MEDICAL SERVICES
The two medieval hospitals treating the sick and diseased, St. Giles's leper house at Spital Boughton and St.
John's outside the Northgate, both survived the Dissolution but had ceased to provide medical care by 1537
and the early 17th century respectively. (fn. 1) In 1602–5 and
1647–8 the Assembly built plague cabins on the edge of
the Roodee, between the Water Tower and the river. (fn. 2) A
charity dispensing medicines to the poor was set up in
1721 with an endowment of £100 under the will of Peter
Cotton. Its apothecary and surgeon were appointed by
the city corporation, (fn. 3) and it still existed in 1757, when
the governors of the newly established infirmary pressed
the corporation to transfer the endowment to them. (fn. 4)
The general infirmary, opened in 1755, in time
provided services more comprehensive than many
voluntary hospitals, so that other medical institutions
developed more slowly in Chester than in some similar
towns. (fn. 5) The infirmary was especially distinguished by
its pioneering fever wards (1784), which obviated the
need for a separate fever hospital, and by a dispensing
and out-patient service which ran on an unusually
large scale. The only other voluntary dispensaries
were therefore late, small, and specialized. (fn. 6) As befitted
an important county town, Chester was exceptionally
well served by medical men in the 18th century, (fn. 7) and
dental practitioners were established from the 1790s. (fn. 8)
Figure 26:
Chester infirmary, before 1830
Chester Royal Infirmary
Chester infirmary was founded after William Stratford,
physician, left £300 in 1753 to endow a county
infirmary. He had the recent local examples of infirmaries in Liverpool (1744), Shrewsbury (1745), and
Manchester (1752). A committee appointed at the
Chester assizes drew up proposals and gathered subscriptions; the subscribers then elected a management
committee, which formulated statutes, appointed the
first staff, fitted up a temporary hospital in the Blue
Coat school, and sought advice in Liverpool and
Manchester. (fn. 9) Out-patients were treated from 1755;
the first in-patient was admitted in 1756. (fn. 10) It was
among the first dozen provincial infirmaries. (fn. 11)
Renamed Chester Royal Infirmary in 1914, (fn. 12) it never
received a royal charter and became a limited company
in 1937. (fn. 13)
The infirmary was intended for those too poor to
pay for medical care at home. Under the earliest
statutes, it did not admit pregnant women, children
under seven years, infectious diseases, or inoperable
and incurable cases. Patients were admitted by
subscriber's ticket on Tuesdays; emergencies at any
time at the discretion of the medical staff. Only the
apothecary and the matron were salaried; the honorary
physicians and surgeons attended patients without
payment on a rota. (fn. 14)
In 1758 the governors bought a site for a new
hospital in the Crofts facing City Walls Road. The
building, designed by William Yoxall and completed in
1761, was built of brick and formed a quadrangle
round a courtyard; it was of two principal storeys
with basements and attics. Offices occupied the raised
ground floor and included a board room, library,
waiting and receiving rooms for the in-patients, and
bedrooms and sitting rooms for the staff; long wards,
each with 24 beds, were in the north and south ranges
of the first and attic floors, men in the south range and
women in the north; nurses' rooms, staircases, and the
chapel were placed in the east and west ranges, one of
the staircases in a projecting bay on the east, the other
rising from the entrance hall on the west; the basements were too poorly lit, drained, and ventilated to be
used. There was no provision to segregate patients with
different types of illness, and no day rooms for those
convalescing. (fn. 15) Despite the governors' complacent view
in 1807 that the building was 'spacious and convenient', (fn. 16) there was growing dissatisfaction with it, led by
Dr. George Cumming, honorary physician 1804–6 and
thereafter a governor. (fn. 17) A report in 1824 concluded that
the infirmary was 'essentially defective' in comparison
with more recent hospital buildings. (fn. 18) After much
controversy, (fn. 19) alterations were completed in 1830 by
the county architect William Cole junior. He divided
the long wards into smaller rooms, lowered the ground
level on all sides except the south in order to allow the
basements to be used, and inserted two new blocks
within the central courtyard, narrowing it on the north
and south. The courtyard blocks contained nurses'
rooms, bathrooms, and W.C.s, and incorporated a
corridor running round the inner side of the original
building, permitting better use of the east and west
ranges. Both original staircases were removed and a
single staircase in the east range was substituted; Cole
added a canted bay to the projecting eastern bay and
moved the chapel into it on the first floor. It was now
possible to make small day rooms as well as separate
wards for different categories of patient, including
surgical, medical, convalescent, accident, and ophthal
mic cases. The same number of beds was provided as
before, but the total space per bed was increased by
over half. At the same time the rooms on the ground
floor were rearranged to accommodate a separate suite
for the dispensing department. (fn. 20)
The governors of the infirmary initially comprised
the numerous individuals who subscribed 2 guineas a
year or more, together with the honorary physicians
and surgeons. General meetings of the governors
appointed the staff and controlled policy; day-to-day
management was carried out by a weekly board open to
any governor. (fn. 21) The open weekly board was replaced
from 1827 to c. 1833 (fn. 22) and permanently in 1865 with a
board of management comprising the honorary medical officers and representatives elected by the governors. (fn. 23) In the 20th century the board included elected
governors, members of the medical staff, and representatives of Chester city and Cheshire, Denbighshire, and
Flintshire county councils, local churches, and other
bodies. (fn. 24)
In the early years the subscribers were mostly from
Chester: 70 per cent in 1778/9 as against 18 per cent
from the rest of the county and 12 per cent from north
Wales. The proportion of non-Cestrians grew as the
subscription list lengthened: by 1839/40 the figures
were 41 per cent Chester, 38 per cent Cheshire, and 20
per cent north Wales. (fn. 25) In 1806 the board discouraged
parishes from subscribing on the reasoning that subscriptions from individuals were easier to collect. (fn. 26) The
railway companies operating from Chester subscribed
from 1838 at the infirmary's request because of the
frequency of accidents to their employees. (fn. 27) Subscribers
and benefactors were entitled to nominate patients by
ticket according to the value of their donations. The
entitlement for subscribers of 2 guineas (much the
commonest sum) was set at one in-patient or two outpatients in 1763 but was frequently changed: one of
each from 1799; two in-patients and any number of
out-patients from 1816; two and ten from 1831; and
two and six from 1854. (fn. 28)
Figure 27:
Chester infirmary, plans: (a) first floor, 1761; (b) first floor, 1830; (c) second floor, 1830
The cost of running the infirmary stood a little
under £2,000 a year c. 1800 and rarely exceeded
£3,000 before 1870. (fn. 29) As in most voluntary hospitals,
subscriptions alone were never sufficient to meet
running costs, even with a peak of c. 500 subscribers in
the first two decades of the 19th century, let alone
when their number dropped to 400 or fewer by mid
century. Average annual subscriptions fell from £1,113
in the years 1806–20 to £959 in 1831–42 but recovered
slowly to over £1,000 in the 1860s. There were periodic
efforts to gain new subscribers, as in 1779, 1807, and
1831. (fn. 30) The financial gap was met partly by legacies and
gifts, which amounted to almost half the subscription
income in 1806–20 and over two thirds in 1831–42.
Surpluses were invested, so that the income from
dividends rose from £319 in 1806/7 to £651 in
1841/2. Fund-raising events in the earlier 19th century
included church collections, subscription assemblies
during Chester races, and a bazaar sale which brought
in £1,500 in 1832. There was also regular income from
the fees paid by medical apprentices (£210 for a fiveyear apprenticeship) and for treating patients belonging to other institutions in the city: the workhouse
from 1784, the county gaol at Chester castle from
1785, and the city council's watch committee (for
police constables and prisoners in police cells) from
1857. (fn. 31) The infirmary was nevertheless sometimes in
severe financial difficulties: economy measures limited
the number of in-patients to 60 in 1786, and to
between 30 and 50 from 1799 to 1807. (fn. 32)
The number of in-patients admitted each year rose
from under 300 in the 1760s and 1770s to average over
500 between 1787 and 1817 (even allowing for lower
numbers in the 1800s) and over 600 in the 1820s. (fn. 33) In
1775 half the in-patients were from city parishes, a fifth
from elsewhere in Cheshire, and a quarter from north
Wales. (fn. 34) Unlike most other voluntary hospitals before
the mid 19th century, (fn. 35) the Chester infirmary also
treated many out-patients, who were of course
mainly from the city. Out-patients outnumbered inpatients from the first. (fn. 36) Out-patient services were
extended in 1764, when a dispensing service was set
up to sell medicines at cost price to the poor, (fn. 37) though
until c. 1783 only a few hundred people made use of it
each year. (fn. 38) By the late 1780s (presumably because the
medicines were then given free) the numbers had
grown to over 3,000 a year, and from 1791 the
dispensary was open every day. (fn. 39) Under pressure
from Dr. Cumming, the infirmary organized a separate
dispensary branch with its own rooms and staff in 1829
to treat out-patients and home patients. (fn. 40) It was so
successful that numbers had to be limited by a change
in the rules a decade later. (fn. 41) The infirmary coped
adequately with a disaster in 1772, when 23 were
killed and 53 injured in a gunpowder explosion at a
puppet show in Watergate Street. (fn. 42)
The infirmary at first had only one paid medical
officer, the apothecary, who doubled as administrator. (fn. 43) The medical duties were separated from financial matters in 1794 and from the secretaryship possibly
in 1815, when the post was renamed house surgeon. (fn. 44)
By 1825 the house surgeon was spending most of his
time visiting patients at home and in the workhouse and
gaol. (fn. 45) An assistant was appointed in 1829 to take charge
of home visiting, and a dispensing surgeon in 1831 for
the out-patients. (fn. 46) The home visiting service was at its
most extensive and burdensome c. 1900 (fn. 47) and continued until 1921, by when the government's national
insurance scheme had made it unnecessary. (fn. 48)
Until the 1850s the normal complement of honorary
officers was three physicians and three surgeons. (fn. 49)
Under John Haygarth, physician 1767–98, the infirmary became in 1784 the first in Britain to admit
smallpox patients, who were isolated under rules
which he had developed during the epidemic of
1777–8. (fn. 50) Haygarth's methods were widely admired
and copied. (fn. 51) The infirmary treated smallpox and fever
patients in rooms within the original building until
1851, but then excluded them in line with practice
elsewhere. (fn. 52) Fever patients were required to pay for
their maintenance, 4s. a week from 1784, 7s. from
1831; the money came either from their parish overseers or from the governors on whose tickets they had
been admitted. (fn. 53)
The scale and nature of the infirmary's care changed
with national trends from the 1860s. The number of
in-patients grew inexorably from (in round figures)
700 admitted in 1867 to 1,550 in 1917 and 4,400 in
1937; out-patients from 5,000 to 6,000 and 14,000 in
the same years; the average daily bed occupancy from
92 in 1900 to 182 in 1937. (fn. 54) The infirmary continued
to serve a wide area: in 1873 half the in-patients were
from Chester and about a quarter each from other
places in Cheshire and north Wales. (fn. 55) In the 20th
century there were proportionately fewer from
Chester: in 1927 the city and county each accounted
for about 30 per cent and the principality 40 per
cent. (fn. 56)
Figure 28:
Infirmary ward, c. 1906
The medical staff grew too. A dental surgeon was
appointed in 1853, and an ophthalmic surgeon in
1885, both as honorary positions. (fn. 57) Including retired
honorary officers kept on as 'consulting' surgeons and
physicians, (fn. 58) by 1900 there were 11 honorary medical
officers, increasing to 22 in 1920 and 28 in 1947. The
salaried medical staff numbered 3, 6, and 11 in the
same years. (fn. 59)
Modern nursing was introduced gradually in the
1860s and 1870s, though never through a Nightingaletrained matron. Efforts were made between 1865 and
1867 to replace the existing infirmary servants, (fn. 60) and
from 1869 a deaconess appointed by the diocese of
Chester assisted with training; (fn. 61) one of the first of the
middle-class trainees was Rose, daughter of Canon
Charles Kingsley. (fn. 62) The number of nurses, including
probationers, grew from 13 in 1880 to 24 in 1890 and
52 in 1911. In 1947 the nursing and technical staff
numbered 130. (fn. 63) In the late 19th and earlier 20th
century the infirmary ran a district nursing service in
poor areas and hired out private nurses to wealthier
households. (fn. 64)
Separate wards for smallpox patients were opened in
the grounds east of the old building in 1868. (fn. 65) They
were in use until the city's isolation hospital was
opened in 1899, (fn. 66) when they were converted into
nurses' rooms. (fn. 67) The range of medical and surgical
care available was continuously expanded in the later
19th and earlier 20th century in line with medical
advances. For example, X-ray equipment was acquired
in 1902 and a pathological laboratory in 1907 — both
gifts of G. W. Hayes — and departments for gynaecology, psychiatry, and orthopaedics were established
between 1924 and 1937. (fn. 68)
The increase in patients and staff necessitated new
building on the 5-a. Infirmary field north of the
original block, which had been bought in 1859 to
prevent any building close to the hospital and as a
recreational area. (fn. 69) The Humberston wing, extending
south-east of the 1761 building and designed by T. M.
Lockwood to provide rooms for nurses and servants,
was opened in 1892. (fn. 70) The main impulse, however,
came from a highly critical report on the existing
buildings in 1909 by the hospital pundit Sir Henry
Burdett, (fn. 71) which found that the wards were among the
most cramped in the country. (fn. 72) The infirmary raised
over £30,000, and a new wing, designed by W. T.
Lockwood in consultation with Paul Waterhouse, was
opened by George V in 1914. It was named after the
principal benefactor, Albert Wood. Refurbishment of
the older buildings continued until 1917. (fn. 73) The
Humberston wing was enlarged in 1923 and another
new block was opened in 1931. (fn. 74) By 1939 there were
225 beds. (fn. 75)
Figure 29:
Chester Royal Infirmary, 1964: wards of 1913 and (right) 1761 building
Running costs became a major problem after c. 1870,
growing slowly from under £3,000 a year to £7,000 by
1914, then accelerating to over £20,000 by 1920,
£40,000 by 1940, and £90,000 in 1947. Subscriptions
(which were more or less static after 1880), investment
income, and payments for services were not meeting
expenditure even in the 1870s, and the infirmary
increasingly depended on private gifts and charitable
fund-raising. From 1883 the 1st and 2nd dukes of
Westminster gave usually £500 a year from visitors'
entrance fees at Eaton Hall; annual church collections,
disappointing c. 1860, revived from 1871 with the
national Hospital Sunday campaign and raised c. £400
a year; and the Chester and District Working Men's
Hospital Saturday Association (part of another
national organization) was formed in 1886 to collect
weekly payments from working men. (fn. 76) After 1918, as
throughout the voluntary hospital sector, new methods
of financing were adopted: the 'Oxford scheme' of
weekly insurance payments was introduced in 1922, (fn. 77)
and means-tested fees for non-members of the scheme
followed in 1931, when the ticket system was finally
abandoned. The financial saviour of the infirmary,
however, was the Deeside Voluntary Hospital Committee, set up in 1929 to collect employees' weekly
contributions, which were deducted from pay and
augmented by their employers. By 1938 the Deeside
scheme had 55,000 members and an annual income of
£23,500. Even so, when the infirmary was brought into
the new National Health Service in 1948 it was running
an annual deficit of £20,000 and selling its investments. (fn. 78) The infirmary continued as part of the
N.H.S. until it was closed in 1994. (fn. 79)
City Hospital (former Workhouse)
Patients from the workhouse on the Roodee were
treated by the infirmary's physicians and surgeons
from 1759, (fn. 80) and from 1784 the guardians of the
poor were regular subscribers to the infirmary. (fn. 81) By
1830 they were paying £40 a year, a sum which Dr.
Cumming of the infirmary thought should be increased
to £150 to cover 1,500 cases a year. (fn. 82) By the 1850s
others were being treated by the poor-law union's own
medical officer. (fn. 83) From 1864 or 1865 all sick paupers
were attended by him, and the guardians stopped using
the infirmary's out-patient service. (fn. 84) Hospital wards
with 247 beds were provided at the new workhouse
built in Hoole Lane in the late 1870s. (fn. 85) The Local
Government Act of 1929 transferred the workhouse to
city council control, under which the hospital was at
first named St. James's and later the City Hospital. In
1947 all the workhouse buildings were made over to
the hospital. (fn. 86) They were demolished after the N.H.S.
closed the hospital in 1991. (fn. 87)
Maternity Care
The main gap in the infirmary's medical provision
was maternity care, deliberately so, because of the fear
of cross-infection. In 1798 Dr. Griffith Rowland
founded the Benevolent Institution as a subscription
charity to provide midwives for poor women in
Chester. Rowland acted alone as its surgeon until
1812; thereafter a panel of five or more gave their
services free. The Institution was managed by a ladies'
committee and employed a matron and four midwives. The income from annual subscriptions was £48
in 1799 and £140 c. 1820. (fn. 88) At first the midwives
worked from their own homes, but in 1899 the duke
of Westminster adapted a house in Grosvenor Street
as a nurses' home. Then or a little later it also had
two maternity beds. In 1904 the Institution was
approved for training. (fn. 89) In 1897 the midwives
attended 402 confinements. (fn. 90) After the National Insurance Act of 1911 gave maternity benefit to all insured
women, the Institution was soon treating more
patients privately than on subscribers' tickets. The
ticket system had been dropped by 1920. (fn. 91)
The growing demand after the First World War for
in-patient maternity care led the Institution to convert
premises at no. 16 Whitefriars into an eight-bed
maternity hospital, which opened in 1925; at the
same time the Institution merged with the Chester
District Nursing Association. (fn. 92) In 1937 a more extensive
midwifery service was begun by a joint committee of
the D.N.A. and the city council. The maternity hospital
closed in 1938 after maternity wards were opened at
the City Hospital, (fn. 93) and the home nursing service was
taken over by the city council in 1948. (fn. 94)
Other Nursing
District nursing in the late 19th century was provided
both by the infirmary and by the Chester Diocesan
Deaconess Institution, established in 1869. The latter
changed its name in 1900 to the Chester District
Nursing Association. (fn. 95) In the early 20th century a lady
superintendent and five district nurses, working from
no. 10 Water Tower Street and supported by subscriptions and donations from individuals, churches, and
charities, treated c. 1,000 cases and made over 20,000
visits a year. The D.N.A. united with the Benevolent
Institution in 1925, (fn. 96) and continued in existence thereafter as a charitable organization, renamed the Chester
Sick Poor Fund in 1953. (fn. 97)
Isolation Hospitals
Although the infirmary treated smallpox and other
infectious diseases, it refused in 1832 and 1849 to take
in cholera patients. (fn. 98) Temporary cholera hospitals were
built on the land which became Grosvenor Park during
the outbreak of 1866, and at Infirmary field in 1892. (fn. 99)
The city council opened its own isolation hospital on
the south side of Sealand Road almost at the city
boundary in 1899 to meet its statutory obligation to
provide treatment for patients with certain notifiable
infectious diseases, among which scarlet fever,
diphtheria, and typhoid were the most common. The
hospital was designed by Harry Beswick with an
administration block and four separate pavilion
wards, accommodating 46 patients in all. It cost
£21,300. In 1900 the corrugated-iron buildings at
Infirmary field were moved to an even more remote
site off Bumper's Lane, south of the isolation hospital,
and arranged as two wards for up to 12 smallpox
patients. (fn. 100) Besides cases from the city, the hospital
took in patients paid for by neighbouring local authorities as well as some private referrals from further
afield, though it was reluctant to make permanent
arrangements which reserved a fixed number of beds
for the use of other authorities except after 1905 for the
Tarvin, Malpas, and Tarporley joint hospital board. (fn. 101)
The hospital usually had between 10 and 20 patients at
any one time, and coped with more serious outbreaks
by putting up temporary accommodation. When
smallpox infected 67 people in 1903, for example, the
council's public health committee put up tents near the
smallpox wards. Its other measures including opening
vaccination points in Lower Bridge Street and Saltney,
closing schools in Handbridge, and cancelling or
postponing some of the regular summer entertainments, and fatalities were restricted to just six. In
1909 tents were again used for an outbreak of scarlet
fever. (fn. 102) The hospital took tuberculosis patients from
1914 under an arrangement with the county council,
but stopped doing so in 1938 when the Cheshire Joint
Sanatorium was enlarged. (fn. 103) The smallpox wards, virtually disused after 1903, housed German prisoners of
war in 1918–19. (fn. 104) As part of the changes leading up to
the creation of the National Health Service, the isola
tion hospital was closed in 1947 and patients were
treated at Clatterbridge Hospital on Wirral until isolation wards were opened at the City Hospital. The
buildings at Sealand Road were made over to the city
council's public assistance committee and reopened in
1948 as an old people's home, Sealand House. (fn. 105)
Psychiatric Care
There were two private madhouses in Foregate Street
in 1787 but none was licensed thereafter. (fn. 106) A county
lunatic asylum was opened in 1829 under the legislation of 1828. (fn. 107) The magistrates bought a 10–a. site, later
enlarged to 55 a., on elevated ground west of Liverpool
Road on the boundary of the city and Bache. The
asylum was designed by William Cole junior and built
in red brick with simple stone dressings to a conventional neo-classical design. It was mainly of two storeys
with full-height basements and had a long range of 21
bays facing Liverpool Road and shorter return wings to
the rear at each end. The main range consisted of a
pedimented central block of five bays and an extra
storey, flanking wings of five bays, and three-bay end
pavilions, projecting by one bay and with canted fullheight bays on their side elevations. The basements of
the main range were occupied by the kitchen, stores,
laundry, brewhouse, and bakehouse. In the central
block there were offices for the medical superintendent,
matron, and other staff on the ground floor; the
committee room, doubling as the chapel, and bedrooms for the senior staff on the first floor; and
servants' bedrooms on the second floor. The rest of
the building accommodated 20 private patients and 70
paupers, and allowed for segregation by class and sex.
Women occupied the wings on the north, men those
on the south. On each side the private patients had
bedrooms in the ground floor of the main range, with a
gallery to the rear commanding views over the countryside to the west. The most disturbed patients were in
the basements of the return ranges, and other paupers
on the first floor above them. Each category of inmates
had a separate 'airing ground' complete with a covered
walk for use in poor weather. The corner pavilions
were taken up by day rooms with bay windows, bathrooms, and warders' offices, the last having internal
windows into the day rooms as well as external ones
looking over the airing grounds. (fn. 108) In 1853, following an
unfavourable report by the Lunacy Commissioners, the
first resident medical superintendent was appointed; in
1854 he abolished mechanical restraint and allowed
most patients to work, play games, and go for walks. (fn. 109)
The number of patients grew almost continuously until
the 1960s, passing 500 in the 1860s, 1,000 c. 1910,
1,500 in the 1920s, and reaching almost 2,000 in the
1930s. The staff similarly increased from 37 in 1848 to
255 (including 15 medical staff) in 1938. (fn. 110)
Building kept pace with the growth in numbers. (fn. 111)
North and south wings accommodating 80 patients
were added to the original block in 1849, and two east
wings containing day rooms in the 1870s. All were of
two storeys. Two detached ward blocks, designed by
T. M. Penson with Gothic detailing, were built between
1857 and 1862 to the west. The chapel was moved
before 1849 to the upper floor of a short wing added
on the west. A free-standing chapel, in Early English
style, was completed west of the original block in 1856
and survived in 2000. It has a short chancel, a nave of
six bays, and north and south porches, and is in brick
with stone dressings and slate roofs.
A complete new hospital with five ward blocks
accommodating 404 men was built between 1895
and 1898 north of the original asylum to designs by
Grayson and Ould, and on its completion the earlier
wards were given over to women patients. The county
architect, Harry Beswick, designed a block for epileptic
patients (completed 1912), a 440-bed infirmary annexe
at the north end of the site (1915), and a new isolation
hospital at the south end (1916, later demolished). A
nurses' home was built in 1938.
The name of the asylum was changed to the County
Mental Hospital in 1921, Upton Mental Hospital when
it joined the N.H.S. in 1948, and Deva Hospital in
1950. (fn. 112) In 1960 it acquired a former military hospital a
mile up the road at Moston as a 370-bed annexe. (fn. 113) The
capacity of the hospital was reduced drastically from
1964 as successive concepts of 'care in the community'
were substituted for hospitalization, and by 1991 it had
only 473 beds. (fn. 114)
Other Dispensaries
A dispensary for skin complaints was established in
1889 at rented premises in City Walls Road near the
infirmary. It was funded mainly by subscribers and
survived until national health insurance was introduced in 1912; it provided free treatment to an average
of over 800 patients a year on an income rarely more
than £100. (fn. 115) There was a Homoeopathic Institution in
Lower Bridge Street in 1855, (fn. 116) and a free homoeopathic
dispensary was founded by Edward Thomas (d. 1906)
in Pepper Street in 1878. He and his son Dr. Edward
Haynes-Thomas ran it until c. 1912. It was supported
by subscribers and in 1889 treated 248 patients on an
income of £50. (fn. 117)
Figure 30:
Cheshire lunatic asylum, original plan, 1828
National Health Service
Plans to co-ordinate the work of the Royal Infirmary
and the City Hospital were being made from 1929, (fn. 118)
and by 1945 they were working closely together under
the auspices of the wartime Emergency Medical
Service. (fn. 119) On the formation of the National Health
Service in 1948, they were grouped with smaller
hospitals at Boughton Heath (the former Tarvin
poor-law union workhouse), Ellesmere Port, and
Runcorn under the Chester and District hospital
management committee (H.M.C.). The mental hospital had its own H.M.C. Both came under Liverpool
regional board and were united as West Cheshire
H.M.C. in 1965. They were reorganized in 1974
within Cheshire area health authority and in 1982
came under Chester health authority, in Mersey
region, which ran all the health services within the
local authority districts of Chester and most of
Ellesmere Port. (fn. 120)
After 1948 the Royal Infirmary specialized in
surgery and out-patients, and the City Hospital in
chronic illness, and chest, maternity, paediatric, and
general medical cases, a division foreshadowed by
their strengths before nationalization. (fn. 121) Pre-war plans
for the expansion of the infirmary were eventually
revived and a large out-patient and casualty department was opened on Infirmary field in 1963. (fn. 122) After
the creation of the West Cheshire H.M.C., it was
decided in 1968 to concentrate all the district's
hospital services at the Liverpool Road site (hitherto
the county mental hospital), which in anticipation was
renamed West Cheshire Hospital. (fn. 123) The maternity unit
was transferred from the City Hospital to a new
building at the south end of the site in 1971. (fn. 124) A
new general wing was opened in 1983, when several
departments moved from the infirmary, and the City
Hospital was left as a 120-bed geriatric unit. (fn. 125) The City
Hospital closed entirely in 1991 when geriatric care
was moved, and the rest of the departments still at the
infirmary moved to Liverpool Road in 1994. West
Cheshire Hospital was renamed the Countess of
Chester Hospital in 1984. (fn. 126)
Private Hospital
A private hospital, the Grosvenor Nuffield, was opened
in Wrexham Road with 30 beds in 1975 and was
enlarged in 1984 to accommodate 40 beds. (fn. 127)