, a fact that might refer to the greater material status of the patients and largely to the exclusion of paupers. ‘As it stands, the hospital is certainly a model establishment – probably one of the best in the kingdom.’ The bathrooms, lavatories, sanitary, disinfecting, furnishing arrangements come in for further praise and are ‘highly creditable to those responsible for the work’ and the ‘glass covered verandahs must be welcomed by those who unhappily have occasion to use them.’

The Blackpool Herald December 8^th 1893.

But then the reporter takes a breath and considers that the expense on the hospital might have gone a little over the top. While he agrees that the ‘miserable little hut behind the cemetery was altogether inadequate and was a disgrace to any civilised community’, was it ‘necessary to go to so much expense in providing for cases of infectious disease which are likely to arise in the best and most popular health resort in the kingdom?’ The cost then is called into question. Having praised the structure of the hospital and satisfying those responsible for its establishment, the reporter then takes the side of the ratepayers and those who ultimately have to bear the cost. He then appears to take exception to the fact that the £3,000 estimated cost is expected to rise to £5,000 and could this be justified to the ratepayers and that this amount might have been better spent in providing a better equipped hospital for accidents and other illnesses rather that the somewhat fictitious epidemic or plague that might or might not occur for the 50 beds that the infectious hospital had at its disposal in such a less likely case. Was it necessary to got to so much more expense to provide a hospital for infectious diseases than for ‘adequate treatment of those unfortunate individuals who happen to sustain grievous injuries either by accident or otherwise?’ Indeed the Sanatorium would not be free from controversy for a long time to come as the subsequent newspaper pages would reveal over the coming years.

It might be quite interesting to note from the aspect no doubt of pure coincidence, that the hospital on New Road had a predecessor in name and situation in London by at least 1840 as this advert in The Morning Herald of May 1840 might reveal.

In the June of 1890 Dr Welch presided over a meeting of the Association of Medical Officers at the Town Hall. The Mayor, Dr Cocker wasn’t able to attend since he was away on a trip at Beaumaris entertaining Council employees. The main discussion was the increasing incidence of cancer, and various causes were considered such as the environmental consequences of flooding to the smoking of clay pipes. On the same newspaper page there is a warning by eminent German Doctor Virchow about wearing tight lace which was experimentally believed to cause malformations of the liver. He went so far as to state that by examining the liver, it was possible to identify the ‘period of fashion that the possessor belonged to.’

The construction of the new Sanatorium had had a more commercial, rival interest as shares for the new and exciting project of the Eiffel Tower in the town were being bought up, the architects had established more permanent premises in the town and drilling had begun on the site of the former Aquarium to test the foundations for the new structure. So perhaps there was less focus on a new sanatorium in the public mind. It did however hold a greater importance than the proposed tramways extensions in the specified £3,000 of its budget while the arguments continued to either extend the Sanatorium in its present site, to revert to the land at the former site by the cemetery, or to find a completely new, more remote site where, in the cautious mind of Dr Cocker, the diseases could not blow in through the windows of the houses that had been, and were being, constructed nearby. It was agreed all round however that in a town which doubled its population every ten years, that a building to accommodate more than the twenty (and more at a crush) patients at present was needed. The procrastination should stop and a decision should be made very soon. It was thus decided in the July meeting of the Sanitary Committee that the building of the Sanatorium extensions, to include an administrative block, an additional ward, outbuildings and a pavilion should begin immediately. But even the weather conditions had something against the new Sanatorium building in New Road, as the strong winds, in January of 1890, which damaged part of the Lower walk in Claremont Park and even ‘rendered passenger traffic well nigh impossible’ on many parts of the promenade, had also blown down a part of one of the gables of the new Sanatorium. There were also the projects of the new Town Hall and the South pier underway, or at least under discussion and while the new Town Hall and the Hospital would be publicly funded, donations through private parties and popular funding events and bazaars were underway to cover the extra expenses of the dream to reality of the new cottage hospital and extras for the new Sanatorium. At this point, and referring to the Prevention of Infectious Diseases Act of 1890, as well as the sanitary inspectors obliging the owners of bedding, clothing etc to be handed over for disinfecting, it also allowed for the inspectors, or the Sanatorium porter, to enter such premises for inspection between the hours of 10am and 6pm. In the October of 1890 a meeting was held by the Council to discuss the adoption of the 1890 Infectious Disease Act. Its progress was delayed at first since here wasn’t the necessary quorum of eight Councillors in attendance at first, When the full complement was achieved after about a quarter of an hour of waiting it was eventually agreed to implement the Act where relevant and it would come into force on January 1^st of the following year of 1891. On Monday 22^nd December, the building work complete, the furnishing of the New Sanatorium was begun and it was hoped that it would soon be up and running but equally hoped for that there would not be many unfortunates with the need to use it.

In July of 1891 the Sanitary Committee decide to ‘authorise the Medical Officer of Health’ to provide ash tubs to property owners to replace the ash pits and, to this purpose, 50 ash tubs were procured by the Committee. The ash tubs would be regularly emptied by the Corporation. At the same time a sub-committee to look after the Sanatorium as it was about to open, was organised and those personnel appointed included Councillors Leigh, Kingsbury, Parkinson, Heap and Ward.

By August of 1891 the Sanitary Committee decided to provide the Sanatorium with gates and posts at the New Road entrance but it is not until the January of 1893 that the editorial of the Blackpool Herald notices that these projected gates have only ‘recently’ been erected. And in April of 1891 as well as discussions regarding the proposed Eiffel Tower for Blackpool, the Corporation agreed to continue the appointment of Dr Welch as the current Medical Officer of Health but to add to his duties that of analyst at a salary of £350 (£36,741.77) per annum. At present all samples, such as tea, sugar and milk, which it was agreed should be analysed for purity weekly, had to be sent to Liverpool for analysis. To do this in Blackpool though would need the setting up of a laboratory at some expense, but as long as Dr Welch had the right credentials, and was willing to act as analyst, the post would not have to be advertised. Less than two years later Dr Welch had been replaced by Dr Anderson so perhaps retirement was deemed better than an increased workload. Discussion for a new general hospital were also under way and a site on Whitegate-lane owned by Councillor Ward, who was willing to sell for his purchase price of £500 (£52,488.25) was considered. The question of providing a general accident hospital for the town was discussed at length in a Council meeting of July 1891, having been suggested earlier in April. It was considered shameful that a town with a population of 25,000 should not have that facility within its boundaries. At present much first aid work was done by the police who were trained in those skills. There was always the question of cost and where this finance should come from and it was suggested to use a fully fumigated old Sanatorium by the cemetery at least as a temporary measure. The Public Health Act only provided for the Local Authorities to erect an infectious disease hospital not an accident or general hospital so here was no means of providing one through the rates. There had been gifts and endowments for the purpose of building an accident hospital but these concerned the building and not the purchase of the land. Laughter was caused when discussing other means of financing such a venture when it was suggested that since footballers provided many accidents for such a general hospital that perhaps a portion of the gate money should be put aside for such a purpose. But ultimately it was decided to go ahead with establishing fund raising to complement the gifts and endowments already in place and reserved within banks and promises.

It seems that the first cases dealt with at the new Sanatorium were the two young children of William Pearson of Rough Hill Layton who had contracted scarlatina. Two other children four and six years old of his had previously died of the disease at home. In the expectation of eliciting the genuine sympathy – and perhaps assistance – from its readers, the Blackpool Herald, in a brief note, describes William Pearson as a ‘hard working man’ and the parents, where the mother is obliquely referred to, who are in ‘very humble circumstances.’ It is one of those many tragedies of life hidden behind the doors of history which only sleep, in its day, or death its finality for those involved, can cure.

Still in July of this year there is the sad case of Lucy Obenaus who was found faced down and presumed drowned on the beach. The police having been called, the body was taken to the old Sanatorium by the cemetery. The face was cut and bruised as a result, it was determined, of being rubbed against the shingle on the shore. An inquest revealed that Lucy had left her position as a domestic in Manchester and had come to Blackpool. She was partial to a drink or two, but this was probably to alleviate a deeper unrest of which no-one was aware but herself. The ineluctable troubles of some can seemingly only be resolved by the cancellation of the life within themselves.

July, too was the occasion of the annual medical report of Dr Anderson. Deaths from diarrhoea, which was considered a summer disease, were almost halved. Dealing with the feeding of infant children, the statistics read that the death rate of those fed on breast milk alone had a higher survival rate than those fed on either a mix of bottle milk alone. Out of 41 cases examined there were no deaths at all among children younger than three months, but 20 deaths of those fed on a mix and 18 of those fed on bottle milk alone. On the whole, the health of the town was satisfactory, but it seems there had been a regional, or perhaps nationwide (the Medical Officers report didn’t specify) ‘beer’ scare during which there had been deaths of arsenic poisoning due to drinking beer. The Medical Officer was pleased to point out, however, that there were only two reported cases in Blackpool. That of drinking in general in Blackpool, or rather drinking to excess, the Medical Officer reported that there had been 15 deaths ‘directly attributed to alcohol’ and expressed a little alarm when only three of these were visitors. On a practical level, the medical officer was authorised to provide ash tubs for property owners in order to get rid of the ash pits commonly in use and towards this end the 50 ash tubs were purchased. At the same time, Bailey’s farm at Warbrick, after inspection, was declared free of swine fever.

In November of 1891, Mr Thomas Howe and Mrs Elizabeth Howe were appointed caretakers at the ‘old sanatorium’. This would lend credence to the fact this establishment was kept on as a sanatorium despite the building of the new one but would be reserved for smallpox cases only. They would be allowed to ‘reside rent free with allowance of coal and gas in lieu of wages, so it seems they were there on standby just in case anything did happen, perhaps in the hope that it didn’t but more to keep the doors open for any other incidences that did occur like the use of the building for a mortuary. Thomas and Elizabeth were in their sixties when they were appointed to the job. Thomas was an army veteran and Elizabeth’s second husband, her first husband having been killed in the Crimea. Thomas had retired after 21 years’ service and her re-marriage would perhaps have disqualified her for her widow’s pension from the Crimea Fund. Elizabeth was well travelled and had been in India during the cholera epidemic which ravaged the country from 1863 to 1875 so would have been quite well versed in the impact of an epidemic. She had volunteered for nursing service at the time but wasn’t needed. Thomas died in 1900 and Elizabeth on 3^rd December 1915, and she shared a keen interest in the progress of the current War. She left three sons and three daughters. Four of her many grandchildren were serving soldiers at the Front. At the time of her death, at 87 years old, she was living with one of her daughters in George Street. She was buried at Layton cemetery, a place she would have known intimately well during her time at the old Sanatorium as she would have looked out onto, and taken many a stroll or ‘promenade’ among the expanse of its popular greenery, well maintained by the cemetery registrar John Wray. There was a dropping off of donations to the Sanatorium for the Christmas, though many of the notable and materially capable people of the town are recorded as generous donors and the nurses made sure a good Christmas time was had by all in their care. The donors to the Victoria Hospital were more numerous as if there might have been a quiet and unspoken stigma attached to the infectious disease hospital. The matron at the hospital, Miss Peel, and the nurses went to great lengths to adorn the wards and give the inmates a Christmas to remember.

But a sanatorium, in its dictionary definition, had another connotation. In discussions over the Blackpool Improvement Bill and those discussions referring to the development of the northern end of the town past Uncle Tom’s Cabin, which were in the neighbouring parish of Bispham at the time, Councillor Handley, the current Borough Treasurer, could proudly claim that the town ‘would have one vast sanatorium along the coast.’ Indeed it was and still is a place where the fresh air, even if you don’t want the relative fun on offer, is conducive to health with a bracing walk or cycle ride along the front, or for the less actively inclined or capable, a quieter and reflective rest on a bench or upon the wide and expansive beach with the risk only of a the mild discomfort of sandy bottom.

Further consideration was given by the Sanitary Committee to the running of the Sanatorium in the March of 1892 when it was decided to provide sufficient office space for the purposes of administration. In the meeting in March, the salary of Mrs Robinson the matron was raised from £30 to £40 (£4,199.06) per annum. The report of the Medical Officer of Health, now Dr Jasper Anderson, showed a net increase of 760 persons a year which meant the construction of 157 extra houses each year. So more people to potentially become sick and increase the possibility of the spread of disease. In April 1891 the date of the census, the population of the town was 23,846 and there were 4,921 houses occupied at an average of 4.81 per house. Compared to 1881 when the population was 14,229 with 2,952 houses at an average of 4.82 per house. Infant mortality was high in the present day and, regarding this, an attempt to understand the reason and to remedy this by the constant consideration of hygiene on the housing premises was a permanent feature within the medical profession. In general there had been over the past year 52 deaths from those diseases categorised as ‘zymotic’ diseases that current medical term to describe a broad category of infectious diseases by the causes understood at the time.

While there were no deaths from smallpox recorded, these statistics included a single death from diphtheria, 10 measles, four scarlet fever, 7 whooping cough, 4 enteric fever, and 24 from diarrhoea of which 21 were under five years of age. Phthisis was the cause of 32 deaths of which seven were visitors. Six deaths were due to influenza during a mini epidemic, and cancer was the cause of 26 deaths. Deaths from injuries amounted to 15. An interesting aspect in the cause of the spread of disease was the fact that school teachers often asked children to call at their neighbours’ houses to enquire why that child was off school and this was considered a direct cause of the spread of disease, and the Medical Officer questioned the practice. As far as the new Sanatorium was concerned, there was a much greater confidence among the public now and a greater willingness to transfer a patient to it. The Council had given ratepayers the privilege of ‘boarding therein’ free of charge, so still the poor rate or the Workhouse was needed for the financially underprivileged. The old Sanatorium was to be kept clean and well ventilated, warmed and ready for a serious outbreak or to take any case that couldn’t be accommodated in the new Sanatorium and especially for any case of the particularly nasty and virulent smallpox.

The costs for the Hospital at the cemetery site and the Sanatorium and are separated, the larger amount relating to the running of the hospital and the smaller amount it would seem to the building itself. For the year up to March 1892 the costs respectively for the Sanatorium and the Hospital are printed as £158 (£16,586.29) and £1,392 (£146,127.28) and that the estimate to March 1893 as £21 (£2,204.51) and £819 (£85,975.75). In October of 1892 it can be reported that the new general Hospital for Blackpool is at last underway and the design and plans are seen for the first time. The layout of the wards of the Hospital reflects that of the Sanatorium, so it would reveal a little of the success of constructing the town’s permanent Sanatorium away from its original and hastily erected and possibly ill-considered wooden structure outside the cemetery. By June of 1892 it had been decided to appoint a permanent nurse for the Sanatorium as it would seem the employment of temporary nurses had been the practice and probably would continue with just the single nurse on a permanent basis. Later in June, on the invitation of Dr Welch, the Medical Officer of Health, the North Western Branch of the Society of Medical Officers met in the town. The reported discussions were largely concerned with the causes of cancer, one primary reason being given was that the mouth would become irritated by nicotine applied by means of short clay pipes. Had this been considered and proven at the time there would no doubt have been less impetus to the tobacco industry and thus cigarette smoking and modern cases of emphysema or COPD would have been negligible, it might be imagined. After the meeting, and before dinner at the Clifton Arms Hotel, the group drove to the Sanatorium where, after inspection, the building was considered suitable enough, ‘that the rooms were light and airy but the general view was that the structure was somewhat small.’ In the Borough Treasurer’s annual report the outlay on the ‘infectious disease hospital’ was £1,795 (£188,432.80) which appeared to represent a further expenditure of £700 (£73,483.54) of which £500 (£52,488.25) was for furnishings and which in its part in increased costs across the board for the borough, meant an increase in the rates. The old Sanatorium expenses for the current year were estimated at £158 (£16,774.77) and for the following year £21 (£2,229.56).

Then, by September the attempted suicide by a young curate, Harry Vonglehn, by throwing himself in front of the 6.15pm train from Lytham at Central station, brought the inadequacies of the old Sanatorium by the cemetery into the spotlight. The injured man was taken to the police station where the first line of first aid was always the regular and trained duties of the policemen. He had been originally assessed at the station and then removed to the Sanatorium, where it was expected there would be better facilities. Taken to the old Sanatorium and having been treated there, where his left arm was amputated and his dislocated right wrist and other body injuries seen to by three doctors, his five day stay in the building, before his brother from Northampton came to take him back home, was ‘not only damp, but that rainwater was a frequent visitor’ and the pleurisy that he was suffering at the time of his departure could be attributed to the damp conditions of his stay. Unless there would be a speedy improvement to the hospital conditions, the editor of the Blackpool Herald, in a damning condemnation, claimed he would publish every name of the Hospital Committee that opposed change, so that the people of Blackpool should know who they were. The Rev Harry Vonglehn had just taken up a curacy in Narborough and was taking a short holiday in Blackpool. No reason is known for his attempt to take his own life but there is a Rev Vonglehn mentioned who conducted a marriage in Sussex in 1904 so, if this is the same man, it would seem he had been given a chance to continue a life to a certain amount of his chosen fulfilment.

By October 1892 the plans for the new general hospital -or infirmary- are available to view. The cost at present is £4,740 (£497,588.57) including the purchase of the land, though only the administrative block would be built in the first instance until further funds to continue the building can be acquired. Interesting to note that the lay out of the new hospital follows ‘the same principle as those in vogue at the new Sanatorium’ where two wards along the sides of a central, shrubbed area, are one male and one female, surgical and medical, each holding eight beds except the medical ward with six. Further back would be wards for special cases and then storage rooms. A gate and a driveway would be added with a gatekeeper’s lodge and there would be generous, landscaped areas.

By December 1892 there was encouraging news for the new Sanatorium as Dr Sergeant, the County Medical Officer, in a report to the Lancashire County Council praised the useful existence of the Sanatorium in Blackpool and refers to the ‘lack of hospital accommodation in every district but Blackpool as a means of curtailing the spread of infectious diseases’. Less encouraging news however was that several houses in the borough had to be condemned as being unfit for human habitation as described under the Housing of the Working Class Act of 1890 and the aim of the procedure was to ‘improve the conditions under which people live.’

In the January of 1893, the Sanatorium was once more the subject of controversy concerning lighting and closet pans. There were those who would criticise the awarding of contracts to those who would inordinately profit from them with backhanders, and would want to argue the corruption of Councillors or others ‘having their finger in the pie when large contracts were awarded.’ Alderman Parkinson, a future Mayor, was such a man under suspicion by the critics, but whose defence was one of integrity and generosity in supplying Wenham lamps for the Hospital. These lamps, gas lamps with reflective properties to increase the light, were not considered suitable by those critics even though they had been used in the Town Hall for years. For these lights, one of which was provided for each ward, Alderman Parkinson, it is claimed, paid for the lighting for nine months afterwards and before they were considered harmful to patients as it caused ‘excitement’ among them in not allowing them to rest, presumably due to their unaccustomed brightness as the world moved away from candlelight alone to dispel the internal darkness. In respect of this, these lamps were no longer used. And for the supply of closet pans which he had ordered from Dublin these, (which had really come from Birmingham) ‘Maguires Sanitary Reform’ closets, a rather verbose name for toilet equipment, which probably had a more popular street name among the population, had been brought over free of cost. And while this equipment was considered unsatisfactory and replaced by proprietary ‘Simplicitus’ closets, Alderman Parkinson, ‘generously’ it is intimated, took over the responsibility for the redundant closet equipment even though they were entirely useless to him… Perhaps they might have been made into garden flower containers at his house at Royal Bank in Marton at some time.

Of all the diseases that spread quickly, smallpox was the most virulent, and vaccination was shown to combat the disease and protect those vaccinated. Blackpool of course was more vulnerable than many a town because of the number of visitors that arrived in the town annually and who could – and did – bring the disease with them. However Blackpool, it was reported, had not had a single case of smallpox since 1886 and the town was at present more free of infectious disease than at any time since 1887. But a guard against the disease could not be dropped. The present mini epidemic in the country was largely due to the unvaccinated, according to Dr Anderson. Where vaccination was ignored there were more deaths among the non-vaccinated, and in the words of the Medical Officer, Dr Anderson, quoting the notices issued in public places inviting the availability, place and times of the vaccination, (Blackpool Herald January 27^th 1893) that ‘efficient vaccination and re-vaccination are the only safeguards against smallpox, and the inhabitants of the district are strongly advised to avail themselves of the present privileges whilst there is leisure, and not to neglect having re-vaccination performed until perhaps a panic occurs, the stock of lymph becomes exhausted and, through hurry, the operation is inefficiently performed.’ However not everyone took up the opportunity as the Blackpool police unanimously declined to take up the directive of the Watch Committee.

By now, according to the annual report of the Medical Officer of Health, there were 295 more inhabited houses in the town and a net population gain of 1,430. Draft bye-laws were under construction to bring into the compass of the law the tents and vans as used for the habitation of gypsies to comply with the ‘Houses for the Working Classes Act’ . It is also interesting to note that, along with the anti-crinoline league and the controversial move to get skirts shorter to five inches above the ground, which would alarmingly, to some, reveal the ankles, while women even in selected, small ways demanded equality with men to have the right to dictate their dress sense, it was a fact that the medical profession was becoming popular with the ‘gentler sex’ and large salaries could be earned, a lady doctor in India at the top of the earnings pile bringing in £4,000 (£424,677.63) a year.

In April of 1893, plans for a new slaughterhouse to be erected on land owned by the Corporation opposite the Sanatorium and next to the railway line, were presented by Mr Wolstenholme, the borough surveyor to the Corporation. Having been accepted by the Corporation and the local butchers, these plans consisted of ten separate slaughter houses each to be let individually to butchers, and a public slaughterhouse. There will be direct access to the railway via a siding and pens for the animals and a portion of open grass where the cattle could graze prior to slaughter. All facilities for the consideration of hygiene had been considered. At the time of writing this account, (2023) the land is now built on with housing, after a problem with their construction where they lay empty and unfinished for a long time. The open field for grazing adjacent to what became Devonshire road, would for over a hundred years’ be available to the last days of many an animal. By the August of 1896, in the height of the holiday season, it was recorded that 3,905 animals had been slaughtered in the public abattoirs of which 3,608 were sheep.

By June 1893, the population of Blackpool having increased to over 26,000, the conflict between the Fylde Sanitary authority and that of Blackpool, led by Dr Jasper Anderson the Medical Officer of Health, re-surfaced as the complaint of the Fylde authority was that Blackpool had refused to admit infectious cases to its Sanatorium. This action, as the Blackpool Herald was quick and determined to defend in its columns, was justified by the fact that not only children attended Blackpool schools from outside the district within the responsibility of the Fylde Authority, but also that most of the milk supplied to Blackpool came from outside Blackpool within the Fylde Authority too. Schools where children congregated were evident sources of the spread of infections, and milk was identified as being a natural source of infection and, as the newspaper strongly pointed out in the defence of its hometown, the several home dairies of the Fylde operated in insanitary conditions as several unidentified instances intimated, had demonstrated. The newspaper offered stronger comment to the effect that if the Fylde Rural Authority were to continue its complaint, these instances would be exposed to the public. But while the Blackpool authority could point to the Fylde Rural authority as the origin of infection and in some cases have reason to complain, equally the Fylde Rural authority could reciprocate as in the case of three scarlet fever cases in Bispham and ten cases at Puddle House Farm in Hardhorn which it was believed had come from Blackpool, as a child had been seven weeks in the Blackpool Sanatorium, stayed at a sister’s house for a week then returned to Puddle House from when the outbreak commenced and many became infected. Dr Sergeant, the county medical officer, could also offer as a complaint about the cases of disease in the Fylde in the parishes next to Blackpool, the fact that the Blackpool Sanitary authority had not allowed bedding to be taken from these areas into the Sanatorium for disinfection and for refusing to take in cases from out of its district. Dr Sergeant however does lay some blame upon the Fylde authority for not taking the responsibility upon itself to isolate cases and disinfect where it is evident that it should be done, and so relieving Blackpool of perhaps undue criticism.

In this month of June there was the opportunity for Dr Anderson to explain the health of Blackpool to the Manchester branch of the Sanitary Inspector’s Association. Praising the town for its health giving properties and opportunities, he nevertheless considered that the holiday season should not be concentrated into the month of August, but spread further throughout the year to avoid congestion for the benefit of the day trippers and holidaymakers of longer stays. The gathering had been in the Town Hall and afterwards this gathered company were taken in waggonettes to the Sanatorium where they saw drain testers at work and then to the town’s destructor in the south of the town. Tea was then taken at the Winter Gardens and all left for home pleased with they had seen and learnt of the health of Blackpool, and the steps taken by the Medical Officer of Health to protect and maintain its health. In Dr Anderson’s health report for the previous month, there hadn’t been a single death recorded from the seven zymotic diseases in the past year, and the general death rate was 9.71 per thousand when taking away the deaths of visitors. There had been 36 births and 32 deaths, a birth rate of 16.6, lower than the corresponding month last year.

For some time now it appears that there had been rumblings beneath the surface that the Sanatorium was not up to standard and, after this began to be passed round as an open secret, it eventually came to a head in November 1893 after Dr Anderson had applied for the forceful removal to the Sanatorium of a child infected with scarlet fever. The child, Delia Riley of 9, Middle Street in the town lived with her parents, four siblings and five lodgers in a house which comprised of a sitting room, kitchen and scullery downstairs, and three bedrooms upstairs. Two of the lodgers slept in one room, three men and a child sept in the second bedroom and the mother and the sick child in the third bedroom. Where the three other children slept isn’t specified but Mr Patrick Riley slept downstairs. The child was looked after well by its mother but, in view of the close contact with others, Dr Anderson advised that the child should be taken to the Sanatorium, and he sought legal permission through the courts via the stipulations of the Public Health Act of 1875, perhaps against the wishes of the worried mother who might not have wanted to leave and be separated from her sick child, especially to a Sanatorium that she perhaps had been led to believe had a poor reputation. While this might have been the correct procedure for Dr Anderson, the opposition to the child being taken to the Sanatorium headed by Dr McIntosh was that the Sanatorium was not fit for purpose in its system of management and quotes as one example the case of a child who was known to be dying from what was described as inflammation, and who had been left unattended and alone throughout the night, the only attention it received was from its parents who had been summoned to its deathbed, and had had received no attention at all from the hospital staff. Sadly, the child eventually died. Not happy with the treatment received at the Sanatorium, the parents made an official complaint which formed an important element to the argument against the poor running of the hospital from that part of the medical profession that could see the shortcomings. From there the doctors rounded on the Sanatorium, led by Drs McIntosh and Kingsbury, the latter controversial in his own right as a practitioner of hypnotism, and demanded an official enquiry which eventually came about on Tuesday 5^th December at the Town Council meeting.

Dr Kingsbury had complained to the Council, who then felt obliged to act on behalf of declining public confidence in the Sanatorium. Dr McIntosh emphasised that he would only send a patient to the Sanatorium if absolutely necessary. Dr Anderson however, seemingly unaware of the shortcomings of the hospital, or not allowing himself to associate himself with the shortcomings, advised that one of his own children was at the hospital and he was quite happy about that. Probably for him to offer a mild criticism after this length of time might be due to the fact that as the Medical Officer of Health, then his child would have received the best attention. While the doctors opposed to his point of view might have been aware of this, it was judiciously left unsaid. Despite the complaints against the hospital, the court granted the right of Dr Anderson to admit Delia, the child in question, to the Sanatorium.

While the Medical Officer of Health Dr Anderson had defended the establishment in front of the magistrate, and received the required permission to send the child to the Sanatorium, Dr Kingsbury, not satisfied with the result it would seem, wrote to both the Sanitary Committee and the Town Council to object to the running of the hospital and threatened to report the same to the Government Local Board of Health. Further, at a specially arranged meeting to discuss the shortcomings of the establishment, discussions regarding the Sanatorium resulted, and proceedings lasted for two and a half hours. To question the current state of affairs of the Sanatorium and its root causes, one of which was the employment of unqualified nurses conveniently from among the women of Queenstown, it was concluded that the porter and matron should be dismissed there and then as the first steps towards recreating public confidence in the Sanatorium. But just before all this happened, and an inquiry looming, by November 30^th 1893 the porter, James Robinson, had judiciously quit, having handed in his notice which it was agreed to accept at this meeting. Perhaps he was aware of the unfolding events and he would likely, guilty or innocent, be in the first line of fire. While his notice to leave was accepted, the Matron, Mrs Robinson, who it seemed had stood her ground to the end either through bloody-mindedness or extreme loyalty to duty, was subsequently discharged, and given three months’ salary in lieu of notice. As the Blackpool Herald of the December 1^st reports, the situation had been described in a subsequent inquiry at the magistrate’s court as ‘a shocking state of affairs’ and to which the matron, husband porter and two nurses had to sit and listen to consisted of, ‘Allegations of misconduct and negligence were considered proved; cases of mismanagement and carelessness were sufficiently substantiated; in fact the organisation and discipline were admitted to be totally unsatisfactory.’ The Sanatorium was considered to be understaffed and ‘that many of the methods of nursing introduced were totally at variance with those prescribed and rigorously enforced in other well-managed hospitals.’ There were those however who thought that the matron should serve her notice as it would leave a vacuity and it would be seen as throwing good money away. Steps would then be desired to be taken by the Corporation as to the future running of the hospital and a replacement and fully qualified matron should be advertised for at a salary of £50 (£5,308.47) a year, while the Medical Officer of Health should make temporary interim arrangements until this post would be filled. So it implies that Mrs Robinson was not a fully qualified matron and, if she had done her job well and in good faith, it wasn’t good enough for the standards now expected on a different level of realisation by those responsible for the institution.

The newspapers then publish the story and take up the case for public debate, now outside the council chamber, on omnibuses, open trams, breakfast tables or office desks as the pages of the newspapers are turned to reveal the opinionated truths. In the defence of the Sanatorium personnel, the Blackpool Herald claimed that the matron and porter had been used as scapegoats and, as they were not answerable to the public, but had a subordinate position to the Medical Officer of Health, Dr Anderson, it is he who should bear the greatest responsibility. It was he who had engaged the part time and unqualified nurses from Queenstown and thus they were answerable to him and not to the matron, thus making her task difficult or more impossible. The inquiry was alarmed to learn that these less qualified nurses were paid 15s (£79.63) a week while the matron herself was on less that a £1 (£106.17) a week which was only marginally more than these nurses. Conflict between the Committee and some medical men had been evident for a long time, and there had been ongoing controversy over the running of the establishment, and heated complaint by some parties challenged by the firm justification of others. Rumours about the poor running of the Sanatorium had also been evident for some time among the public. The poor running of the Sanatorium had been emphasised by the fact that staff were recruited from the local vicinity of Queenstown without proper training, and practises were not fit for the purpose of a properly run hospital. Even though complaints had been voiced previously, there was a conspiracy of silence within the nurses and the Matron, and no useful comment could come from that quarter to confirm the accusations. But the argument in defence of the nurses who worked there was that they had more tasks to do than just nursing, even to carrying the coals for the burner, and had to sleep at the premises rather than officially at the matron’s house, such were the unreasonable demands on their time. The Medical Officer of Health, Dr Anderson, claimed that the Sanatorium was working well, but other doctors, led by Dr Macintosh had argued otherwise, that the organisation and discipline of the entire place were entirely unsatisfactory and proven in several cases of neglect and misconduct in fact, all in all, it was that ‘shocking state of affairs’. However the blame for the inefficiency within the Sanatorium was laid at the feet of Dr Anderson who after all was the overseer of the establishment and he was directly responsible to the Sanitary Committee. Suddenly on investigation in the police court all came to light and it was evident to some that Dr Anderson had been aware for some time about the inherent inefficiencies. This had been put strongly, among others, by Dr Kingsbury who pressed for an inquiry as antagonism between the medical profession and the Sanitary Committee was to be avoided in the public interest. While the nurses were engaged by the Medical Officer, the Matron thus had no control over them and could not discipline them. A fully responsible and qualified Matron in complete control of staff was what was required and who could ‘defy interference from anyone and who is alone responsible to the Sanitary Committee’ was what was required. The doctors, it seemed, could not even agree among themselves about the running of the hospital, so the matron didn’t stand much of a chance to undertake her work properly. However, the resolution was not complete at that time as there were objections to a stipend of £50 (£5,308.47) a year which was considered risible for a qualified matron and the causal, unqualified workers from Queenstown having been paid that 15s (£79.63), a week while the prospected salary for the new Matron was that less than a measly £1 (£106.17) per week not much more than the untrained staff.

Dr Kingsbury, a strong proponent of changes to the Sanatorium and a man on the exploratory fringes of advanced medicine in his publication on hypnosis, continued to insist that the Sanitary Committee proceed with changes to the running of the Sanatorium. And so it was a job for the Sanitary Committee, and Councillor T H Smith as its Chairman, to meet and resolve and, in doing so, agreed that changes had to be made to bring the establishment up to standard and to employ a matron, if one could be found, at that proposed £50 a year with board, washing and uniform provided.

And into the broader area of conflict and disagreement, and the somewhat continuing mutual suspicion and occasionally hostile verbal conflict between the Blackpool and the Fylde authorities in the efficiency and capabilities of carrying out inspections regarding aspects of health, while the Fylde authority did not want infectious subjects sent to the Workhouse and thus endangering the area, the Blackpool authority was on constant alert of the surrounding districts especially concerning milk which might be contaminated and coming in from the surrounding districts of the Fylde. A special watch by the Blackpool Medical Officer of Health was kept on an unnamed farm in Staining where he claimed he would know if there was ever an outbreak of typhoid fever, it would undoubtedly come from there.

But away from the lively and heated debate in the Council chambers, there was a public appeal for gifts and donations for those unfortunately confined to the Sanatorium during the Christmas period. At that time there was a serious flu outbreak, widely distributed enough to be described as an epidemic, and the kindly words of the newspaper towards the unfortunate inmates of the Sanatorium reflected the compassionate proclivities of a Mrs Barton of Lytham Road who, ‘will gladly undertake the distribution of gifts to the sick poor, and presents to the Sanatorium should be left at that institution.’ It was approaching mid-winter when this ‘serious’ epidemic of flu was prevalent and a non-medical, tongue-in-cheek explanation of its origin was given by the Blackpool Herald in the consideration that ‘the people are too much given to gossiping at draughty street corners’ especially at a time when a strong and cold north westerly wind was blowing through the town.’ Christmas was always a time to reflect upon the needy in a naturally, charitable way and the Blackpool Herald of late December encouraged it readers to reflect upon those unfortunate enough to find themselves as patients within the Sanatorium, most especially the children.

In the January of 1894, after reading the CV’s of 37 applicants, five were chosen for interview and out of these, 34 year old Miss Mary Cain, who was in a similar post in Liverpool, was unanimously chosen as the highly qualified matron. She would have control of the staff and could hire and fire them, and she would be obliged to report progress each month to the Sanitary Committee. At the same time, Dr Anderson was appointed as medical superintendent of the Sanatorium.

In the May of 1894, the salary of Dr Anderson was increased from £300 to £350 (£32,216.92 to £37,586.41) per annum. The original amount was to be only a £25 (£2,684.74) increase but a £50 (£5,369.49) increase was considered to be more appropriate, even though there was opposition in at least one quarter to any advance in salary at all. The sole objector to the salary increase, Councillor Wildman, also objected to the height of the Sanatorium boundary wall on New Road, and claimed that it should be lowered so that the public could get a view of the well laid out and picturesque grounds. He was shouted down however during the meeting, as not only did the Committee not want to display and advertise an infectious diseases hospital beyond what was necessary on one of the ‘main highways into the town’ but also that Councillor Wildman also owned a property next to the Sanatorium and, it might have been assumed, wanted to share the view of the greenery rather the blank, uninteresting wall, and his purposes were deemed to be, in no uncertain terms, purely self-interested.

However, all seemed to be ok with the Sanatorium from then until the June of 1895 when its controversy free period was interrupted by a doctor objecting to his refusal to be admitted to see to a patient of his whom he had allowed to be admitted there. This caused the other ‘medical gentlemen’ to rise up in arms against this arrangement, and the Sanitary Committee would be approached to explain, and expected to resolve, the situation. By law the doctors had to remove an infectious patient to the Sanatorium, and the patient would be willing to go on the professional advice of its doctor and thus, being under his care, able to see him any time while there. It was resolved eventually, but it demonstrates that doctors and the institution of the hospital were still at loggerheads and would also be, before too long, at the town’s Victoria hospital too with a similar argument, as private medical practice had now to construct a relationship with public, municipal institutions owned ultimately by the ratepayers.

In 1896 Dr Anderson, as the superintendent, writes to the editor of the Blackpool Herald to say thank you for all the Christmas donations to the Sanatorium. These are detailed in the subsequent publication, as fruit and flowers from Miss Howson of Bispham, books for the nurses’ use from Mr and Mrs Bancroft of Lower King Street, perhaps the same Mr Bancroft that provided the inmates of the Kirkham workhouse with a concert party in the December of 1892, fruit and flowers from Mrs Wildman of New Road, who perhaps was showing more generosity to the establishment than her husband had, and games and cards from Mrs Blackburn of the Post office. Dr Anderson was pleased to announce that, with the small surplus above the balance of the accounts of £11 6s 8d (£1,245.72) for the Sanatorium Christmas funds for the year, a bicycle had been purchased for the nurses’ use and he hoped that further donations would result in at least the purchase of a second bicycle, as at present the nurses could only ride out alone. Two collections of books are being arranged, one for the use of the nurses when off duty in the administrative block, and the other to be kept solely in the scarlatina ward for the use of the patients there.

In 1897 the ‘old’ Sanatorium gets a mention as it has been reserved for smallpox cases alone, though Dr Anderson, in his annual report reveals that the town has been free of the disease since 1895, so it can be assumed that the old Sanatorium had remained largely empty since then. It is however, shown in a court case in 1901 that it had been used as a mortuary after the police station on Lower King Street had stopped being used as a somewhat inadequate mortuary due to the smells arising from the below ground level. There is concern expressed by Dr Anderson in his report that the building, being of flimsy construction in the beginning, should only be a temporary measure and that a more substantial and fit for purpose joint hospital for smallpox should be considered for the authorities within the Joint Hospital Board of Fylde, Garstang and Preston. This would eventually result in the provision and construction of such a hospital at Moss Side, between Blackpool and Lytham. This annual report of 1897 covers all aspects of health, including the preventative measures of the cleaning of the streets and the disposal of refuse, to dealing with diseases and illnesses when they occur. Measles was prevalent as many people came in from other districts to the town, and there had been several cases of enteric fever which resulted in deaths (13 in all out of 66 cases) in some instances from eating mussels from an area under the piers which was contaminated with sewage. Infant mortality was a grave concern as the number of deaths of 70 recorded in August, totalled more than half, at 36 in number. The sewage outfall is not so far away from the pier jetties as to be washed over the mussel beds with an incoming tide, and the outfall from Spen Dyke, only 460 yards from Central pier, is immediately by the promenade hulking and only opened out when the tide is half way up. It was recommended that this outlet be moved to further up the sands to the low water mark like the other outlets and that the pier jetties be cleared of all mussels. Among these recommendations made were those of considering the use of the old Sanatorium for purposes other than small pox cases and ‘that plans be got for enlarging the Infectious Diseases Hospital, and improving the accommodation for suspicious cases of infectious disease, and for discharging patients.’(Blackpool Herald 9^th July 1897.)

The report of the Medical Officer of Health for the year 1896-97 was published in July of 1897. In a statistical analysis, the birth rate was 25.66 per 1,000 and which included 48 illegitimate children out of the 940 births. There were 630 deaths of which 123 were visitors, and 149 children under the age of 1 year. There were 73 deaths from the zymotic diseases (as opposed to 109 in 1895) and while there were no deaths from smallpox or influenza, there were 9 from scarlet fever, 1 from diphtheria, 5 croup, 13 enteric fever, 4 measles, 8 whooping cough, and 33 diarrhoea. There were 20 deaths from cancer, and 17 from tubercular conditions other than phthisis, 6 after the confinement of giving birth, 16 from injuries. The old Sanatorium was not fit for purpose anymore as the extensions to the cemetery will soon absorb it and the doctor might have considered that smallpox was largely under control though, if there was an epidemic, he was aware the lack of adequate facilities.

By now improvements had been made and the reputation of the new hospital had risen into the scale of positive public and professional opinion. The matron, Miss Cain, and the nurses can at last be singled out for their professionalism and care in the way that they carry out their duties. There was little objection to being admitted on a voluntary basis, as patients now feel they can be better treated there than at home, though when cases of different sorts were too numerous for the hospital to cope with, a method of selection had to be undertaken. Doctors were now allowed in to visit their private patients, which somewhat countered the fact that the hospital was an isolation hospital. However now, and perhaps for the first time since an isolation hospital for infectious disease had been established in 1876 the matron and nursing methods could at last be given the highest praise in public without objection. During this year 212 patients had been admitted out of 427 cases notified, 206 discharged and only 13 deaths (though only 6 deaths in another report). The total expenses of the hospital to include the sinking fund amounted to £1,785 (£191,690.70) with patient fees amounting to £79 (£8,483.79), and including within the total amount, £106 (£11,383.31) for the old Sanatorium. The average cost to the ratepayer for each patient was £1 3s 9d (approx £125.28) per week. It was however due to the speedy growth of Blackpool that the town’s health should be under the serious and continuing observation and control of the medical profession and, regarding this among other considerations, was that plans should be drawn up in a practical sense to enlarge the present Sanatorium and see to its even better accommodation and nature of discharging. Also considering the use of the old Sanatorium for cases other than the smallpox specifically used for at present, it was agreed that even the present arrangement for small pox cases was inadequate there. The cemetery was expanding and soon corpses would be buried within twenty feet of the building and in the not too distant future, the cemetery would take over the Sanatorium site and corpses would be buried there too. It was questioned why smallpox cases should not be treated with the same respect as other cases. It wasn’t the best of places from which to view the burial of others from your hospital bed in the very temporary accommodation that the hospital constituted. It was Dr Anderson’s view that the present situation could not last longer than two years and in that time another site should be found. Regarding the expense of this and the difficulty of finding a suitable site within the Borough, his own expressed opinion that ‘some agreement with the Joint Hospital Board to be formed for small-pox purposes alone for the Rural District Councils of the Fylde, Garstang and Preston’, that is to share the responsibility with the surrounding districts.

However along with the rapid development of the town, different problems had arisen to challenge the control of illness and disease. Not all the districts had yet been provided with a linked sewerage system and where houses were built outside this provision, the use of cess pools as in the times of yore were still naturally in use, and there was also the issue of contamination of wells for drinking water where habitations were not yet connected to the piped water system, and these wells had to monitored. This was a problem as far as infection was concerned, and the efficient removal of sewage, traditionally used to spread on the fields for agriculture, or sent out to sea where it was hoped it would not be seen or met again especially by holiday makers, was an added problem.

The proposal that a sewage farm should be provided had not been given any consideration, and it was considered sufficient to let the sewage flow out into the sea to the north and south of the town, leaving the central part more accommodating for holidaymakers where the raw sewage was evident for those partaking of beach activities. The solution for this was to move the sewerage facilities further out to the low water mark so conceivably less unpleasant matter would be brought back to the more populated parts of the beach. The removal of rubbish other than sewage, an activity referred to as scavenging, was also a continuing concern for the Medical Officer of Health as in 1897 for instance, in the holiday season, of August and into September, 2,618 loads of rubbish were collected and taken to the destructor by the gasworks. Factories, dairies and houses were continuously inspected as part of the Medical Officer’s duties and in this respect the incidence of phthisis (TB) from damp houses, to the infections from contaminated milk had been statistically reduced as well as the nuisances from badly ventilated houses and drains. The suspicion of the sea water contaminated by sewage was evident and, in the Medical Officer’s advice, that public baths should be provided for the ‘use of the inhabitants’, though no mention of the day trippers or holiday makers.

Not everyone can be kept happy, and not all the people can be pleased all the time. Sometimes complaints are valid and other times they can be prejudicially based without relying on too many facts. In 1897 there was a complaint by a member of the public in a letter to the editor of the Blackpool Herald about the generally insanitary conditions of the town’s streets and an opinion, it would seem, held by more than just the complainant, and also that the Sanatorium was too close to ‘small dwellings’ which now it would seem were being erected in that part of Layton. Sometimes complaints whimper themselves to sleep as is the hope of those complained at, and sometimes action has to be taken if the complaints stay widely awake. While the streets continued to be cleaned, and the general health of the town was under continuing consideration and review, the Sanatorium continued to function in its present location for a century and more, winning over the objectors and those of the following generations wondering what all the fuss was about, or not knowing at all as it becomes obscured by the passage of time.

By December 1897 it was agreed to engage more trained nurses at the Sanatorium at £28 (£3,006.91) per annum. For Christmas of 1897, responding once more to an appeal from Dr Anderson for gifts to the Sanatorium in which there was only one older inmate in an unspecified number of inmates, the rest being young, there were many gifts in kind and cash to make festive cheer. With these donated funds, the matron and nurses were able to decorate the wards with garlands and holly and on Christmas Eve, stockings were hung for each inmate. Some of the younger inmates, it is reported, also hung up their trousers with the legs tied up at the bottom as improvised stockings. For the dinner there was turkey, sausages and ham, plum pudding and dessert. At this time the parents visited the hospital but were only allowed to look in with worried faces at their children through the windows, but with the understanding that their child was receiving the best attention. In the afternoon there were games and ‘romps’ before a high tea, followed by the stripping of the Christmas trees, of which there were two, one being left for New Year. As the Blackpool Herald concludes in its report of this event, ‘The patients, nurses and servants all came in for a share of the dolls, fancy articles, pen knives, silver pencil cases etc., which crowded the tree. This was an exciting close to a happy day and, for the New Year another treat is in store.’ In this contented report, it does seem by now that the Sanatorium had a better reputation and a system in place both in its on-site running and in its outside administration where professional bickering was no longer evident and the opinion of all in was in unison, providing the necessary recipe to inspire public confidence. And also of Christmas this year, the Blackpool Herald reports that, ‘ The 21 patients at the new Victoria Hospital, ‘suffering from accidental injuries or from some of the ills that flesh is heir to’, were not forgotten either, and equally enjoyed fun, games and gifts from generous donations and the kind attentions of the staff.’

The annual Medical Officer’s report for 1899, which was his eighth report, for a population increase of over 5,000, though encouraging, ‘while the very low death rate of the last year affords grounds for congratulation, the health conditions of some parts of the district are still capable of much improvement’, thus showing a lack of progress in some aspects recommended earlier. The sewer pipe exit of Spen Dyke by the promenade had still not been extended as far as the low water mark and the recommended plans for the extension to the new Sanatorium to include further accommodation for patients had not yet been presented. The question of the old Sanatorium for smallpox cases alone had been largely settled by an agreement with the local Unions to send cases to the workhouse at Kirkham. There were four parts to Dr Anderson’s report, that of gathering statistics to help with analysis, that of the control of the spread of infectious diseases, the general sanitary condition of the district and the fourth, that of meteorology as the responsibility for weather report had been moved from the Borough Surveyor to the Health Department when equipment was moved from the north pier and elsewhere to the Sanatorium grounds in this year. In August of the previous year of 1898 there were 9,356 inhabited houses in a population of 20,540 as given. There had been 1,260 births in the district, which included 13 at the Kirkham Workhouse and of which there were 73 considered illegitimate. There had been 629 deaths, 16 of which occurred at the Kirkham Workhouse and four more in Manchester infirmaries. Added on to the death rate there were 143 deaths of visitors which it had been decided not to include as the illnesses had come in from outside the town. Each natural death had an immediately recorded cause, but of those which required an inquest, there were 12 through injuries, 2 suicides, 1 natural causes, 3 accidental drownings, 5 suffocation, 5 opium poisonings and six from excessive drinking. 26 other deaths had no certified cause. Of the infectious, ‘zymotic’ diseases notified, there were 259 measles, 77 scarlet fever, 10 diphtheria, 67 enteric fever and 5 puerperal fever. 28 people had been admitted to the Sanatorium as opposed to 22 the previous year, the average stay being 29 days. There were no deaths from smallpox, 5 from scarlet fever, 7 from measles, 2 from whooping cough, and 101 from diarrhoea. 23 of this total were visitors. Along with the insistence of vaccination as a controller of disease there were the anti-vaccinators who might take advantage of the fact that vaccination was not obligatory in certain instances. Dr Anderson as a proponent of vaccination and re-vaccination hoped that the general population would consider vaccination as preventive of disease and they would not have to wait for an epidemic to happen concerning the very fatal smallpox, and such like highly infectious diseases, before offering themselves to vaccination.

The early identification of disease was paramount to recovery at the hospital, but that there was a problem with friends and family who kept their patients at home until too late. While there was an increase in identification in both scarlet fever and enteric fever, these had been well cared for at the hospital and Dr Anderson could report as, ‘showing that the hospital is performing excellently the work it was intended to do, and that its administration, no matter what difficulties it has to contend with and criticism to meet, is giving general satisfaction.’ The old Sanatorium was not however considered fit for purpose and smallpox cases should receive as much care as others (and not in the cold, makeshift building with a grand view of a graveyard outside the windows that the old Sanatorium provided as referred to earlier). The problem of the old Sanatorium had not yet been fully resolved at this date.

In this year however, there was tragedy at the Sanatorium as two nurses contracted enteric fever from their work duty. While one of the nurses recovered, the second one died, and the newspaper, in its appreciation, reported her as one of the most popular and conscientious of the nurses among staff and patients. She was found however to be infected with tuberculosis and her cause of death was recorded as meningitis. Perhaps to allay public fears her tragic death was emphasised as the first recorded death of a member of staff since the hospital opened.

The costs for the Sanatorium for this year had been £1,383 (£147,050.31) and the average stay in the hospital for the 167 patients admitted was an average of 32.7 days. The cost per week per patient worked out as £1 10s 01d (approx £160.00) or £78 0s 05d (approx £8,293.51) for the year. The cost to the ratepayers of each patient averaged out at £1 15s 8.5d (approx £188.00) which was a little more than 12s (£63.80) increase on the previous financial year.

If this is largely the end of the story of the old Sanatorium by the cemetery site, the new Sanatorium continued to function and serve the community in cases of infectious diseases.

~~~~~~

PART TWO…..

The New Sanatorium

As the concept of a sanatorium had now been largely accepted, and the institution was able to function without the interference of opposed ideas, its story is now more one of function rather than the reason for its existence in the first place. It was accepted and, as such, it was ‘just there,’ existing with much less controversy and hence with much less newsworthiness. It was however a bit of a mysterious place, hidden behind high walls and concealed by trees and shrubbery and barred to the public, its function dealing with strange and life threatening diseases which could be locked away behind those secretive walls. However the bigger question was, with a growing and politically more active and influential population, how big it should be, and how should it be financed.

Into the new century and, by 1900, the new Sanatorium was gaining in public confidence and status as a regular institution rather than an unnecessary ornament to satisfy just a few crazed individuals, and the old Sanatorium was kept in its unenvious position next to the cemetery, its uses relegated to serving as a spare room for a possible outbreak of smallpox and then as a makeshift accident hospital and temporary and makeshift mortuary. 1900 was a quiet year for the Sanatorium and it was left to get on with its work without the criticism it had been used to. Christmas perpetuates the tradition of charity which was received with great enthusiasm by the patients, and administered with care by the staff under the direction of the matron Miss Cain. 1900 was no different, and with the gifts for patients hanging from the Christmas tree and the children made sure to believe that Father Christmas had arrived during the night bringing toys and gifts, a good time was had by all. The most well received gift however was tobacco for the male patients, though in an age when no health warning was attached and smoking considered as a male privilege. These were the people who could generally afford a place at the Sanatorium, but even for those further inland at the Workhouse in Kirkham, and also the recipients of charity, they were also nevertheless capable of knitting and sewing and creating decorations for the ‘domiciles’ and where the Master and Matron Trickey and staff pulled out the stops along with the charitable donations of compassionate well-wishers to make Christmas and New year as contented as possible. The following year 80 residents of the Workhouse were taken on a trip to Blackpool. All the party were dressed well in order for them to be indistinguishable from the rest of the crowds in the town. They were taken by tram to Fleetwood and then a trip round around the Wyre light on a steamer and back to Blackpool on the tram when they were given a meal at the Station Coffee Palace before returning to Kirkham.

The main feature of the year was the construction of the Fylde Joint Hospital Infectious Diseases Hospital at Moss-Side and, as the construction was nearing completion, applications for a porter and porteress appeared in the newspapers towards the end of 1901 The salaries were somewhat unevenly distributed, unless representing more work and responsibility for the man at £30 (£3,051.12) per annum as the porter, and £20 (£2,034.08) a year for the porteress. Both posts included extras and which also appertained to the matron at £30 per annum ‘together with rations, washing, and furnished apartments’. For the post of matron, it is insisted that ‘applicants must be fully qualified nurses with at least three years’ Hospital training’. The post was awarded to a Miss McCarthy who continued in her role until her resignation due to retirement in 1935 and a Miss Beardsall had been appointed to replace her. It was hoped that the Hospital would be ready for the summer of 1901 and available for all cases except smallpox, but the opening didn’t take place until the April of 1902. The average cost of a bed by 1904 was calculated at £573 (£57,649.84), the liability of the cost of the Joint Hospitals had being determined by size of population of each district, the larger the population then the larger the contribution. In 1904 applications once more appeared in the newspapers for a porter and porteress, as it might be assumed that the job had proved unsatisfactory for those employed or their employers. In the same year there was a scarlet fever epidemic which resulted in the closing of schools and some patients from Blackpool being removed to Moss Side. The Hospital had opened to children by 1906 when Christmas appeals for the children isolated there were included with the other hospitals. From that date, the newspapers have several stories and anecdotes, mostly of sad content, of those confined there and mostly from Fleetwood as the Blackpool papers are not yet available in digital form for many of these years. In 1935 the hospital was ‘overcrowded’ and extensions to accommodate at least an extra 18 beds were considered so that by 1937 an application for £27,000 (£1,521,885.94) to the Minister of Health for these extensions.

Back in Blackpool, by August of this year, on the announcement that Dr Anderson would be leaving his post as Medical Officer of Health to take up a ‘more lucrative’ position in Capetown, a meeting was then necessarily held to consider the appointment of his successor and the successful candidate was 36 year old Dr F Coutts, and who appeared well qualified for the job in his knowledge of bacteriology. Indeed, by December, he was giving a lecture on ‘Food and Bacterial Disease’ to the Blackpool Literary Society. Dr Coutts was from Ashton in Mersey and who would take over the post on September 2^nd of this year. With a change of Medical Officer once more, it perhaps inspired the Fleetwood Chronicle to reflect upon the post of the departed Dr Anderson. In a column of 6^th September of 1901, it suggests that ‘Blackpool’s immunity from serious epidemic outbreaks, and the speedy arrest of those which threatened, has done much in maintaining the town’s popularity’. In 1893 Dr Anderson had prevented an outbreak of smallpox from spreading through the town. In another concern in 1894 when smallpox had been identified, first in two lodging houses then in a third, the residents were immediately vaccinated and placed in the Sanatorium, and strict measures were taken to disinfect the premises and materials involved. Smaller outbreaks during the course of the year were similarly dealt with, ‘before the public knew anything about it’. A further scare was averted through the false news of a woman visitor dying of Asiatic cholera. Through Dr Anderson’s investigation in her home town, it was discovered that the woman had died of heart disease and not cholera, this news thus saving Blackpool’s vital holiday season as well as the good reputation of the town. Dr Anderson’s term saw the virtual end of all private slaughter houses and a veterinary inspector to inspect the carcasses before being offered for public consumption. The strict assessment of food offered for sale in the shops, and the hygiene of the premises were strictly enforced and the Medical Office was not slow to prosecute for breaches of such. Blackpool, through Dr Anderson was the first municipality to introduce rules for ice cream manufacture and succeeded, through lecturing throughout the country, in establishing a law that would require all ice cream vendors to be registered. In the 1899 Improvement Act for the town, powers were eventually received, against opposition, but with the cooperation of other towns to deal with the spread of tuberculosis through the consumption of milk. This had taken some time and effort but eventually the Local Government Board was able to be convinced, and a law was passed known as the ‘milk law’ and, similarly to ice cream, those supplying milk would have to be registered and comply with statutory sanitary considerations. Regarding the Sanatorium, it had only been opened for a few months on his arrival as Medical Officer, and in this reflective newspaper column he is given no criticism but all the credit for turning things around and providing a better administration to the place, introducing a properly qualified matron and trained staff. In this report it seems that Mr Robinson was the porter who happened to have a wife employed at the Sanatorium with him and who took on the duties of a matron, which does not appear to be the correct assumption as she, qualified or not, had been employed specifically as matron. It was Dr Anderson who had taken the Corporation and private companies to task over the ‘black smoke’ nuisance, and it is to his credit that by 1901 this ‘black smoke’ and its chimneys were less of a menace. It is also attributed to Dr Anderson that the Shop Act had been implemented and maintained against much opposition in the town. This required shop assistants (mostly referred to as females) should not work more than 72 hours per week in order not to over tire them and keep them fit and healthy. The long hours of the holiday season meant long hours for workers if profits were to be made and resulted in the opposition that Dr Anderson faced in front of the employers. The building bye-laws were as much a problem for Dr Anderson, and houses were built at a consistently speedy rate as the population was now over 40,000 and corners would be cut if at all possible. There was also the problem of overcrowding in the boarding houses and it was necessary to make midnight visits to properties to make sure that the inordinately close proximity of bodies and souls did not represent the threat of potential epidemic or the health of the town in general. The article concludes in its praise of the retiring Medical Officer of Health as he would be stepping on to the boat for Capetown at Southampton, ‘In the name of the town, we wish him every success, and happiness in his new appointment.’ No doubt, in South Africa at the time, there would be plenty to do in the field of medicine as the war continued.

In 1901 too it seems that the Poulton District had been appointed its own Medical Officer of Health in Dr Starkie who, in his first annual report, had praised Dr Anderson for allowing a patient with scarlet fever in his district, to be admitted to the Sanatorium in Blackpool.

The health of the town from1900 to 1901 shows the improvements that Dr Anderson had made. Deaths from diarrhoea, the common summer disease, were down annually from 81 in 1899, to 55 in this year. Infant deaths showed that the 41 children below six months who had died, there were none of those who had been entirely breast fed. The overall death rate had been 14.35 per thousand, less than other towns of similar size. Alcohol proved problematical, as the doctor showed with some surprised concern, as there were 15 attributed to this and only 3 of them were visitors. There was the need for the town to extend the Sanatorium to keep up in proportion to the growth of the town in its increasing population.

The census return taken and published in the following year shows that there were 50 men working as physicians or surgeons in the town, 14 dentists and 5 veterinary surgeons and there were 106 women working as nurses or midwives, 66 of who were single and 40 either married or widowed. Most women workers in all occupations were single, leaving the married woman to keep home and rely on the male income. But regarding the opening of the first Sanatorium 25 years ago, the focus on health had come a long way, from the employment of a single matron and a couple of less qualified nurses in a wooden hut in the middle of nowhere, to the establishment of a purpose built hospital with the agreed consensus of medical and administrative staff and the confidence of the public.

In 1901 too, it seems, that the Poulton District had been appointed its own Medical Officer of Health in Dr Starkie who, in his first annual report, praises Dr Anderson for allowing a patient with scarlet fever in his district, to be admitted to the Sanatorium in Blackpool. From this date the Medical Officer of Health, and superintendent of the Sanatorium was now Dr Coutts, who took over the post on September 2^nd of this year, after the resignation of Dr Anderson to take up a post in South Africa.

The question of the lack of a suitable mortuary had come about in this year as the body of a Mrs Annie Eliza Smith had remained in its coffin at the house where she was employed as a housekeeper to property owners who lived in Manchester. There was no mortuary for the coffin to be taken to as the only mortuary facility available had been in the police station and, owing to the smells arising to the police court above it, it was no longer used but there was a temporary one at the old Sanatorium by the cemetery. There was the suggestion that since the new Sanatorium had cost so much then why wasn’t a mortuary provided with the plans? A new mortuary would eventually be provided, but this would at first be built by the old Sanatorium on land next to the cemetery, so the question of the distance of travel from the town had not been resolved and the question of a mortuary being away from the centre of the town maintained. A new mortuary would eventually be provided at the New Road Sanatorium but the discussions would drag on for a while longer yet.

The salary of the new medical Officer of Health, Dr Coutts, would be £400 (£40,681.65) per annum with four yearly increments of £25 (£2,542.60). In the budget costs announced in 1901 for the previous year of 1900, the Sanatorium had cost £8,375 (£851,772.11). It wasn’t long before the newly appointed Medical Officer was in action as he proceeded to have all the rolling stock of the tramways disinfected. He was also instrumental in discussions to provide sanitary conveniences for the gypsies in their tents at South Shore. ‘It’s time something should be done’ is the opinion of the Blackpool Times in printing the short comment. His first health report, published in 1902 and consisting of 130 pages, revealed the somewhat unsatisfactorily dirty state of several of the unpaved back streets. He urged that all new houses be built upon a foundation of concrete – this would apply in particular to the south of the town on a substrate of peat and blown sand since the natural, glacial, boulder clay doesn’t make an appearance to the surface of the town until the north is reached. Of the population, it is officially over 40,000 though Dr Coutts estimates, probably quite correctly that in real terms, due to the nature of the town, this figure is more likely to be nearer 50,000. There is a ratio of women over men (seven men to nine women). The number of inhabited houses counted 10,647 with an average number of 4.87 persons to a house. There were 1,140 registered births of which 13 took place in the Kirkham workhouse and 76 were considered in the language of the time as ‘illegitimate’ births. There were 847 deaths, 131 of which were temporary visitors and there were 21 deaths in the Kirkham workhouse. There were 195 deaths of children under one year old, fourteen of which were not born in the town, 81 between 1 and 5 years old, 415 between 5 and 65 and 156 over 65. Of the deaths from the infectious diseases there were 204 in number, largely pneumonia and phthisis, and there were 29 deaths ‘from violence’ and five deaths from cancer and many from heart disease and ‘apoplexy’. Of the nationwide epidemic during the previous autumn and winter all the cases were treated in the old Sanatorium and ‘all recovered without any serious complications.’ Though the doctor does not mention the disease by name, he is presumably referring to smallpox. Enquiries made into the causes of infectious diseases dictated the actions taken by the Heath Department. During the year, 4,828 visits were paid to butchers and other tradesman regarding the quality of food on sale, resulting in eight prosecutions. Of the three private slaughter houses in the Borough, inspected by Mr Giblin the veterinary inspector, all were found to be following correct hygienic procedures. There were 151 visits to milk shops and dairies, but defects found in the shippons for which some vital remodelling would be desired. The registration of milk producers and vendors was being dealt with as well as the registration of ice cream vendors as per the Blackpool Improvement Act of 1899. 68 of the bakehouses on the register had been visited and four of these, found to be wanting in hygiene had been closed under the Factory and Workshop Act of 1896. Three cases had been dealt with under the Shop Hours Act in which the limit of working hours was set at 74 per week. There were three registered common lodging houses and these were regularly inspected, 105 visits having been made during the year. In regard to this, only one case of infectious disease was identified, this found in a ‘sandwich man’ – perhaps as a casual job as a newspaper seller and advertiser – and he was quickly dispatched to the Sanatorium, with a public means of paying for his stay it can be assumed. Smoke was also a nuisance and at the time an observation of two and a half minutes per half hour in which black smoke exited a chimney was considered sufficient grounds for prosecution. These observations resulted in four prosecutions. Regarding sewage on the beach there were 151 inspections made with enough reason to suggest that the beaches could be clearer of evident sewage if the times of discharge could be set to coincide with the appropriate tide times. Since the sewerage pipes had been lengthened to continue further out to the low tide mark however the cleanliness of the sands had improved.

As the responsibility for weather recording was taken over by the Health Department, some equipment was removed to the Sanatorium grounds. It’s not been determined whether this refers to the new Sanatorium rather than the old one by the cemetery. This latter one, largely redundant and in close proximity to the proposed new purpose build of an observatory by the railway line might be considered to have been an ideal site. During 1899, a sunshine recorder and a Fortin’s barometer had been placed in the Sanatorium grounds, New Road, and a rain gauge fixed there in 1901 before that purpose built brick and stone Observatory was provided in 1903 (‘about half a mile’ away) from the old Sanatorium on higher ground by the railway line, and when the equipment from various parts of the town was transferred to the purpose built observatory. In 1902 an anemometer (a Dine’s self-recording pressure tube) was placed at the north east corner of the North Pier Pavilion. The varying wind pressures could be observed by visitors and others alike, as the equipment mechanically activated a recording pen upon a graph through a tube from the top of the building.

In the Blackpool accounts for 1901-02 the Sanatorium had cost £1,938 1s 10d with a patient contribution of £114 4s 5d. There was so much public confidence in the Sanatorium now that it was considered more favourable, for those with money, to send their children there rather than keep them at home and risk further infection.

But the question still rumbled along whether it was right to extend the Sanatorium on its present new Road site or rebuild upon the 30 acre site that the Corporation had purchased alongside the cemetery. At the time the original Sanatorium was placed by the cemetery, it was in a remote area, but in the ten years since then, Layton had become much more built up and so both sites, present and past did not represent that remoteness that perhaps an isolation hospital should need. This question was constantly in the mindset of those responsible both for and against the siting, or indeed the very need for a sanatorium, a doubt that still persisted in a part of the argument and the argument would continue for a while longer. By January 1902 the Corporation were in favour of adding an extra 44 beds and improving facilities all round to that ‘excellent Socialistic institution, that admirable ratepayers’ mutual insurance against infectious disease’. It would cost £12,000 to £15,000, (£1,220,449.59 – £1,525,561.99) to create ‘one of the finest and best equipped in the country.’ But there were still those who were sceptical about the scheme, which meant that there would continue to be a delay in getting things started.

Christmas of 1901 had shown a falling off, for some reason, of subscriptions to the Sanatorium, but nevertheless the children were well supplied with sweets and fruit and toys under the supervision of the nurses and staff. Likewise at the hospital and the workhouse, those responsible and capable looked after, with equally generous hearts and consideration, the wellbeing of those unfortunate and less capable in the true spirit of a generous human interaction.

Matron Miss Cain had left the Sanatorium in 1901 to join Dr Anderson at the City Hospital in Capetown. But the show must go on and in January of 1902 a new matron, Miss Brown was appointed for the Sanatorium and who would take up her appointment about the middle of the month, coming from Liverpool where she was matron. She would continue in the post until 1905 when she would return to Liverpool. One newspaper article prints the name as Miss Florence Bell but this would evidently be a misprint. At a meeting of the Sanitary Committee, a detail was resolved concerning the boots of a patient at the Infectious Diseases Hospital that, if these boots cannot be disinfected, than a new pair will be provided at the Committee’s expense. Another detail concerned the purchase of another horse for the Sanatorium to replace the one, quite unfortunately, and inappropriately, perhaps, called ‘Hooligan’. And tenders for the construction of extensions to the Sanatorium would appertain to the current site only, and, presumably be invalidated or re-confirmed if a new site were to be chosen. Regarding cesspools, the Medical Officer would want any situated within a statutory distance from the Council sewerage to be abolished. And it was time to consider sanitary conveniences for the gypsies at South Shore which had been an issue for the Medical Health Committee for some time. It was also time to disinfect the whole of the fleet of tramcars.

And of course the existing Sanatorium needed regular maintaining:-

The status of the old Sanatorium in its use as a mortuary in its position by the cemetery was soon called into question when the jurors were required to travel the perceived inordinate distance to the cemetery over the inquest on the tragic death of 29 year old Alfred Carney, foreman lift engineer at the Tower, and employed at the Tower since its opening. The jurors, who it seemed were all older men, having worked all day, were required to walk the four miles or so round trip to the mortuary at the old Sanatorium at a late hour of night since there was no provision for a cab, which they would have had to pay for themselves, and the general opinion at the subsequent inquest was that such provision should be considered in future. Alfred Carney of 9 Percy Street was on top of the lift while he instructed the liftman to raise it slowly while he examined it. When at 288 feet the liftman, Sydney Bailey, saw something drop and he thought Alfred had dropped his bag, but looking out saw it is was one of his workmate’s legs. Sydney had the presence of mind to stop the lift and call out to his fellow workmates before collapsing on the floor of the lift car in shock. Three men ran up the iron staircase and retrieved the body by bringing up the second lift and secured the mutilated body, sending it down to a waiting ambulance at the foot of the tower. The Blackpool Times gives a vivid and perhaps exaggerated description, dispensing with a little sensitivity for the cause of dramatic effect, ‘The heart rending shrieks of the driver of the lift when he made the discovery, could be heard all over the building, and the blood, which flowed from the poor fellow’s injuries was carried by the strong east wind right on to the Promenade. In fact, several people on the front were for a time of the opinion that Blackpool was experiencing the phenomenon of a shower of red rain.’ Alfred, a married man, was considered a sober individual, a good worker and liked by his fellow workers and as the Blackpool Times concludes, ‘the accident was of a shocking nature and caused quite a painful sensation throughout the town.’

In May of 1902 it was eventually decided to build a new mortuary on a plot of land next to the Sanatorium in New Road, by the cemetery. It was to have room for seven bodies and a separate room for post mortem facilities. The original cost was estimated at £1,000 (£101,704.13) but this was reduced, on examination of the plans to £600 (£61,022.48) in order to save cost to the ratepayers. A tender of that £600 was accepted from Mr George Collins for its construction.

June witnessed the coronation of King Edward 7^th and the beginning of the Edwardian era and on the Saturday 29^th Blackpool celebrated in style. Britain was still highly nationalistic and proud and aggressively protective of its world power status represented in its empire and economy. The recent death of the Queen and the serious illness of the heir to the throne were threats to the nominal and highly worshipped heads of that Empire. Blackpool held its coronation celebrations in the face of controversy. The ox-roasting event, organised by the Corporation and which was to take place at the Raikes Hall Gardens, did not take place there at all despite the carcass being hung up and ready to roast, but the cooked meat was brought from elsewhere. The subsequent distribution of meat begged the question of where was the ox roasted and critics in the newspaper columns suggested rather strongly that it might have been roasted in the destructor or even at the Sanatorium, the two places where it would be less likely to be prepared for different reasons. In the distraction of pride in its empire, it was then the people themselves who suffered as the claims of the distribution of meat often went only to the wealthy and those of status.

In July of this year the Sanatorium is recorded as ‘at present a record in the small number of cases under treatment,’ a fact which gave credence to the claim to good health of the town and this had come about due to the healthy expenditure on the vital elements of controlling the spread of diseases. There was the cost of the Sanatorium itself and some of its highly paid officials, which may or may not have been a jealousy or a mild resentment towards those employed to look after the health of the town. £150,000 (£15,255,619.92) had been spent in sewering the town, and on top of that there was the cost of the destructor, the cleaning of the streets and the street conveniences.

On the 30^th of the month the town invited the members of the British Medical Association, which was holding its annual conference in Manchester. The idea was to lure the profession into considering Blackpool as the healthiest place they could recommend to send their patients for recovery. The Mayor, Alderman James Howarth met them at the station. In all, there were 200 invitations though how many took the opportunity of the trip to Blackpool is not revealed. They were taken to many of the local attractions ending up with a banquet at the Imperial Hotel. The Blackpool Times, in heaping praise upon the publicity stunt in successfully inviting a doctors’ conference to the town concludes, ‘They will discover that Blackpool is not just a mere tripper’s paradise – a crowded and jostling pleasure resort – but a town with fine meteorological and climatic qualities, and a place where ozone is inhaled in every breath we breathe, and where diverting and wholesome amusements are available as they are nowhere else. Hence the visit of the doctors to Blackpool will be as beneficial to the profession as it will be to the town itself.’ Blackpool is now a small town with a population of over 50,000 with a death rate 10.68 as compared to Brighton with 15.6 and for 72 of the great towns as 15.2 and as its Sanatorium was virtually empty, a credit to the efforts to keep the town clean and healthy.

The expenses for the year as accounted in August, included the travelling expenses for Council business. For the Medical Officer to attend the Medical Congress £14.14s, 0d approx. £1,523.86) and for Dr Alderman Kingsbury to attend the Tuberculosis Congress £8 4s 2d (approx. £808). The proposed Promenade widening was under discussion at the time and would soon be undertaken. It had engendered almost as much controversy as the Sanatorium had done in the past, and which continued to do so. The cost of sending a delegation to the Rhine regarding a contract for basalt to be used on the Promenade amounted to £175 12s 0d (£18,000). The contract for the supply of basalt was eventually established with stone from Northern Ireland. The Sanatorium itself, as a necessary extractor from the budget, cost £1,938 1s 10d (approx. £197,102.61) with patient contributions amounting to £114 4s 5d (approx £11,600.00) and it is now salutary to be able to claim that (only) those who can afford to pay are more than happy to send their children to the Sanatorium than risk further infection by keeping them at home. The costs for a delegation of Councillors Catterall, Cartledge and Hill along with the veterinary surgeon to Poulton and Fleetwood to buy a horse for the Sanatorium cost the ratepayers 8s 9d (approx £44.00).

In the same month of August it is deemed important enough news to report that PC Gerard of the Blackpool Police force is seriously ill in the Sanatorium. Relatives had been sent for, and the sentiment expressed was that it was hoped he would recover soon. PC Gerard appears to reflect the varied life of a policeman at the turn of the 20^th century. His role was not just to catch criminals and keep order, but also to act as a front line first aider, as often the policeman was first at the scene. From attending to misdemeanours when sleeping out was a criminal offence, to attending to drunken brawls and domestic violence through excessive drinking, to sexual assaults, to the careless use of a kite by a 15 year old boy and which cut the face of a woman riding atop an open tram, to attending to accidents such as falling off a donkey, or a woman with a broken leg having fallen on the slope down to the beach, of the lifeless body of a railway porter found on the track, where he had accidentally fallen in attempting to close the door of a moving train, left open by hasty passengers. Those injured he had advised and arranged to be taken to hospital, a place where he had ended up himself being the same flesh and blood as those arrested, cautioned, advised, assisted, or on occasion physically tackled. By October it was reported that PC Gerard was improving slowly at the Sanatorium and, in the same paper, it was declared that Councillor Mather of the Sanitary Department stated that the extensions to the Sanatorium would go ahead as soon as funding allowed. So, though an agreement had been arrived at, nothing could be done until the finance made an appearance. By November this urgency for extension was reiterated in the Blackpool Times.

In October, the young son of Mrs Elisabeth Moore of Chapel Street was struck down with scarlet fever and was taken to the Sanatorium and consequently a van was sent round to the house to collect the relevant clothing and bedding for disinfection at the hospital but, when it arrived, there was nothing to remove as it had all been taken away for whatever reason. Maybe they had limited bedding in the house to avoid disinfection, but Mrs Moore claimed that it was only a few clothes. This resulted in a prosecution but as it was the first case that had to be dealt with in this respect, and the defendant claimed ignorance of the requirements, instead of the £5 (£508.52) fine, only a 5s (approx. £25.50) costs was deemed necessary.

At Christmas time the usual appeal was sent out for gifts and toys for those unfortunate enough to be spending their festive period in the Sanatorium. There were several willing and generous donors. Regarding the gifts, or the fare, as it is described, ‘The fare for those who are able to touch it with safety, will be of the best.’ All gifts and subscriptions were instructed to be left with the Medical Officer of Health at 21 Birley Street, which had been opened there in 1901. At the time there were 33 patients in the hospital and some of the bunting and decorations were supplied by florist Mr Lonsdale of Glen Royd nurseries, Whitegate Drive, whose son was in the Sanatorium. Glen Royd would keep its name but change its function, later becoming a Co-operative Society rest home and then a municipal maternity home. Christmas dinner at the Sanatorium was turkey and plum pudding. In the evening the nurses had their annual dinner whilst the servants, not being forgotten, had theirs’ on Boxing Day. Christmas Day celebrations were postponed at the Workhouse due to the continuing recovery from serious illness of popular Master, Mr T O Trickey, but the inmates would nevertheless be assured of a generous Christmas fare. At the Victoria Hospital an equally eventful Christmas day was made possible by Matron Miss Peel and staff, the generous donations of many contributors and the visits of friends and family on the day. Rules were slightly relaxed and, quite ironically perhaps, the men were allowed to smoke for the whole of the day. The Christmas tree was in the male ward and all the 38 patients congregated there to receive their gifts from it, the porter, Mt Butterworth making ‘a fine’ Father Christmas. Christmas at the Sanatorium was created assiduously by the Matron and staff to be one of ‘sweet memory’. The wards re decorated as usual and there was a generous Christmas meal after the Christmas presents from the tree had been opened. The art muslin which had been used for the bunting had been given by Mr Lonsdale of Glen Royd on Whitegate Drive.

While the inmates of the workhouse had no doubt conformed and had been vaccinated, Mr Albert Stansfield of Fleetwood had, on Christmas Eve won his case to prevent his fourth child from being vaccinated. Albert had claimed to have had smallpox and in his words would not wish it upon his worst enemy, but his older children had been ill after vaccination and he was objecting on the grounds of conscience to present his fourth child for vaccination. Unwilling to prosecute in this instance, the court accepted his case with the warning that he must accept that he was doing the wrong thing. No doubt, Albert Stansfield felt, in his relief, that it was perhaps the best Christmas present while other might have thought him a fool.

But these unfortunate people could perhaps count their blessings that they weren’t among the 300 applicants for the means-tested Blackpool Relief Fund and who had little to cheer about Christmas unless they belonged to those few who were able and willing, as there are in every society at every social level, to get around the system and acquire more than that handed out to each.

By February 1903 the new brick built mortuary had been completed on land in between the cemetery and the old Sanatorium. It had been built to the design of the Borough Surveyor, now Mr J S Brodie, and incorporating design suggestions by Dr Coutts, the Medical Officer of Health, though at present during Dr Coutts’ illness it is left to Dr Butcher, the police surgeon, to praise its completion as a credit to a town much larger than Blackpool. Plain and unimposing on the outside, it had many modern design features internally relative to modern post mortem requirements and understandings. It consisted of a doctor’s or jury room, next to which is the post mortem chamber. This is provided with a Doulton’s 6 foot by 2 foot (2m x 20cm approx) white glass mortuary table, supported on fire glass pedestals. The mortuary room itself is provided with seven slate sabs suitably supported and each screened off by the ‘latest sanitary, waterproof curtain’. There are no windows in this room, only a skylight on the north side. However there is a parallel passage through which the bodies can be observed and identified by relatives and jury as and when necessary. Drainage at this part of the site had been carefully considered and the sewers laid in concrete, and throughout the floors are concrete and above, the ceilings are of yellow pine. The walls are of enamelled bricks and the ventilation is provided by ‘Shoreland’s patent adjustable inlets and outlets.’ Boiling water is available in five minutes through one of ‘Fletcher Russells Multibar hot water boilers’ situated in the doctor’s room and the rooms are heated by the same Fletcher Russell patent gas fires. Evidently a lot of thought and consideration had gone into its construction and the requirements of its function. The general contractors had been  Messrs Dryland and Preston who had offices in Blackpool and Littleborough, the joinery work that of Thomas Hartley and the plumbing the work of Messrs Coulston and sons, so much of the work had been kept local.

But back to the new Sanatorium, the cost of £25,000 (£2,542,603.32) for extensions was still proving problematical. While it was considered by all that Blackpool should maintain and protect its status as a health giving resort where thousands upon thousands arrive for the purpose of breathing in the fresh air away from the congestion of the heavily populated cities, the nature of the extensions to the Sanatorium were called into question. It was built when Blackpool had a population of 23,000 and now that figure was around 53,000. The contention was still that the building was now too close to the expanding town and should be removed entirely to a more remote spot, and it might be cheaper to pull it down and build it elsewhere anyway, the statistics provided being that land on other sites could be bought for between 1s 6d (approx. £7.50) where the ten acres required would cost £3,630 (£369,186.00) an acre and 2s (£10 17) per yard or £400 (£40,681.65) an acre at £4,000 (£406,816.53). The present site could be sold for 5s (approx. £26.00) per yard totalling £7,748 (£788,003.62) for the four acres it occupied. Sites suggested like Whitegate Drive, Dickinson (Dickson) Road, or between Blackpool and Bispham, ie at Hoo Hill are now heavily populated and would have been eventually subject to the same criticism had the site been moved to any of these places. The argument was eventually settled in favour of extending on the present site, and a delay would be detrimental to the progress of the idea of a Sanatorium suitable for current purpose and needed immediately, and it was decided to approach the Local Government Board for a loan of £23,304 (£2,370,113.11) for the construction of an administrative block and spaces for 24 more beds. This didn’t put an end to queries and counter proposals in the Council Chamber and even the school children, it was claimed with some legitimacy, walking past the hospital daily to and from the Devonshire Road School were being put at risk because of the proximity to the hospital and any airborne infection. But eventually the extension would be built on the current site, but not without further discussion, controversy and debate.

In 1903 the, ‘great event of the year,’ was the opening of the Observatory built in 1899 about half a mile away from the old Sanatorium upon higher ground. It was at this date that the equipment kept at the Sanatorium grounds was moved to the new purpose built building. Prior to 1883, observations had been taken privately from a house in South Shore before the Borough Surveyor took over the recordings, and when the equipment was donated by the private ‘gentleman’ of South Shore, who doesn’t get named, in 1883, the instruments were transferred to Bailey’s Hotel and then to a garden in Queen Street, while an anemometer was placed on North Pier close by. But, by September 30th 1893 when the responsibility for the readings was taken over by the Health Department, the equipment and its instruments, with its protective Stevenson’s screen, along with the rain gauge were transferred to the grounds of the Sanatorium in New Road. The readings for the year of 1903 showed a warmer winter but a cooler than average summer and some very heavy rainfall and a less scientifically defined observation of wind strength of 87 miles per hour in the blowing down of the tram station at Squire’s Gate. Then, following Nick Moore, the observatory closed and the meteorological reading equipment was then moved first to Stanley Park and then to Squires Gate airport where it remains today.

At Christmas time both the Victoria hospital and the Sanatorium were the recipients of charitable gifts and donations of ‘toys, books and all kinds of seasonal presents’ and these at the Sanatorium, distributed by Dr Coutts. They included in a long list in the newspaper column along with their individual named donors and represented, dolls, games and toys, sweets, a rocking horse, books and magazines, a turkey from the Reverend Mother of the Convent at Layton Hill, more turkeys, a pheasant and sausages, oranges, apples and biscuits, Christmas cards and clothes. The Victoria Hospital had an even longer list of well-wishing donors while at the Sanatorium, the Matron, Mrs Brown ensured that all the patients under her care experienced a happy Christmas time. For the meal there was the traditional turkey and plum pudding and there were games in the evening. The Christmas tree was laden with toys and gifts from these many donors, one of which was ‘Mr Gerrard’ from the police station and it would be gratifying to consider this was the same PC Gerrard who had recovered from the reason for his stay in the hospital. He donated 10s 6d (£12.55).

By January 1904 the extension to the Sanatorium was once more up for debate. An institution which had now been largely free of public controversy for a decade, was once more in the news, and the question now was whether to build on another site or whether to improve and extend the present site. This resulted in an enquiry arranged at the Town Hall under the chairmanship of Dr Farrar, the Local Government Inspector, and which was attended by nearly every member of the Council. The resident population of the town had increased to over 50,000, which could reach well over 100,000 in the peak holiday periods and the hospital only had 20 beds to accommodate this large amount of people and potential cases of infectious disease. While the cost was always a legitimate consideration for those responsible to the ratepayers, there was also the siting of the hospital and, as the town grew and developed around the hospital, there were those who considered it to be in the wrong place and wanted it knocked down and moved to a more remote spot away from populated areas. In this regard the site next to the cemetery was reintroduced to the argument as it would be convenient for doctors and visitors as the new tram route would soon be in service to its terminus by the cemetery. For the scheme on the present site the Council wanted sanction to borrow £23,500 (£2,360,842.30) to extend the hospital there, but those opposed to this scheme, and wanting another site, claimed that it would cost, presumably an acceptable £7,000 to £8,000 (£703,229.62 to £803,691.00) to demolish the present building. However, while a petition signed by 435 people living near the hospital and which included doctors, tradesmen and company housekeepers objecting to any extension on the present site, the Town Clerk explained, in attempting to allay fears, that the Council had a small hospital out at Elswick for smallpox cases so only less serious cases would be accommodated at the present hospital. It was proposed to create accommodation for 54 more beds (which would work out as a total costing £435 (£43,700.70) per bed to build the extension and to include ‘an administrative block, an isolation block, two ward pavilions, laundry, disinfecting and boiler house and mortuary block.’ The matter of cost was given serious consideration and by comparison the infectious hospital at Moss Side cost £573 (£57,564.37) a bed, when averaged, and Blackpool’s Victoria Hospital £581 (£58,368.06) per bed. It would also cost an estimated £46,000 (£4,621,223.23) to move to another site.

The arguments for the suitability of the present site took in the land levels and the consideration of drainage and sewerage and the distance between buildings, as also more particularly details as the prevention of the dissemination of contaminated air or dust into the surrounding atmosphere, as was considered in the construction of new houses. The inadequacies of the present building were pointed out as the ‘cramped accommodation of the nurses’ block where there were sometimes three nurses to a room and it was considered that a nurse should have a room to herself. There were 21 nurses currently working at the site and 18 servants, and these latter who would, it would be expected, live off site. The enquiry concluded that the present site should be extended and that there should be no delay in getting it underway. In the end the majority of the medical men got their way and the construction regarding drainage was shown to be overcome and the cost of staying rather moving elsewhere was accepted and the sanction to borrow the £23,000 needed was received on the 25^th of February and working out at £435 per bed.

The plans for the extensions were passed in June at a meeting of the Building Plans Committee.

1904 was the year of the promenade widening 100 feet towards the sea, constructed out of countless tons of concrete, basalt and shingle from the shores of Bispham and Little Bispham, for which the Lancashire Council sued the Blackpool Corporation for £99 (£9,906.27) for the damage done to its Bispham roads in carting the many tons of shingle to Blackpool. While this claim was due in the courts in July of the following year, a second claim from the Bispham Urban authority alone was eventually resolved the following year as the Council would pay £375 (£37,728.95) in compensation. As far as health goes for the many visitors who gathered to watch in fascination the progress of the new Promenade construction, August saw the resignation of deputy sanitary inspector Dr Clement Hope, as well as the monitoring of chimneys which poured out black smoke and the threat of cautioning before prosecution and the protection of the working conditions of children, two girls of who had been found to have been working 80 hours per week, six hours over the accepted limit and prosecutions were under way.

The health report for the previous year for the town, ending in May and compiled by Dr Coutts, saw a very low death rate. Deaths from Infectious diseases were also at a low level, and would have been better had not the unusually high number of deaths from whooping cough, from which there were 14 deaths alone, marked the figure up. The poorer classes who inhabited the working class areas of Revoe and Queenstown were, in the opinion of Dr Coutts, in need of education in hygiene, and this should be the duty of a specially trained female Sanitary Inspector or Health Visitor, and an early appointment of this duty would be recommended. Wash-houses should be provided in this respect and the sewers should be regularly inspected for ventilation. There were 1,218 births during the year, 11 being at the Kirkham Workhouse. 70 births were of an illegitimate nature at a rate of 1.32 per thousand and there were 165 deaths of infant children under 12 months. Of the 804 deaths in total, 121 were temporary residents and 19 at the Kirkham Workhouse. Food supplies and slaughter houses continued to be inspected as well as private houses and the three common lodging houses in the town.

By November, the Blackpool Times had in its columns an appeal for books, magazines, spare article, toys, anything that wasn’t needed but too good to throw away for the Fever Hospital on New Road and the Victoria Hospital on Whitegate Drive, along with the Cottage hospitals of both Lytham and Fleetwood, and not to forget that lonely place of isolation out at Moss Side.

There are those in any age and any society who would make profit by more unscrupulous means and in the December of 1904, John Barrow was such a person. He had called on several people in the town asking for money for the tram fare back to Thornton where his son, Richard, worked as a cow man and who had contracted anthrax. His plea to the generous people who had given him money was that he had been in the Sanatorium for six weeks (and in another report, 14 weeks with typhoid fever) and was now destitute. A Mr Cardwell, however, of Devonshire Road had suspected that his story might not be true and, after he had given him a shilling (1s; £5.09), later found out that his suspicions were correct. So John Barrow ended up in court. There were nine charges altogether and the amounts he had borrowed ranged from 2d (9p) to 2s 6d (£12.71), this latter from RHO Hills. The chairman of the Blackpool bench had little sympathy for a man who would abuse charity and the generosity of the people. Perhaps emphasising his contempt, the Chairman stressed that he, ‘did not know a town that did more for needy people, and subscribed more to charity than Blackpool’. In uncompromising manner he sentenced the defendant to three months hard labour in each case to run concurrently.

The usual Christmas appeal appears in the papers from the Matron and Medical Officer to give a little seasonal joy to the children isolated from family and friends, and all donations received with welcome at the office of the Medical Officer, 21 Birley Street. There were many people who contributed and PC Gerrard was once more on the list of donors. There was also a box at the hospital gates in which small donations were placed by individuals perhaps without the means of more generous donations. As a result of this appeal, Miss Brown the matron and the nine nursing staff gave the four patients in the typhoid ward and the 28 patients in the scarlet fever ward a festive period ‘as much as circumstances would allow’. The Christmas tree in the scarlet fever ward reached to the ceiling and Dr Coutts was once more on hand to distribute the toys and gifts from this tree to the unfortunate patients. Dinner was once more turkey and plum pudding, with blanc-mange and jellies for dessert. The ‘maids’, as the servants are described, presumably an all-female staff, had their dinner on Boxing Day and were given the evening off. The nurses and matron had their dinner the following evening and were accompanied by Drs Coutts, Johnson, and Stewart and his wife. Similar charity was shown by the community to the Victoria Hospital and the churches too exercised their stated compassion for the poor by organising gifts and events for those in need. The Chief Constable’s appeal for his Clothing Fund was well patronised and both the Workhouse in Kirkham and the common lodging house in Blackpool were not forgotten by those actively interested in the consideration and support of the needy.

Since the controversy over the cost and the placement of the Sanatorium was now largely irrelevant, and the project had been decided and was well under way, the argument in the early part of 1905 regarding public health was largely due to the objections of public conveniences, for which James Eaves had the contract, being constructed on the Promenade in full view of the hotels to which some of the hotel proprietors took exception. These were positioned opposite the Foxhall and the Manchester hotels.

In May it can be reported that the Sanatorium extensions are well under way and a finishing date has been projected for August 8^th, and this confidence is repeated in June, though by the end of August, in reality, it still had a couple of weeks to go before completion was reported. In August, Blackpool came in for praise by the president of the Sanitary Inspectors Association in the annual conference in London, as the ‘great sanatorium for the working classes of Lancashire and Yorkshire.’ While this class of people who worked the engine room of the Empire could be patronised in such a manner, their mass political representation was only in its infancy. The health of the town was continually monitored, a fact which would naturally keep down the number of inmates to the Sanatorium. The sanitary department made 598 visits to properties in the north of the town and 394 in the south. Smoke nuisance was continually under review and was a permanent concern and there had been many complaints. Three degrees of smoke nuisance from chimneys were identified by the colours of black, white and yellow.

Unemployment was now a considerable problem in the town, and established charities did their best to alleviate the hardship encountered through the lack of work where there was no idleness to work but a keenness to do so if work were to be available. A propos this, the idea of a soup kitchen was born and proposed by Tom Ward in the Brunswick electoral Ward which contained the distinctly working class area of Revoe, and the proposed locations would be in the Bethesda School or the Primitive Methodist School.

By December the Sanatorium is in the news once more as it was inspected by the Fylde District Sanitary Association and who were shown round by the architect of the extensions, Mr F Waddington. The new buildings included an administrative block, a ward pavilion for 22 beds, an isolation block for 10 beds a laundry, a disinfecting block and a mortuary. At a total cost of £15,000 (£1,509,158.10) it would work out at £430 (£43,262.53) per bed they were informed.

On the appointment of Miss Edith Proctor to the Sanatorium, a paragraph in the Nursing section of the publication, ‘Hospital’ of July 29^th 1905 reads, ‘The authorities of isolation hospitals are frequently far from careful in the choice of matrons for these important institutions. We therefore welcome the selection of a Nightingale nurse as matron of the Blackpool Infectious Diseases Hospital. Miss Procter, whose appointment we announce to-day, was trained at the Nightingale School, St Thomas’s Hospital, and the Cardiff Infectious Diseases Hospital, of which she has been deputy matron. She has also been matron of two other Welsh isolation hospitals, and her training and career justify the belief that she will prove equal to her new duties at Blackpool.’ In this publication, her name is spelled, ‘Procter’, rather than the ‘Proctor’ as it appears in the newspapers.

The Sanitary Committee placed on record within its minutes its appreciation of Miss Brown who has left her duties as matron of the Sanatorium to take up duties in Liverpool. It is not certain at this time what happened to Miss Cain nor does it seem newsworthy enough anymore to print the change of matron in an institution which was perhaps now considered quiet and reserved and devoid of controversy.

One of the features of Christmas was a reprise of last year’s doll competition run by the Blackpool Herald in which young girls were invited to dress and send in dolls for the Hospital and the Sanatorium, and for which prizes were given for the best ones. So no doubt there were both thrills and disappointments for the many children who sent in the dolls, and thrills alone for those who received them at their hospital beds. An example of a letter, accompanying one of these dolls and which reflected the sentiment of many others presented for the competition, reads; ‘Dear Sir, I have much pleasure in dressing this doll, and I hope it will bring joy and happiness to some little invalid in one of the Hospitals or Convalescent Homes during Christmastide. Her wardrobe consists of a pair of knickers, stays, red flannel skirt, white skirt, white blouse, dark green costume and hat to match. All her clothes take off.’ The signature is left out in the newspaper. One of the prizes awarded this year was to a young girl in the hospital who is bed ridden at present after three operation on her hips. There were 44 patients, mostly children, in the Sanatorium this Christmas, and the usual Christmas fare of turkey and plum pudding, blancmange and jellies were provided, and the toys from the heavily laden Christmas tree were once more distributed by Dr Coutts. The Matron and staff had their special meal on Christmas night and on Christmas Eve it had been the turn for the servants and domestics, now a difference between men, as servants, and domestics, as women, suggested. PC Gerrard was once more a contributor of funds as was for the second time Dr Billing, who would find fame or perhaps notoriety in his association as a practitioner involved with the ‘Brides in the Baths’ murder, one of which would take place in Blackpool in the years that were yet to arrive.

As the new year of 1906 arrived, and once Christmas was over and done with, the doors of charity in the corridors of the human condition were closed off a little, but never shut completely in some quarters, and human society progressed in the opening of the new Secondary school on Raikes Road as the question of secondary education was high on the political agenda as the school leaving age was fixed at a higher level and proof of age was needed for employment purposes. The question directly with health was whether to open up an outdoor sanatorium in an area away from the Kirkham Workhouse or, as was contended, there was enough space in that institution to create the facility there. It was also deemed necessary to make it obligatory to report cases of consumption since, as advised by the National Association for the Prevention of Consumption, the condition was on the increase. This Association also advised to prevent the careless spread of the disease, to place notices on the trams advising travellers not to cough and spit. Indeed it was considered a regular habit and the Blackpool Corporation decided to take measures to stop this ‘filthy habit,’ and even prosecute if it felt there was enough justification to do so. Since consumption was rife, it must have been quite a regular sound among the crowds that came to the town for their holidays away from the dirty industrial towns.

By Monday, March 26^th the Sanatorium extensions were officially opened by the Mayor, Councillor Broadhead, (who had previously laid the foundation stone) for inspection by the Corporation and, while there was still opposition between Council members as to the need, cost and value of the Sanatorium, it was claimed that, ‘it would be difficult to point to a similar building which has such advantages on up to date principles as this institution. Reference was made to the old wooden ‘Ducker’ Sanatorium at the cemetery grounds, a place that one of the party, John Wray, cemetery registrar, knew intimately well, and the progress that had been made with the building of the new Sanatorium, a progress furthered by the new extensions. As the tour of inspection continued, it would have seen a suite of rooms within the administrative block comprising of a sitting room, bathroom and bedroom which was at present used by the matron, but contemplated for the use eventually of a resident medical officer. But the matron, Miss Brown would not see the new accommodation for real for, in July, the Sanitary Committee placed on record within its minutes its appreciation as she would leave to take up duties back in Liverpool from where she had originally come.

The building also consisted of accommodation for nurses in the form of a large sitting room, dining room and servants’ hall and a dispensary and matron’s office combined. There is kitchen with a stone floor and gas and steam cooking facilities and storage room, two specifically for meat and milk. Above this, on the two upper floors, the inspection party would have seen the 17 bedrooms for nurses and servants provided with linen cupboards and two bathrooms. It is heated throughout via radiators fed from a boiler (‘calorifier’) in a basement cellar. The main patient accommodation is provided in a pavilion running east-west. Her there are two rooms of ten beds separated, as the male and female wards, by the nurses’ duty room in the middle. There are two private rooms in each ward with a single bed each. The end of each ward is provided with a green glazed chimney breast and green tiled hearths. Electricity is used and there are wall plugs by each bed to which incandescent electric bedside lamps can be attached. Outside the south wall is a glass verandah in the middle of which is the main entrance, and here there is a scullery, food lift to the upper floors and stairs to a children’s play room which is above the nurses’ duty room. Another block visited was a double isolation block with two 3-bed wards, 2 single bed wards and a lavatory, and the intention was to use this specifically for scarlet fever. The previous laundry building had been pulled down and the new one is equipped with all the ‘latest machinery and appliances’ and was also visited. This building consisted of a sorting room, wash house, drying room, ironing room and delivery room. The wash house was provided with a Summerscales washing machine, a hydro extractor, soap boiler and starching trough. In the drying room are four clothes horses and the drying is effected by the blowing of hot air. The ironing room has a 72 inch callender as well as an ironing stove. This equipment is powered by 9 horse power AC electric motor. The disinfecting block has two rooms, one for infected clothes and the other for the disinfected ones. Disinfection was by means of two steam disinfectors and dried subsequently by hot air. For the boilers, a new 60 foot chimney had been erected but in the cause of economy, and today the buzz word being recycling, the steam was collected and pumped back to the boilers.

But a projected scheme to build a second pavilion and a block to contain the porter’s lodge and a discharge block had been deferred to another time and which would cost about £5,000 (£503,052.70). So the Sanatorium now has accommodation for 54 beds and 8 cots. In all the cost of the work from the beginning, to include the projected extra 22 beds, has worked out at £33,900 (£3,410,697.31) or, broken down into a statistical viewpoint, £424 (£42,658.87) per bed. In all, it was believed that the extra accommodation and space would mean that better care could be taken with patients, and the diseases themselves more easily dealt with and controlled, and it was hoped also that the new extensions and facilities would provide for the future of many years to come. The contract for the supply of groceries to the Sanatorium was won by Messrs Burgon and Co.

Referring to the next available OS map of 1909, the new Sanatorium has been expanded westwards and now consists of nine separate buildings. The present Devonshire Road terminates at New Road and the Sanatorium is directly opposite the show ground where the C&S brewery would be constructed, and the abattoir beyond is evident. One of the buildings within the old Sanatorium area is now designated as a mortuary, though it is unclear as to which building belongs to that title nor the function of the other three buildings of varying sizes. While 1906 finally saw the end of the old Sanatorium with its removal (taken from Nick Moore’s comprehensive history of Blackpool) after serving its purpose under difficult conditions, the same year saw the extensions to the new Sanatorium completed. The old Sanatorium was at last taken down and the grounds eventually would be absorbed by the cemetery and those whose time had expired in their life above it.

1906 was the year in which the Open Air League was projected. It was much about the philosophy of keeping an open window for ventilation and the free flow of air to maintain a healthier environment, especially in more populated rooms like classrooms. As it was considered that, for the treatment and hopeful cure of phthisis, not only was the concept of fresh air promoted for even the simplest of tasks of opening window for ventilation, an outdoor sanatorium was also suggested as the responsibility of the local authority towards its population. This might take the shape of an industrial farm colony and would, it was believed, encourage sufferers, who belonged to the poor class of people to work outdoors and, if not able, to then be encouraged to an institution where much of the therapy would be outdoors. For the reasonably active, outdoor skills could be taught in order to prepare the patient for a life of work once cured or confident enough in health to be able to work. The aim of the League was to publicise the idea and to bring it to the attention of local authorities who might take up the idea. The movement was either encouraged or an influence upon the move to create an open air sanatorium for consumptives at Midhurst in Kent, financed by Sir Edward Cassel, father in law to Blackpool MP Wilfrid Ashley who had given £150,000 (£15,091,581.00) to King Edward V11 to use as he pleased. Perhaps because the king’s own life threatening illness previously which delayed his coronation, he had taken an interest in disease and its cures, and he had chosen the sanatorium for his gift. It was opened on June 13^th and its collection area was nationwide, and included Blackpool from where patients were sometimes controversially sent.

1906 was also the year when Blackpool was liable to a reduced amount payable to the Fylde Union for the Workhouse at Kirkham. All authorities in the district were liable to pay an amount and Blackpool, a little aggrieved at being obliged to contribute a higher amount than other authorities, was in credit by over £800 (£80,488.43) which meant a reduced bill for 1906. Capital expenditure on the Sanatorium for the previous financial year had been £9,365 (£942,217.71).

In May Dr Coutts was elected to President of the Blackpool Literary and Scientific Society at the annual meeting at the Town Hall, while at the same meeting, Mrs Coutts had given an ‘excellent paper on Marie Antoinette.’ The treasurer of the society was L H Franceys, the man who would be responsible for the moving of the Victoria Hospital away from its original site on Whitegate Drive, to its present site at Whinney Heys, another controversial move. Medicine and science went hand in hand.

The annual medical report of 206 pages regarding the health of the town, and compiled by Dr Coutts, ‘demonstrates in a striking way how thoroughly Blackpool is looked after in all matters of hygiene and sanitation.’ It shows that the death rate has decreased for the fourth year in succession and now is only 14.2 per thousand. Of the contagious, zymotic, diseases these deaths recorded the lowest figures on record and all these were from summer diarrhoea condition which did not have to be notified to the authorities. The majority of these deaths were in children under one year of age. The blame was not put on the mother but on the pressures the mother might have in the Blackpool season, and in some cases poverty preventing the acquisition of suitably healthy food. This being the case, Dr Coutts was a little disappointed that the appointment of a female sanitary inspector, who might advise on the greater care in the feeding of infant children had been put off once more. The increase in deaths due to cancer in the population is probably the result of older people coming into the town from other districts with the defects of age already registered within the body. There is now a fresh water supply to every part of the Borough and the new reservoir in Bowland, when completed, will provide 332 million gallons, so there should be no chance of a water drought in the population now recorded as over 55,000. There is a general antipathy towards vaccination in the population, but Dr Coutts stressed it would be beneficial in preventing the spread of infectious diseases if all children reaching 12 years old should be vaccinated against them or, some cases, re-vaccinated.

In September, over 200 delegates of the Sanitary Inspectors Association descended upon Blackpool. Greeted at the Town Hall by the mayor, they wandered through the town in the following five days, to the Winter Gardens, the Grand Theatre and other venues for business and inspected the Sanatorium, destructor and the abattoir and were free to wander anywhere they wanted at night. At the end of the conference there was a trip to Windermere organised for those who wanted that, or alternatively an excursion to Douglas for those who preferred a sea trip. The Conference ended on the Sunday where the delegates joined the mayor for a service at St John’s Church.

For Christmas once more, the usual requests and reminders appear in the papers reaching out to those of capable, charitable sympathies for donations for the hospitals and Sanatorium. Dorothy, the lady correspondent in the Lady’s column was confident in asking, through the proven generosity of the Blackpool readers, for books toys, flowers, and fruit. In the days of charity from those who have to towards those who have not, before the accepted responsibility of the State to do so, Dorothy was sure that, ‘You will certainly enjoy your Christmas better if you have helped a little child or its harassed parents to do so, too.’ This, she points out, would complement the distribution of the Chief Constable Derham’s, clothing fund which would take pace in a few days. In commenting upon the doll competition once more, ‘Dorothy’ was a little disappointed that the contributions were well down on last year, but the winner was that of a meticulously lifelike, lifeboat man sent in by 13 year old Grace Darling Parr, who would have, in the family surname, much experience and knowledge of the dress and lifestyle of a lifeboat man, whose family name along with crew members often graced the pages of the newspapers with real tales of bravery out at sea.

On a snowy, Christmas day, when the tam tracks were covered and impassable, and football matched abandoned, Christmas at both the Sanatorium and the Hospital was celebrated and enjoyed by patients and staff in the usual way and a long list of contributors is published.

So ended the year which had seen the opening of the Sanatorium extensions, the laying of the foundation stones of the Waterloo and Claremont Council schools and, among other churches, the two Mission Churches of St Thomas in Layton and St Andrew’s in Revoe. The year of 1907 began with the distribution of the Chief Constable’s clothing fund at the Police Station on South King Street. For this, the Blackpool Gazette and Herald is confident to state that, ‘In scores of households throughout Blackpool there will be a feeling of deep gratitude and contentment..’ and, ‘In this bitterly cold weather, the gifts of warm clothing will be especially appreciated.’ There were 2,000 ‘ragged looking’ children between three and thirteen years of age that arrived at the police station, seen to by the duty police officers and Mrs Orme and the Sisters of the Nursing Division of the Ambulance Brigade. Poverty and health was, in the first instance, not yet the full responsibility of elected Government as a state duty to alleviate, but that of the collective or private individual.

Early in the year, Dr Butcher was paid 10 guineas (£1,094.94), extra for standing in for Dr Coutts once more during his illness. The amount was seen as paltry as Dr Butcher had frequently stood in for Dr Coutts in the past. At the meeting of the Fylde Board of Guardians there was a motion to request from the Local Government Board to extend the borrowing time for the new workhouse from 30 years to 50 years. The Workhouse was still a focus for poverty and destitution on the Fylde Coast including Blackpool, as an unnamed young woman, homeless as it appeared and of unreported status, was found in St Annes and taken to the Workhouse. The £3 10s (£398.16) that was found upon her was put in the common fund of the institution.

On a less dramatic note, and one that would not tweak the heart strings, but important nevertheless, the contract for the supply of uniforms and overcoats to the Health Department of the Corporation had been awarded to Mr H Cornall of South Shore.

But in February, the Sanatorium was not able to save the life of Mr Arthur Wright who had been admitted there in February. The doctors who treated him thought he may have been suffering from an infectious disease but could not identify it. Mr Wright, who was only 40 years of age had had an outfitting business in Blackpool but which had failed, and which he had given up some time ago and went to live at 12, Wyre Grove. He was a member of the Royal Antedeluvian Order of Buffalos, a party of who carried his coffin to the cemetery at Layton. A post mortem revealed he had had a ‘disease of the brain’ which of course would not be curable or treatable at the Sanatorium. He left a wife and three children to continue their lives without him.

By March Dr Coutts, now fit and well, had been requested by the Health Committee to enquire about costs and facilities to accommodate the assistant resident medical officer at the Sanatorium, as proposed in the original plans for the administration of the institution. The appointment of this medical officer was not entirely acceptable to some who thought that it would be more appropriate to appoint a medical ‘gentleman’ to go around the day school’s from time to time in order to detect any possible cause or evidence of infectious disease, nipping it in the bud as it were. The proposal for a resident medical officer at the Sanatorium would only include board and accommodation, but there would be no specific salary, implying only a part time capacity if and when as needed. This indeed was agreed and finalised in August when Dr F L Hirst was appointed to the position for a six months’ period. He would act as deputy Medical Officer and take over in the absence of Dr Coutts, without salary as agreed earlier but accommodation and board, and a job which might be seen as perk rather than a charitable obligation. It was a fact which was taken up and criticised in some circles but justified as a kind of apprenticeship for the successful candidate in giving the opportunity to study for the Diploma of Health, as suggested by Dr Coutts.

Dr Coutts was also responsible for a periodical meteorological report, and was pleased to announce that Blackpool had recorded a very sunny latter part of March though the first couple of week had been wet. On another topic, while the several adverts in the newspapers glorified the provision and use of Turkish baths for health purposes, the Health Committee was considering the appointment, to a background of female agitation towards the right to vote, of a Lady Medical Officer. Not to be younger than 30 years of age and a starting salary of £65 (£6,470.11) a year with three annual increments of £5 (£497.70) to a limit of £80 (£7,963.22). It was with some controlled surprise that the newspapers could refer to the appointment of the Lady Health Inspector, Miss Annie Heaton, and who began her duties in the July of 1907, that it is a coincidence that the infant mortality rate of the town had reduced further in the quarterly review. Her salary by January of the following year was increased from £70 (£6,967.82) to £78 (£7,764.14). By the following year, too there is a Dr Victoria Bennett working successfully as a schools’ medical inspector without, it seems, too much obstruction. There were many children however who were sent to school in ‘an exceedingly unclean condition’ and their hair in a verminous state, I guess, for which the ‘Nitty Nora, bug explorer’ of many school days ago would be obliged to investigate. The figures for the year’s health of the town in general, give favourable, statistical death rates, through which it could be understood that the health of Blackpool’s population was in good state. In the same month the supply of groceries to the Sanatorium was awarded to Messrs Burgons, to Mr A Bridge for meat, bread to Mr Webb and drugs to Mr Boothroyd.

In June, the town once more hosted the annual conference of the North Western branch of the Incorporated Society of Medical Officers of Health for Lancashire. First there was lunch at the Winter Gardens then down to work at the Town Hall, where they were cordially welcomed by the Mayor, who had recently been cautioned by a policeman for speeding down the promenade. He wasn’t given a ticket, perhaps the policeman wanted to stay a policeman by keeping his job. After the conference the party were taken by char-a-banc on a tour to the various sites in the town relative to health consideration, and included the destructor, the abattoirs, the meteorological observatory and the Sanatorium, and each site was given the approval of the whole party. Indeed, in October, it could be shown that the inspections of milk had shown no traces of the tuberculosis that could be transferred to humans via the cow’s milk. The destructor was regularly monitored and found to be working satisfactorily despite the fact it had broken down at one time and had been the subject of complaints. And the Sanatorium, and the fact that visitors could be accommodated there and that symptoms could be identified and diagnosed and swiftly dealt with came in for praise from two ‘gentlemen’ from Barrow and Wigan who respectively felt the need to write to the Town Hall to appreciate the ‘kind attention and skilful treatment their children had received while in the hospital. In each case a cheque of undisclosed amounts was received ‘in grateful acknowledgement of those services.’

The emotional, physical and psychological health of children beyond the range of diseases was continually monitored and acted upon by the NSPCC and in July alone, 11 complaints of neglect were investigated by the Society’s north west branch, 12 of which were found to be serious and involved 45 children and ten offenders, on top of which there were 10 further cases issued with advice or warnings. In all 80 visits of supervision were made by the Society. It is not known how many of these cases referred to Blackpool alone.

By December the Christmas appeals are under way, and a special consideration for the children in the Sanatorium, isolated and ‘ruthlessly torn from the family circle in the interests of public health.’ All hospital and institutions are in need of the popular sentiment of charity, backed up by money and gifts. Donations of both can be forwarded to the Birley Street office of the Medical Officer or to the Blackpool Times office in Church Street, in which paper this appeal was made. As usual there was a good response to the appeal, and an even longer list for this year of contributors of books toys, sweets, gifts, and food items large and small from a host of generous folk, is once more printed in a long column, and similarly with the Victoria Hospital organised by the matron, Miss Peel. The matron of the Sanatorium now Miss Proctor along with Dr Coutts and the staff combined to make it a happy Christmas for all the 77 unfortunate patients in the seasonally decorated diphtheria, typhoid and scarlet fever wards. Once more the children awoke to find their stockings full by their bedsides, and gifts from the large Christmas tree were due to be distributed later on. Plum pudding and turkey was on the menu once more and, while the eight maids had their Christmas dinner, the dozen or so nurses took on their roles in looking after the patients, and had their dinner on the 27th. And in the Christmas spirit, The Fylde Board of Guardians had decided to grant an extra sixpence to those in receipt of poor relief. And to the 250 inmates, and organised by the master and matron Mr and Mrs Perry, it was seen as generous, and in the circumstances it probably was that the children were take to the new workhouse for their dinner but returned to the old one for their tea. And, in a deed that was not concerned with the need for Christmas spirit, there was also potential prosecution for those who might have stolen 200 pigs from the Workhouse grounds in Kirkham.

While Dr Coutts, in his meteorological capacity, recorded that there was more rainfall in the town in November than last year but, on the other hand, more sunshine, there was an army of men from the unemployment register keeping the streets of the town clean. And the Fylde Sanitary Authority attended, in Lytham, a lecture on ‘Our Milk Supplies’ to which there was ‘lively debate ‘afterwards.

In January of 1908 where ‘pathetic scenes’ were witnessed by the observer from the Fleetwood Chronicle at the police station in Blackpool where the deprived and impoverished children received their clothing from the Chief Constable Derham’s clothing fund, over at the Sanatorium was witnessed the death on the 7^th of the month of Mr Percy Robinson at only 37 years of age, as typhoid had developed from a period of being unwell. He was one of the founders of the Blackpool Sailing Club and a supporter of the National Lifeboat Institution. Well known in Poulton where he used to live, and Preston where he worked as chief clerk in the office of the Justice of the Peace, which he had attended n New Year’s Day, he was one of those energetic and popular people, sadly missed not only by his widow and two young sons.

The same paper on the 15^th of the month contained the report of the Council meeting and the contention of Dr Iredale that disease can be spread from the borrowing of library books which, during the course of a year can pass through many hundreds of hands, and travel to a great number of addresses. The provision of free libraries was considered a popular social requirement and the siting of the new Carnegie library, away from its current position at the Assembly Rooms (later built on Queen St as it is known today) was being discussed with opinionated vigour. It seems it was fairly new concept to consider and deal with. Dr Ireland contended that the natural, unthinking habits or carelessness of the borrower in turning pages with a damp finger, or spillages on the book, even in small amounts like a mild spot of grease or even a blood stain can carry diseases from one place to another, and in the case of a borrowed book to many places, and some of these can be very dirty houses. One of Dr Iredale’s contentions emphasised that books were popular with bed-ridden people and who are usually ill at the time with infectious ailments, and coughing and spluttering upon the book they are reading, especially in the case of consumption, allowed germs to multiply. While books had been taken to the Sanatorium to be disinfected, there wasn’t a fool proof method of fully disinfecting such an item as a book as you would have to take out each page and disinfect it separately. Dr Ireland had seen books that he would not put in a pigsty and smelled so strong there was not a harsh enough word for it, and he could name the dirty houses and the names of those who had possessed the books. So with the idea of the new library for which an estimated £15,000 (£1,493,103.23) might be spent, there had been no consideration that ‘they had not the means to keep their little library clean.’ But Dr Ireland’s conviction did not move the Council, after a vote on he subject, decided to take any action over his claims, not regarding them as important enough, and remaining sceptical over them.

In modern times (time of writing; 2023) there was the sad case of an old man living on his own who was discovered some time after his death in bed, having been eaten alive by bed bugs considered to have arrived in his home via a second hand book. So the question persists through the ages, and perhaps Dr Ireland’s claim might have had more credence at the time.

This month, too Dr Coutts gave a long talk about food hygiene to the Blackpool and South Shore Grocer’s Association. The long article has much information in it but sadly too corrupt on the digitised page to be legible to any reasonable transcription.

In the case of the neighbouring parish of Bispham, its Medical Officer of Health, Dr J Johnson, in his annual report, refers to three cases of scarlet fever, two of which were contracted by children attending schools outside the district where the fever was rife. One of these children was sent to the Sanatorium in Blackpool, without the knowledge or consent of the doctor it seems, so it is presumed they were able to pay. The other two remained in isolation at home and it is understood all three recovered as did a case of diphtheria. However one child died having contracted enteric fever, prompting the doctor to advise parents to take advantage of the isolation hospital at the Moss Side Infectious Hospital where open air treatment was available so there would less confinement to indoors as there would be at home.

The Victoria Hospital ball on the last day of January is described by the lady journalist, ‘Dorothy’ in several long columns, and features more than anything else the vivid descriptions of the women in their finery. No doubt looking grand indeed among the attendance at the revived annual ball at the Winter Gardens could be counted Mrs Dr Coutts ‘is always beautifully gowned and she looked so sweet and charming in, eau de Nil silk, the skirt having several shaped frills and paillettes of Paris lace, having a pretty black centre, the décolletage being very dainty with circular appliques of Paris lace while she wore a black velvet collar round her throat.’ And the matron of the hospital, Miss Peel, ‘was charming in a dark green costume and also wore her pretty white nurse’s cap.’ There was Mrs Winder who, if the wife of local Dr Winder, would be influential in nursing duties during WW1 which was not far off, ‘appeared in cream silk, having a deep satin band at the hem of the skirt, and the dainty bodice cut square on the décolletage.’ The Sanatorium matron, Miss Proctor ‘wore a more stylish gown of white chiffon with relief of black band at the hem of the skirt, and folds of black chiffon on the décolletage and puffed elbow sleeves.’ Mrs L H Franceys ‘was charming in her white silk gown, the under sleeves being of white net, the folded ceinture of white silk, while the décolletage had a dainty berthe of white lace.’

It was a different event on the beach where the woman’s movement towards the freedom from convenient male definition and the right to vote threatened to make a noise on the beach with the new gramophone when the weather would be finer. It was these women and the ten thousand who marched in London of June of this year who freed up the female to eventually wear what she wanted and were ultimately responsible for today’s female shapes where décolletage is not a mere suggestion and lower bodies perhaps over-tightly fitted into explicit buttock wobbling lycra that is the scene on today’s (2023) promenade.

In March, the Royal Sanitary Institution held its conference in the town, Dr Coutts being naturally mine host to the delegates. Visits were made to all the relevant sites, first stop being the Refuse Destructor Works where Mr Bee the superintendent showed them the ‘mortar making, clinker cleaning, tin crushing and fish manure plants’, which together would make an interesting day’s work for Mr Bee. Oyster shells, tons of them annually, made good agricultural manure and the plant could sell on some of its products from the waste that arrived at its goods yard. Luncheon was taken at the Tower Cafe after a visit to the Electrical Works when a tramcar took the party to the Gynn, Blackpool’s northern boundary. Here the Borough Surveyor J S Brodie took over to view the sea defences and the replacement sewage works at a cost of £460.00 (£45,788.50). Back they came to the Talbot Square to view the new sea defences there and then on to the Manchester Square and the new sewage pump which would prevent backup and flooding of waste material at high tide or in heavy rain. It is the year too where the public conveniences ‘a most objectionable eyesore’ opposite the Manchester Hotel which had invited criticism from the hoteliers who had to look out upon them and also from a public point of view, except no doubt from those who had a desperate need for their use, were proposed to be removed in a scheme which would see an attempt to clean up the beaches by constructing a sewage screen and filter in its place and the cost of approximately £3,000 (£298,620.65) was considered worth it. Then it was the turn of the Sanatorium which involved a trip back to Talbot Square and a change of tram to reach the institution. All the buildings and especially the new extensions were examined before tea was taken in an empty ward and the proceedings rounded off with the usual courteous, and deserved no doubt, thanks.

In March also, among increases in salary for Corporation employees, Miss Proctor of the Sanatorium received an increase of £10 (£995.40) per annum. The fees for vaccinations to be charged by the officers of the Fylde Guardians for both Lytham and Blackpool and district were set at 3s 6d (£17.42) if within two miles, and up to 5s (25p; £24.89) for cases over two miles from the centre of the district. Dr Coutts also received an award, but not a monetary one as he gained a BSc in Public Health to add to the Diploma of Public Health which he already held.

When the Sanatorium discharged its patients, and when these were young children, many were still in need of care and protection in the form of nourishment, and this responsibility fell voluntarily upon the Ladies Sick Poor Association which, like all charities, depended on the charity of its members and outside contributions to survive. Just like at Christmas for the hospitals, balls and bazaars and church collections and the private donations of individuals supported the work. This year the annual ball realised £53 17s 9d (over £5,000). In their annual review in April, the Association paid tribute to the lady Health Visitor, Miss Heaton, and the valuable and successful work she had undertaken. Here the great many cases of poverty and sickness in urgent need of relief she had attended to, and her advice to mothers and the help given by the Ladies Sick Poor Association in tandem with Miss Heaton, had prevented the deaths of many an infant child. In the last year, the Association had deal with 771 cases of need and each was supplied with nourishing food. But the main theme of the Association in this meeting was to encourage the funding for district nurses based at Victoria Hospital and who could be at the disposal of the Association.

By April, as scavenging the streets was considered exceptionally important to the cleanliness, and consequently the health of the town, it was decided to obtain ‘a dozen more of the orderly trucks,’ for the collection of waste and rubbish. In matters of public health also, the question of public sea water baths once more arose in the Council chamber. A site between the North pier and the Metropole was considered suitable but discussions and a decision would have to wait until the question of the public library and the market improvement scheme had been dealt with.

In April, tenders for the supplies to the Sanatorium were awarded to John Holt for meat, Mr W Richardson for bread, Mr Pye for milk and Henry Cornall for the making and supply of uniforms. The Grocers’ Association had recently been assured, on request, that all grocers could apply for supply and not, as perhaps insinuated, restricted to a few Council ‘favourites’.

Dr Coutts’ medical report for the year makes good reading, despite the fact that the summer had been a rather dreary one with little sun and lots of rain. With a population now at over 58,000, the death rate, infant mortality rate and the number of reported zymotic cases of disease were all lower than the previous year. In particular, he attributes the low death rates in measles to the early notification of the disease and consequently its earlier treatment. He also addresses, in stating the great safeguard and re-vaccination of children reaching 12 years of age, the organised opposition to vaccination and those taking unfair advantage of the conscientious objector clause and if this stance spreads, ‘there will be serious consequences to face in the future’. He would not have known that his argument would be revisited at the outset the 2019 covid pandemic. In the report it is revealed that tuberculosis is a big killer and out of the 788 deaths recorded for the year, 85 of these were from that condition. It was a condition that hadn’t improved at the rate of the other zymotic diseases, the rates of which had fallen and were under control, it seemed apparent. Blackpool, he claimed, was an ideal place to send a person for recovery if the disease was in its early stages only, but if it was advanced with ‘much haemorrhage and wasting and poor appetite’ then the strong winds and bracing climate would prove too much for them. Cancer was also an increasing problem in the town and there had been 57 deaths, 52 of which were residents and the other five, visitors. There had been 776 cases of infectious diseases of which typhoid fever and diphtheria had increased, scarlet fever had slightly decreased but there had been no cases of smallpox reported.

In April, an unnamed fisherman from Blackpool was sent all the way down to the Sandgate Sanatorium on the south coast, but had only stayed a single night before coming back home. It is not known what had put him off, but it was thought that he would have a better chance of recovery at home, which was presumably from consumption which the Blackpool Sanatorium didn’t seem to deal with directly. The cost of sending paupers to the Sandgate Sanatorium was borne by the Fylde Guardians and these costs were carefully monitored. There was natural controversy in sending ‘pauper’ patients all that way away when fresh air and outdoor facilities could be provided at the Workhouse but then, in sending them there, there would be no need to go to the expense of building special accommodation for these consumptive paupers at Kirkham. The cost at this time was between 30s (approx £149.00) and 2 guineas (approx £219.00) per week per patient. The ongoing arguments for the good status of the Workhouse are necessarily it seems, cost before compassion. Within the same discussions, there was considered no need to pay foster parents of the young children in the establishment as they were getting board and rent free. In the case of the provision of slippers for the children, since they were going about in their clogs, perhaps compassion and practicality won over cost as it was decided in a vote of 18 to 9 to provide the slippers. One argument for cost above compassion was that ‘the pauper children in Ireland run about in bare feet’ and ‘why not here’ was the suggestion as such luxuries might be considered unnecessary if added to cost.

In August it is learnt that Dr Coutts has successfully applied for a post with the Local Government Board Inspector. He will be leaving his post as Medical Officer for Blackpool and he begins his new role on October 1^st. He is missed by the departments with which he worked in the food trade. He worked hard to maintain clean water, unadulterated and pure food and hygiene in home or factory. He was also responsible for moving the dispersed meteorological equipment from both the North pier and the Sanatorium to a new site by the Hoo Hill bridge (this would be the footbridge over the railway, not the modern road underneath the bridge).

By September it was at last agreed to appoint a lady Schools Medical Officer to work under the supervision of the Medical Officer of Health in close conjunction with the education department at a salary of £200 per annum. Her duties would include the regular inspection of children as well as the supervision of the home life of the child, each with a reference to the prevention of the spread of infectious diseases. She would work closely with the head teachers and keep both parents and schools informed of any actions or decisions necessary.

On 29^th September, the popular Dr Coutts was given a generous send-off at the Sanatorium. It appears that the whole of the medical department including Councillors and staff at the Sanatorium were there to wish him well on his departure. He was presented with two silver candlesticks and a silver casket, the latter which was inscribed, ‘County Borough of Blackpool. Presented to Dr Francis J H Coutts by the Mayor on behalf of the Chairman and Vice Chairman of the Health Committee, and the staff of the Public Health Department and Infectious Diseases Hospital, as a token of esteem. September 29^th 1908.’ After the congratulating speeches and Dr Coutts own appreciation of those present and the time he had spent with them, there was a group photograph taken and, perhaps sadly, the whereabouts of this to date is not known. But that was not the end of proceedings as Dr Coutts was invited to the Town Hall for another presentation. This time it was a hand engraved tea tray from local jewellers Mr R Holt. The inscription read, ‘Presented by his brother officials to F J H Coutts Esq., MD, BSc, DPH, FCS, Medical Officer of Health on his appointment upon the medical staff of the Local Government Board. Blackpool, September 29^th 1908.’ And it still wasn’t the end as he was further presented with a framed address by the South Shore Grocers Association.

By December the run up to Christmas was started off with the doll dressing competition once more in the Blackpool Gazette and Herald and its sister paper the Fleetwood Chronicle which often contained duplicated pages. The results of this would be felt in a beneficial way to the inmates of the hospitals and the Sanatorium, which was the purpose of the competition. And indeed Christmas at the Sanatorium was made as happy an affair as it was possible to do so once more with the generous donations of those who could and those who felt the desire to give. The usual, large Christmas tree hanging with gifts and decoration was provided and in the decorated wards each child’s bed was provided with a gift filled stocking to wake up to. All the patients were treated to a sumptuous Christmas meal and the maids and staff would have theirs later on. As usual too, the newspaper could print a long list of well wishing and generous contributors.

So into January of 1909 a nurse Berry who had been at the Sanatorium for seven years left to fill another post in Yorkshire, and it was necessary to find a successor. And in the same month of 1909, Dr Rees Jones is now the Medical Officer and would continue, in a long stint, until 1940. In his first report he could announce that the death rate was slightly higher, except infantile death which showed a decrease, and there was no concern about the zymotic rate which compared favourably with previous years. There were 1,048 births during the (previous) year and 880 deaths. He had naturally taken over the meteorological report as part of his job remit, and could announce in the December recordings that Christmas day was one of the brightest days and the highest temperature was 51 degrees while the lowest was recorded as 17.2 on the last day.

The last day of January was the day of the Hospital Ball at the ‘beautiful’ Tower Ballroom and in which received the patronage of the leading families of the Fylde. The programme lasted from 8.15pm to 2.30 am and the dances comprised of fourteen waltzes, three lancers, a two step and a barn dance, so there would be many tired leading families making their way home in the early hours. While the waltzes were classed as valses, the sumptuous supper laid on had also a European flavour with a content of Galatine of Turkey a la Renaissance, Chicken a la Perigeux , Westphalia ham, Gele au vin, blancmange and even a taste of English hidden in the menu in game pie and ox tongue. The men, worth only a mention in name for their presence, took second place to the women in impact of appearance, and correspondent ‘Dorothy’ had two columns in the Blackpool Herald to describe the exquisite attire. Among the many women described in those two columns are included Miss Peel as the hospital matron ‘who looked exceedingly well in a lovely gown of ivory white satin with panes of lovely lace on the bodice bordered with silk bobbed fringe, similar exquisite Irish lace falling over the hem of the skirt in particularly elegant fashion with the pretty bobbed silk fringe border. Accompanying her were several of the charming nurses from the Hospital in their daintily sweet uniforms.’ Miss Proctor matron of the Sanatorium was ‘effectively gowned in white chiffon, with lovely relief of lines of black lace and touches of velvet on the bodice, the graceful skirt having a smart velvet band to the hem’. Mrs Doctor Iredale, without a first name, as all the Mrs and Misses were, and only a representative of her husband or pater familias whose name and status was obliged to protect by looking her best, ‘looked particularly well in a handsome cream lace dress, with finer lace adorning the graceful bodice. She also wore a cluster of pink rosebuds in her pretty, fair hair’. The men, while no doubt appreciating the status of the female form were probably more interested in the contrived slenderness of a corseted waist or the teasing depth of the décolletage.

In April the Sanatorium had the distinction of being able to accommodate Dr Mercer from East Lancashire on a three month training programme in infectious diseases. The Sanatorium also received a request from the Fleetwood Territorial Camp to send any infectious cases there that might be identified in the temporary camp. It is not known whether this request was accepted or not.

The supplies to the Sanatorium were awarded to Mrs Annie Robinson for bread, Mr Pye for milk, fish Mr Hilton, drugs W C Richardson, meat Mr E Garsden, and groceries Mr F J Brandwood. The sanitary Inspector uniforms once more to Mr Henry Cornall, and the uniforms for the Sanatorium staff to Mr W Crabtree and the supply of mackintosh sheeting to Messrs C Mackintosh and Co Ltd.

By June, the annual health report of the town was published by Dr Rees Jones and shows a satisfactory death rate for a town like Blackpool, for which a favourable heath report is vital. The infant mortality rate was slightly higher at 137 out of a thousand births which included those of visitors and those at the Workhouse in Kirkham of Blackpool residents. However, as the report of Mrs Heaton, the Lady Medical Officer, 20 of these had died at birth before feeding could be considered an attributive cause. Of the other cases 27 were breast fed and 97 hand fed and the conclusion was that breast feeding was the more ‘viable’. The Sanatorium comes for somewhat elegiac praise from the doctor, ‘From the short experience which I have had as Medical Superintendent of the Sanatorium, I can speak with praise for the matron, Miss Proctor, for her skill and management, and of the whole Nursing Staff, for the conscientious and able way in which they have carried out their duties on attendance upon the sick.’

Disinfection, it seemed, had moved away from steam alone to a set of chemicals and methods with names that would send some of the hardiest germs, and even the humans subjected to them, running for their lives. An infected premises would first be washed down thoroughly with a perchloride of mercury or formaldehyde and then fumigated with formaldehyde. Spraying machines had been introduced to facilitate the process. For removable items, they were taken to the Sanatorium and disinfected by steam. In 1908, 35,712 articles had been removed and disinfected in that way. For typhoid and diphtheria, the drains would be flushed with a solution of chloride of lime and, in a wider infected area, the sewers too would be similarly flushed. The drains are systematically tested from premises infected by enteric fever, diarrhoea and diphtheria.

In June there was, it seems, a legitimate complaint from the Fylde Guardians about sending a patient from Blackpool down to the Sandgate Sanatorium. For some reason the patient, an un-named man, had behaved as if he had thought he was being sent down for a holiday since he had no respect for the discipline of the place, ‘defying the medical officer and sister in charge’. The request from the South Coast Sanatorium was to have the man sent back to Blackpool and, while the Fylde Board could not prevent this, it would be counter-productive if an uncured man returned to the community as it could prove disastrous to that community. A patient could, by law, leave the hospitals as there was no legislation in place to make it obligatory to stay, a fact that continued to aggrieve those in the medical profession who would like to see a patient’s stay through to a cure instead if an infected person being freely allowed back into the community where the disease would spread to others. The south coast was indeed a long way off to send a patient to and, in August, the Blackpool relief Committee had recommended that a woman consumptive should be sent to the nearer Delamere Forest Sanatorium, which is a little nearer in Cheshire. Since the Fylde Board of Guardians had to stand the cost, the Blackpool Committee were criticised for not establishing the cost before recommendation. It was agreed however that if the cost did not exceed 5s (25p:£14.82) a week more than the Sandgate Sanatorium, then it could be accepted. While there were many complaints about sending a patient to the Sandgate Sanatorium, and many complaints from the patients themselves, there are always those who have opposite experiences and opinions, and in July of the following year a letter was received by the Fylde Board of Guardians thanking them for their consideration in sending the lady correspondent there, and for the fine treatment she received while there. This may have consolidated the opinion of those in favour of sending patients there and not to seek other Sanatorium venues.

In August of 1909 the annual cost of the year amounted to £3,772 (£371,513.42) for the Sanatorium, sundry sanitary expenses of £3,434, (£338,222.98) the mortuary, £4 (£393.97) and the ambulance £34 (£3,348.74).

In November, Alderman Heyes and Councillors Whiteside, Eaves and Hampson were elected to the committee of the Fylde, Preston and Garstang Joint Smallpox Hospital at Elswick a hospital which would soon have its share of controversy.

In December, it was decided to appoint a second Schools’ Inspection Officer. Offered to either sex, it was awarded to Miss Dora Bunting, a well qualified lady with a vast amount of experience up and down the country in a variety of institutions. December is the time for the annual appeal in the newspapers for contributions to the hospitals and the Sanatorium, and this year was no different as, at the Sanatorium ‘ there are a number of patients, mostly children who, owing to infectious disease, will be compulsorily isolated from their families and friends during the whole of the Christmas season.’ Families and friends may, if lucky, be just a face at the window. The office of the Medical Officer of Health was still 21 Birley Street to which donations could be sent. However this year, while there had been a greater number of children in the Sanatorium, the donations had fallen far short of previous years. It may have been the particularly bad weather preventing the purchase of presents and the appeal for the Ellen Vannin shipwreck disaster for the ‘charitably disposed,’ and a fresh appeal was made by Christmas Eve. However the effort put in by the staff and its ‘much beloved’ matron, Miss Proctor to decorate the wards and a Christmas tree whose branches were weighed down with toys and gifts, gave the 70 patients, who were mostly children, a memorably happy time. And it wasn’t just the Sanatorium but also the Victoria Hospital, the Lytham and Fleetwood cottage hospitals, the Lytham Home of Refuge and its nine children occupants on Warton Street in the town, and the Workhouse at Kirkham were all recipients of the charities of those who had the will and the means and the compassion to give.

It was decided in March of this year, at the meeting of the Health Committee, to make the position of Medical Officer of Health as a permanent position instead of being annually renewable. On other matters, the Health Committee decided to renew the contract for the supply of coal to the Sanatorium to Mr Fletcher for the following twelve months. The Medical Officer’s report for the month showed that had been 91 births and 54 deaths, a single death in this figure was that of a visitor.

As the open air treatment of consumptives was considered to be beneficial to the cure of the condition, the report of the Fylde Board of Guardians recommended that consumptive patients should now be sent to the nearer Westmoreland Sanatorium at Grange over Sands rather than all the way down to Sandgate on the south coast, and even then it was considered that patients returned home too soon and before they had properly recovered. This sanatorium did indeed get used as in the case of a Thornton man, 41 year old John Kehoe, who had been discharged as having improved satisfactorily. Returning home he returned to work at the Alkali works in Thornton where, after working a long shift, he was sadly found dead by his landlady the following day. No cause of death was reported, so no means of knowing here whether he had been sent home too early.

The Guardians also recommended that open air provision should be made in the groundsof the Fylde Workhouse, for those members who had visited the Workhouse would be failing in their public duty if action wasn’t taken immediately. In the words of member Mr W R Brandwood, ‘to alleviate the suffering of the patients’ in trying ‘to wipe out the fearful scourge which affected the whole of England.’ The cost of building two small shelters at the Workhouse in Kirkham was estimated at £45 (£4,385.99), but would need specialised nurses too to add the cost, and two small shelters might not be enough as consumption was a big issue with an unknown potential to an increase in the number of sufferers. By 1911 it was suggested that the hospital at Elswick should be used for this open air isolation hospital, but this suggestion remained at the suggestion stage as there was still the favoured opinion of creating required open space at the current Sanatorium. The Elswick hospital had remained empty and the staff idle, so why not use it usefully. Later in the year two small open air ‘huts’ were built but there was no provision included here for the indoor treatment of consumptives, the argument now being that to treat phthisis properly, the cost of sending a patient away should not be a stumbling block to the authority. Phthisis was a terrible disease and deserved the respect of any other disease, as stressed by those who championed its cause for a cure and hopeful eradication.

In mid June it is reported that Robert Garnett, a musician who had been at the Winter Gardens for a good number of years, was lying very ill with typhoid in the Sanatorium on New Road, and been there for about eighteen weeks. Friends and acquaintances offered their goodwill and hoped he would soon get well. To no avail however, as he sadly passed away at the age of only 33 years on the 17^th of June.

Once more, it is demonstrated that the life of a matron or nurse wasn’t only confined to the Sanatorium. They were capable of discarding their uniforms for something more exquisite if the social situation required it, and ‘Dorothy of the Blackpool Herald was on hand to describe it. The wedding of Frank Jepson and Ellen (Nellie) Jones at the Sacred Church in the town and then a reception afterwards at the Derby Arms before a honeymoon in Llandudno was a grand affair. Frank Jepson was the popular director of the Palace Theatre orchestra and Nellie Jones was the daughter of the Mr and Mrs Jones of the Palatine Hotel. To attend the ceremony among the finely dressed guests, Miss Proctor the matron of the Sanatorium was ‘decidedly attractive, costumed in navy blue faced-cloth, her hat of navy blue chip, having a band across the side of cerise velvet, and sprays of navy blue flowers.’ Miss Roberts of the Sanatorium looked particularly nice, costumed in cream serge, handsomely braided, and wearing also a lovely picture hat which suited her immensely.’ It is almost as if Dorothy, in her unconditional praise of the female presentation was a male though a male might have been tempted to include a little of the evidently physical body shape and form in his descriptions.

The decision to employ a district nurse having been taken, the relevant advertisement was laced in the newspapers.

The expenditure on the Sanatorium for the year ending in March 31^st amounted to £3,994 (£389,281.04), and that of sundry sanitary expenses £3,499 (£341,035.15).

By the time of the Brighton Congress of the Royal Sanitary Institute in September, attended by Dr Rees-Jones and Councillor W H Hampson, the condition of consumption was considered nationally to be grave enough to consider the creation of open air municipal Sanatoria specifically for that condition. On their return, the two Blackpool representatives were able to convince the Corporation that such an establishment was necessary for the town, and the preliminaries included considering two possible sites for the building and open air facilities. There was land belonging to the Corporation in New Road beyond the new show ground and closer to the cemetery and there was the suggestion of building the facility by the current Sanatorium. In the early stages a committee was appointed to look into the project and the costs. Health, of course, is the first predicate of a happy life and a long article in the Fleetwood Times of November 5^th projects the modern idea of health and how to maintain it. It contains references to commercial ideas and products which are ok for those who can afford them, or whose circumstances allow them the time and opportunity to use them. A time at a private Sanatorium for convalescence had many advantages for those in these privileged circumstance, but in unequal society these facilities are not available to everyone. Soon all these ideas of health and convalescence would take on a new urgency and meaning, and little choice would be involved as Blackpool would fill up with soldiers in training, and a little later many of the same soldiers began filling the hospitals and the many specially created convalescent homes as patients, with their severe illnesses and life threatening injuries as they might have to look ahead to a limbless future from the pride and energy of being a healthy young male just a few months earlier.

Christmas comes around again and the annual reminders to the public that donations to the Sanatorium would be most welcome at the offices of the Medical Officer of Health at 21 Birley Street. This would be the last Christmas that the donations would be taken there as the new Health Offices in Sefton Street were nearly finished and in structure, only lacked a roof.

The question of anti-vaccination reappears in the November of 1910, and represents the underlying scepticism of mass vaccination as a correspondent in the Fleetwood Times stands up for the children who have no say in the matter, and for the parents who are criminalised for refusing to have their children vaccinated. Mass vaccination is indeed ultimately effective in controlling the spread of disease, but inevitably there are those very few and unfortunate to who it has only a detrimental effect as their bodies might react unfavourably to the vaccine.

Christmas comes around again and while the Victoria Hospital with its 55 patients was well looked after by Miss Peel, the matron, and its flurry of well-wishing visitors with their generous donations, the Sanatorium, ‘looked more like a home of mirth than a place for the suffering,’ as Miss Proctor and staff, assisted by their generous donors with food, decorations and gifts, ‘made Christmas very pleasant for the patients.’ The patients, though fewer than the previous year, were once more mostly children and this year it was recorded that Nurse Eachus played Father Christmas. A full Christmas dinner was had by all who were well enough to eat in quantity and the Salvation Army band was on hand to play seasonal – and no doubt religious too – tunes. Away from the hospitals at the Mayor, Councillor Broadhead’s Christmas ‘at home’ invitation at the Town Hall, those concerned with the hospitals and who could take the time off, attended in all their splendour and once more ‘Dorothy’ goes to town with the women’s attire. Perhaps if the men had been in their underpants, they may have been worth a mention, or not, but it is the women who are on show and steal it all the time. Of the four hundred guests consisting of the more materially comfortable and influential families and personages, Dorothy, ‘our female correspondent’, is in her element. Of the medical profession present that can be identified, Mrs Rees-Jones ‘was costumed in mulberry cloth, her black, satin toque having upright bows of silver in front, with black wings at the side. She also wore lovely moleskin furs.’ Miss Peel of the Victoria Hospital was ‘costumed in cream, her pretty purple toque having wings at the side.’ Mrs L H Franceys of the hospital was, ‘decidedly attractive, costumed in brown, her pretty brown hat having a handsome black plume at the side.’ Miss Proctor of the Sanatorium, ‘appeared in black, with a pretty toque, with wings at the side, and black fox fur stole.’ Mrs Iredale was, ‘stylishly in costumed in navy blue, and also wore a very becoming black velvet toque, with broad silver ornament in front of crown, and Dr Dora Bunting, the only one to be given a forename was, ‘costumed in navy blue and also wore black furs.’

On the other side of society there were generous donations and handouts to the poor and the Police Constable’s clothing fund was distributed to the children. The hospitals were well patronised with donations, and at the Workhouse at Kirkham when the inmates had the Christmas dinner on Boxing Day, where ‘excellent arrangements’ had been made by Mr and Mrs Colshaw the Master and matron, there were ‘merry scenes.’

T

In the January of 1911 the hospital ball, which was a lavish affair, took place at the end of the month and is recorded by ‘Mignonne’ in the Blackpool Herald, but here there wasn’t the thrill or the skill and the enthusiasm of ‘Dorothy’ in describing the female attire. There were many women of note within the community present and there were a few nurses who had a name only and presumably wore something but not of enough import to warrant attention or description. Outside these social events, the more mundane question in the Council chamber was that of whether to use the hospital at Elswick for consumptives or use the present Sanatorium. Still it was debated, and yet no decision on the matter was taken.

And away from the Council Chambers, the Blackpool Socialist party, at a public meeting regarding health, passed a resolution which was to be presented the Council, ‘That this meeting of Blackpool Socialists heartily sympathises with the proposal to provide free ladies lavatories in Blackpool, and hereby urges the Council on grounds of health and injustice to the female sex to adopt the proposal at the earliest possible moment.’ (Fleetwood Express January 28^th 1911). Perhaps in building up a town with the profits of bricks and mortar in property, it should not be forgotten that it is people who are both the creators and the ultimate end point of profit, and these should not be forgotten in their moment of need.

By the end of January however, the Blackpool Health Committee had made the decision to visit the Elswick Joint Hospital to consider the possibility of using the building for the treatment of consumptives. The building had originalyl been intended for the isolation of smallpox patients, but in fact had never been used despite the obligation and joint responsibility of the Blackpool authority paying nearly £700 (£68,226.52) annually. However, there was much controversy over the site as it was on soft and boggy ground, and it was only two spades’ depth before the water table was reached. To use this hospital in a damp and low lying area would be no use at all in the treatment of consumptives. There were examples in other parts of the country of similar actions being taken where the incidence of smallpox had decreased and thus creating spare capacity for other uses. However at a special meeting attended by invitee Dr Sergeant, the County Medical Officer, he advised on postponing the decision for six months since smallpox, he understood, occurred in ten year cycles and a new cycle was potentially due to commence at any time. So there would be another half year before any decision would be made. This perhaps left more free debating space for the inclusion of ladies lavatories on the agenda when the Blackpool Health Committee was able to consider the question of free public lavatories for women, first brought up at the Brighton Congress of the previous year, and championed by the policy of the Independent Socialists.

In Dr Rees-Jones’ medical report for the previous year of 1910, Blackpool recorded it lowest ever death rate. This, claims the doctor, correctly meant there had been less illness, less cost of keeping the ill confined in hospitals, and less disruption to the working population with consequently less time off. The death rate from infectious diseases was only bettered by 1907 and this is attributed to, ‘the care and devotion of the matron and the nursing staff at the Sanatorium.’ The general health of the town is due also to the vigilance and diligence of the Sanitary authority in carrying out its work. . A graph was available to print in the newspaper of the death rate.

January too, of this year, in keeping the streets clean and managing waste, the town’s refuse destructor had recycled, by selling, eight tons of fish manure, 115 tons of mortar to supply the very active building trade, 32 tons of scrap iron, and found homes for reusable 58 loads of ground clinker and ashes.

The question of sending a patient down to the Sandgate Sanatorium arose again in May when an un-named Blackpool man who had been sent down there by the Fylde Board of Guardians asked to be sent home because he felt cured. He claimed he had been looked after well, felt better, and wanted to return to work. There were those on the Committee of the Board of Guardians who thought the Guardians were too free with applications for the Sanatorium there. If the man wanted to return home there was nothing they could do to stop him, and it was all a waste of time and money to send a patient there especially if they returned incompletely cured.

Of course when there seems to be no cure for a disease or an ailment there are always those beyond the medical profession wo are willing to give confident opinion and a column in the Blackpool Herald does such service to its readers as they address their problems or their opinions of cure or preventative disease regime to the columnist ‘MD’. The rest and the good diet and exercise recommended in the column would most likely work for those who have the leisure time and sufficient income to cover the costs. Many would have had, as those who could take the time for a promenade along the sea front in their finery and eat some wholesome fare, but many more who had the exigencies of seeing to their daily tasks to feed themselves and their families, wouldn’t. But it’s all advice and useful if it could accommodate everyone for a healthy population or even just a portion of it.

In the July of 1911 it was recorded in the Fleetwood Express that Mr Thomas Sanderson, Chief Sanitary Inspector, had completed 30 years in the employ of the Corporation, and it was worthy of sending a reporter around to Sefton Street for an informal chat, and to compile the story of his time in the service. He began work as a labourer in the Highways Department when Blackpool’s population was only 12,000 which had increased to 60,000 by the end of his 30 years’ service. He then joined the Fire Brigade as a volunteer, in the days when the tenders were horse drawn and, at one time, during the celebratory Preston Guild, he had spent eight hours in the saddle. He attended some serious fires until his resignation in 1891 when his required duties for the Corporation became too involved. In 1894 he was made deputy Sanitary Inspector, a post he held until July 1900 when he was made Chief Sanitary Inspector. One of the posts he had relinquished at this time was the chief meteorological recorder at the two sites of the North Pier and the Sanatorium on New Road. The Health and Cleaning departments were a single unit until separated in 1901. From Abingdon Street the Health Offices were then moved to Birley Street and as the work of the department increased due to the size and population of the town, staff were increased and new and more spacious offices in Sefton Street were built.

In the smallpox outbreak of 1894, Thomas Sanderson visited all the common lodging houses in the town between midnight and one o’clock in the morning to check for sufferers. Along with Dr Anderson who forcibly vaccinated all the ‘tramps’ (between 600 and 700) of the town, it was generally accepted that the vigilance of the two had resulted in keeping the disease out of the town. If found to have the disease, the patient was removed to the Sanatorium, but there is one instance of one of these, presumably reluctant, patients escaping from the hospital. Dr Anderson had no more to do than to seek out the patient whom he found in Preston and brought him back in the Preston hospital ambulance.

While Chief Inspector of Health, he had helped the organisation of both the Grocers Association and the Fylde Dairy Farmers Association in the cause of making sure of a pure supply of uncontaminated food to the town. He successfully prosecuted via the Food and Drugs act in relation to the description of butter when not pure butter, and his samples, when analysed, found arsenic added to beer. In all, along with the Medical Officer, he had been responsible for the relative good health of the town over the last 30 years.

In the Medical Officer’s report for the preceding year, and published in the newspapers on the 5^th September 1911. The report of 200 pages had been a little hampered by the removal of the Medical Offices to Sefton Street, and the publication of the census reports of that decade. The mortality rate was 12.47, the infant death rate 104 and the zymotic rate was 0.73 each per 1,000, this in a resident population of just below 60,000. Three deaths were recorded as from alcohol alone and all were women, but alcohol was a contributory factor in other certified causes of death such as cirrhosis of the liver. There were 13 deaths from diabetes and 50 from cancer. The general decrease in the death rate is attributed to the stringent efforts of the medical authorities to inspect, sanitise and vaccinate as preventative measures. Where disease had been identified and reported, the cases at the Sanatorium had reduced from 477 in 1909 to 303 in 1910. The cost to the ratepayer of keeping a patient at the Sanatorium at an average stay of 41 days for 287 patients, where feeding constituted £4 11s, (approx £439) was £2 5s 6d (approx £244) as compared to £1 13s 9d (approx £171) the previous year. The total cost of the Sanatorium being £3,888 (£378,949.60).

In September of 1911 another type of death was featured in the newspapers as the reports of two separate motoring fatalities about the same time and about which only traffic legislation rather than medical advice could prevent.

1911 was the year when an Insurance Bill was being read out and discussed in Parliament where a contribution was required to cover the cost of long term illnesses and hospital stays, including the sanatoria. In the present system of health care, the worker if it could be afforded, subscribed to a private scheme. The claims that the Insurance Act, a complicated affair that took some understanding would, through a national contribution scheme, provide less extensive insurance against illness than a private scheme ie 13weeks rather than the 26 weeks of the private schemes.

While in the Fylde, the case of an unnamed St Annes baker who wanted three of his children suffering from consumption admitted to the sanatorium for treatment, the argument was much about the £150 (£14,619.97) a year it would cost the Fylde Guardians. Here, it was suggested the children would be better off in the Workhouse, though there was no suitable accommodation there, and the best place would be the Sandgate Sanatorium. The baker was willing to pay 3s (£14.62) a week and, since the children were not disabled they could be put to good use there. The argument included whether the sanatoria were the right place for consumptives and that the 3s proposed by the baker should be increased to 1s 6d (£7.31, ie. 50%) more and which local authority should have the responsibility of decision and cost. A vote taken however, weighed more upon compassion, and it was agreed, by the casting vote of the chairman that the Fylde Board should take the responsibility and the applicant only pay the 3s offered. Another case in the April of the following year concerned a Blackpool man who had been receiving treatment at an unnamed sanatorium for nine months at the expense of the Fylde Guardians and had taken himself home and then applied for an allowance to keep himself at home. It was agreed by the doctor of the sanatorium that treatment was ineffective and the man himself wanted to go home to his wife and ten children where he could be most useful. Six of his children were at home and four working in service. After the offer of going to the workhouse had been declined, since he could take as much care of himself as he could in the workhouse, it was eventually agreed to award the man 7s 6d (£36.55) a week. This perhaps would be less than the cost of keeping him in the Workhouse and the man was evidently pining for home and it was not just expedient to let him stay at home but also more practical and sympathetic.

While it is understood that most patients survived their stay in the Sanatorium, there is the recording of death, if that person has a name of any popular note in society. On the 23^rd October 1911, the death was recorded from enteric fever at the Sanatorium of Mr Stewart Duncan Alexander, a popular entertainer. He was the principal tenor in the, ‘So and So’s,’ a comedic operatic group engaged on the North Pier and who were into the second week of that engagement. He was only 34 years of age. His greatest success had been at the Strand Theatre in London where he played the tenor’s part in ‘The Merry Peasant’ and from where he went on to form the ‘So and So’s’ about seven years ago. Originally intended for the medical profession, he had to give up his studies at Jesus College, Cambridge due to ill health and went into entertainment as an alternative.

Scientific research continued, and in this year of 1911, it was demonstrated that the different forms of bacteria, bacilli and cocci, could be identified in human breath when it had been formerly understood only to consist of water vapour and its constituent elements. In November of 1911 the Health Committee met to discuss Local Government Board’s, new ‘Public Health (Tuberculosis) Regulations which attempted to ease the notification of the disease among the responsible parties in which there was a voluntary element of notification. The Act which came into force on Jan 1^st 1912 made the notification of disease a legal requirement. In January, too, since consumption had become a notifiable disease, the cases of this and other diseases would no doubt increase. For consumptives, it was proposed by the district joint hospitals to use the new, and largely unused new small pox isolation hospital at Elswick, which had cost £22,406 16s (approx £2,183,833.52) to build for cases of consumption since it was perceived as climatically suitable. The last case of small pox at that hospital had been in 1909, and the original, temporary building had been sufficient to accommodate the relatively few cases of other diseases. Blackpool was paying its contribution as part of the joint responsibility, and to change its use from smallpox to consumption would mean there would at least be some return on the expenditure.

The National Insurance Act for the Liberal Government of Lloyd George, was a controversial Actwith those who held the power and influence in society, having to relinquish some of it to the working majority. It was an active time as the workers who had created the Empire demanded more of a say in affairs. Dock strikes, miners’ strikes and the continuing disruption of the suffragists and their militant partners, the suffragettes were changing society. The objections to the Act came from those who would suffer most, one party being the employers, as labour costs increased. As the human being will always be a human being until, perhaps replaced by machines, there are those within the Insurance Act who would take or advantage of it by cheating as the claims for sickness benefit rocketed with an essential proportion of convenient sickness and often at the expense of those who might genuinely need it but are unqualified to receive it. While compassion could be shown to those who were classed as paupers, or feeble minded, by those responsible for organising their care, there was also the practical approach of how real or how much of their own fault there was in their condition.

At the Workhouse, there was some objection to the proposal to buy an ironing machine at a cost of £161 5s (approx. £15,729.10) as this would give the inmates less work to do and create a ‘palace’ out of the place, to which many would be attracted to come. However, the motion was passed as the laundress had much work to do, in taking in the clothes from the Children’s home and there were not enough able bodied personnel at the Workhouse to assist her effectively.

By the end of 1911 a school nurse had been appointed and, when Christmas came around again, the time at the hospitals and the Sanatorium was conducted once more by the tradition of generous donations of cash and kind and the hard work of the staff in decorating the rooms and bringing the Christmas spirit to the appreciative patients.

As the year turned into 1912, February witnessed the death of John Preston Proctor a local dignitary to which the whole of the available staff at the Sanatorium staff attended the funeral service and interment. It has not been established to date whether John was in any way related to the Matron Miss Edith Proctor.

In June of 1912 the Medical Officer’s report was published, and it ascribed the higher than usual death rate (14.5 per 1,000) to that of infant mortality (126 per 1,000) and this itself due to unusually the hot and dry weather. The birth rate, too had fallen and there were 975 births registered, 474 males and 499 females. Of infectious diseases, measles was the most prevalent but scarlet fever, enteric fever, and diphtheria were low. Because of the need now to report any incidence of consumption as compulsory, the road to the eradication of the disease could be undertaken with more confidence. Of the notifications of the diseases, there were 84 for scarlet fever and only 2 deaths, diphtheria 40 and 6, measles 1,181 and 13, puerperal fever 5 and 2, erysipelas (dermatological disease) 26 and 3. In mid 1911 the estimated population was 61,052 with 13,714 inhabited houses. Inspection of basement dwellings, which were popular to let at cheap rates and could augment the income of the house owner, showed an improvement in conditions. The Sanatorium treated 213 cases which was a lower number than previous years.

In August 1912 the Sanatorium was in need of repainting and tenders were invited for this work.

The Insurance Act of 1912 was proving problematical as the legislation was complicated. It seems that Blackpool would be obliged to have its own specific Medical Officer, to act on behalf of the National Insurance Commissioners, to administer the regulations. The doctors in general, it might seem, did not take kindly to Government interference but, as an interim idea, it was suggested that Dr Rees Jones should act as that Officer at a Sanitary Committee meeting consisting now of both men and women. The Act would expect for a contribution to an approved Society, and contributors would be entitled to Sanatorium treatment. A National Insurance card would be issued to employees who would pay buy weekly a 6d (= 2½p; £2.36) stamp to affix to it. It was a time when the nationalisation of the coal mines was being discussed as nationalisation conflicted with private enterprise in a similar way to health care. An objection to the Act was that it would mean an increase in taxation with the Governments contribution to the provision of sanatoria for Local Authorities. One of the ideals of the Act was to get rid of the blight of consumption and, as the regular correspondent in the Blackpool Herald of August 20^th 1912 commented, ideas of treatment change according to the current understanding and, while it was not necessary to provide large and expensive sanatoria but rather, in cases of consumption, to provide the best accommodation in open air as much as possible for such cases. Government contribution to funding would be available for such buildings and discussions at Blackpool would continue on the provision of a sanatorium at Elswick, which was once more being considered as a joint responsibility with the other districts. The Insurance Act was thus seen as an act of despotism which increased local taxation, not an act to bring fairness to most, and protection from disease for everybody. A counter comment in the newspapers would remind those who amass wealth at the expense of those other of God’s creatures,’ the poor ill-clad urchins who may be seen daily at the Rigby Road Gas Works in their wretchedness, following and picking up the coke that falls from the carts etc., leaving the coke heaps, that it is a disgrace to “Progress” and Blackpool. They remind me of Lazarus at the feet of the rich man’s table.’ (Blackpool Gazette and Herald 29^th Oct 1912.)

The treatment of consumption was an ongoing issue, and at the Congress of the Royal Sanitary Institute held at York in September, Dr Rees Jones, along with Alderman Hampson Chairman of the Blackpool Health Committee, came back with the confident idea of separating severe cases from those mild cases which are more curable, the use of tuberculin in the treatment and the advantages of a tuberculin dispensary officer where a population of 60,000 as in the case of Blackpool would warrant such an appointment especially if that officer could combine the appointment with treatments at a sanatorium.

By September of 1912, as the first applications for sanatorium treatment were received by the Blackpool Sanatorium Benefit sub committee regarding the recent Act, which had come into force in July, and at the meeting in September of the Sanitary Committee, it was revealed that the Insurance Commissioners had agreed with the arrangements made for the sanatorium treatments. Dr Rees Jones had indeed been appointed as the medical advisor for insurance applications at a salary of £21 (£1,984.77) per year. The question of domiciliary, or treatment at home, was later discussed, and the doctors would argue that a double fee should be paid for night visits if needed, and the question of the difference in payment between insured patients and their own, private patients was raised. It was a question of private practice conflicting with state benefit and the obligation of the Council to underwrite this at a cost ultimately to the ratepayer. The treatment of patients at home, where that patient was reluctant to go into an institution, played a significant part in the debate on how to implement the Insurance Act, but also at this time it was considered to approach the sanatorium at Meathorpe, Grange over Sands for terms in sending patients of consumption there for treatment. Patients were usually reluctant to leave their homes to go into an institution because home life would be disrupted, especially if they were a wage earner. Where funding for a stay at a sanatorium, or a voluntary application and outside the Council funding, which the Council was expected to pay half for an uninsured patient, both the Ladies Sick Poor Association and the Chief Constable’s Children’s Clothing Fund would be approached in an attempt to provide assistance in such cases.

There were now regular meetings of the Blackpool Insurance Committee to discuss the requirements of the apportioning of funding in terms of health. The discussions included correspondence with the National Insurance Commissioners. Here, the Commissioners decided that the 3s 6d (£16.53) as fees, for attendance by a doctor should be reduced to 2s 6d (£11.81) as to comply with the agreed rate elsewhere.

A different source of income for the ever reliable sympathisers of society and those who show compassion to others, was evident in the will of Mrs Jane Ash, who was actually Mrs Jane Higgins and married to Mr Frederick Ash JP of Blackpool. Jane Ash left a contribution to the Sanatorium as well as the Victoria Hospital among many other hospitals. In each of these institutions she requested that a cot in the name of ‘Mary Ann and Jane Higgin’ be provided, though no doubt excluding the Battersea Dog’s Home which was included, or the National Lifeboat Institution where for either, there would be no need, it is assumed.

Eventually it was agreed, by Dr Rees Jones, that one of the wards of the New Road Sanatorium was to be put aside as a temporary ward specifically for the treatment of pulmonary tuberculosis, and it would be the first time that such a policy had been enacted to completely isolate such cases.

And at Christmas time again the festivities were not ignored in either Victoria Hospital or the Sanatorium. At the Sanatorium there were three Christmas trees, and the matron Miss Edith M Proctor and staff had ensured the wards were fully decorated. At this time the consumptive patients were allowed to have friends and family in for tea and while the maids had their dinner in the evening, the staff had theirs on Boxing Day. For this to take place, many donations, most of which were given named donors, were received in cash and kind as books, toys and gifts and seasonal food items.

In January of 1913 a somewhat extensive article in the Blackpool Herald attempted to explain the Insurance Act to its readers as the general medical benefits come into force the following day (Wednesday, January 15^th). In Blackpool there were an estimated 12,000 insured persons. The objections of the doctors had been largely overcome, and local chemists had been sanctioned to act as dispensaries for drugs. The benefits included sickness allowances for 13 weeks then a reduced rate for the following 13 weeks if required. Maternity benefit extended to the wife of an insured person if the mother wasn’t herself insured. There were three ways in which a sufferer from consumption could apply for help, ether to be treated at home, or from a central dispensary, which hadn’t yet been appointed by the Health Committee, or at a sanatorium. Accommodation on a temporary basis had been arranged at the New Road Sanatorium, but the Council was looking further afield for more suitable accommodation. There is also provided in the Act, a benefit in cases of disablement. Sickness benefit of 10s (50p; £47.94) a week for men and 7s 6d (47½; £35.81) for women. It was eventually decided as a temporary measure to last for a year, to set aside 12 beds at the Victoria Hospital and six at an, as yet undecided, curative sanatorium. It would cost the Authority £1,156 (£110,371.82) with an addition to that cost from the Insurance Commissioners. It was decided to have just one authority to deal with these consumptives, and this would rest with the Insurance Committee rather than the Health Committee of the Town Council.

The Sandgate Sanatorium had a good report in the meeting of the Fylde Board of Guardians, in which several letters of praise were read out from patients returned and cured. It was a time when several cases of desertion of families by husbands from Blackpool had arisen and though 6s (30p; £28.64) a week was awarded in two cases to prevent the deserted children growing up into delinquents, and it would also save the cost on society at a future date. It was recommended that the boys at least should be sent to a training ship, in which discipline was uncompromising. Indeed, four boys from the Children’s Home had been sent to the Indefatigable, moored at Liverpool.

By now (Jan 1913) Dr Godley had been elected to represent the doctors on the local panel of the Insurance Act Committee. Uninsured consumptives would receive half the cost from the Local Authority and the other half from the Government.

On the 9^th of February the sad news of the death of Mr George Alfred Schottler took place. He had been a consumptive patient at the Sanatorium for about three months the previous year. Son of the licensee of the Manchester Hotel, he was tragically found by his mother dead in the toilet on that Sunday morning. He was only 36 years old.

Tenders for supplies to the Sanatorium were placed in the newspapers in March.

On March 3^rd of 1913, the monthly meeting of the Blackpool Insurance Committee met, and was able to announce the appointment of newly elected members, Drs Godley, Butcher and Barton. These new members were then added to the Sanatorium and Medical Benefits sub-Committee. An application from Dr Rees Jones to join the panel was also accepted. There was much to discuss and to get doctors and laymen councillors working in tandem without disruptive counter opinions and attitudes. This didn’t always happen as, in the April meeting, several members left the room making it impossible to reach any decision. £100 (£9,547.73) had been received from the National Health Insurance Commissioners and there was now £149 11s 2d (approx. £14,000) in the bank. It seems that there were panel doctors whose patients could receive the benefits of the Act and non-panel doctors, who would be exempt from assistance if their patients chose them for medical assistance. By April, with much discussion as to how to include all relevant parties equally, and the question of remuneration for doctors, it was agreed to appoint Dr Winder of South Shore as representative to the non-panel doctors on the Committee. At this time it was considered necessary for there to be at least two women on the Committee. The provisions of the Act, and the arrangements to pursue its terms and keep in line with it in a new concept of looking after the sick, took much discussion, argument and counter argument in the Council chambers and within the various Committees.

The Health Committee had kept in budget for the year. The receipts from the patients (referred to as inmates rather than patients, perhaps implying a stigma attached to contracting an infectious disease) of the Sanatorium amounted to £214 (£20,401.86) which was considered a large increase. The budget for the following year allowed £300 (£28,643.20) for the new regulations regarding tuberculosis, and £240 (£22,914.56) for the erection of a storeroom at the abattoir where there was a problem with the large amounts of offal produced. The question was whether to use it on the farms or burn it on the destructor. Taking it to the destructor meant a journey through the town and local objections had been raised against this.

By May, the Joint Hospital Board had agreed to loan the Elswick Hospital to the Lancashire County Council for the isolation of cases of smallpox, subject to drain improvements being carried out. This would relieve the Joint Hospital Board of the ‘white elephant’ that the hospital had been described through its lack of use in the preceding ten years or so since it had been built. A condition of this loan was that another site for a smallpox hospital with fourteen beds should be found in Elswick and a site at Elswick Leys known as ‘The Cottage’ was considered to the objection of the 230 or so residents of the village. This was with justification as the land was low lying and often flooded. The question of sewage was a serious consideration as the usual course of action was to direct it into an existing ditch, though a septic tank was proposed in this instance to quell the objections of the dairy farmers who did not want their land contaminated with sewage through flooding. It was also a concern that Elswick was a popular spot visited by tourists in the summer months and the local income was augmented by catering at this time. There had already been a reduction in visitor numbers since the original hospital had been built and this new hospital would exacerbate that. It was hoped however by the local Board that the proposed site would be accepted by the Government. The site of the hospital as described on the Elswick Parish Council website is ‘where the four large houses at the entrance to the village on Roseacre Road now stand’ and ‘later the infamous Hoole House Bail Hostel.’ (Link in the acknowledgements at the end).

On more practical matters, a tramway shelter was being provided along New Road by the Sanatorium which would be of use to both tramway patrons and visitors to the Sanatorium. The reporter in the newspaper hoped that the seats would be respected by the children as there was an issue with the seats of these shelters being abused used by children (who it was easy to accuse), and who made the seats unfit for seating as they use them to stand upon, and it was hoped that they could be instructed by their teachers not to do so, thus leaving them available for those tired passengers and walkers who had most need of them.

In July the arrangements for the treatment of insured consumptive cases at the New Road Sanatorium was only waiting for the approval of the Local Government Board. The question of the meeting for July was whether doctors, should refuse insurance vouchers from holiday makers or those from out of town for whatever reason. It was considered within the rules to refuse these applications at that time.

But as much as the medical profession, and the organisation of society to support it via the concept of insurance, there was little effective support for the sickness of the mind. While an idea of understanding the human mind through phrenology, manifested on the beach and the promenade of the town, had approached the subject sometimes for serious analysis and often for material profit, a sad and equally alarming case of the sick mind was heard at the Blackpool Police court at the end of June when a young man of 20, subject to the ever potentially incontinence of his male sexuality and who had recently been released from the Sanatorium after a three month stay was caught by a passer-by attempting to sexually assault a three year girl near the Sanatorium. The woman confronted him and a van driver stopped and gave chase, eventually catching him, taking him to the New Road police station. Here his father had explained that his son was not right in the head and not been since the day he was born. He was afflicted with consumption and couldn’t get his breath, so he wasn’t sure why he could have run away as stated. His son was sent to prison for three months in the second division, a lighter sentence which perhaps was unable to grasp the severity of a crime considered much more seriously today. The little girl was saved by the prompt action of others, but perhaps no organised help for any of her subsequent trauma, nor for that of both sets of parents in the continuing confusion of the human condition.

And as we share the world with other living creatures, in July, there was a demonstration of the humane killing animals at the abattoir on New Road. A new method of killing had been introduced under the auspices of the RSPCA which involved a soft bullet fired from a gun-like contraption. A soft bullet was used as it had been demonstrated that a hard bullet could go right through the skull of the animal and injure anyone in the vicinity. Blackpool was reluctant to use the new methods and the butchers themselves were reluctant to have the responsibility of using a gun-like piece of equipment, preferring the old method of pole axing the animal. In the demonstration of the new method undertaken, Dr Rees Jones was able to show that the animal was quite dead despite the animals’ muscle spasms.

The Medical report for the previous year of 1912 was published in August by Dr Rees Jones. As there were now 500 more inhabited houses than the previous year, it naturally represented an increase in population, now estimated at 62,125. Basement dwellings were a particular bane to the Medical doctor as they provided a convenient means of cramming people into small and potentially unhealthy spaces for an easy profit to the property owner. Constant supervision was needed for these regarding lighting and ventilation. The birth rate was the lowest yet, and there had been 90 illegitimate births, 13 of which had occurred at the Kirkham Workhouse. Infant mortality was much lower, 85 children under the age of 12 months had died, a low figure which could be not only attributed to a favourable climate for the year, but also the hard work of the medical authority across the board. There was now a school Medical Officer, Dr Martha Adams who had seen to 573 medical cases during the year and had referred on those cases that needed further assessment or treatment. Fifty children had been provided with spectacles and the provision of dental treatment was at present under consideration. The death rate for the year was 12.14 per thousand. Only one case of scarlet fever out 83 reported proved fatal. Half of these cases were of children of school age. Of diphtheria there were 55 notifications, again mostly in children of school age and five cases had proved fatal. There were 720 cases of measles, and only four deaths from this disease. Pulmonary tuberculosis proved the most fatal disease, 133 cases being reported and which accounted for 49 deaths. There was a single and unusual case of an infant death due to diabetes in the year. The cost of the Sanatorium was £3,594. (£343,145.59). The cost of keeping the staff and patients well fed, worked out at 5s 1d (approx. £23.90) per week, which considered favourable and the work of the matron, Miss Proctor and the nursing staff were given good credit.

The question of the cost and distance of travel for jurymen concerned with inquests on deceased bodies from their homes to the mortuary on New Road and back to the police station was once more brought up, but dismissed by the Coroner as it was none of his business. The newspaper liked to report that the jurors and its foreman were perennial complainers and should accept the fact that the jurors should pay their own tram fares to and from the mortuary as a requisite of their duty.

Blackpool was a little slow in resolving the insurance question of accepting the green cards of visitors and temporary workers to the town and a deputation from the Insurance Commissioners visited the town to explain how other seaside towns were dealing with the issue. The doctors on the Benefits panel had then agreed to meet and work it out among themselves.

As the workings of the National Insurance Act proceeded, there arose the criticism of the limited time that the insurance benefit would last, as there were cases of patients being oblige to leave the sanatoria after the 13 week period of insurance and yet not being cured, making the cost of keeping a patient worthless. At a meeting of the Blackpool Insurance Committee in October, it was agreed that the Committee should join the National Association of Insurance Committees and pay an annual due of £3 3s (£330.75). The somewhat complex details of the Insurance considerations were discussed in an attempt to clear the air and attempt to get everyone on the same page, and the doctors fully aware of their requirements with the Insurance scheme. There was a vacancy on the panel created by the resignation of Miss Peel, the matron of Victoria Hospital, and this was filled by Miss Hoyle the matron of the St Margaret’s Rescue Home. Of the Sanatorium benefit sub Committee of twelve members, it was pointed out by Mrs Edwards that only one woman in the dozen was not enough and the woman’s opinion would not be represented sufficiently, though the vote for this at the time was lost. Another consideration was the payments of the doctors on the panel for work carried out on insured persons.

The National Insurance Act was new and complex and was the subject of the research by the Fabian Research Department to learn of its successes and failures. There were 16,000 people in Blackpool now registered to the Insurance in the terms of the Insurance Act. The major topic at the November meeting of the Blackpool Insurance Committee was the provision of drugs and the safety and effectiveness of the supply, and if a doctor was not happy with the progress of a patient using the drugs, he had the facility to query the quality of the drugs used. The Sanatorium Committee revealed that it had received two new applications, one for three months treatment and one for a month’s dispensary treatment, where the patient would be treated at home it would seem.

December comes around once more and Dorothy, the regular, representative female columnist of the Blackpool Times, was the first to remind the reading public of the gratefulness that would be expressed by donations to the hospital over the Christmas period, and not forgetting the patients of the Sanatorium who she seemed to consider were sometimes neglected in the public consciousness. The appeal, as was the norm, was well received and both the Victoria hospital and the Sanatorium were, once more, well patronised. At the Sanatorium the Christmas tree, ‘laden with toys and illuminated with electric glow lamps’ (supplied by the Electrical Department) was put up in the scarlet fever ward where there were several children.

1914 arrived, and the Insurance Act continued to be monitored and its finer details and issues, hitherto unseen, arose for both medical assistance and Sanatorium qualification. In January the budget report of the Blackpool Insurance Committee concerning the costs of the new Insurance scheme for July 1912 to January of this year was published. £7,484 (£714,552.48) had been received from the National Insurance Commissioners, and £63 (£6,015.07) from the Sanatorium Benefits, contributions from Approved Insurance Societies forming a small part of this income. Costs totalling £7,002 (£668,532.40) out of this income included doctors’ fees of £4,466, (£426,401.84) drugs and appliances, £1,042 (£99,487.40). The costs of the Sanatorium Benefit Fund included nearly £500 (£47,738.67) for maintenance of patients in the Hospitals and the Sanatorium, and the payments of staff and administration requirements as well expensed incurred by members attending the Insurance Commissioners Conference.

In February, while the Factory Act had provided for a woman to have four weeks off work after giving birth, there was no remuneration for her time off. The Insurance Act now provided for four weeks paid leave. An After Care Committee had recently been formed which provided after care for illness and consisted of ladies whose work was mostly of a charitable, unpaid nature. Led by Mrs H M Edwardes her address to the Insurance Committee in the February meeting was both forceful and erudite, and looked towards a future of compassionate care. The State had shown its consideration of this and, ‘We will free ourselves of the indictment that we have hitherto done nothing to make better workers and citizens, but have done everything to keep poverty alive’.

In February, the salary of the Medical Officer Dr Rees Jones was increased from the maximum reached of £600 (£57,286.41) – he had arrived at a salary of £500 (£49,246.21) per annum with four annual increments of £25, worth around £2,500. However since there were extra duties incurred due to the further treatment of consumptives under the Insurance Act, it was agreed on his application to increase this maximum to £700 (£66,834.14) in line with doctor’s salaries in other parts of the country and to award an immediate £21 (£2,005.02) per annum. Medical Inspectors salaries were also increased from £104 (£9,929.64) per annum to a maximum of £119 (£11,361.80) by three yearly increments of £5 (£477.39).

In the early hours of the third of April, those patients at the Sanatorium who were light sleepers, or who hadn’t yet been able to get to sleep would have been woken or alarmed by a very serious fire. It was a fire which raged for hours and which virtually destroyed the printing works of Maxwell and Co. just behind the Sanatorium on Boothley Road. Burning into the daylight of the morning, it would also have been a topic of discussion for those just waking up and would have alarmed the staff in its proximity to the building.

Away from the Sanatorium, as the arguments over the correct use of Insurance forms for patients continued to be an issue in its detail, the annual health of school children, compiled by the school medical officers, Dr Rees Jones and Dr Martha Adams, showed that, out of 4,063 children inspected, those children in cramped and ill-ventilated dwellings were likely to be nervy and fidgety, and poor nutrition constituted poor health. Regarding teeth, the lack of dentistry was an issue, cares was quite prevalent and the use of the toothbrush was encouraged. Spectacles were provided for those with defective eyesight. Soon the spectacle Department on Bristol Ave would be supplying spectacles to those men who would otherwise not qualify for military service without them as the War began. The cost of each inspection was 5s (25p; £23.42) and an application had been made to the Board of Education for financial assistance. 162 children were found to have chest complaints, seven of these suffering from pulmonary tuberculosis. Three of these children were admitted to the Sanatorium and after a stay of some months were considered cured and released apart from a single unfortunate child who had sadly died. St Vitus’s dance was quite prevalent and especially in Marton where rheumatism attributed to the wet, clay ground was common. There were also 64 cases of scalp ringworm and children under school age were invited for treatment. As far as psychiatric conditions were concerned, children were given various degrees of description as imbecile, feeble-minded, very backward or retarded, merely backward or dull and then epileptic or deaf mute. It was considered that two classrooms should be set aside at Revoe School for those considered ‘backward’ and ‘mentally defective,’ while those other descriptions and the deaf mutes, who were otherwise considered intelligent, should be sent to an institution. Here they could receive specialist training, while psychiatry was still in its infancy.

In the budget report of June 1914, Alderman Heap, the chancellor of Blackpool’s exchequer was able to report that the ‘Health Committee had spent £815 (£77,698.67) less than the estimate, which arose from additional patients’ fees at the Sanatorium. There were now more people, in unquestioning manner, willing to pay for the ‘great advantages of children going to the Sanatorium.’ This was referring not only to residents, but visitors as well. So the Sanatorium had further settled down into the public and professional mindset as a regular institution with no mysterious connotations, and one that now had both that public and professional confidence that it had lacked for such a long time from its inception and through it growth and sometimes painful development.

By the end of April, the total expenditure of the Health Committee for the sanitary expenses which include drain testing, the meteorological observatory, that contribution to the Fylde Joint Hospital and that of the Sanatorium on New Road reached £2,892 (£276,120.49) and within that amount the Sanatorium amounted to £797 (£76,095.45). The report shows satisfaction in the amounts spent and the favourable balance achieved, though there was dissatisfaction regarding the overspending on drugs and a fact which had occurred in a number of Lancashire towns.

At the end of May, because of the extra amount of work having to be undertaken for the treatment of consumptives, it was decided to appoint a night nurse at the Sanatorium. In a time of rapid population growth, the work of the Health Committee was never ceasing. In the last month ending on the 9^th May 1,937 home visits were made, a quarter of these by the District Nurse and many of these included homes where births had occurred. 88 tests of house drains had been made and sanitary defects at 74 houses were remedied. Visits were made to bake houses and common lodging houses, and 36 visits were made to workplaces regarding the safety and maximum working hours of employees. And of two applications regarding the opening of fish and chip shops, which were classified as ‘offensive trades’ as they were concerned with the treatment of dead organic matter under the 1875 Public Health Act, one was granted and the other refused.

By June a new motor street sweeper, purchased a cost of £600 (£57,286.41) was successfully demonstrated in front of the Mayor and Councillors on a stretch of the Promenade between Talbot Square and Victoria Street. Perhaps this was to the dismay of the street sweepers who could see their jobs disappearing in the advance of mechanisation. A motor ambulance had also been bought at a similar cost of £600.

In June, the Royal Sanitary Institute held its 29^th annual meeting in Blackpool and which took place at the Secondary School. The subjects discussed had a wide range which included the water supply, removal of household waste, the cleanliness of the streets, where it was disclosed that Blackpool had a higher percentage of wood pavement than most other towns, and this was considered as less hygienic. It was considered that in all towns a better method of collecting household waste was not available to replace the ‘method of refuse collection by calling at each separate house with a dust cart and a couple of grimy workmen.’ Burning of household refuse was perhaps the most hygienic way of the disposal of this refuse, but a way of converting it into fertilising manure would be less wasteful and more scientific.

Regarding the physical cleanliness of towns, the futuristic idealistic vision wished for by the Institute, in the words of John Shanks Brodie, Blackpool Borough Engineer and Surveyor presiding and in quoting a “distinguished” but un-named writer reads, ‘may we therefore, in true scientific optimism, discern the approaching time when all highways will be clean, noiseless, non-slippery and well lighted; when every man, however poor, will, if he cares to, be the owner of his own comfortable home; when all towns and villages will have wide, beautiful, tree-shaded streets; when every cottage, however much isolated in the country will have an abundant supply of good and pure water, adequate drainage and pure fresh air; when heat and light will be laid on to every dwelling house in the shape of a gas, a liquid or an electric current, and coals and coke will be unknown articles near the habitation of man; when house refuse will be removed from each house by means of pipes or tubes as sewage is at present, and used to replenish the earth from whence it came? When these scientific forecasts, or prophecies, have come to pass (and they are now visible in the eye of faith) then shall we municipal engineers and surveyors feel that our efforts in “directing the forces of nature for the use and convenience of man,” have not been in vain.’ Blackpool itself was expanding rapidly and the future of towns was seen as accommodating the motorised vehicle alongside the development of garden cities. The development of towns was seen as most important to prevent the creation of slums. The complex consequences of the National Insurance Act were discussed in detail and the practicality of cremation over interment of the dead. Slaughter houses for animals were too infrequent over the whole country and some of the delegates were invited to breakfast at the Winter Gardens by the National Temperance League to discuss the problem of alcohol and where it was very evident in adversely affecting the health of population. The delegates had a few trips out to inspect various places, or for mere pleasure, Southport, the Lakes and the Isle of Man and the Elswick Hospital for Consumptives, sewage stations and fish hatcheries and the cotton mills of Preston.

In July, the Sanitary Committee agreed to use the wards of the Sanatorium for consumptive patients for another year and to sanction a dispensary at the Health Offices on Sefton Street. While an interesting statistic regarding street cleaning shows that 1,096,900 gallons of salt water were used for watering the streets, 17,500 for washing the streets and 21,990 for flushing gullies and manholes.

The work of the Insurance Committee was published in a report of July 1914. Accepting the detailed and complex requirements of the Insurance Act, it was generous in its praise for those on the Committee who had administered the Act in the town, and agreed that the budget had been well controlled in spending on Sanatorium benefits, doctors’ panel funds, and temporary residence funds. Payments to doctors totalled £5,334 1s 6d (approx. £509,276) and, while some doctors had fewer than a hundred patients on their panel, others had over 1,000. It was advised that all those insured people who had not selected a doctor, to do so immediately and not wait until sickness demands the need for one.

A Health Exhibition to coincide with the annual Congress of the Royal Sanitary Institute was held at the ‘old skating rink’ on Warbreck Road. Blackpool had become a popular place for exhibitions due to the large amounts of people attracted to the town in the summer months. The exhibits were various and included electric signage and lighting, a ventilated boot called a Ventor which allowed the foot to breathe hygienically, so that ‘the feet are preserved from many ill effects,’ and on the same stall, the ‘Drain Tell Tale’, which notifies of any blockage in a drain. Another stall included a petrol air gas generator for heating large areas. It described its good use for country houses, but no doubt could be equally used in hospitals and other, larger public buildings. It had won the highest silver medal at the two previous annual exhibitions. The RSPCA had a stall with a particular attention to the humane killing of animals. The curative properties of pine baths were exhibited on another stand and on yet another, the disinfecting properties of Fumol a propriety disinfectant now used in schools and hospitals and portable fumigators, which can easily be carried in a bag, and can do the work of three men in disinfecting houses. Elbie ‘dustless’ dusters, treated with chemical and which are antiseptic, sanitary, absorbent and healthy are exhibited on stand 15.

The following articles are from the Fleetwood Express 4/7/1914).

The energies, thrills and interests in the July the exhibition were followed on 28th of the month by the outbreak of WW1 by the negative, regressive, destructive nature of the human being. Though deemed necessary, it was perhaps considered just a nuisance interlude within the progress of the human being to better things, and national pride would see it through to the end and it would be all over by Christmas anyway. It would, however, create a new focus on medicine as Blackpool played host to the RAMC, the army medical unit which moved its headquarters to the town from its regular headquarters in Aldershot. Soon the Victoria Hospital would have two ancillary hospitals to cope with the large numbers of injured soldiers returned from the fighting, and the Fylde Coast would supplement this by several more convalescent homes, the largest being that at Squires Gate built on the financially failed racecourse. Blackpool also had the advantage of having plentiful accommodation to billet the soldiers streaming into the town for training. So the mood could be seen as quite upbeat and patriotic as the first men began to join up and so, on the 5^th August several police reservists answered the call, guardsmen PC’s Hillsden, Taylor, Goodwin, Sturman, Whalley and Mason and artillery men PC’s Raistrick and Kay all left from the police station at South King Street and were given a rousing farewell from North station. There was only a single regretful absentee from the party and that was PC F Whalley who was lying ill at the Sanatorium and was unable to join in the excitement along with his brother. Three sons of Mr R Whiteside, Sanitary Inspector are now serving with the colours, two keen to join up immediately and were now in training, and the third was already in the navy and transferred to HMS Illustrious. Mr Whiteside was keen to join up too and had offered his services. Dr Rees Jones himself discussed the possibility of a replacement for his Sanatorium duties should he be called up as he expected to be so, as well as the public analyst Mr Hodgson had joined his regiment via his connection with the Territorials. At the same time 14 men from the Tramways Department, eight from the Electricity Department and a few from the Cleansing department had all left to join up.

At the end of August, the annual Health Report for the town for the previous year was published. There were another 575 inhabited houses as against last year, and a warm, dry summer had contributed to an increased death rate, though there had been an increased birth rate. The administrative control of consumption, an ongoing and serious issue since the Insurance Act, was still in its early days and, ‘arrangements for a fully equipped curative sanatorium for Blackpool are in progress.’ Regarding infant mortality, the warning of abandoning breast feeding for other sources which might be contaminated by extraneous matter was emphasised in the report, and the consumption of alcohol had no place for the mother, cow’s milk being suggested as the best drink. As the writer of this, the doctor had recommended the mother to drink Guinness during her pregnancies due to its iron content. This was over 40 years after Dr Rees Jones’ statement. The doctor was Irish.

Dr Rees Jones recommended that the valuable work of health visitor Mrs Waring be supplemented with an extra nurse. While the charity work of the ladies Sick Poor Association contributed valuably so much so that the Doctor considered it should be given at least some funding from local or national sources.

Scarlet fever continued to be a scourge and, out of 102 cases, two proved fatal. There were 41 cases of diphtheria and six deaths, 13 deaths out of 1,232 cases of measles, 13 cases of enteric fever and a single death. Of tuberculosis, there were 44 more cases recorded resulting in 49 deaths. At the Sanatorium there was an increase in work due to the obligation of treating consumptive patients. Total cases of all diseases treated amounted to 263, which is 46 more than the previous year. The total cost for the Sanatorium for the year was £3,415 (approx £326,055) and maintenance per head working out at 5s 10d (approx £28) per week. Praise was given to the matron and the staff for capably taking on this extra work. Basements used as tenements with their restricted light and ventilation continued to be a particular bane to Dr Rees Jones and he hoped for legislation to curb their use in this manner.

The case of 35 year old Emma Nelson, who was suffering from the first stages of consumption, was a strange one as the verdict at the inquest on her death was that of natural causes. She had been treated by several doctors, including Dr Rees Jones, for the disease and had been admitted to the Sanatorium, but found that she was not getting any better there and left voluntarily to be treated by her doctor at home. Then, while walking out with her husband one evening they were both assaulted by a stranger. Witnesses to the event described seeing each of them receive a heavy blow to the face which knocked them down, first Mr Nelson then his wife. The man ran away and was never caught despite being seen again on a couple of occasions, leading to complaints about the efficiency of the police force. Soon after, Mrs Nelson was admitted to hospital with an improvised bandage on his jaw but no evidence, even with an autopsy was found of an injury to the jaw. She died soon after being admitted and despite a lengthy inquest the jury could only return, on the evidence presented, a verdict of death by natural causes which excluded consumption and referred to poisoning of the kidneys and resultant heart failure.

By 1^st September it was agreed that a replacement for Dr Rees Jones should be found and Alderman Hampson and Councillor Hardman be appointed to search for a suitable candidate. A replacement analyst had been found in Mr S E Melling of Chester to replace Mr Hodgson during his absence. The cost of the war had now begun to take hold across the board as a request to the Fylde Board of Guardians for increase of 3d (approx 7p; £1.19) a day per patient at the Sandgate Sanatorium as the cost of food had increased. This was agreed at the fortnightly meeting of the Fylde Board of Guardians in the Union offices in Kirkham, as there were only three cases at the Sanatorium at that time. It was reported at this meeting that there were only three cases of relief from the Kirkham area, but 54 from Fleetwood and 124 from Blackpool of which 80 of these were permanent cases.

As the recruitment office on Bank Hey Street was perhaps the busiest place in the town, and the deaths of those killed in the defence of the realm began to appear in the newspapers, and the matron of the Fleetwood Cottage hospital in Dover looking after war wounded, the Health Committee nevertheless had to continue to deal with the job in hand. In October there was a lengthy discussion concerning the legitimacy of an insurance complaint which had arisen, and the Committee had to decide who was right and equally, who might be wrong in the terms of the law. But in December there was no question of payment for pharmacy or for doctors’ services for those persons and dependents, insured or not, of active service men. A vote of thanks for this gratuitous treatment was given at the meeting of the Insurance Committee on the 7^th of the month.

In October, the Elswick Sanatorium for pulmonary tuberculosis and run by the County Council been opened and already had six patients. Still in the process of being prepared, there would eventually be 60 beds at the Sanatorium. Meanwhile in Blackpool, the Victoria hospital had accepted several injured Belgian soldiers, and the town was discussing the provision of billeting for the expected arrival of the soldiers. Civilian, Belgian refugees were already arriving in the town before Blackpool itself would soon be accepting a large contingent and a school provided for the children of these fugitives at Revoe. For those troops who would be suffering from any kind of infectious disease, arrangements had been made with the Administrative Medical Officer of the Troops to receive each patient at the Sanatorium at the rate of two guineas (£2 2s; £199.81) each per week.

In the Christmas of 1914, there was a danger of forgetting the regular charitable needs of the people in the hospitals as appeals for the War Fund and wounded soldiers, or for gifts to the soldiers at the front each qualified for charitable funding from the pockets of the compassionate, willing or capable. The hospital reminded those people of the extra work it had undertaken in treating wounded Belgian soldiers and refugees. The Sanatorium placed a regular appeal in the newspapers in the usual manner, ‘Any contribution of toys etc., and subscriptions in money, will be utilised to promote the happiness and pleasure of the patients so isolated for the protection of the more fortunate members of the community.’

And Christmas was celebrated in a spirit perhaps a little subdued to the War but the Victoria Hospital now with its new Matron, Miss Borton threw everything into providing a spectacular Christmas, and one in which the War could be forgotten, if only temporarily. Sixteen of the soldiers were patients, and the flags of many nations were displayed in those men’s wards. The children were allowed to bring in their friends and family into their brightly decorated wards. The matron of the Sanatorium, mow Miss Parston provided a similar bright and cheery Christmas with great regard to the many generous donors of gifts and cash, and the Mother Superior of the Convent presenting her traditional goose and toys.

The New Year arrived, and now there were 10,000 troops, which increased to 12,000 in the first month, billeted in the town, mostly in training and fit and healthy. But life goes on and business is conducted as normal when the Insurance Committee met, for a few minutes only to accept the resignation, through ill health, of one its members. The question of the Belgian refugees and Insurance had also to be resolved with the employers’ contributions expected for non-British subjects and this was eventually sorted out. And the natural death, unrelated to war, of the Mr Jeremiah Wolstenholme, former Blackpool Borough surveyor and the architect of the Sanatorium occurred. A Blackburn man, he was buried in the family vault in Accrington. Some Belgian soldiers having recovered from their wounds at the hospitals in the town were now returning to London and for those still under care, it is reported that the King had sent a large number of pheasants which were well received by them.

The ongoing national drive to eradicate tuberculosis was discussed at the meeting of the Blackpool Health Committee in late January. In the requirement to create a special hospital for consumptives, it was decided to erect a new building at Dover Farm, Staining, which was owned by the Corporation. The land had been bought at a cost of £2,571 (£218,693.47) and the extra cost of building and furnishings would cost £9,728 (£827,479.62) of which there would be a Government grant of £3,240 (£275,599.71). At present the cases are treated at the Sanatorium on New Road with some success, but lacking specialist provision and definitive finance. The scheme at Staining seems to have been shelved in December of 1919 in favour of Woodhouse farm at Carleton and, since Dover farm was to be sold, presumably the proceeds would go towards the purchase of this. In order to use the farm at Carleton it would prove convenient to include the district within the Borough boundary, discussions about which continued into 1920. The cost of scavenging for the last month of 1914 was £1,024 (£87,103.12), 200 men currently being employed overall in the streets, collecting from houses and at the destructor. In cleaning the streets, 118,400 gallons of sea water had been used and 50, 800 for flushing the drains. 1600 tons of refuse had been dealt with at the destructor at an average of 1s ½d (approx. £4.25) a ton. Sales from the destructor included one ton of fish guano, 87 tons of mortar, 30 tons of scrap iron and ‘124 loads of ashes and clinkers’.

Mr Clement Hope was appointed from his position as Assistant Inspector to Inspector of meats as Mr Newby, the current Inspector was away on National Reserve duty. It was also now considered that a clinic for expectant mothers and maternity considerations was necessary. It was proposed to provide a home which would accommodate those considered in need of it, and it would cost about £520 (£44,232.05) to run, of which the Local Government Board would support half of the cost.

Among the many Departments to contribute periodically to the National Relief Fund, and as printed in the newspapers, to ease the cost of the War were both the Sanatorium and Cemetery Departments.

In February, Mrs Winder, the wife of Dr Winder, provided a theatre box for seven wounded British soldiers who were having treatment at the Hospital. The performance was the children’s fantasy ballet, ‘The Magic Goose.’ The hospital for wounded soldiers on Station Road was proving a slight concern as it had, at present in February, no soldiers, but there were sick Territorials occupying eight of the beds. Twelve regular soldiers had recently left, and there had been a drop in contributions for the hospital’s upkeep and wounded soldiers were expected at any time.

In the May of 1915 the Corporation was encouraged by instruction from the Local Government Board to pursue the provision of a Sanatorium specifically for consumptives. Plans had been approved by the Local Board and the site at Dover farm in Staining, just outside the Borough boundary, and which the Council owned, had been inspected. To this effect, after a long discussion in the Council chambers, the site before any other site was considered suitable for the erection of a separate hospital as being suitable enough for consumptives who were at present ‘accommodated and treated at the New Road Sanatorium.’ It would cost an estimated £1,000 (£85,061.64) a year to run. After the visit by Committee members to the site in Chain Lane, and the drainage question had been answered in a positive manner by the Borough Surveyor, J S Brodie, it was agreed that the site about half a mile beyond the brewery, ‘lies in a well sheltered hollow, a picturesque little valley from which the land rises to a considerable height on the easterly side.’ This summit afforded a very fine view of Blackpool. However there were objections of a completely opposite nature to this site as being completely inadequately situated for the cure of consumptives, as one seemingly knowledgeable correspondent put it in understanding that the Council had originally bought the land and property for the use as a rifle range for the Volunteers, and were desperate now to find a use for this white elephant. It was thus, ‘a flat, misty, cold-earthed, boggy, windswept, treeless, dull, desolate, depressing spot,’ a site, indeed in those conditions, not conducive to the cure of consumption. The Council had already considered the site and it had been suggested earlier at the March meeting that, due to objections of the site from other quarters and members of the Committee that, those who objected should look for another spot. The very real and practical objections were the distance from the town centre for the transport of construction materials and the consideration of providing lighting through electricity and the possible shortfalls of the site as being not ideal for Consumptive recovery. However these problems were left for another time at this stage and only the detail of the design of one of the bedrooms was considered at this meeting.

The War though, which should have been finished the previous Christmas, was still going on and having its affect across the board of all social considerations. However, despite the great and evident losses of human life resulting from the terrible conflict, the war against the ‘white plague’ of consumption which was as much a killer as the armaments of the opposing military forces on the battlefields, was indeed considered an equal killer, and the fight against the scourge continued. In this case the tuberculosis officer Dr Brunwin was now on war service and it would be necessary to replace him, so it was agreed to appoint the current Medical Officer of Health Dr E W Rees Jones. The article in the paper shares its space with local men joining the colours and the obituaries of men who have been killed in action. Soon the town would have a large military convalescent hospital constructed on the racecourse ground at Squires Gate. So there would be a different kind of hospital again, and several other hospitals would emerge for recovery from war related injuries, some auxiliaries to the main, general Victoria Hospital in the town, to which there was no controversy over the need for provision or construction. And the town would also be headquarters to the RAMC, the medical arm of the army which would have a large presence in the town and the question of the day in May of this year was how would billeting, if introduced on a large scale, affect the town and the consequences for the health of large concentrations of people. The Sanatorium would take up a role as one of the several auxiliary military hospitals in the town where space provided.

And the drain on the male, resident constituent of the town continued as more Corporation staff ‘answered the call’ to sign up. At the end of March, L Brownbridge and T E Barker of the tramways clerical staff and E Barlow from the Health Office all joined the Royal Naval Sick Berth Reserve. The RAMC were now in town and the patronymic of the writer of this arrived in the town, billeted in Cheltenham Road and the name stayed to this date while writing this. Coming from Liverpool, the military medical men were billeted at North Shore and on 28^th March they were entertained at St Paul’s parochial hall, a venue which provided their entertainment.

This year saw the opening of the Savoy Hydro Hotel on the promenade at North Shore. Built by J Fielding and sons, the incorporation of the modern concept of sanitary arrangements could be advertised confidently to the full as the ‘latest hygienic improvements’ which including the enamelled fireclay equipment with the ‘most up to date ideas’ relating to the fittings.

All the Corporation Departments continued to contribute to the National Relief Fund, and in April those of the Sanatorium amounted to 17s 10d, (approx. £76.00), the Health Department £6 2s 3d (approx. £511.00) and the Cemetery Department, £ 7s 9d (apprx.£33.00).

On the 15^th April 1915 the sad death took place of Harry Wilkinson, a popular local amateur entertainer who had been at the Sanatorium for about eight weeks after contracting typhoid fever. He was discharged after recovering, but had had a relapse from which he didn’t recover. A newsagent and tobacconist on Topping Street in the town, he had formed a duo with his sister called the ‘Wiltons’ and also formed an entertainment company, which they called the ‘Victoria Concert Party.’ Many of the entertainments were given for charity, and the last performance that Harry completed was the principal role in ‘The Mousmé’ (The Maids of Japan) with the Amateur Dramatic Society.

As the Corporation was in unison to release as many men for the military as they could possibly to do so, and pushed for conscription on a national scale, 84 names were put forward as available for release, and those from the public health and the cemetery were on the list of potentially available men. As the need for the production of munitions became more vital, it wasn’t, however, considered necessary yet for women to take on the work of men. The Health Department revealed an underspending on the budget for the year, the Fylde Joint Hospital costing £522 (£44,402.18) and Sanatorium £4,659, (£396,302.17) the maintenance of patients at the Sanatorium constituting £1,533 (£130,399.49) of this.

And news of Blackpool comes from overseas as Dr Hirst had been a resident official at the Sanatorium eight years since and, as he was on the way to Serbia by sea to give medical aid to the stricken people, he met up with a young nurse on the steamer, a Miss Theresa Crumblehulme who had recently been on the nursing staff at the Sanatorium as a night sister and had left ‘about a month ago’ to join the Serbia Relief Committee at Skoplje hospital. While Dr Hirst would eventually make his way to Ceylon, Nurse Crumblehulme, a Preston woman, would remain in Serbia. It was reported that they had had plenty to talk about concerning their Blackpool connection. When nurse Crumblehulme had reached Serbia, she was able to write home to her mother at 60 Egan Street in Preston and inform her that she was with Lady Paget’s hospital in Uskub to where she had been sent. As Serbia was invaded, and Belgrade fell to the Austrian enemy, Lady Paget’s nursing mission stayed behind to attend to the sick and wounded, while other nursing units stayed with the retreating Serbian army until eventually captured and enduring a gruelling ordeal until eventually repatriated. Miss Walmsley of Fleetwood was one of these nurses and was able to briefly recount her story to the Fleetwood Chronicle on returning home. There was then a long gap before Theresa Crumblehulme was able to write home and friends and family became very concerned for her welfare, but a very brief letter arrived at the Sanatorium to say she was safe and well. It was written from the ‘Sixth Reserve, Lady Paget’s Hospital Skoplje Serbia and reads, ‘My Dear Matron – Only just a line to say I am safe and well, and hope to return to England soon. We have lots of wounded every day … do not write, Matron because I won’t get the letter. We are allowed to write just a little. I have sent a few lines to my mother. The country here is simply glorious, with all the snow on the mountains. I am feeling the cold rather a lot but we have heaps of work. Give the Doctor my kind regards and also the nurses.’

This selfless and courageous work of the nurses is glorified in the newspaper’s comment as, ‘By their magnificent act of courage and noble self-sacrifice in staying behind to administer to friend and foe alike, it is clear from the foregoing that Nurse Crumblehulme and her brave colleagues in Lady Paget’s nursing corps have been instrumental in performing a task that will be to their lasting credit, and for which it is impossible to speak in terms of too high praise.’ (Crumblehulme is often spelled in the papers as Crombleholme). Theresa Crumblehulme spent twelve months away and before returning home to Preston, she called on her former matron, Miss Proctor, at the Sanatorium in Blackpool. Here she describes her own, serious ordeal and indeed thrills, and those of her companions. After the Bulgarians had captured Uskub, though the Bulgarians treated them well, food was scarce and they didn’t have a taste of bread, but only biscuits, for months. Even then the Serbians fully expected to be relieved by the British, help which did not come immediately. She suffered a bout of dysentery and then was operated upon for appendicitis during her stay. It was while she was still delicate after her appendicitis operation that the Austrians offered them safe conduct through their country and they went from there to Sofia where they remained for a month and were treated well. Here Lady Paget was put up in a hotel as a guest of the Queen, and the other 54 members of the group were allowed the freedom to walk about the streets and even visit the imprisoned British soldiers who were mostly from the Leinster and Munster regiments. From here the party went to Bucharest, capital of a country that didn’t know whether it would soon be at war or not and it didn’t know what side to take, wisely, probably waiting to see which side would be the likely winner. Here the nurse received a signed picture of the Queen of Roumania. The party then had a somewhat gruelling journey in avoiding Germany and going through Moscow, Petrograd, Stockholm and Denmark but, through all their travels they were a celebrated party and received appreciation by the high society in signed, royal portraits and interviews with royalty. The party eventually reached home in Great Britain in the first part of 1916 and each received, through Lady Paget, a copy of a letter sent by the prime Minister of Serbia, Mr Pashitch to the secretary of the Serbian Relief Fund in London, showing his nations gratitude to ‘all the noble daughters and sons of the great British nation, who have not only sacrificed their freedom, but also risked their lives for the health and good of the Serbian soldiers and Serbian people.’

Nurse Crumblehulme eventually resumed her work at the Sanatorium on returning home and was appointed the second full time health visitor working with infantile children when it was deemed that more attention should be paid to maternity and the health of young children.

Still in May, as the concept of a maternity home, with provision for ten mothers, and at an estimated cost of £520 (£44,232.05) per year, was agreed upon quite confidently, it eventually had to be shelved because of lack of available funds, perhaps because the Local Government Board had accepted the plans for a Sanatorium for consumptives at Dover Farm. The Local Government Board was also interested to learn if a replacement had been chosen for the departed Dr Brunwin to the military. The reply was that Dr Rees Jones would fill the vacancy created until a preplacement is found. Elsewhere, there was, as at the Victoria hospital, a difficulty in getting a quorum of representatives at a meeting in order to legitimately reach a resolution of the content of discussions. Often meetings were delayed or even cancelled, due to the members’ indifference at not attending. The meeting for April had to be cancelled due to this indifference and non-attendance.

As the newspapers’ pages reveal the pictures and the stories of many a soldier’s death, it also publishes the monthly contributions to the National Relief Fund in which is revealed the amount donated from the Health Department and Sanatorium to be £2.12s.0d (£221 16). The delivery of goods to the hospital and Sanatorium could be a hazardous business on occasion. Five workers from the united flower service held at South Shore Parish Church were thrown from their cab in a collision, and their goods of flowers and fruits went with them. Luckily no-one was hurt and the only reported damage was few broken eggs.

The July monthly meeting of the Blackpool Insurance Committee, was attended by Dr Winder, dressed in the khaki of an officer of the RAMC and who received a ‘cordial reception’ as he was now connected with the Weeton Camp which had just been established. Consideration was also given to Dr English who had been in the Dardanelles and (Captain) Dr Jeffrey who had enlisted as a combatant and not specifically as a doctor. The topic of discussion, after discussing the change of personnel, male and female, of the Committee, was the large cost of Sanatorium benefit especially for domiciliary visiting, and it was hoped that the Insurance Commissioners could increase their contribution to local authorities. It was a time when the Fylde Sanatorium had to increase its charges for maintenance to 4s (£21.27) a day, to defray increased costs due to the War.

The National Relief Fund contributions published for July include 3s 9d (approx £17.00) from the Sanatorium, £1 2s 5d (approx £89.56) from the Cemetery and £2 11s 0d (£136.90) from the Health Department. There was also an appeal for the support of the widows and children of Indian Muslim soldiers killed in France. Arriving in Marseilles from the warmth of their homeland, both the Hindu and the Muslim soldiers had died in the cold, icy trenches of Neuve Chapelle, where the Christian husband of my grandmother also died on the first day of the battle on the day before her birthday. Some birthday presents are inappropriate.

In August, the Sanatorium staff were able to muster 3s (£12.76) for the National Relief Fund and the cemetery 17s 4d (£73.72). But the Insurance Committee and doctors were now at loggerheads as differences of opinion emerged. It was claimed by at least one doctor that, while the medical men were away on national duty and receiving 24s (£100.87) a day, it was unfair, in several cases, for those panel doctors to expect their professional colleagues to see their Insured patients on their panel for free. The claims of Dr Woodhead that this was the case and that he could claim seeing a doctor rubbing his hands with glee at realising the amount of money he could earn, were dismissed by the panel. Some doctors had only small panels and others had thousands of patients and which included private as well as Insurance panel patients, but it was the duty of the doctors at home to look after those who were among the fighting and, in supporting their colleagues, would be preserving their practices for when they returned home. The number of panel patients that a doctor could deal with came under consideration as perhaps for the efficiency of the system, it might be that a doctor could have too many patients. On other matters, Dr Kitchen was appointed Chairman of the Sanatorium Benefit Committee. There were now nine patients under institutional treatment.

The 19^th August saw the death of William Eaves, builder of the Sanatorium. Flags were flown at the Sanatorium and all the public buildings on the route from St Cuthbert’s church to the cemetery at Layton. The works of Willian Eaves and Co were closed for several days.

In September, the contributions to the National Relief Fund were published as among many others, the Sanatorium staff, 3s 9d, (approx. £16.00) the Cleansing Department £7 15s 3d (approx. £658.00) and the cemetery, £1 1s 1d. (£16.01). In a single case referred to at the meeting of the Blackpool Insurance Committee, it was confirmed, due to a query, that if there were no spaces available in the Sanatorium than it is the doctor’s prerogative to authorise admittance to another available Sanatorium.

In the Blackpool Herald 29^th September 1916 we learn of another former member of staff of the New Road Sanatorium in Sergeant E Swift, of the RAMC, 5th London General Hospital before ‘joining the colours’. He is pictured in Malta with two Blackpool colleagues, Sergeant J Cooke of the ASC remount department and Corporal J Lynch of the King’s Own Royal Lancasters. Unfortunately the picture of the three men is too corrupt to reproduce here.

On the 7^th October 1915, James Eaves, nephew of the recently deceased William Eaves, died. Among many building contracts, he had been responsible for building extensions to the Sanatorium and the Elswick Hospital for consumptives. The report of the medical officer showed that the death rate was 14 per 1,000 while the birth rate was a little less at 12 per 1,000. While more members of the Health Department left for military duties at home or abroad, three women were temporarily employed to cover their absence.

December arrives and by the 10^th the usual appeal for donations of toys, gifts and subscriptions for those unfortunate children isolated from their families in the Sanatorium, is printed in the newspapers.

At the monthly meeting of the Insurance Committee it was discussed that a centralised authority should be formed for the regulation of chemists’ accounts.

In an appeal of great female compassion, Dorothy, the regular columnist of ‘A Woman’s World and its Musings’ reminds her readers of not only the plight of the ‘shut ins’ at the Sanatorium who are isolated from their families, but also the poor, pathetic children at the orphanage, playing happily in the ignorance of the denial of a home life with parents.

For Christmas this year the Sanatorium was ‘more like a fairyland’ and the children’s evident happiness was made possible by the keen attention of the staff and the many donations from regular donors, along with some new names. The same happy atmosphere prevailed at the Victoria Hospital too, under the direction of the matron Miss Borton, where the Mayor played a secondary, civil role as Father Christmas. Those eight children at the orphanage too, were not neglected under the care of Miss Swallow.

At the monthly meeting of the Insurance Committee, much time was spent in respectfully regretting the death of the Chairman, Dr Butcher and the sterling work he had undertaken not only as the Committee’s chairman, but also as the secretary of the Victoria Hospital. It seems that Dr Butcher was a well respected and well trusted man, knowledgeable and highly capable in his profession. Sanatorium questions were continually considered, and in the January meeting, a lecture would be given on the ‘Weak points of Sanatorium Treatment – After Care’ by Mr S Jacob MA LLD. The relatively high cost of keeping patients at the Blackpool Sanatorium was contrasted with the lower cost of other Sanatoriums. At Blackpool, the annual cost was £1,588 (£114,296.67) or £2 7s (£169.15) per bed for the 13 patients currently receiving treatment there, while at other Sanatoria the cost per bed was only £1 12s 6d, (£115.51), so good savings could be made. An explanation wasn’t immediately available and the so the point made was referred back for more consideration.

On the 13^th March, the new hospital for infectious cases was opened on Leys Lane in Elswick, just a short distance away from the Sanatorium for tuberculosis and leased by the County Council. The new hospital for infectious diseases had twelve beds, six for men and equally six for women. The problems of drainage and the disposal of sewage, which had been the sticking points previous to the scheme being accepted, had been overcome.

With conscription now in force, the Blackpool Insurance Committee had to deal with the conscription of chemists who were currently categorised under schedule D as being a reserved occupation not eligible for call up. However, as the categories of reserved occupation were being reviewed, it may be that the chemist might be eligible for call up. The argument against this was that these chemists had much more work to do now that so many doctors were on military duty and chemists’ assistants were also in shorter supply due to previous voluntary attestation and now conscription. It was agreed that all efforts should be put into keeping the chemist as a reserved occupation. At the same meeting, Dr J Stewart was introduced as Dr Butcher’s replacement.

The budget report of the Health Committee for the year, published in May, revealed a slight overspend of £43 (£3,094.93) on the total cost of £11,718 (£843,405.77). Sanatorium expenses exceeded the budget by £500 (£35,987.62) but, with the receipt of £1003 (£72,191.16) as the income from patients, the net amount worked out at £935 (£67,296.84) below the estimate. The abattoirs exceed the estimate slightly and there was a surprise revenue from the public lavatories of £2,630 (£189,294.86) with a net profit of £521 (£37,499.10).

The Insurance Committee thought it a good idea to meet quarterly rather than once a month, and discussed the practicality of whether the panel doctors should be allowed to leave for military duty, and whether arrangements should be made to replace them in their absence. The Sanatorium Benefits sub-Committee visited the Sanatorium on May 10^th in accordance with the requirements of the Insurance Committee, and found everything in order.

At the end of June, a Belgian refugee, who isn’t named, and was ineligible for military service, passed with distinction, a speed shorthand test at the Palatine School and was taken on as an employee of the Heath Department. More nurses are qualifying through the St John’s Ambulance Service and become eligible for call up to military hospital duties. Some left for hospitals in other towns or cities and others took up roles in the auxiliary, Adelaide and Seafield hospitals in Blackpool.

At the Town Council meeting in September, while the premises of the Chief Constable, who had contracted an illness at the police station, which was also his home address, had been deemed insanitary due to a drainage problem and had recently cost £200 (£14,395.05) to fix, the case of two more policemen who had applied for financial assistance were refused it, as the claim that they had contracted their illness from the police station was not accepted as they did not live on the premises as the Chief Constable did. In the same, brief meeting at, ultimately, a Government request, and with a patriotic desire and responsibility, it was suggested that the cost of equipment at the Red Cross Hospital at the Church Institute on Station Road should be taken on by the Council, though no decision was made at this brief meeting.

An October medical report states that Blackpool is particularly free of infectious diseases, and the number of patients at the Sanatorium is less than usual. It was a time when, with so many men and wage earners occupied with the fighting away from their homes, the considerations of maternity and child welfare should have more focus and importance despite the need for economies across the board. It was accepted by the Council that at present the work should be undertaken by the current staff until extra, qualified staff could be appointed. An extra Health visitor would, howeve,r be appointed at a salary of £100 (£7,197.52) and the salaries of the current nurses, Jackman, Prendred and Grant, be increased. Where patients could not afford the fees payable, it was suggested that Dr Rees Jones should attend such cases, medical or midwifery, and that the cost of this which was estimated at £264 (£19,001.46) per annum, would be borne both by the Council and a 50% contribution from the Government. However, items such as clothing, food and bedding would have to come out of an available charitable fund, as there was no provision for these in the scheme. Nurse Theresa Crumblehulme from the Sanatorium, now safely home from her Serbian relief experiences, was one of these new appointees.

In November, regarding applications of trades described as a ‘fried’ fish shop on Crosland Road and a rag store near Woodfield Road, both were refused regarding the new powers of the Health Committee. The fish and chip at 8 Crosland Road was already in existence and must have been an application for an extension or otherwise as, in September, the death in France, after horrifying injuries, was announced of Private Henry Arthur Anstil, who had carried on his business at that address. Also in November and, at the time, indirectly connected with health and safety, the women workers in the coke yard at the Gas works there was now a proposal for them to wear ‘more workman like attire’ instead of the skirts they were currently wearing as women were now evolving naturally into the workplace by the circumstances that the War presented to them.

And Christmas comes around once more and, once more, there are the appeals to remember those at both the Victoria Hospital and the Sanatorium, and the many donations of money and kind received made for a happy Christmas at the Victoria hospital and its auxiliaries, the Workhouse in Kirkham and the Sanatorium at which place, ‘The matron and nursing staff threw their whole heart into the task of making their charges happy. The children especially enjoyed themselves.’

As the great number of soldiers continued to flood the town, there was the debate on how much the young girls of the town were immodest in being attracted to them. With the attitudes of the time and the largely secondary role of the female, it was easy to blame the women for sexual improprieties but, whatever the attitudes, there was still the concerns for sexual diseases, and of course consequent pregnancies, which the man was able to ignore but which for the woman was a life changing reality in either its thrill or its despair. The mother of the writer of this was ‘illegitimate’ at this time and in this way and, even today, the event has an influence upon the words written here. A husband killed in the trenches, leaving a young, pregnant woman with a toddler, and needing attention and comfort and in whom the predatory ex-soldier found an easy prey. Whether the father had been adversely affected by a war experience and whatever the reality, it was the experience of that generation, and another child born into the uncertainty of life.

The budget for the year announced in April showed that, with the introduction of motor vehicles for street cleaning, a considerable economy was achieved but, with the increased cost of electricity, the Sanatorium is proving more expensive as well as with the increased costs of provisions. This accounted for £450 (£25,831.60) in the increase in costs. Provision has been made for the re-painting of the Sanatorium, a three yearly requirement and £100 (£5,740.36) had been put aside for this. The Health Department in dealing with drain testing, meteorological observations, street cleaning and the abattoirs among many of its responsibilities, now had the extra cost of a maternity and child welfare scheme and a new campaign to deal with venereal diseases. The Government pays half the cost of the maternity and child welfare scheme, and it pays three quarters of the drive against venereal disease, at an estimated cost of £700 (£40,182.49). As for the hospital at Elswick, it was assumed that due to the Government ban on capital investment, that the scheme would be delayed until after War.

In this year, it is briefly stated that the Victoria Hospital was about to appoint a lady doctor to the post of resident house surgeon. In October, Thomas Fletcher, the chairman of the Blackpool Insurance Committee, was elected to the Executive Council of the National Association of Insurance Committees. Here it is stressed that the responsibilities of the National and Local Committees extend to the provision of benefits, including Sanatorium benefits to discharged soldiers, both insured and uninsured soldiers. It predicts of a time, ‘when a Ministry of Health is established, more and more attention will have to be paid to the physical welfare of the nation, especially of the young.’

Both the Savoy Hotel at North Shore and the Queen’ Hydro at South Shore have now been taken over for the accommodation of convalescent officers.

In mid-December columnist ‘Dorothy’ reprises her heartfelt appeal to remember the ‘shut ins’ at the Sanatorium and anywhere else there might be those in need. Nor does she forget to mention the Sarah Massey orphanage on New Road. But she doesn’t forget the ‘boys’ in the trenches and the conditions they endure, nor does she avoid giving praise to those tireless women who show their affection, in this one by knitting warm woollen socks, for the winter time of the year. And the Christmas celebrations at both the hospital and the Sanatorium, along with their many subscribers and donors, passed by ‘where nowhere does the spirit of Christmas manifest itself more admirably than in our hospitals.’

Into 1918, and at the Blackpool and District ‘At Home’ annual gathering, an informal affair taking place at the Secondary School at Raikes Parade, there was a whist drive and the prizes for this were handed out by the Mayor. In the usual round of compliments each speaker was able to praise the work of those present in their municipal duties. And Dr Rees Jones was no exception in his compliment to Mayor Parkinson and he also took advantage in praising Miss Proctor, matron of the Sanatorium, and the ladies of the Catering Committee for providing the refreshments.

Food, of course, is essential not only for health but also for life itself, and for those ordinary people there was gardening advice as food became scarcer and bread making and at the confectioners’ trade meeting at Jenkinson’s café, the addition of potato mash into bread making was discussed. For the expected 80,000 visitors, a food deputation went down to London to have discussions with the food officials there, and were assured that sufficient supplies of rationed food would be available. Due to perhaps unfair criticism of the Food Control Committee of the Council not supplying butchers with meat for visitors, a cold storage place for this purpose would be acquired near Chapel Street for the convenient distribution of meat. An important part of the Food Control Committee was to ensure that food was available to all and consequent to this, prices had to be monitored and controlled. The grocers and butchers, and even jam manufactures who relied on a supply of sugar and all who retailed the food had to be taken into account in any action taken, and was referred to them if not at first then after representations.

Regarding the work of the Medical Officer of Health in connection with the Military Hospital at Squire’s Gate, the Fylde Board of Guardians decided to increase his salary by £40 (£1,880.76) a year, an amount that would be refunded by the Local Board of Health. The Health Committee’s estimates for the coming year amounted to £16,022 (£753,338.36) and which included £614 (£28,869.66) for the Fylde Joint Hospital, £60 (£2,821.14) for meteorological observations, £1,738 (£81,719.02) for the abattoirs, and £5,320 (£250,141.06) for the Sanatorium, an increased expenditure on which the cost of living was blamed. Apart from street cleaning and drain testing, there was some predicted income from each cost which achieved a lower net figure. There was a pleasant surprise for the ice cream makers and vendors as the Watch Committee allowed the sale of ice cream. Not the real deal but a substitute variety called ‘water ices’. There was a rush now to obtain stands on the sands and several tenders were sent in. This at a time when the need to preserve water was paramount and the avoidance of waste, particularly in domestic households, could be undertaken. Food supplies were at their limit, compelling the farmers to complain of young couples ‘trespassing’ in the corn fields during the summer where they would lay down to conceal themselves and thus flatten the corn making it rotten and useless.

As well as several nurses at the various military hospitals in the own coming to the attention of the Secretary of State for War, the name of Miss Edith M Proctor was honoured in the London Gazette ‘in recognition of her valuable work on behalf of the military authorities.’ Since there had been a great military presence in the town, it necessitated extra work and not only cases within the Borough but also outside the boundary as the men from the Convalescent Camp at Squires gate were admitted to the Sanatorium. For the extra work within the Borough boundaries, it included the inspection and disinfection of billets and the inspection of the premises of food contractors of the War Office. For Blackpool’s health in general and the incidence of disease, it was first shown that mortality within a lower birth rate was 81.3 per 1,000, though 60 children under 23 months old had died. Illegitimate births constituted 85 in number. With regard to infectious diseases notified, there were 88 of scarlet fever but no deaths, 67 of diphtheria and four deaths, 1,168 of measles and two deaths and seven cases of enteric fever and a single death. There were no reported cases of smallpox. At the Sanatorium where the matron and staff were under a great deal of pressure to keep things running efficiently, they had to deal with 582 cases during the year. Of these, there were 112 scarlet fever, 119 diphtheria, 10 enteric fever, 100 measles, a single puerperal fever, 3 erysipelas, 101 tuberculosis, 13 cerebro-spinal meningitis, 2 chicken pox, one of infantile paralysis, a single malaria and 11 mumps. There were now two permanent health visitors in the town who made several hundreds of visits to expectant mothers and children under 12 months, and children in another age category up to five years old. An infant clinic for under five years old was open now for two days rather than the former single day on a Wednesday. The District nurses had made 4,414 sickness visits with the added workload of over 20, 000 military in the town.

The death of Mr Croasdale, a local lad and the son of Mr and Mrs Croasdale of the Railway Hotel occurred. He had been ill for some time and the previous year had spent several weeks at the Pendryffen Hall Sanatorium, Penmaenmawr where he had been sent for treatment.

Since the passing of the Maternity and Child Welfare Act, there was more power, and equally responsibility, on the local authority to make provisions for this welfare. ‘The supreme importance of maternity and child welfare work at the present time needs no emphasis,’ in the words of the Local Government Board. As well as services such as nurseries and creches and the current visits of the local home visitors, convalescent homes and homes for deserted or widowed mothers and children and mothers with illegitimate children, should be considered and provided, and steps towards these ends were first considered by the attendance of a conference to be held in Preston in the coming days.

1918 was the year of the worldwide flu pandemic and, where the War killed millions, the pandemic indiscriminately killed more, it possessed no patriotism nor did it take sides. The advice from Dr Rees Jones was the advice put out in the recent covid pandemic of 2019. If masks weren’t worn then at least the mouth should be covered when coughing and sneezing. Keep houses well ventilated and mixing with others, when infected, is to be avoided as this will pass the germs on to non-infected persons. There was limited space at the Sanatorium for those who didn’t have the facilities to avoid close contact with others. In the doctor’s words, ‘If everyone person who is suffering from influenza or catarrh recognised that he is a likely source of infection to others, that some of the persons affected by him may die a s a result of that infection, and took all precautions, the present disability and mortality from catarrhal epidemics would be materially reduced.’ (Blackpool Times, 24^th October 1918). All schools had originally been closed for a fortnight, but this was extended as the two weeks has expired as it was deemed the flu had not abated sufficiently. Later still, it was agreed to keep the schools closed until after the Christmas holidays. Even into 1919 there were still four wards at the Sanatorium put aside for flu victims as well as the ‘outdoor’ nurses assisting those in their own homes.

Not all members of the medical profession, or those with clerical duties for the same, are of purist, self-sacrificing nature, as they are human beings. In November, and at the Manchester Assizes, Samuel Ashford a clerk with the Medical Board, along with estate agent George Yates were sentenced to imprisonment for taking bribes to keep men out of the army. Samuel Ashford got six months and his co-conspirator, three.

In November, the Sanatorium is witness to the sadness of losing a child and the unfairness that it might be seen to be freely distributed to some, and not to others. Mr John Smith Scholes, newsagent at Talbot Road Station corner, had lost his only son, who was only nine years old, to influenza. He had been ill only a few days and was admitted to the Sanatorium where he soon died. His father had been wounded in France while serving with the RGA the year previously and had been discharged as medically unfit.

Later in November, amid all the cautious thrills of the declaration of a ceasefire, there were still duties to be undertaken in the Council chambers. While there was discussion about acquiring a motor ambulance for the Sanatorium use, no decision could be arrived at in this first instance. It was now peace time, at least it was hoped that way, since it was only a ceasefire not an armistice, and Dr Rees Jones was authorised to attend a meeting concerning the creation of the Ministry of Health, a bill that it was hoped would pass through Parliament. The question of creating a maternity home was considered in applying to the Local Government Board for sanction to spend £800 (£37,615.20) in converting the St Margaret’s Home for girls on Whitegate Drive, and the cost to include the alteration of the building and the provision of furnishings, and it was hoped that it would be completed at an early date. There was also the question of the large numbers of returning soldiers suffering from consumption, and the need to extend suitable accommodation for them, though in Blackpool’s case it was considered an emergency.

In December of 1918, Dr Rees Jones himself was confined to the Sanatorium as a patient as he had contracted diphtheria. Dr L Brown would take over his duties until he is recovered. Dr Rees Jones wold recover a couple of weeks before Christmas and was able to resume duties then. On a healthier note for some, food inspectors Miss E Christmas and assistant Miss E Sanderson received a 5s (£14.25) increase in their weekly wages.

As it is Christmas time once more, the appeals go out to not forget the unfortunates in the hospitals. The Food Control Committee had guaranteed a supply of butter and meat for the Christmas period. There was already a double meat ration, and the Committee was further asking the Ministry of Food for a double supply of both margarine and butter. Even though the fighting had finished, there was still a need to be assiduous in the control of the food supply. As the flu epidemic was still a major issue, the Ministry of Food, while seeking medical opinion, was considering the supply of spirits in the areas where it might be needed by influenza sufferers.

It was a time when soldiers were returning home in droves and each day must have witnessed copious tears in extremely joyous meetings. But equally there were many who would never return home. Dr Ikin, the Director of Education in Blackpool, and his family, could welcome home just a single son of the four who went out. But even then he was immediately admitted to the nursing home after a gruelling journey home, to No 8 Raikes Parade, suffering from appendicitis.

Once more, Christmas at the hospitals in the town was provided with the efforts of the donors and the staff. At the Victoria Hospital, the soldier’s ward was bedecked with flags, the female ward with flowers and greenery, and in the children’s ward was the Christmas tree as per tradition. Father Christmas from RHO Hills visited the children to distribute gifts, Mr Parker from Parker’s Hotel distributed, while not considered conducive to health today, cigars and cigarettes to the ‘Tommies’ in the soldiers’ ward and the Mayor and doctors Baird and Dunderdale distributed the gifts from the Christmas tree to all patients. At the auxiliary Adelaide, Military Hospital, situated at the Adelaide Street Wesleyan School, the Mayor and Mayoress (Mr and Mrs Parkinson) distributed gifts to the soldiers. And the soldiers, present and former, had subscribed to a presentation of a gold watch to the matron Miss J Ford, a recipient of the Royal Red Cross, and a brooch from the staff. Similar scenes we witnessed at the Seafield Hospital on the South Promenade and the Station Road hospital as well as the Military Convalescent Hospital at Squires Gate. At the Sanatorium Miss Proctor and staff once more ‘threw themselves wholeheartedly into the work of making their young charges as happy as possible.’ This was helped by the long list of donors who had generously replied to the appeal, or those who were perennial donors.

In the January of 1919, while all the attention was on celebrating a great Victory and the Victory Ball at the Tower turned into to a question of social inequality, life within the veneers of society continued. In the police court, and on remand, was a Margaret Skarretts, a 38 year old woman, and a widow of no fixed abode, but at present working as a laundress at the Elswick Sanatorium. She was accused of stealing towels, bedsheets, blankets and sheets and many other items that are easily picked up and concealed. She had then sent them to a pawn broker in Liverpool, where she had connections, and received the money back for them. Many items were found in her locker at the Sanatorium, and many more in Liverpool. Margaret had been employed at the Sanatorium since June of 1917. The selfishness of survival persists whether among those with billions in bank accounts or for those with nothing in the fridge. The morality exists somewhere in the middle and is not fully attainable by all within the social structures that the animal human being inhabits.

With the War being over, more energy could be put into municipal matters, and the question of Dover farm, shelved due to the War, being used as Sanatorium for consumptives was once more brought up, but it was decided first, to seek alternative sites. It seems that the idea for this site was eventually given up and by 1919 the site was being offered for saleand in the January of 1920,Woodhouse farm in Carleton was being considered an alternative. Woodhouse Farm on today’s map would have been to the right of the road away from Blackpool, on the right hand bend proceeding from the railway crossing at Carleton, just after the present access road to the present Crematorium. Regarding tuberculosis, it was also decided to employ a single full time nurse to attend to tuberculosis cases to take the place of the two district nurses. The question of the maternity home on Whitegate Drive was give further consideration and waited only for approval from the Local Government Board of Health before proceeding. This was approved in March of 1919 after an estimated cost had been submitted. Two midwives would be appointed for the home and, employed by the Council, and thus would transfer the responsibility from the private to the public sector of society. An eye clinic and dentistry for children under five years old, as well as expectant mothers and those mothers with children under five years, would be put in place, and a convalescent home for mothers and consideration for diet for those in difficult financial circumstances. The home was inspected once more by the Blackpool health Committee as the alterations were being carried out in May, and it provided an opportunity to congratulate a Miss Roberts who had completed 21 years’ service at the Sanatorium.

While WW1 had finished, bar signing the armistice, and fighting continued here and there and wouldn’t stop for the rest of the century and beyond, the war against disease is a permanent struggle. An Order from the Local Government Board now declared pneumonia, malaria, dysentery and trench fever, as notifiable diseases, to come into force on March 1^st, when the local medical officers will have the obligation to search out the causes and take the appropriate action to prevent the spread. By the end March, deaths from influenza were receding in number by over 1,000 a week (2,320 down from 3,889). Curiously Dr Leonard Hill of the meteorological society claimed that those who worked in gas work and explosive factories rarely came down with colds and flu, and the reason being that of the inhalation of gases and more, that moderate smokers would be less prone to contracting the disease.

At a meeting of the Fylde Board of Guardians, there was the controversy of who should take responsibility for a consumptive ten year old Blackpool girl. She had been in a home and it was unfair on the others in the home to be exposed to the disease and, while she should be sent to a Sanatorium somewhere, the argument was deflected from the Fylde Board to the Blackpool Tuberculosis Committee and back, and each in the lack of action in their responsibilities could be prosecuted. The girl, a difficult girl it seems, was eventually put in an institution against her wishes, but payment coming from a grandfather as her father, for whom she had given a false name, could not be verified.

It seems that Dr Rees Jones had retired at this date and applications for a replacement were put out at a salary of £600 (£25,635.01) a year. At this date (March 22^nd) four applicants had been selected for interview. And the health of the town now included the assistance to disabled soldiers and as the Military Hospital at Squires was decommissioned and handed over to the civilian sector, soldiers were released back to several towns and those who remained were retrained at the Camp.

A sad, and complicated, case of a child caught in the middle of a squabble for ownership and parentage came up in the courts when a Miss Barrowclough was taken to the Sanatorium suffering from influenza and pneumonia, and sadly died there. She had a daughter but had never revealed the father’s identity, despite having lived for six years at 108 Elisabeth Street with a Miss Emma Smith. The court did not want to know the status of the relationship between the two women at the address, but it appears that others objected to it, and attempted forcibly to snatch the child from Emma Smith at an opportune moment in the street, and found themselves in court because of it. One of the women had had care of the child named as Edith, now 9 years old at one time, and the other lady was aware that the father of the child was her brother and had looked after his daughter Edith at several addresses during her short life. The judge concluded that since Miss Barraclough (who is never given a forename) and Emma Smith had left all their estate to each other, that the two women defendants wanted at least a part of the estate to which they felt entitled as having more of blood connection to the child. There is no indication of what might have happened to little Edith, other than it is assumed she was allowed to stay with Emma Smith.

On the 15^th April, dairyman Edgar Hoyle was fined for provided short measures to the Sanatorium which he had been supplying for the last twelve months. It seems that the measuring jugs he was using were not calibrated, and each time the measure of milk poured out was short. He had originally supplied the milk from his shop with the correct measures but, since the Sanatorium had requested an earlier, 6am delivery of milk, it was collected from North Station where the jugs he was using did not have measures. He was fined 20s (£1; £42.73) and costs and 5s (25p; (£10.18) for all other cases.

On the 20^th June 1919 a two days’ traditional country fair was held at the Agricultural showground on New Road, just across the road from the Sanatorium. It was the brain child of Miss Proctor the matron who had the firm support of Mrs Bean of South Shore, whose daughter had been looked after by the matron at the Sanatorium. Largely on behalf of St Thomas’s Mission church, a close neighbour of the Sanatorium, there would be a stall in aid of funds for the Sanatorium. It was a sunny day for the opening which was introduced by Councillor Alderman Collins, an attendant at the church, and who was active in opening up Caunce Street to provide a thoroughfare to the town centre and to bring St Thomas’s out of a relative isolation and ‘on to the map’. The event eventually made £110 (£4,699.75) and was later considered by ‘Dorothy’ in her regular column as very successful, and praise was due to Miss Proctor and Miss Roberts and the sanatorium staff for making the event such a success.

June 27^th saw the death in ‘a’ sanatorium at Blackpool, (the newspaper is not specific but it might be assumed to be the New Road Sanatorium), of 19 year old John Carter. He had originally joined the RFC the year previously but had gone to France with the Rifle Brigade and was wounded and taken prisoner in March of 1918. Having been released after the armistice he spent some time in a London Hospital and then Liverpool and then to Hazel Grove in Stockport before being discharged, when he returned to his parents, their only son, and whose address was 7 Myrtle Street in Blackpool. It seems that he had never been able to recover from his wounds and the gassed condition of his lungs, and entered the ‘sanatorium’ where he died on June 27^th. ‘Thus another of Blackpool’s sons made the supreme sacrifice for King and Country,’ concluded the Blackpool Times of July 5^th 1919. Originally from a Blackburn family, the funeral took place at Blackburn cemetery. The parents, of course, had also made that sacrifice in delivering their only son to the conflict.

The mortuary in New Road was used in the sad case of a new born baby found in one of the carriages of a train that had arrived at Central Station from Manchester. It had been wrapped in some brown paper and a copy of the Daily Sketch. A few days previously, and in the same column of the newspaper, was the report of a newly born baby found in the toilet pan of the YMCA on Talbot Road. The mother was a servant girl at the premises who, it was evident, had attempted to keep her pregnancy concealed and was indignant that one her colleagues suggested she might be as her increased size might have been evident to those close to her or bothering to look and who might be bold enough to make that suggestion. In a situation of hopelessness, with a big unanswerable question mark over her future where she would lose her job, her life style, status and her reputation drastic action was deemed necessary. Whether the baby was born alive or stillborn, there had been a limited attempt to conceal it.

In the Budget speech of June 1919, Mayor Parkinson could proudly proclaim that Blackpool was the second lowest rated borough in the country and a 6d (£1.07) increase in the rates was all that was necessary despite the added responsibilities of the municipalities as the trend to decentralisation continued. The added financial considerations of the maternity home, housing for the working classes, in which sites for council housing had been selected, tuberculosis responsibilities and education were all on the agenda.

The medical arm of the army, the RAMC, was naturally and intimately connected to medicine and during the War had been highly evident in Blackpool. Colonel Barron of the Kings Lancashire Convalescent Home at Squire’s Gate had seen the need for a national Ministry of Health. After the War it was suggested, at different times by Captains Brown and Bernard that a captive airship, tethered high in the purer air of the atmosphere above the polluted towns could be used as a tuberculosis sanatorium. This theory of this perhaps was a lot stronger than the practicality of achieving it.

In June of 1919, the Victoria Hospital received a letter of praise and gratitude from the War Office for its role in looking after the soldiers during the War. Addressed to the Chairman of the Board of Management of the Hospital, it read;- ‘Sir, I am commanded by the Army Council to thank you for the valuable assistance which your Hospital has rendered in the service of the sick and wounded. I am to assure you that your kind and patriotic action has been deeply appreciated. I am to request that you will be good enough to convey to the staff of the Hospital the thanks of the Army Council for the whole-hearted attention and devotion which they have given to the patients who have been under their care.’

In July, the health report of the town was published in the abbreviated form that had been adopted during the war years. Interestingly, since immigration is a current (2023) national issue, and the death rate continued to be higher than the birth rate in the town, Dr Rees Jones shows his concern as;-‘It is obvious to all that immigration rather than natural increase of population will be the main factor in maintaining our existence as a local community, and we must therefore attract new residents to our town and organise our Public Health so that they shall live under conditions conducive to individual health in so far as they can be procured by external surroundings.’ (Blackpool Gazette and Herald 4^th July 1919). Of the 1,073 deaths in the town, those from infectious diseases were 16 from measles, 129 from influenza, 89 from pulmonary tuberculosis, 102 from cancer, 53 from apoplexy, 69 rom valvular disease of the heart, 162 from bronchitis and pneumonia, 37 from Bright’s Disease and 29 as a result of premature births. The worrying factor for the doctor was the death rate of infant children, as 85 children under the age of twelve months had died during the previous year. The rate was 110.5 per 1,000. 57 of these deaths occurred before the child had reached the age of three months. Of infectious diseases, while there were no cases of smallpox notified of all the diseases with a requirement for notification, deaths occurred only from diphtheria, puerperal fever, measles and there were 108 deaths from tuberculosis (pulmonary and non-pulmonary).The worst killer was influenza and though during the year it wasn’t at first a notifiable disease, there were nevertheless 129 deaths attributed to it. The number of patients treated at the Sanatorium had been 572. There had been 88 births during the year that had not been notified and it was thought that legal proceedings would have to be taken not only against the parents but also the medical practitioners if things did not improve. The appointment of two midwives ‘whose services will be charged according to the ability to pay’ would see ‘the commencement of the transformation of the whole midwifery service from a private to a municipal one.’

So it’s July and the Armistice being signed, Peace celebrations took place all over the town and surrounding districts, as indeed throughout the nation. At the Sanatorium and Victoria Hospitals, the children were treated to toys and gifts and at the Sanatorium, the children were treated to a Punch and Judy show and later a visit from the Mayor Alderman Collins and his wife.

The new Ministry of Health has now been created and Dr Coutts, the former Medical Officer of Health for Blackpool has been appointed as one of the five senior officers.

It seems that the slaughtering of animals at the abattoirs had continued in the old ways despite the availability of more ‘humane’ ways of slaughter but now, once more, the Health Committee were urging the use of the ‘Humane Killer’ and were arranging for a demonstration at the earliest date possible. As a statistic, 1,195 animals had been slaughtered at the abattoir in June as opposed to 1,030 in the same month of the previous year.

Though the War was over, it would take time to get back to normality, and though restrictions on food supply had been relaxed a little, Food Control on a national scale would remain for another six months, that is, during the winter months, and the Blackpool Food Committee would continue to operate. In September there was a longer than usual meeting of the Health Committee to discuss varying topics. Here it was decided to increase the maintenance charges for non-ratepayers at the Sanatorium, and it was a time when greater consideration was needed to be given to the blind as the number of blinded soldiers had made it a matter of some urgency. Here the Ministry of Health was prepared to give financial assistance to those agencies which were concerned with the welfare of the blind, and it was the responsibility of the local Heath Authority in Blackpool to consider what action could be taken on that behalf. On the death in action of the former Chief Assistant Sanitary Inspector, Mr Moister, it was agreed to appoint Mr J Tolmaer to the position. One of the chief topics of discussion was the provision of a Day Nursery for children whose mothers were out of work for the day, now an increasing feature of the working day for families. The ascendancy of the human being over all other animals was contained within the plans to extend the abattoirs and to find more efficient way of getting rid of the rat problem.

In a continuing, symbiotic relationship with the church of St Thomas, the nurses and matron of the Sanatorium had organised a stall at the school and raised £42. It was hoped that this stall would raise about £500 (£21,362.51). On November 11^th a very moving ceremony took place at the cenotaph to commemorate the dead of the war. As death took place not only with disease and accident, it also took place in great numbers due to the inability of the human being to organise itself in harmonious communities, preferring suspicion, scepticism and doubt due to an inability to seek compromise as a solution before violence.

As the Sanatorium was a notable place in its position in the town, as much as directions were most easily described if one or several pubs were among the instructions, a letter was received by a Mrs Beatrice Yates of Layton demanding money which was to be put in a bag and left by the telegraph pole on the corner of the Sanatorium and Devonshire Road. It had been sent by a Lewis Hawkins and, since Beatrice Yates had contacted the police, and they were on the spot to arrest him, he was caught collecting the bag which she had been advised to place there. Maintaining it was only a joke and he would have given the money back, a desperate Lewis Hawkins really had no defence.

December and it’s Christmas time once more, and the appeals not to forget the unfortunate children in the Sanatorium and Hospitals are published as short paragraphs in the newspapers. Dorothy once more reminds her readers to remember the children in the orphanage on New Road where the matron, Edith Swallow, is ‘mother’ to them, and also the ‘shut ins’ at the Sanatorium and the Chief Constable’s Clothing Fund. And the appeals from each quarter did not disappoint. The children at the Victoria Hospital in their wards decorated with flowers and greenery were treated with a visit from Father Christmas and after the distribution of presents from the tree, tucked into a fine meal. At the Sanatorium the nursing staff spared no effort in creating a happy festive occasion for the children, in particular with presents from the Christmas tree and a visit from the Father Christmas once more from Hills Bazaar. And for the adults, as well as a visit from the Mayor, there was a selection of music in the grounds, played by the Lifeboat Band. At the orphanage, the children had had the most wonderful Christmas under a weight of donations. And it is a wonder whether this success is the result of the power of the press or merely the natural and often untapped expressed compassion for humanity, or maybe little bit of both.

Into the January of 1920 and while it was considered by now to include Carleton within the Borough boundary which would take an Act of Parliament, the Maternity Home was ready for opening but only delayed by the non-arrival of bedsteads. The costs for staying at the Home had been agreed at 30s (£63.10) for a fortnight’s stay as an ‘all inclusive’ arrangement of medical and nursing attendance and maintenance. The question of nurses’ working hours at the Sanatorium also comes up for consideration as the national trend towards the ideal of an eight hour day which had been promoted quite energetically by industrial action in other parts of the working community for some time now. While it was considered quite appropriate for a nurse to reduce her working hours from the excesses she was used to, since ‘they are no less entitled than tram drivers’ for instance, there was not enough accommodation in the building to expedite this. However, an increased remuneration was considered to compensate for this shortfall.

The influenza pandemic persisted into 1920 and in February of that year the Medical Officer of Health, Dr Rees Jones, published medical advice in the newspapers, the advert below extracted from the Fleetwood Express of 14th February 1919, Valentine’s wish perhaps for all those suffering, and the distress and disruption to society that the disease continued to cause. There was help for those in need of financial assistance, and the Sanatorium provided a limited amount of space for certain circumstances. Poulton was pleased that no cases from its district were required to go the Sanatorium regarding this provision. Also perhaps advice which could have been written a hundred years later as covid 19 continued to rage.

In reviewing the rate and the salaries of certain of the council staff, it was decided to raise the salary of Martha Adams, the School Medical Officer of Health from £450 to £650 (£16,642.49 – £24,039.16) a year. Perhaps such was the new power of women in the credit of their recent grant of suffrage, and the acceptance of equal potential, that the rise to £450 had only been granted two months ago. It was decided at the same meeting to ratify the decision to increase the salaries of the nurses and maids at the Sanatorium, and to provide the extra accommodation, the lack of which that was preventing the organising of the reduction in working hours to eight a day.

By May the Elswick Sanatorium scheme, interrupted by the War, could now be completed and under the aegis of the Ministry of Health, could now be purchased from the Fylde Joint Hospital Board by the Lancashire County Council to use as a hospital for the treatment of tuberculosis sufferers at a cost of £23,000 (£850,616.38) with a further cost of £34,000 (£1,257,432.91) to extend the current 48 beds to 114, which would out a cost of £180.00 (£6,657.00) per bed.

As a regular columnist of the local papers could reveal with, perhaps, a little cynicism when he regularly took the tram to Layton from Blackpool, that when the tram is ready to depart the conductor would cry, as the bell was rung and the latecomers were scurrying to catch it, ‘Hurry up for the Sanatorium, Slaughterhouses and Cemetery!’. Such was the ride from Talbot Square to the terminus at the cemetery in Layton, a route travelled largely for practical purposes and not for sightseers in general. The cemetery however, in the grandeur of its open spaces and the capably maintained landscape of trees, shrubs and brightly coloured flowers, in the holiday season was a draw for the holidaymakers, for the peace of its surroundings as the town lacked yet a municipal park in which to take such a quiet and reflective stroll.

The death rate from pulmonary tuberculosis is now recorded as the lowest ever. At Elswick the number of patients treated there between 1914 and 1920 was 731 insured and 100 non-insured. And people in general are living three to four more years than before, according to Life Assurance statistics, which perhaps might not be that reliable if the poorer people could not afford to take out a policy. Improved conditions of housing designed to improve the health of the working classes was a serious and current consideration and Council estates began to develop.

~~~~~~~

Information on Blackpool news is scarce from this date on as it seems the Blackpool papers are not available as digitised documents from this date, so the Fleetwood papers, occasionally identical, have largely to be relied upon. And in November, it was reported that the matron of the Sanatorium gave a lecture on consumption to the Church Women’s Club at the Parish Room in Fleetwood, a lecture which, as reported was thoroughly appreciated.

~~~~~~~

April of 1922 saw the sad death by suicide of 21 year old Mark Cotterill from Droylsden. He had been at the Elswick Sanatorium since January, and the doctor described his medical case as a ‘bad one’. He had cut his throat in the lavatory and the matron at the Sanatorium, Isobel Barclay, and nursing sister Rhoda Hill, did all they could when they came to his aid when found, but to avail. There had been no indication that Mark had been suffering from any kind of despair or depression that might have noted him being prone to such final action. During the year April 1921 to April 1922 there were three cases of ‘tubercular lung’ sent to the Sanatorium, a brief note in the report of the Poulton Medical Officer of Health doesn’t indicate which Sanatorium whether it be Elswick or Blackpool.

The Sanatorium ground was tragically the last resting pace of an infant male body. It had been wrapped in newspaper and brown paper and discovered by a couple of lads who had climbed the railings to retrieve a football. There was a torso only as the limbs and head had been amputated and the body was badly decomposed. The boys alerted the staff of the Sanatorium and a man arrived and called the police when the body was taken to the mortuary before an inquest took place a short time later. This was the fourth case in recent weeks that an infant child’s body had been found discarded and wrapped in newspaper and brown paper.

By September of 1922, there were concerns that the Workhouse was overcrowded, and an extension of the building was becoming urgent. And here was a filler, caveat, paragraph in the Fleetwood Chronicle of 13^th July 1923 which described the difference between a contagious disease and an infectious disease, the former being passed on by being in the direct presence of another person, and the latter being passed on by the result of being in the vicinity of a person through infected droplets in the air via coughing and sneezing.

From July 30^th to August 4^th, a Blackpool delegation will be among the international 500 who will attend the 34^th annual conference of the Royal Sanitary Institute held once more at Hull.

In 1924 there had been an embargo on health grounds on mussel gathering in the Ribble estuary, and samples had been sent to Liverpool for bacteriological analysis, a report about which would then be sent to the Ministry of Health. At a meeting of the relevant authorities at St Annes Town Hall, it was to be hoped that this would come back favourable to the mussel gatherers whose livelihoods had been badly affected by the embargo.

In 1925 an article in the Fleetwood Chronicle entitled, ‘Fighting the White Scourge’, the report of Chief Dr G Lissant Cox, the Central Tuberculosis Officer to the Lancashire County Council, is described. Lancashire has a less than national average incidence of tuberculosis both pulmonary and non-pulmonary. While more cases are notified out of obligation, there is also the fact that there are more efficient methods to identify and diagnose the disease. Regarding the Elswick Sanatorium there had been 65 cases dealt with in the preceding year. The Lancashire County Council was under the obligation to vacate the premises and the TB cases moved elsewhere in the event of a serious epidemic of smallpox. The 11 acres of the Sanatorium treated patients with the fresh air of the outdoors, ‘good and well-cooked food’, and with graduated exercise and rest. There was enough room to construct a special x-ray room, and a women’s recreation room was built by the patients. In this respect the mental health of the patients being an important consideration, appropriate work was found for both males and females. The men had a carpenter’s room and a chicken run, supervised by the female convalescent patients, which would soon count 300 hens in seven runs and providing nearly 30,000 eggs per year. Eggs were sold from the produce of this and by 1931 the Sanatorium had helped to achieve an excess of £40 (£2,254.65) over costs and the sale of various wooden items such as step ladders and furniture. The ladies’ recreation room was entirely equipped by their efforts and acquired competence at woodwork. There was also, quite soon, five acres of land under cultivation, and lawns and planted borders around the building itself. Electric lighting had recently been installed and this gave a brighter atmosphere both to work and relax within. The advantage of the artificial, electric, light meant that more patients per day could be seen to, and more thorough examinations could be carried out. By 1929 the x-ray department could examine patients from all around the district. In October of that year, there were 65 patients, and the average length of stay before cure of a pulmonary tuberculosis case, was six and a quarter months, and for the non-pulmonary cases, 10 months. The average cost to the rates of the Sanatorium was 1½d (33p) in the £1.

In Blackpool there had been complaints made by local residents to the Ministry of Health regarding the caravans at Marton, and since Marton was not yet part of Blackpool, it was to the Fylde Rural District Council to resolve. On the censuses there are many residential caravan addresses and some of these belonged to the much maligned gypsies of the town. They would be eventually removed as the new housing would be erected and as Blackpool would incorporate the district to within its Borough boundaries. Correspondence was already underway between the two regarding this proposed amalgamation as well as with Carleton and Thornton Cleveleys.

By 1927 the death rate from tuberculosis was the lowest recorded for the fourth year running and the number of cases notified was also staying low. This was is in contrast to the ten years before the war when there was little or no decline in the death figures from pulmonary or non-pulmonary tuberculosis. This favourable result was considered due to the measures taken to combat the disease and the more efficient methods of dealing with it and the advance of medical knowledge and practices. What was considered surprising was that the low death rate persisted, despite the fact of the very high unemployment figures in industry and poor, crowded housing conditions. The social distinction between men and women was considered in the varying death rate between the two sexes. Women after about 25 years of age, and usually married, largely spend their time at home and have a lower death rate after that age, whereas the man who is at work and mixing with others or socialising in clubs and pubs is naturally more at risk from infection.

In May of 1930, Mr Edward Smith, the chief clerk in the Blackpool Medical Department, lost a brother, Frederick Smith to illness and subsequent death by natural causes it appears. Living in Fleetwood at the time, Fred Smith took a keen interest in ambulance work and, during the War, he was one the most highly esteemed officers at the Whalley military hospital, one of the biggest in the country with beds for over 2,000 patients. He is buried at Fleetwood cemetery.

On the 14^th May, John Deakin, former manager of publicity at the Tower died at the Sanatorium, though no cause of death mentioned. He had had a career in theatre management and, when he came to Blackpool from Stockport, he became manager of publicity at the Grand Theatre and continued in this role when the theatre was taken over by the Tower Company. He was 52 years old and a bachelor, and lived at 94 Peter Street with his sister Nellie. He died at the time when it was becoming evident that the Treaty of Versailles which had ended the War, was the worst treaty ever signed, in its vindictiveness to the enemy countries, and it was a surprise that another war had not yet started. The health of the World would soon be at stake once more.

In 1931 Jack Hopwood was born at the Sanatorium. His mother had worked in munitions in Blackpool and his father had been a POW in Germany during the War. Nick Moore has the Sanatorium first used as an overspill maternity home in 1920 and it would seem that this continued for some years. A midwifery qualification appears in the status of the staff, as midwifery moved away from local less qualified women to a more universally acceptable status through examination and training. This is most evident in the story of Sadie Stranex, from Carelton, who completed her CMB (Central Midwives Board) at the Sanatorium in Blackpool. Of a religious conviction, she had followed her fiancé, a missionary and teacher, out to Abyssinia as a maternity nurse at a hospital at Asba Teferi. During her time there, in 1935, there was a malaria epidemic and her workload was full as many babies succumbed to the epidemic. The nurses themselves had to take regular doses of quinine to counter the infection. She had expected to get married in May but had to postpone the ceremony until September due to appendicitis.

The further, obstetric function of the Sanatorium is evident in the death at the Sanatorium, of 31 year old Winifred Hargreaves of Fleetwood who, in 1936, had been admitted to the maternity ward due to her confinement. She had been seen to previously in 1933 but, after an unidentified condition and subsequent operation, was declared to be fine. On this second occasion, however she was found to be seriously ill and the baby, in this instance, was removed in order to save her life. Her heart has stopped and the team worked tirelessly to resuscitate her in the evidence at the inquest of Dr Isabella Milne, the maternity health officer of Blackpool. Winifred Hargreaves was a woman who ‘was extremely desirous of going through everything if she could only have this baby’. Such is life for those who wish to give it but are denied the privilege. It was her brother who was called to advise of her death at the hospital, as her husband, a trawler skipper may well have been out at sea.

Also in 1936, Mrs Bessie Clough of Kemp Street Fleetwood died at the Sanatorium. The cause is not revealed, but she had a six week old baby daughter so there is the possibility that her illness was connected to child birth. Her death was mourned by many.

There is also the tragic case of 27 year old Gladys Jordan of Cleveleys, who died at the hospital as the result of a self-procured abortion in the February of 1939. Married, it seemed that, according to the inquest, the couple had had some differences and, to bring up a child, at least for the father, would not be appropriate. It seems also that as consequence of that, out of fear, confusion or compulsion, she took steps to abort rather than continue the pregnancy.

By 1931 Fleetwood is regarded by some doctors as one of the finest seaside health resorts, just a lack of hotel accommodation prevents it from being recommended for patients on a larger scale. The Elswick Sanatorium had now been chosen as a centre for carrying out specialised surgical methods of treatment. This new surgery, perhaps in its honest infancy, sadly proved fatal to 33 year old Frank Palin, a fish packer, who died an hour after his operation, when an operation was considered the only option possible due to his condition. But the main feature of the hospital, when an operation was not considered necessary, was that it provided a controlled atmosphere where patients could enjoy that most efficient of cures, which is rest. An extension of this is to be found in the Fleetwood Chronicle of 20^th May 1932 in an article on a British Sanatorium in the Alps. While the location isn’t revealed, it describes the advances of medical knowledge and the progress and relevance of psychology in treatment and convalescence. The sanatorium is high up in the mountains, a more rarefied atmosphere, free from the smoke and dirt of industry, with electrical conveniences like buzzers to call the nurses, space and relaxation. However, this place is only for the rich who would be able to afford such luxuries as are described. But the final paragraph reads, perhaps containing a relief in the knowledge that a cure for the white scourge of consumption, so evident in the midst of society, is nevertheless at hand and one day might be available to all, ‘There are many VC’s in this battle who will never wear the decoration on their tunics; they wear it in the smile in their eyes, the kindness of their voices, the resolute will to hide the scars they bear.’ This is nevertheless true across the board and not entirely confined to patients indulging in the privileges of a super sanatorium. It is indeed true that a kind word, or a kind, accepting, uncritical face which can reach the beating heart of any human individual, can cure a thousand ills.

While the influenza pandemic had long since abated, flu was nevertheless a perennial scourge of the human animal and in the January of 1933 it appeared once more to disrupt the sports programme as well as the criminal court proceedings of the district.

And the Sanatorium was in need of repainting again, and consequently tenders were invited through the newspapers. The six months’ contracts repeated in September of the year.

And the new Matron for the Sanatorium arrives to take up her post;

Miss Whitaker, the description continues, who is a native of Alfreton, Derbyshire, started her training at the Isolation Hospital Muswell Hill, London; received her general training at the Royal Hospital, Chesterfield, and her midwifery training at the Leicester Municipal Maternity Home. She has a wide experience, having been staff nurse, Sister and Deputy Matron at the General Hospital, Hitchen, and Ward Sister at the City Hospital, Birmingham. From 1926 to December 1929, she was Ward Sister at the Blackpool Sanatorium and returns to Blackpool, fresh from the Isolation Hospital at Muswell Hill, where she was first Ward Sister and afterwards Night Sister. Miss Whitaker has pleasant memories of Blackpool, and looks forward to renewing these when she takes up her new duties at the beginning of November.

In the editorial of the Blackpool Times of 27^th October the health of the nation can be accredited in a great way to the National Insurance Act of 1912. Much progress has been made in the development of clinics, and the provision of the availability of these for all those in need, rich and poor alike. While sickness will always be around, the nation’s health is under the guidance of a good system and trained personnel, and there are not as many sickly children in ‘today’s’ world.

A week before Christmas Eve, the Blackpool Times, in a somewhat self-promotional, but nevertheless compassionate article concerning ‘The Blackpool Times Christmas Doll and Toy Fund’, Uncle Mac of the children’s columns arrived at each of the Victoria Hospital and the Sanatorium bearing quality gifts to the children confined through illness, and missing a normal happy Christmas time at home. The Fund incorporated all the Blackpool and Fleetwood Hospitals, the Sanatorium, the Orphanage and the ‘poorest homes of the Blackpool unemployed’. For the little girl called Eileen at the Victoria Hospital who had the added misery that her parents couldn’t visit because they had been struck down with flu, Uncle Mac saved the day in an institution where the nursing staff had spared no effort to make the wards and corridors, and the patients within them, as bright and cheery as possible. A happy Christmas time was provided for all, and equally presumably enjoyed by all. And at the Sanatorium, young Peter had been very ill as he was stricken with scarlet fever. Recovering slightly, by Christmas he was able to enjoy the decorated ward and ‘kind hearted’ people, who had responded generously to the Blackpool Times appeal, and there was no shortage of quality toys to compensate for the loneliness of isolation, to complement the efforts of the staff in decorating the place and made sure there was hearty meal for all. And the Blackpool Times did not stop merely at the institutions, but Uncle Mac in his car, visited private houses too where the very poor had limited, or no means of providing any form of happy Christmas for their children.

May of 1936 saw the death of Alma Taylor of Southwood Ave at the Elswick Sanatorium, and her mother, Mrs E Taylor, wished to thank all the staff at the Sanatorium for their kindness during her illness. And in November of 1937, 28 year old Annie Blanchard of 16 Gordon Road Fleetwood also died at the Elswick Sanatorium, and likewise the staff at the hospital were thanked for their kindness.

By 1936, as the move towards the health of the nation into the public sector and away from the private, it could be argued, by an ‘ex Councillor’ in the Fleetwood Chronicle, that the ratepayers themselves should be more aware of the rates levied by the municipal authorities in order to maintain a level of service. It should not be a dictate but more of an agreement via the democratic process. The trend at time of writing, 2023, is largely being reversed with the issue of health being directed towards the private sector rather than the public. But it is still largely true that an electorate regards as dictators rather than delegated representatives of their concerns, those it has elected, often due to an ignorance of the political process.

In November of 1937, Mr Colin Hague Topham, a partner in the firm of Topham and Chadwick of Fleetwood, died of an unreported illness at the Blackpool Sanatorium, leaving a widow and to sons.

By 1939, and reported in the Fleetwood Chronicle of October 6^th, a date which had seen the beginning of a new World War, Mrs Mitchison of Pharos Street, was in the Elswick Sanatorium when she heard the news that her young daughter, seven year old Jean, had been killed by collapsing sandbags which had been piled up to protect the air raid shelter by Fleetwood baths. While the sandbags may not have been constructed entirely properly regarding the weight increase due to the absorption of rain, the major complaint at the subsequent inquest was that people would poke their sticks and umbrellas into the bags and many of the bags were oozing sand. One young boy had fallen off the stack and broken his leg shortly before the stack collapsed. Jean’s father was a taxi driver of long standing in the town and little Jean herself, one of six children of a well-liked and respected family, had taken part in several of Fleetwood’s children’s pantomimes.

And it being war time once more, the papers are full of the grief of loved ones lost forever in the theatres of war as the continuing illnesses of the human being express themselves, taking the innocent as well as the guilty along with them. The names of serviceman never coming back, especially those sailors from mined or torpedoed vessels, fill the obituary columns. But peace time naturally continues to take life away as well as bring it into existence and, though many lives are improved or even saved by the time spent in the Sanatoria, there are many young and old who spend their last hours there. Their sad loss is expressed with sympathy to all those who looked after them in the time before their decease. There were several deaths at the Elswick Sanatorium, and a single one recorded and noted at the Blackpool Sanatorium, in the newspapers seen. Wendy Barnes was the one case at the Blackpool Sanatorium, and Mrs Houghton, Vera Knight, George Roe, 19 year old Mary Le-Jeune and Vera Clarke at Elswick, each memoriam containing grateful thanks to all who showed kindness, and the staff at the hospitals are specially thanked. A particular one at the Elswick Sanatorium concerned Mr Matthew Woods of 11, Oxford Road, Fleetwood. He perhaps would have considered his death as a rather ignominious one as he was one of the ‘best known trawler boatswains’ in the town and, like hundreds of fishermen who had come in from the sea, had gone nobly off to Dunkirk to rescue the retreating British Expeditionary Force from the beaches. When this was completed, he joined the Royal Naval Reserve but contracted an illness which resulted in his return home and his admission to the Elswick Sanatorium. This was 1941 and he was 29 years old and had had an active and incident filled life as a trawler man, beginning his seafaring life at 14 years old. His father, also Matthew, had met his death on the Doris which disappeared taking all hands with it in 1914 off the Scottish coast. Matthew left a wife and children who attended his funeral and Mrs Woods thanked the doctor and Sanatorium staff at Elswick for their kindness and consideration.

In June of 1947, Councillor Saer had recently signed the agreement for the ‘transfer of the Sanatorium belonging to the Fylde and Garstang Joint Smallpox Hospital Hospital Committee to the County Council at a cost of £18,500 (£598,963.44).'(Fleetwood Chronicle June 13^th 1947). In this year the National Insurance Act came into force and was the culmination in concept of a Welfare State begun with the Insurance Acts from 1911 and beyond.

So, from this time on, the Sanatorium settled into a regular, well understood and respected function, with further extensions added in 1928 and a boundary wall in 1930. A dermatology unit was added and, as the writer of this once more, my son was a day patient when he was infected with impetigo which was in the 1990’s. The hospital had remained on the site for over a hundred years until its demolition in 2007 and, for much of it later existence, without the complaints to which it had first been accustomed. From that date the empty site  was first used as a temporary car park, contained within the preserved boundary walls, and then used conveniently for the ambulance parking while the new ambulance station was being built on Waterloo Road, and finished by 2023. At time of writing, the land that was once Boon Heys and belonged to Bispham Endowed School, and had a long life as the Sanatorium, is now an empty site awaiting development which, in editing this in June of 2024, the site is proposed, and planning permission applied for, the erection of Law Courts, removed from their current siting. In a long and comprehensive document, this planning application concerns the erection of a three story building for use as a court-house with judicial chambers… ‘with associated landscaping and partial removal of a boundary wall.’ The wall itself, ‘as a locally listed heritage asset would be suitably preserved,’ and would be repaired and redecorated to ‘represent different phases of development of the original hospital, with rendered panels and railings.’ Concern is given over to these panels being prone to graffiti which, in the expression of a just few individuals is the bane of the majority, and which has been evident for some time.

When I did jury service in about 1970 at the Law Courts recently built at Central at the time, there was a case in the court which was dismissed as not having enough evidence to proceed. It did mean that I and the other jurors were not needed to represent a decision but it brought a smile to at least my inner self when it was pronounced that the case was dismissed as the court advised that ‘we need something more concrete’. The large and spacious law courts had recently been built with tons of concrete and very functional in design to reflect the mindset of the period. In the current situation, regarding the construction of the proposed new Law Courts, greater consideration is given, as a requirement of law, to environmental issues and aesthetic qualities thus regarding, via environmental protection and visual pleasantness as necessary to promote, as much as possible, the social psychological and emotional health of the town as much as those in former years were obliged to regard disease and its causes and cures.

To be continued. 7/7/24..

Sources and Acknowledgements.

and Further reading

The vast majority of the story has been derived (and with thanks) from (several hundred) contemporary newspapers of the British Library Newspaper archive accessed via Findmypast. Access to census returns and BMD’s etc where necessary, also via findmypast.

The British Newspaper Archive https://www.britishnewspaperarchive.co.uk/ Findmypast https://www.findmypast.co.uk/

Nick Moore:- https://www.visitlytham.info/wp-content/uploads/2019/02/History-of-Blackpool-Nick-Moore.pdf

Tabes mesenterica; https://www.bmj.com/content/1/2197/339.3

Inflation calculator. Calculated for 2023 all through the document.

https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator

Colin Reed Blackpool in the 1850’s cmronline:

Blackpool-in-the-1850s-kickstart-to-the-modern-town/ https://www.cmronline.co.uk/

https://www.cmronline.co.uk/ibbison-street-and-the-district-of-revoe-blackpool/

Blackpool and the Fylde during WW1…. https://www.smashwords.com/books/view/875498

Ibbison Street and the District of Revoe, Blackpool

Ducker Hospitals. https://historic-hospitals.com/2015/07/12/doecker-portable-hospitals/

The Ducker House, American prefab of the 1880s

Wenham lamps

https://collection.sciencemuseumgroup.org.uk/objects/co8644505/wenham-reflex-illuminator-component-object

Cholera epidemic in India 1863-1875:-

https://en.wikipedia.org/wiki/Category:Epidemics_in_India

The Mousmé:-

https://gsarchive.net/british/mousme/index.html

Midwifery:-https://memoriesofnursing.uk/articles/midwifery-in-britain-in-the-twentieth-century

Midwifery in Britain in the Twentieth Century

HMT Charles Boyes:-

https://uboat.net/allies/warships/ship/6968.html

The wreck of the trawler Doris

https://redrosecollections.lancashire.gov.uk/view-item?i=261141&WINID=1717525420713

Indefatigable Liverpool

https://www.ts-indefatigable-oba.org/training-ships-on-the-mersey

Borough Surveyor JS Brodie speech;-

https://journals.sagepub.com/doi/10.1177/146642401503600306

Charing Cross Hospital

https://www.imperial.nhs.uk/about-us/blog/celebrating-200-years-of-charing-cross-hospital

Inflation calculator. Each year calculated for the equivalent cost in 2023.

https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator

Short description of the Hospital:-

https://www.heritagegateway.org.uk/Gateway/Results_Single.aspx?uid=1076042&resourceID=19191

The appointment of Matron Miss Edith Proctor in 1905.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188650/pdf/hosplond74135-0019.pdf

Dr George Kingsbury and hypnotism

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426986

Elswick Sanatorium

https://discovery.nationalarchives.gov.uk/details/r/C2323050

Ebay card sent to the Sanatorium

https://www.ebay.ph/itm/176002144665

Blackpool Council proposal and application for the development of the land:-

https://democracy.blackpool.gov.uk/documents/s89004/Item%2010%2023-0777_Courts_reports.pdf

The status of women in Blackpool

https://clok.uclan.ac.uk/25640/1/Hobbs%20Womens%20History%20Review%20%282%29.pdf

Nurses in Blackpool

https://kingscollections.org/nurses/search-results?id=5420&asId=as0&search=blackpool&sub.x=0&sub.y=0

Elswick Hospital from the parish Council Website

http://elswickparishcouncil.co.uk/page.php?id=18

Military auxiliary hospitals in Blackpool:-

https://www.wartimememoriesproject.com/greatwar/hospitals

Moss Side Hospital

https://juliettegregsonheritagephotographer.blogspot.com/2019/03/devonshire-road-hospital-soon-to-be.html

For several images of the derelict Hospital:-

https://www.28dayslater.co.uk/threads/devonshire-road-hospital-blackpool-march-07.11083

Other histories of Blackpool and brief biographies of several of the Layton cemetery ‘residents’ compiled for the guides of the cemetery, are included at cmronline.co.uk.

Compiled by Colin Reed 2023 – 2024.