Manchester’s Hospitals, 1752–1948
Until the creation of the National Health Service in 1948, most hospitals were either charitable bodies — voluntary hospitals — or run by Poor Law Guardians or the local authorities.
- Voluntary Hospitals
- Manchester Royal Infirmary
- Poor Law and Local Authority Hospitals
- Withington (Chorlton Union) Hospital
- Discussion Points
- Additional Resources
Voluntary Hospitals
Manchester’s voluntary hospitals were prestigious institutions and a focus for its civic pride. Manchester Royal Infirmary (MRI), founded in 1752, was both the city’s largest hospital and its greatest charity. Until 1908, it sat at the heart of the city in Piccadilly.
Other voluntary hospitals provided specialist treatment such as the Christie Hospital and Manchester Eye Hospital, while others supported a particular locality, such as Ancoats Hospital or Manchester Northern Hospital in Cheetham Hill. By the early 1900s, there were over twenty voluntary hospitals in Manchester alone.
Voluntary hospitals were funded by charitable donations and by subscriptions. Often a voluntary hospital would be created from an initial major endowment from a wealthy donor, and with its day to day running being supported by fund raising and money provided by subscribers; in return, subscribers could nominate other people for treatment by providing them with recommendation tickets.
Voluntary hospitals treated both inpatients and outpatients (home visits by a doctor). Treatments were usually free or funded through medical insurance provided by friendly societies, but access to healthcare could be unpredictable. There was no assurance of treatment and much depended on the hospitals’ success in raising money to provide good services.
Most voluntary hospitals had appeals committees, which raised money through social events and bazaars. As medical treatments became more complex and demand increased, many voluntary hospitals tried to meet rising costs through increased private care, paid for by the patients themselves. In the inter-war period, several Manchester hospitals opened private patients wards.
Manchester Royal Infirmary
The MRI was a general hospital, with a wide range of specialist departments. Many of its physicians and surgeons were nationally prominent figures, and its standards of care were usually high.
From 1754 to 1908, the Infirmary was located in Piccadilly , but in 1909 it moved to a new site at Oxford Road. The move was controversial, with many Mancunians opposing the removal of key institution to the suburbs.
MRI’s doctors generally supported this move as it meant better facilities and the potential of working more closely with the University over medical education and research. MRI also ran two hospitals in Cheadle: a mental hospital (later known as Cheadle Royal) and the Barnes Hospital, a convalescent hospital inspired by Victorian ideas of semi-rural locations as aids to patient recuperation.
Poor Law and Local Authority Hospitals
Poor Law hospitals were initiated by the 1834 Poor Law Amendment Act. The Act established a national system of poor law unions, which administered workhouses for the very poor — ‘paupers’. These workhouses included small infirmaries within the main workhouse to treat the sick. Over time, medical provision improved, and larger hospitals were built usually adjacent to the workhouse.
Treatment was free, and initially restricted to workhouse inmates, but was later extended to others. Generally, the medical services provided were more basic than in a voluntary hospital. Manchester had several Poor Law hospitals including Crumpsall, Booth Hall and Chorlton Union (Withington). Manchester Council took over these hospitals in 1930.
Local authorities also ran hospitals. These were mainly mental hospitals, as required by successive county asylum acts, and isolation and tuberculosis hospitals. Local authority hospitals in the Manchester area included Prestwich Mental Hospital, Monsall Hospital and Baguley Sanatorium.
Withington (Chorlton Union) Hospital
Withington Hospital in south Manchester was run by the Chorlton Poor Law Union until 1915, after which it was transferred to the Manchester Union. It was located within the complex of workhouse buildings and was one of te best-equipped poor law hospitals in the country.
The Hospital was substantially redesigned by the Manchester architect, Thomas Worthington in 1864–6, as a pavilion-style hospital. These hospitals comprised linked blocks of accommodation with long narrow wards and numerous windows to maximise ventilation, which was considered essential to a recuperative environment. Worthington was advised by Florence Nightingale about this design.
Withington also played important role in nurse training, and unusaually for a poor law hospital was recognised as a training centre by the General Nursing Council.
Withington Hospital closed at this site in 2002.
Discussion Points
How did the hospital system of Victorian Manchester differ from our NHS system?
What were the problems of maintaining a hospital system based mainly on charitable contributions? Who gained and who lost out under this system?
Why did hospitals become the most prestigious charities in urban Victorian Britain?
Additional Resources
John Pickstone, Medicine and Industrial Society: a History of Hospital Development in Manchester and Its Region, 1752–1946 (Manchester 1985)
Related Special Collections Blog Posts
“Florence Nightingale, Thomas Worthington, and the Chorlton Union Hospital”
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