Early Administration of the Hospital

The management of Haslar Hospital underwent numerous changes in its two hundred and fifty six years of history, but when it first opened its doors in 1753 the responsibility for the day to day running of the hospital lay with the Surgeon and agent for Gosport, Mr Richard Porter, who had for some time coped with the almost insurmountable problems in the area.
Obviously this gentleman proved unsatisfactory for a letter from Vice Admiral Boscawen1  dated 12 April 1755 drew attention to the inadequacies of the administration of the hospital: “The hospital at Haslar is so ill conducted that it little answers the design of it”. The Admiral laid the blame squarely on the shoulders of Mr Porter;
“The Agent is also the Surgeon, his profits by the 6/8d (33p) (a per capita payment) are above £2000 per annum and the office of agent alone is sufficient employment for him”.
The income of £2000 was incredible for those days and the Admiral’s comments were endorsed by Mr Ward who was the contractor for all the stores to be used in the hospital from bedding to biscuits.
“....at present there is drunkenness and all sorts of licentiousness committed by the people there, many of which are very far from being proper objects for a hospital”,  Was this the staff or patients one has to ask, no doubt both.
The Commissioners acted quickly and dispatched Sir Edward Hawke2  to investigate. The accusations were proved correct, Sir Edward on arrival at Haslar finding the gate porter missing from his post and chaos reigning in the hospital. Accordingly the Commissioners issued a series of orders in May 1755 appointing a Mr Francis Jones as Agent, Mr Richard Porter, previously both Surgeon and Agent, as the first surgeon, and the first Physician and Senior Administrator, Dr George Cuthbert. The salary of the latter gentleman was to be £200 per annum and although Richard Porters new salary is not recorded, it must be assumed that he took a substantial cut in income.
Dr Cuthbert administered the hospital with the help of a small council for a few years. His successor, James Lind, was perhaps one of the most distinguished of all naval doctors: his work on scurvy and other diseases of seaman earned him the title of ‘Father of Nautical Medicine’.
Lind in a letter to a friend dated 3rd September 1758 explains the situation thus:
“The hospital is under the direction of the Physician in Council – two master surgeons, the agent and steward and lately two new members are added viz, Doctor Welch, Physician to the Forton3  Hospital (which receives the marines only about a mile distant from us) and the surgeons of that hospital. But this Council must act entirely by orders from the Board of Sick and Hurt”.
Accommodation was to be the main recurring problem for the next hundred years. The hospital was prematurely opened to admit 100 men lying in builders huts and there are constant requests from the Commissioners for more beds to be found, such as the urgent instruction of the 31st March 1755, “You are hereby requested and directed to use all possible expedition in making provision for the reception of 200 additional patients in the hospital at Haslar4.
Even when the two new wings were completed in 1762 the shortage of beds was still acute and it became necessary to use old hulks as ‘hospital ships’ for temporary accommodation. Although built to hold 1,500 patients, by 1755 one thousand eight hundred had to be accommodated and in 1790 Admiral Barrington5  in his report drew attention to the fact that there were 2,100 patients in the buildings causing considerable overcrowding.
But these were only part of the problems facing Doctor Cuthbert and his successors. The patients, largely impressed men, were not dedicated to the Fleet in which they served. As soon as they were able to walk they were anxious to disappear into obscurity to avoid the press gangs. They were described as both ‘numerous and ungovernable’.
The hospital staff was not to be compared with the disciplined and dedicated body of doctors and nurses who manned the hospital in later centuries. The nurses were in general associated with drunkenness, theft and forgery6, and a level of sexual activity7  which makes the so-called permissive society appear almost puritanical.
To bring a semblance of order to such a scene was an impossible task and although early physicians did try valiantly, their efforts were doomed to failure. James Lind drew up a comprehensive and thorough list of rules and regulations for the efficient management of the hospital but it is doubtful if they were ever used even as guidelines, let alone as rules to be obeyed.
One of the reasons originally given for the erection of the hospital was to stem the “pernicious evil” of desertions, and yet numbers “discharged run” were enormous8. Gradually complaints began to become significant and when the Executive Captains of the Navy began themselves to complain to the Admiralty, something had to be done, and the first of two major official investigations into the management of Haslar was initiated by the orders of the Privy Council.
On the 26th August 1795 Captain William Yeo9  took command of Haslar assisted by two Lieutenants and such was the order for the next hundred years.
 
Eric C Birbeck MVO
Haslar Heritage Group 2011
Published in the Journal of the Royal Naval Medical Service.
 

1 Made Vice Admiral in February 1755 and a Lord of the Admiralty. In July 1755 Boscawen took on the French in the North Atlantic at the opening of the Seven Years War.  He was to become C in C Portsmouth in 1757 and no doubt dealt with matters at Haslar once more.
2 Admiral Sir Edward Hawke was to command the British Fleet and defeat the French fleet at the battle of ‘Quiberon Bay’ November 1759 and rated as one of the greatest sea battles
3 The Forton Hospital was owned by Nathaniel Jackson and reportedly had 700 beds; Jackson was paid on a per capita basis as was Mr Richard Porter Surgeon and Agent for Gosport.
4 Papers held by the National Maritime Museum show that there was much correspondence at the time regarding the provision of Beds, Linen and Cooking utensils as well as the employment of staff who were stated as being unruly and drunk. Other letters demand that greater numbers of patients should be admitted.
5 Admiral Barrington served with Hawke in the seven years war and was responsible for the Relief of Gibraltar in 1782. 
6 A letter written by three patients in December 1761 demanded action is taken against staff who had threatened them and others, even by the drawing of a knife by a nurse. The patients were afraid to eat their rations less they be poisoned.
7 One Nurse Brown was dismissed by the Hospital Executive for infecting a number of patients with a foul disease.
8 Records show that some patients even escaped to take shore leave and returned to Haslar in a worse state than when first admitted.
9 Died 1808 and buried in the Paddock Burial area of Haslar.

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