Medical history of Worcester through the public eye & the significance of Charles Hastings.

A placement week may be seen by some as a chance to get more experience in the field you want to work in, or for others may be seen as something you have to do. But, I can assure you, after my week at The Infirmary, a placement week means much more. During my placement week, as part of being a Univeristy of Exeter History student,  I was given the exciting task to explore other museums/educational sites in Worcester. Through visiting other museums and tours in Worcester, I have experienced the interconnectivity of the history shared, and learnt vast amounts of history about my home city. One of the most significant figures who was shared across the museums was Charles Hastings, founder of the Provincial Medical and Surgical Association, which later became known as the British Medical Association (BMA). The guided city tour with Worcester Walks beginning at Guild Hall, made links with Charles Hastings as did the Tudor House and Museum and Worcester City Art Gallery and Museum. Therefore, I became quickly educated on the history of The Infirmary and BMA through visiting other places, whilst having an amazing time! 

Firstly, I began with the guided city tour with Worcester Walks, which began outside Guild Hall and progressed to the river side, the back of the Cathedral and then ended on Angel Street. Our guide was a woman named Miriam, who was actually a nurse during the time the Charles Hastings Building was in fact the Worcester Royal Infirmary. As you can imagine, I was very enthusiastic about hearing her words on the Infirmary and what life used to be like, especially being a nurse herself! The tour was very informative and took us on a beautiful walk around the city. Although, I would recommend you feel awake and prepared to take it all in as it is a lot of information, and also a long walk (especially when it rains). When we arrived outside of the Cathedral, Miriam pointed us towards one of the stained glass windows and recalled the story of Charles Hastings. Immediately I made the link between the Infirmary and the Cathedral, as Miriam highlighted the significance of Charles Hastings with his contribution to medicine and formation of what we know as the British Medical Association today!

Following on, I then visited the Worcester City Art Gallery and Museum, just past Foregate Street. I was greeted by a lady in a reconstructed Chemist exhibit, known as ‘Steward’s Chemist Shop’. This showed a fantastic collection of different pharmaceuticals used from 1876 till the shop closed in 1973. Medicine again! This was definitely the most authentic and interactive elements to the museum that I enjoyed. Whilst walking round, I spotted a familiar face in a portrait painting held on a wall, Charles Hastings. Another link to the Infirmary! Wandering round the exhibition you feel like you are literally travelling through time with all of the different soldier’s costumes.

The following day I visited Tudor House museum, a building consisting of three houses all dating back to the 16th century. Here, we were given a tour of the museum with great detail into each object. Each room is set up as a different style, either a bathroom, kitchen, dentists/doctors, with amazing objects to suit. The display of how the wall was made is fascinating and gives the audience a real insight into the foundations of the building. In the section for the famous people of Worcester was Charles Hastings, complete with his life story, which was great to see. Overall, I think the Tudor House museum is a great way to explore history as the set up helps you experience the reality of how it was when it was used. Similar to the Infirmary, Tudor House relies on volunteers to help keep it running which demonstrates the amazing work these volunteers are doing with the quality of the museum!

The Commandery was one of my final visits during my placement, and what a magnificent end! The Commandry is a grade I listed building, with over 800 years of history and most famous for being the Royalist Headquarters during the Battle of Worcester 1651 in the Civil War. The Commandery was the only place where I couldn’t find a link to Charles Hastings. However, the Commandery offered spectacular views of the garden (especially when the sun is shining) and a great insight into the Civil War and Battle of Worcester. There were hats to try on, swords on show and some amazing architecture which really promoted the museum. I would argue that the Commandery was more suited to older audiences, rather than younger, because of the style and layout.

The Infirmary was my favourite museum I visited in terms of interactivity and engagement, some potential bias there, as it is filled with amazing touch screens to listen to oral histories, and models of bodies etc. The constant music of Elgar playing in the background really links to Worcester’s history, creating a positive environment to the museum. A medical atmosphere is accomplished with the sound of a surgical beep in the background, transforming the guests experience. Once again, the audience are really catered for from old to young, with more recent history for those who would remember, and interactive models and games for children to get involved in. Considering the space given is significantly small, the museum has accomplished in educating and accommodating for its audiences. And of course, Charles Hastings! The building itself is named ‘The Charles Hastings Building’ and there are vast amounts of information on him too!

Holly Ashley

University of Exeter, Placement Student

My research on the Worcester Development Project: An Overview

For the past few months, I have been researching the history of mental health care within Worcester, which has led to me finding some  boxes of documents in The Hive detailing the Worcester Development Project (the project undertaken in the 1970s-80s to modernise mental health care within the district). The Project proposed was the closure of the large mental hospital, Powick, that had served Worcester and the surrounding areas since 1847, and the replacement of this with an integrated system of day units, general hospital wards, rehabilitation hostels and purpose-built mental health units within the community[1].

Closure of Powick was planned for 1980[2] and was marketed as a positive, revolutionary change for the treatment of mental health in Britain; however, the response to the closure of Powick and the new system was varied within the community. Some viewed community care as a logical extension of the previous changes to mental health care such as the introduction of drugs which made institutionalisation less necessary overall, whilst others saw it as the unnecessary closure of a community itself without enough consideration to the effect this would have on the patients[3]. Powick was finally closed in 1989 after substantial delays and the new system of community care was launched[4].

In 1968, Powick was a large site with 949 beds that served both short-term and long-term patients. Powick was actually performing better than the national average, with only 16% of patients classed as long stay[5]. Despite this positive performance, there was a growing philosophy among politicians and some professionals that the old style mental hospital led to isolation from the community and as a result, the institutionalisation of many long-term patients. The growing condemnation of mental hospitals is displayed in the 1968 World in Action documentary featuring Powick, which arguably set out to present a negative portrayal of the hospital in order to further condemn mental hospitals and rouse support for community care[6]. Along with this public condemnation of institutionalisation, there was a focus on the positive effects community-based care could have and a general sentiment that community care would be a more effective way of treating mental health. For instance, whilst the World in Action documentary displayed a lack of privacy and dignity for patients, documents found in The Archives included rhetoric based around promoting the ‘self-determination and autonomy’ and the ‘dignity’ of patients through community care[7]. It would seem that although not everybody agreed with the closure of Powick, the direction of political and public rhetoric pushed the community care agenda until it was recognised as the next logical step for mental health care. In 1983, the Griffiths Report on the NHS recommended that the closure of mental hospitals was necessary, and so this is what eventually happened[8].

Before the implementation of community care, mental health services in Worcester and the surrounding area were primarily comprised of Powick Hospital, Worcester Royal Infirmary, Kidderminster General and a day unit in Evesham, Malvern. This was supported by just a few rehabilitation hostels such as Perryfields hostel which provided 12 beds[9]. Some community services were already in place but this was more of a fragmented system, which was to be replaced by a complete system of care. The government and the Health Authorities were aiming for smaller, dispersed units throughout the area where patients would be treated in the locality, giving them access to the amenities of the local community. It was thought that this style of mental health care would foster greater independence and ability for patients to re-join the community after treatment.

For instance, one unit set up as part of the Worcester Development Project was the Franche Road mental health hostel, which opened early on in the project in 1976. It was initially built to accommodate 12 residents and then later increased to a maximum of 15. The aim of this hostel was to provide rehabilitation care and eventually aid the transition of residents into independent living. Out of 71 former residents surveyed, the majority of them had moved on into independent facilities such as council houses, privately rented accommodation or purchased their own house[10].

Complete information for every single unit set up could not be found but the below table sets out information on a number of the units that were provided as part of the Worcester Development Project and shows the breadth of the Project. Many more day units and hostels were established as part of this project, going some way to make up for the loss of beds at Powick.

(information for the table found in BA12248/1 (v) 'NHS Advisory Service and DHSS Social Services Joint Report'; bA12247/2 (ii), 'Folder of notes on the Worcester Development Project'; P. Hall and I. Brockington, The Closure of Mental Hospitals, 1981)

Furthermore, although less long-term beds were provided, it was found that the number of contacts between patients and day hospitals/units had increased exponentially between 1971 and 1988, the years in which Powick was run down. The attendance at day hospitals is particularly notable – with an increase from 189 attendances in 1971 to 25,772 attendances in 1988. Clearly the new facilities that were set up were utilised by many more patients than they had previously, providing support to previous long-stay patients. The below table, taken from Hall and Brockingon's The Closure of Mental Hospitals, details the increase in importance of day units as the number of beds at Powick was decreasing.

Source: P. Hall, I.  Brockington The Closure of Mental Hospitals, 1981 p. 84.

Whether or not the population of Worcester thought this new style of care was better or worse than the treatment provided by Powick is not an easy question to answer, with a variety of opinions depending on each individual circumstance. Some thought that implementation of community care was a necessary modernisation of mental health services. Conversely, some disagreed with the ideals of community care as they thought for some patients, the routine and the safety of Powick was a positive thing. This research instead serves to provide information on the topic based upon documents contained in The Hive, piecing together why the Worcester Development Project was undertaken in the first place and what units were set up as part of this project.

Fern Evans

[1] P. Hall, R. Gillard, ‘The Worcester Development Project’ International Journal of Social Psychiatry, Volume 28, 1982, p. 163-172.

[2] Archive Reference BA12248/1 (viii) ‘Powick Task Force final draft version, 25 May 1987.

[3] BA12248/1 (xvi) – Dream or Nightmare? The Closure of Long-Stay Mental Hospitals and Community Care.

[4] P. Hall, I. Brockington, The Closure of Mental Hospitals, 1981.

[5]BA12248/1 (i) ‘Draft Feasibility Study for the Worcester Development Project, June 1969.

[6] TV Documentary, ‘World in Action’, 1968.

[7] BA12248/1 (xii) ‘Worcester Mental Health Unit – Community Staffed Homes in Worcester, Operational Philosophy’.

[8] BA12248/1 (xvi) – Dream or Nightmare? The Closure of Long-Stay Mental Hospitals and Community Care.

[9]BA12248/1 (i) ‘Draft Feasibility Study for the Worcester Development Project, June 1969.

[10] BA12248/1 (iv) January 1985, Comprehensive Operational Report on the Mental Health Hostel in Kidderminster.

DON'T DESTROY THE MEDICAL MUSEUM!

The collections now held by the George Marshall Medical Museum were nearly done for!

A clipping from the Worcester Evening News on Monday 17 February, 1997.

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