Annual report of the Board of Control : 32nd, 1945.

Date:
1945
Catalogue details

Licence: In copyright

Credit: Annual report of the Board of Control : 32nd, 1945. Source: Wellcome Collection.

    11/64 (page 7)
    SECTION I Pre-war plans for Surrender of Accommodation in Mental Institutions to the Emergency Medical Service During the early months of 1938, the Board of Control undertook, at the request of the Ministry of Health, a survey of the accommodation in mental hospitals and mental deficiency institutions in England and Wales with a view to estimating the number of beds which might be made available for civilian casualties in the event of war. The proposals submitted by the Board as a result of the survey contemplated the evacuation and surrender to the Emergency Medical Service of 16 of the 101 County and Borough Mental Hospitals and 10 of the 89 Certified Institutions for mental defectives administered by local authorities or joint boards. The scheme involved the evacuation of rather more than 25,000 beds and it was estimated that by the installation of additional beds a total of about 42,000 beds for casualties could be provided in the accommodation to be surrendered. Considerable progress was made in working out the details of the scheme, which would in all probability have been brought into operation if the international crisis of September, 1938, had culminated in war. During the latter part of the year, however, conferences between representatives of the Ministry of Health and the Board led to a fundamental change of plan. It was felt that a scheme based upon the complete evacuation of a comparatively small number of selected institutions might result in the provision of an excessive number of casualty beds in some areas and a shortage in others. To meet this objection the Board proposed, and the Ministry accepted, an alternative scheme under which the necessary beds would be found by the partial evacuation of the majority of the mental hospitals and larger mental deficiency institutions. Certain hospitals were already so overcrowded that they had to be omitted from the scheme, and the general rule was adopted that in no hospital should more than 25 per cent, of the total authorised accommodation be given up. The administrative arrangements were on the footing that the Medical Superintendent remained in administrative charge of the whole hospital including the portion allocated to the Emergency Medical Service. As regards the medical staffing of the Emergency Medical Service wards, the usual arrange¬ ment was for medical officers to be specially seconded for this work, but in some hospitals it was found convenient for members of the hospital staff to undertake the care of Emergency Medical Service patients in addition to their normal duties. The visiting committees were asked to undertake responsibility (subject, of course, to financial reimbursement) for the supply of food and such common services as washing, heating and lighting, while the Emergency Medical Service provided such extra ward equipment and medical and surgical stores as might be required for the purposes of a casualty hospital. This scheme provided also for the complete or almost complete evacuation of a few selected mental hospitals and mental deficiency institutions. Operation and development of the war plan When the time came to put these plans into operation, they worked with such smoothness and rapidity that the necessary transfers were completed within little more than 24 hours. The hospitals and institutions completely evacuated were Park Prewett Mental Hospital (Hampshire), Horton Mental Hospital (Epsom), Hill End Mental Hospital (Hertfordshire), Hollymoor Mental Hospital (Birmingham), Westwood Mental Deficiency Colony (Leeds) and Shotley Bridge Mental Deficiency Colony (Newcastle). In the remaining