The Blackpool Sanatorium for Infectious Diseases and the Health of Blackpool.
1/ Late 1876 to early 1900’s.
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 19th 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, who then might 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. There were numerous ash pits for burning rubbish and while a basic sewerage system had been 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. 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. 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. 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 had had any right to interfere. 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 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 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.
But this new Sanatorium 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 matron being in the middle of all this uncertainty perhaps had had enough and had found little option but to resign.
But maybe there was another reason or her resignation and departure. On 7th 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 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.
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, 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 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 the 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 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 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 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.
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 30th, 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.
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 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 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 holidaymaker 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 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 of these diseases, 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. Sewer 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.
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 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 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 wiped out by diphtheria. Of the Ashton family at Breedy Butts, first the parents had died, and then the children, 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 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.
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.
On Thursday January 12th 1888, the dominating question regarding the ongoing controversy over thestatus and siting of the Sanatorium came to 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 a 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 patient 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 andan editorial column of the Blackpool Herald of 20th 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 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.
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 months’ 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 5th 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 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).
The purchase of the land for the new Sanatorium from the Guardians of Bispham Endowed School would cost more specifically £788 8s 9d (a little more than £84,623.12). 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 awayfrom the heated argument over the status of the infectious diseases hospital. In Marchof 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 was 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.
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 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.
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 the Blackpool Herald of 24th December 1890 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 discussions.
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 10th 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 8th May, the Sanitary Committee determined that, ‘On the 10th 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 30th 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 construction of the new Sanatorium 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. Indeed 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, also blew 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 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.
Bu 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. 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.
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.
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 and would be reserved for smallpox cases only. But a sanatorium 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.
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 serous 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 Sanatorium and Infectious Diseases hospital 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 at 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 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 will 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’.
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 arrive 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 27th 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’ of 1885. 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 than returned to Puddle House when the outbreak then 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.
For some time now it appears that there had been rumblings beneath the surface that theSanatorium 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 5th 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 30th 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, 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.
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 was 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 ‘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 15s (£79.63), a week while the prospected salary for the new Matron was 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.
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.
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.
In 1896 Dr Anderson, as the superintendent, writes to the editor of the Blackpool Herald to say thank you for all the 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 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 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 cases from eating mussels from an area which was contaminated with sewage. 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.
By now improvements had been made and the reputation of the new hospital had risen into the scale of positive public and profession 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 removal of rubbish other than sewage 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 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.
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 20,540as given. There had been 1,260 births in the district which included 13 at the Kirkham workhouse 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.
By 1901 the census return 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 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. It seems that from this date the Medical Officer of Health, and superintendent of the Sanatorium was now Dr Coutts, who took over the post on September 2nd of this year, after what might expected to be the retirement of Dr Anderson.
As the responsibility for weather recording was taken over by the Health Department, some equipment as removed to the Sanatorium grounds. It’s not been determined whether this refers to the new Sanatorium rather than then 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 be 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 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, near to the railway bridge. 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.
By January 1904 the extension to the Sanatorium was once more up for debate. An institution which had now been largely free of 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 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 (referred to for the first time) 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 July 1905 the Sanitary Committee placed on record within its minutes its appreciation of a 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.
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.
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.
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. As the writer of this, my own mother was a scarlet fever patient there as a young girl in the 1920’s and a son a day patient with impetigo in the 1990’s. It is hoped that the story can continue in the creation of a part two.
Sources and Acknowledgements
The vast majority of the story has been derived from (several hundred contemporary newspapers of the British Library Newspaper archive accessed via Findmypast.
Tabes mesenterica; https://www.bmj.com/content/1/2197/339.3
Inflation calculator https://www.bankofengland.co.uk/monetary-policy/inflation/inflation-calculator
Colin Reed Blackpool in the 1850’s cmronline…
Duckers Hospital. https://historic-hospitals.com/2015/07/12/doecker-portable-hospitals/