I spend too long reading old newspapers and one thing is timeless, which is the worry that the local healthcare provision isn’t sufficient. This letter to the Norwich Mercury in January 1825 spells out the problems which the correspondent thought needed to be dealt with.
“It now becomes a matter of serious and important consideration, in what way the funds are to be employed, which have been liberally afforded to the Hospital during the present year; and as much advantage will be derived from having the public attention directed to this point, I beg leave to offer, through your means, to the attention of the Governors, a few remarks on the subject.
The clear profits of the last Festival having been from £2400 to £2500, we must consider £300 of this sum, to defray the preparatory expences of the next Festival. The balance is therefore £2100; and to this may be added the late very munificent donation of £533, which increases the funds of the present year to the extent of £2633, beyond the average income.
With regard to the appropriation of this balance, I presume that the first consideration will necessarily be, whether the establishment, on its present scale, admit of any improvements. This is a circumstance of which the gentlemen who are most conversant in the details of hospital management are the most competent judges, and I would only observe upon it, that as there are no wards but such as are in constant use, the operations of cleansing, whitewashing, and painting, must occasionally diminish, for many weeks, and even some months, the accommodation of the patients: and that an additional ward would therefore be very important, in order to give full effect to those which the Hospital possesses.
Such an extra accommodation would likewise permit a ward to be employed for males or females, as an occasional overflow of the one description of patients or the other, might render necessary.
This goes upon the presumption, that the Hospital does not require any permanent magnification; but when the increased and increasing population of the city of Norwich and the county of Norfolk are taken into account, it will hardly be considered, that an establishment, which was intended for 80 or 90 patients half a century ago, when the population was near 10,000 less than it now is, could not, at the present time, be advantageously enlarged.
By the printed report it appears, that during the last twelve years, the average annual admissions have increased about a fourth; viz. from about 500 to 600; but it has very frequently happened, as is well known, that for many weeks together several of the applicants have not been admitted, though some of them have come from a considerable distance, and at great fatigue, expence, and inconvenience. This is an evil which can only be supplied by a permanent addition of beds to the Hospital.
The necessity for more room was felt even during the life-time of Dr. Alderson, who died in 1821; and plans and estimates were in his time obtained, as to the mode of enlarging the Hospital, by the erection of two new wards at the North-west corner of it. The state of the finances might at that time prevent the measure from being carried into effect, but the friends of the Hospital may now congratulate themselves, that there are the means of accomplishing this, or any other plan for increasing the utility of the establishment, which may be deemed necessary.
The erection of two new wards, similar in size to the present, and the addition of one of them to the regular establishment of the Hospital, may be easily provided for. By the printed accounts it appears that the housekeeping expences amount to about £16 or £17 per patient: that is, supposing 90 persons, including the officers, to be always on the diet tables of the Hospital. An addition of 15 patients, including nurses, &c. would not exceed, at £20 per annum per patient, £300. If the erection of two new wards amounts to £1000, there will still remain to be disposed of £1500, of the balance above mentioned. Suppose one of the new wards to be considered as independent on the Festival for its support, £900 or £1000, of this money will be required to keep it open till the next festival, when a similar sum may be appropriated to the same object.
Thus will the benefits of a Festival be immediately felt, in the increased relief afforded to the poorer orders of society, and at the same time a fair prospect afforded of keeping up the advantages of the augmented accommodation in future. The experiment would not hazard at all the safety of the establishment: for a ward which is meant to depend on a Festival for its support, might cease to be employed, if the funds intended to keep it open should fail. But when it is considered that the expences of future Festivals will be less than those of the last, and that none of their receipts will be necessary in new erections, there will be every prospect afforded, of not only keeping up, permanently, an augmented number of patients, but of likewise preventing the necessity of appropriating, in the regular support of the charity, those donations and legacies which, without aiming at making it independent of the continued protection of the public, should provide for its permanent and increasing utility.
I remain, Sir,
Your obedient servant,
A SUBSCRIBER.”
The hospital had been built in 1771 as a charitable institute and it was for a long time unable to cope with the demand placed upon it. A new hospital was built on the same site in 1883 and free healthcare was out of reach for many, but letters such as this seem to have a reassuring presence that the health service will probably never really be able to cope with the demands placed upon it.
As another aside (I have a lot of those), I personally prefer the archaic spelling of ‘expences’, although the origins are from the French word ‘espense’, so the current spelling does have historic integrity….
