Medical and general reports and accounts for the year ended 31st December, 1947 : Ham Common, Richmond, Surrey / The Cassel Hospital for Functional Nervous Disorders.

  • Cassel Hospital for Functional Nervous Disorders (Richmond, England)
Date:
[1948?]
Catalogue details

Licence: In copyright

Credit: Medical and general reports and accounts for the year ended 31st December, 1947 : Ham Common, Richmond, Surrey / The Cassel Hospital for Functional Nervous Disorders. Source: Wellcome Collection.

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    The Medical Director’s Report ANNUAL REPORT FOR 1947 THE year 1947 was a fateful one for the hospital. At the year’s beginning, Swaylands, the home of the hospital ever since its inception, was still in the hands of the military, the hospital was still in its evacuation site at Ash Hall, Stoke-on-Trent, and the owners of Ash Hall had given notice that the lease could not be renewed after November, 1947. For various reasons the possibility of returning to Sway- lands in 1947 was very remote. The War Office was reluctant, but eventually agreed, to release the building for the hospital. In any event it was plain that Swaylands would require much internal alteration and redecoration before the hospital could return there. The kitchens were old, the whole electrical installation needed renewal and the heating and water systems needed much attention. The building would be more expensive to run than it had ever been, and with the changed labour conditions following upon the war, it was extremely doubtful if a large enough domestic staff could be found. The amount of domestic labour required in Swaylands was high, in view of the large floor space, the difficult lay-out and the fact that heating on the second and third floors was by coal fires in patients’ bedrooms. Apart from increased wage rates, the post-war shortage of domestic labour, coupled with the fact that Tonbridge, the nearest labour source, was seven miles from the hospital, gave cause for concern. A financial in¬ vestigation showed that the raised cost of living spread over 64 patients would make the fees higher than they had ever been and the possibility of increasing the number of beds to approximately 100 in the hope of reducing the cost per patient, was explored. The estimated capital costs of building involved even in the most economical alteration plans and the difficulty of obtaining licences precluded this step as a practical immediate plan for 1947. Any return to the site itself would of course present other organizational problems. The expansion of the hospital from one of 30 beds at Ash Hall to 100 at Swaylands would demand major recruitment of nursing, medical, administrative and maintenance staff. In the rural isolation of Swaylands this recruitment would ob¬ viously be difficult, particularly in view of the extreme nursing shortage that prevailed in 1947. The kind of staff welfare which had grown as a national pattern in the seven years of the hospital’s evacuation could not easily be met at Swaylands. Various expedients such as buying a hostel at Tonbridge and running a bus service for domestic and nursing staff to the hospital, were too expensive to be practicable. It became plain then, early in 1947, that the diffi¬ culties of converging the large, delightful but old- fashioned and rambling building of Swaylands into a modern hospital, economical in service and staff, were insuperable. With many regrets it was decided to seek a new site. This was an urgent matter in view of our having to leave Ash Hall by November. From the beginning of the year at the height of the housing shortage, an alternative building was being sought, and England and Wales were combed by the House Governor, the Matron and myself for a building that would offer good facilities for treatment, that could be run economically, that would be near a labour source, and that could be occupied in 1947 Avithout the delays consequent upon altering the existing buildings at Swaylands. The Medical Com¬ mittee, in addition, considered the possible implications on medical policy of having the new hospital near a toAvn. It was knoAAm that Dr. T. A. Ross, the first Medical Director, had always regarded the rural isolation of Swaylands as conferring only mixed benefits on the patients, and that he had encountered many difficulties in rehabilitation because patients were unable to complete treatment unless they stayed at Swaylands till they were quite well. The rural site offered little opportunity for industrial re¬ habilitation, Avhile treatment Avas proceeding, and patients had to face major problems of readjustment on leaving. The Medical Committee decided that it was desirable to have the hospital near a large tovvn so that improving patients could, as soon as they were able, take on out-patient status and be helped by treatment to meet face to face difficulties of settlement into social and industrial life. This policy of “ con¬ tinuation out-patients ” has my full support from a medical point of view. In addition, a shorter stay at the hospital Avould reduce the cost of treating each patient. In May an hotel at Bournemouth Avas found which seemed to have some advantages over SAvaylands. It was a modern economical building, capable of housing nursing staff as well as 80 patients, offering good external recreational and social facilities. It Avas thought to be too far from the psychiatric life of London to attract easily good medical staff, and it Avas felt that to set a hospital for neurosis in a holiday toAvn Avas likely to influence the therapeutic atmosphere for the worse. It was, however, the most suitable building found at that time and arrangements to buy the building proceeded.