253, Duke St.
Although there are many complaints made nowadays about the level of service available from the National Health Service, it is difficult now to conceive of the conditions in previous centuries when access to medical aid was largely the province of the rich and powerful. The poor had to depend upon the charity of others, which tended to be sporadic and often meagre. Occasional support was on offer from the Glasgow's Town Council when finances allowed for this. Recourse was often made to the Kirk which tried to maintain its traditional role with regard to succouring the ailing and needy even after the Reformation left it with far less resources than before.
For ordinary folk, where illness was persistent or even life-long, and there was no family support, there was an inevitable decline into pauperism. This might be alleviated to some extent where the person was allowed to beg within the confines of their native parish or where some financial assistance was provided from charitable sources. With the advent of Glasgow's Royal Infirmary in 1794 there was established at long last a permanent facility which offered universal treatment for medical emergencies, and selective admission for those conditions susceptible to the rudimentary medical care then available. But admittance to the Royal Infirmary was difficult and necessarily limited to a relative few, and did not provide for the chronically sick and disabled, or for the terminally ill.
Glasgow's population expanded in the early years of the 19th century and the difficulties facing the disabled poor became enormous as traditional and already limited sources of support were overwhelmed. The response which was eventually developed was on a national level. As a consequence of the Poor Law Amendment Act of 1845, the responsibility of the four Parochial Boards of the Glasgow area - City, Barony, Govan and Gorbals - as well as the others throughout the country was established for the provision of medical assistance to the disabled poor of their parishes. Since one of the criteria for receipt of help under Scottish Poor Law always had been that people had to be both poor and disabled, there was a considerable demand upon the medical resources of the Poor Law institutions.
Funding of the poorhouses and of those persons on the outdoor relief roles could come from a variety of sources, but in the main it came from a charge on local parish ratepayers. This could prove problematic for areas such as Gorbals which had a generally poor population, but no matter what the district, the Board members were usually reluctant to place too great a burden on the ratepayers, into which category they themselves fell! The variability in the level of funding raised led also to a variability in the services which were provided from parish to parish.
The Barony parish extended to 13.91 square miles in area, with a population of almost 290,000, making it one of the most densely inhabited parishes in Scotland. To meet its obligations the Parochial Board built Barnhill poorhouse in Springburn in 1853. Like most other poorhouses, the hospital facilities were incorporated initially into the same building, but in 1880 a separate hospital was built on site, with additional facilities added in 1887.
Glasgow City developed a system of relief based upon the Town Hospital which had been established in 1733, but had then used the old Royal Lunatic Asylum buildings in Parliamentary Road from 1843 when the Town Hospital proved inadequate to the task. The Asylum building had then become Glasgow City’s poorhouse. Although Glasgow had a smaller population than the Barony, it had the larger pauper population due to the concentration of slums and its common lodging houses in the central area.
Applications for relief had to be made and very strict criteria met before Parochial Boards would provide it. Disability had to be part and parcel of the presenting problems, and so just about all recipients required some degree of medical support. If a person was a first time applicant then the request was processed, supposedly, within 24 hours. A medical examination was required and the Inspector of the Poor made a recommendation to the Relief Committee which would make a final decision. If relief was granted then this would include the determination as to whether it was to be provided on an outdoor basis or an admission to the poorhouse itself was necessary.
Severity of illness itself was no guarantee that relief would be provided. If the “breadwinner” was deemed to be fit and able then ailing dependants could be refused medical support, and referred on to charitable institutions. There was such tremendous social stigma attached to entry to the poorhouse that the Poor Law hospitals were viewed as a last resort by poor souls at the end of their tether. It must have been heart-rending to find that even the last resort was not available to you.
If the person was already within the poorhouse and required hospitalisation then they could simply be transferred to the wards. If the person was on outdoor relief then there was some possibility that medical aid could be provided on that basis, although this could not be guaranteed.
From their inception, the standards of medical care and treatment provided at the poorhouses fell considerably short of that in the voluntary hospitals such as the Royal Infirmary. There was a reluctance to meet the expenditure that would be incurred to update practice and equipment, and maintain a skilled staff. It was many years after antiseptic techniques had become routine practice at the Royal Infirmary that the City poorhouse hospital would consider its use on their premises.
As late as 1892 at the City poorhouse surgery was carried out on the wards - or even the ward kitchens - within sight and earshot of other patients. There was gross overcrowding which breached local legislation. It was not rare to find hospital beds being shared, and ordinary inmates spilling over from their own accommodation into the wards. There was even less likelihood of beds becoming vacant than in the voluntary hospitals as the inmates were quite likely to be suffering from chronic, incurable and terminal conditions - ailments which the voluntary hospitals were less inclined to deal with.
In 1894 the Parochial Boards were replaced by the Parish Councils as a result of the Local Government Act of that year. A few years later, in 1898, City and Barony parishes merged to pool their resources, provide a more uniform service and save money. At the merger with Barony, the City facility was closed down and all paupers were diverted to Barnhill. Hospital accommodation was eventually separated from this facility when three specially built Poor Law hospitals were constructed between 1902-04; the Western District, Eastern District and Stobhill Hospitals.
Stobhill was the largest of the three with over 1,700 beds available. It was used for the treatment and long term care of the chronically ill, all the needy children of the two parishes, and for the treatment of tubercular patients. The other two hospitals could provide 500 beds between them and were used for the treatment of acute medical and surgical emergencies.
The Eastern District Hospital was built in Duke Street and opened in 1904. It came to be known locally as Duke Street Hospital. The red sandstone, highly ornate block facing onto the street was an imposing structure, built in a French Renaissance style, with its own small triumphal arch giving access to the buildings behind.
Along with the other Poor Law hospitals, Duke Street was transferred to the control of the municipal authorities in 1930, and was ultimately incorporated into the National Health Service in 1948 as part of the Royal Infirmary group. As such it provided a wide variety of facilities to the local community including general surgical and medical units. A maternity unit was added in the 1940s, and it is credited with being the first general hospital to incorporate psychiatric assessment wards. The latter was followed up with a psychiatric out-patients department in the 1970s.
After 1948 there was a drift towards the provision of treatment for chronic conditions rather than acute ones, the latter tending to become the prerogative of the Royal Infirmary. In the final stages of its history as a hospital, Duke Street was used solely as a geriatric unit for long stay residents. With the building of the Queen Elizabeth Building at the Royal Infirmary in the 1980s it was argued that the facilities at Duke Street were no longer required. Although it was eventually closed for admissions in 1992, it retained a population of older patients until as late as 1994 while alternative accommodation could be obtained in the private nursing homes which had sprung up in the area with the advent of the Government's "Care in the Community" policy.
Most of the buildings were demolished by early 1995, except for the main block, which had been Listed in 1970 as a category B building. This was acquired by Loretto Housing Association which was looking for an appropriate building to lodge residents from the nearby Great Eastern Hotel, this being scheduled for closure in late 2000. The hospital was converted in that year to provide the accommodation the project required. It is interesting to note that the hospital was built to provide a service for the poorest souls of the community, and has now come full circle.
Gaffney, Rona (1982); “Poor Law hospitals 1845-1914”. In Checkland, Olive & Lamb, Margaret (Eds) (1982); “Health Care as Social History.” Aberdeen University Press, Aberdeen.
(C) 2006 Gordon Adams