Botleys Park Hospital

1 Dates of Opening and Closing

Botleys Park Colony for Mental Defectives had its formal opening ceremony on 24 June 1939, one of the latest large asylums to be built in the area. It was finally closed in 1997 as patients were moved gradually to small homes in their local communities from the 1980s

Botleys Park Mansion and 337 acres of parkland was acquired by Surrey County Council In 1928 as responsibility for the feebleminded was being passed from the Metropolitan Asylums Board to the local councils.  Patients were transferred there along with nurses, into the mansion as the hospital was being built over the nine years from 1930.

Before this, non-troublesome patients were kept in workhouses – notably Godstone Union Workhouse (named Clerk’s Croft Mental Deficiency Institution from 1930-1939 when it closed) and mainly Chertsey Union Workhouse (renamed Murray House form 1930 – 1984).  Murray House was also known as Botleys Park Annex and was always needed until patients were placed in the community.

Both workhouses had opened in the mid to late 1830s.

Extra premises were acquired by the Ministry of Health in 1948, Brook House in Addlestone (20 beds) Royal Hostel in Elstead (20) and Sherbourne House as a hostel for 20 older girls in 1949.

2 Who was instrumental in the opening with brief biographies

Botleys Park Colony was opened by Lady Henriques, wife of Sir Philip Henriques, the Chairman of Surrey County Council and a Barrister.  His family came from Normandy, coincidental because when BPH became an Emergency War Hospital it was the first port of call for those injured in Normandy.

The opening was attended by the great and the good from Surrey County Council, Croydon Council (who would contract patients to this hospital) the Board of Control and the general public.  It was reported the in local paper, the Herald and News (6206/8/4 1-2)

3 Numbers of inmates

For Chertsey Union Workhouse:

  • The 1861 census shows 9 idiots, 2 weak-minded, 2 bed ridden and 1 with fits from 237 inmates (84 of them being elderly) in 1881, there are 6 imbeciles and 1 deaf and blind (of 257 inmates, 99 of them elderly)
  • By 1911, there were 12 imbeciles, 4 feeble-minded, 2 epileptic, 1 blind, 1 deaf and dumb and one cripple (of of 237 inmates, 88 of whom were elderly).

No further census is available but examination of the Admissions and Discharge books (CD for the Index) shows that admissions of feeble-minded increased substantially after the 1927 Act classified the morally degenerate as feeble-minded.

Numbers of Feeble minded admitted

 

 

 

 

 

 

 

 

All these new admissions were single women of child-bearing age, mainly in their 20s.  This suggests they could be single mothers or prostitutes, the then recently coined term morally degenerate.

Botleys Park Colony was built for 1,200 patients, 600 males, 300 females and 300 children.  An Annexe at Murray House could accommodated 282 people.  Total of 1482.

On opening, Clerk’s Croft was closed and  all their inmates were transferred –  159 low-grade males, 26 with dysentery isolated in a separate villa until they were free of infection.

On opening in 1939, there were 292 males, 384 females and 132 patients (total 808), just over half full.

The certificates from the Board of Control showed the numbers of patients allowed.  As accommodation increased, so did these numbers.  In 1938, before the official opening, there were to be 300 females and juveniles of both sexes at Murray House and 109 males in Botleys Park.

With the outbreak of WW2, Botleys Park became and Emergency Hospital resulting in serious overcrowding in some villas. 36 women and 99 children were transferred to Murray House.

By the end of 1939, there were 256 males in 5 villas, 156 females in the children’s villas and 14 children, i.e. 6 of the male villas and all of the female villas were part of the Emergency Hospital, which had 864 beds. This meant accommodation was overcrowded for the mental patients, even after the war, when St Peters Hospital became established on the site.

In 1946, numbers had grown to 1198, not including the tubercular unit at Murray House

In April 1947 (C) the hospital ward for tubercular patients was considered to be insufficient and many patients are accommodated with the mental deficient ones thus enabling the spread of disease. It was recommended to use beds given over the the War Hospital. There was said to be severe overcrowding amongst the mentally deficient.

In 1941, overcrowding in Murray House meant that one nurse could be in charge of 80 patients.

In 1946, an article in Nursing Times dated 27 July 1946 states that there are 1000 patients without the mentally to cope for themselves.

In 1948 (NHS) there were 1198 beds plus 300 at Murray House. (670 men, 615 women over 16 and 155 boys, 65 girls 15 and under, looked after by 97 male and 105 female nurses, some of whom where part-time.

In 1950, there were 1320 beds in total including a hostel.

In 1955, there were 1223 beds with 255 at Murray House (total 1478)

In 1960, there were 1547 beds, half of the new admissions being children, 95% of whom were severely disabled.

by 1973, there were 1000 patients.  Dr Joan Bicknell, the Consultant Psychiatrist thought 10% of them could be moved back to the community.

In 1974, there were 1109 beds.

By 1983, there were 950 beds, and in 1986, 620 (including Brook House at Addlestone) as patients were gradually being rehabilitated into the community with their families or in smaller units. Murray House still had 91 patients.

By 1990, with 503 beds, it became the Botleys Park Resource Centre, then following another reorganisation, under the Bournewood Community and Mental Health Trust, it was renamed Bournewood Hospital. Most of the hospital closed in 1997 and the staff looking after patients in community homes transferred to the North Surrey Primary care trust

Murray House the building of the former Chertsey Union Workhouse, had a bungalow for 30 adults,  Home for 38 children, one for 11 older boys

In 1851, there were between 170 and 211 inmates (it varied week to week) BG 1/11/5

The 1861 Census showed 228 inmates including 50 older (65+) men, 50 older women and 80 children under 14.

By 1881, the workhouse was overcrowded with 257 inmates and at least 5 staff.

By 1911 the Census showed a separate school for 88 boys aged 11 – 15 and 10 staff.  The workhouse had 237 inmates and  12 staff.

By 1983, there were 91 residents in Murray House.

4 Classification of inmates

The 1861 Census showed 5 tramps, 9 idiots, 2 feeble-minded, 1 with fits (epileptic) and 2 bed-ridden amongst the the 228 inmates.  There were 34 older (65+) men, 17 older women and 80 children under 14. National statistics for workhouses show almost half the inmates were children, so Chertsey would have been typical. There would have been dementia amongst the older people.

By 1881, of the 257 inmates, there were 35 vagrants, 6 imbeciles, also 2 epileptics, 1 deaf and  1 blind.  The older men numbered 44, while there were only 18 older women

the 1911 Census listed 38 vagrants, 12 imbeciles, 4 feeble-minded, 2 epileptic, 1 deaf, 1 blind and 1 cripple amongst the 237 inmates. There were 43 older men and 17 older women.

No Census records were available after 1911, but the Chertsey Poor Law Union Admission and Discharge books show increasing numbers of single women of child-bearing age were admitted as feeble-minded with no evidence of their discharge.

By 1939, villas were for troublesome, low-grade  and high-grade inmates.  Epileptics were also admitted.

The Nursing Times (1946, F) notes the grading of patients as idiots, imbeciles and feeble-minded or moral defectives (according to the 1927 Act) arriving through the law courts via petty crime or prostitution.

In 1960, BPH had 245 detained (‘sectioned’) patients and 1297 informal ones.

In 1983, (SHC 6206/9/2) here were 91 patients, many physically handicapped and a large number with severe behaviour problems.

5 Description of the buildings

Chertsey Union Workhouse was built in 1836, designed by architect  Sampson Kempthorne who built many workhouses to the same design.  It had  a basic Y-shaped structure of 3 storey wings, each sealed from the other and open only to the triangular ground between the wings.  The wings were for men, women and children. The whole was surrounded by a hexagonal wall.  It looked forbidding and such workhouses were compared to prisons.  Over time, this building was substantially modified as it was unsuitable and more rectangular 2 storey building prevailed. A chapel was built in 1868 and fever wards added in 1871.  In 1883, a fever ward and a tramp ward was added, then in 1894, an infirmary.

The 1911 Board of Guardians Minutes shows there was need for a new building for sick children, and that 2 extra bedrooms would be constructed for nurses in the attics – expenses were approved to board the floors and for lathe and plaster for the walls and ceilings.  A new home for little girls was also needed.

Nowadays, the site has been sold for residential development.  The remaining Grade 2 listed buildings are the chapel and the administration block – both now residential.

Clerk’s Croft (Godstone Union Workhouse) was built in 1839 near Bletchingly.  It was U-shaped with a separate school block. By 1910, an infirmay and separate infectious block had been added. It closed in 1939 when BPH opened and was developed in the 1980s as Clerk’s Croft Housing Estate.

In 1932 when BPH opened first, patients and nurses were accommodated in Botleys Park Mansion, with an extra wing added soon after as the building project began.  Botleys Park included the Mansion in 774 ares of park and farm land.  Murray House Certified Institution for Mental Defectives included the main 2-storey building, a bungalow for 30 adults, a Home for 38 children, a home for 1 older boys and a refractory boys home plus a nurses home and a staff cottage.  There was also a garage, garden store and a mortuary…   In the mid 1930s, extra huts were built for 44 more patients.

By 1939, besides Botleys Park Mansion, which was used as a Nurses’ Home (a Facebook page shows the affection the staff had for the place), the new buildings were arranged in a ‘village’ style with the male premises on round one green and the female and children around another green and general facilities in the centre.

Females – 4 villas, 1 villa for Low Grade patients and 1 for Troublesome patients,

Males – 8 villas, plus 1 for Low Grade and 1 for Troublesome patients

Children – 4 villas on the same side as the females.

Kitchens, strorerooms , boiler rooms and Laundry.

A Recreation Hall which could seat 750 with a special floor built for dancing, a stage and space at the back for library and chapel.

Medical – A hospital with 56 beds (but in 2 halves to separate male and female patients!) with a TB block that had large windows and a verandah for access to open air.

Educational – a school for 200 children in 8 classrooms, workshops on 3 sites

Three pairs of cottages had been built for farm staff.

Leisure – A Recreation Hall  with stage and cinematograph equipment, Courtyard and extensive grounds

Services – An Admin block, Laundry, Boiler House, Kitchen and Staff Mess

Male villas were on one side of the site, female and children on the other side.

The villas were mostly 2 storey, with dormitories above and day rooms below.  Single storey villas were used for those with physical and mental handicaps.

Much was made of the piped hot water system to supply heating and hot water to all the buildings.

6 Living conditions – food, no of rooms and bedrooms

Food

Diets, ie food allowances were always controlled.

Chertsey Union Workhouse expenses showed the larger part of expense on bread, flour and mild. This would reflect the diet of bread and gruel with occasional meat.

In the 1911 Board of Guardian Minutes, the new Master questioned the quality of the milk and bread.  Adulteration was generally common at the time and the costs of these commodities had gone down that year (the cheapest bid accepted?)

Each inmate received exactly the same amount of food according to a ‘dietary’ issued by the workhouse authorities whether or not they wanted that ration.  From 1900 workhouses could create their own weekly menus from a selection of around 50 dishes.

The same type of regulation applied in BPH with regard to the food and amounts served. Food inspectors called for the proportion of meat in meat pie be increased to 10%.

(B) In 1939, ‘coffee is given once a week for breakfast, but many do not like it so they are allowed tea.  Marmalade is to be given on Fridays instead of Saturdays

Rooms

On opening, villas accommodating 60 would have 2 dormitories on the 1st floor with day rooms on the ground floor.

Overcrowding was common during WW2 when accommodation was given over to the Emergency Hospital and afterwards when St Peters Hospital became established on the site.

By 1948, Murray House, supposedly with 300 beds, could only accommodate 221 without serious overcrowding 91 beds being broken.

7 Model of care

In workhouses, life was hard to deter only those who were really destitute.  Uniforms were worn, women, children and men were separated and food could be poor.  However, in the late 19th and early 20th century, free medical care and schooling for children were more than the poor outside workhouses could afford.

As time went on, workhouses became increasingly the last resort for those who could not cope, such as the frail, the elderly and the mentally challenged and also children, who were thought to have a better life and education inside a workhouse. Chertsey Union Workhouse was one of the first to be built and had a school (a schoolmaster was noted in the 1861 census).  However the 1834 building shows small windows on one side of the block only (poor ventilation) so the rooms were dark.

Diet was controlled by the Poor Law Commission with weekly menus.  Looking at the Board of Guardian Minutes, which itemised expenditure, the main expenses were for bread and groceries, with meat being occasional and forming a small part of the diet.

Although County Asylums existed for those needing their care, it was cheaper to keep those who were not disruptive in the workhouse.  Staying in bed was advised for the elderly and depressed.

In Botleys Park Hospital from 1939,  the idea was that patients were kept occupied, with 69 men working on the farm looking after horses, cattle, pigs and poultry.  There were 15 cows in milk, pigs and poultry, 110 acres of crops and 45 of pasture. Men also worked in the market garden and the grounds.  Both sexes worked in the kitchens and doing other domestic work.  Some 64 women worked in the laundry.

The stated aims were:(E)

1 Provision of supervision and adequate care of those who require it

2 Treatment by ordinary medical or surgical methods of illness or defect

3  Suitable training of a long duration

4 Gradual reestablishment in the community of suitably stabilised people

5 Excellent centre for research

The training is adapted to the needs of adults and children to develop the maximum potential of each, to mould the character and personality an inculcate good behaviour and habits.

In 1948 at Murray House patients were occupied with rug-making, book-binding and painting, also gardening.

The premises and activities were visited regularly by members of different committees and reports made to the Standing Sub-committee (6206/1/4)

Patients could apply to go out on license to a relative  or for discharge. Many discharges were refused as it was thought the patients were unsuitable, but leave to go out on license for 2 – 7 days was often allowed.

The activities continued:

‘the sitting rooms and dormitories were in good condition and the patients enjoyed making bedspreads’  (14.Jan 1937)

Each month the facilities were inspected

‘the flock picking shed as well as the day rooms and dormitories were in good order and the food supplies were excellent, especially the fish’ (March 1937)

By 1950, Murray House a separate 24 bed house to accommodate High Grade Patients employed by local industrial firms.  By 1957, the premises had undergone improvement and patients were occupied making chain-link fencing, assembling cardboard, packing polythene bags and sheets and making waxed paper bags.

By the 1970s, patients received education, training occupational therapy and medical care.

8 Quality of care

Epileptics are treated with Eparutin:  some patients have had pre-frontal lobotomies (E).

The Nursing Times notes (F) that there is no glamour in this type of work, turnover is slow, often with little hope as only the minority are able to go back outside.

In the early 70’s Dr Joan Bicknell, Consultant Psychiatrist and Head of the Hospital brought in more structured programs for patients.  She started annual psychiatric reviews and encouraged nurses to identify deaf patients who were isolated and unresponsive because of their condition.  They had weekly group meetings with these patients and started the use of sign language (Makaton) which improved their lives and the morale of the nurses. (BPH nurses Facebook)

Dr Joan Bicknell moved on in 1980 to become the first female Chair of Psychiatry in Learning Disability at St George’s Hospital and wrote many books and papers about the treatment of mentally disabled people – a unit for them is named after her at Springfield Hospital.  She headed a Task Force (with Mr Terence Ward, the Divisional Nursing Officer) sent from Botleys to Normansfield in 1978  to improve the conditions there. ( The Times, 30 Nov))

However, by 1983 (Guardian Feb 15 and Oct 15) patients were said to be seriously at risk in a report commissioned by the Department of Health.  The conditions  and facilities were poor and there was serious underfunding, understaffing and overcrowding.  One million pounds were to be invested in the first year to improve conditions so that BPH can be used as a resource centre for the community.  400 of the 900 patients will be moved into smaller units in the community.

9 Staffing numbers and details

The 1861 Census shows 6 staff for 233 inmates. This includes the schoolmaster and schoolmistress for the 82 children but no medical staff.

Before 1863, no nurses were employed in workhouses outside London. (VW)

By 1881, there were 6 staff for 257 inmates including a 2 nurses, a sanitary nurse and schoolmistress for the 54 children.

By 1911, there were 18 staff on the census for 237 inmates with 6 sick nurses plus a superintendent nurse, also an imbecile nurse and a children’s nurse.

Details of the school appear on a separate listing of the census.  There were 10 staff for the school of 88 boys between 11 and 16. There is 1 school teacher, but outside staff must have been employed as all the older boys, from 14 up were described as in training – e.g. pupil gardener.

The 1911 Board of Guardian’s Minutes book refers to a Dr Milsome, the Medical Officer for the workhouse – the first time a medical officer is mentioned, although payments of different doctors of particular services have been mentioned.  In January, he asked for an increase in salary – it was granted in February, from  £85 p.a. to £110 p.a.  He also received payments for extra medical services.

Three more staff were appointed that year. In February, an advertisement was published in the ‘Chertsey Union’   for a married couple to be ‘Infirm Attendants’ – at £30 for the man to attend meals, do bathing, relieve the Porter and anything else and £25 for the woman to attend meals, clean the wards and make herself generally useful.  A children’s nurse was appointed at £30 p.a. in March.  In April the job of ‘Matron’s Assistant’ was to be advertised in the Telegraph.  She would have to be proficient with a sewing machine to cut out and make up clothes, also keep charge of the stores.  Preference would be given to one who could play the harmonium in the chapel.  Again, pay is £30 p.a.

In 1939, when BPH opened, there were 76 nurses and 18 maids (E)

In 1946 (F) there for 75 men and 60 women nurses for 1000 patients – severely short staffed. Health visitors are able to do much to prevent people becoming patients by education in the home.

In 1950s, there was an acute shortage of nurses.  On the female side, there were only 57 full time and 35 part time of the 144 full time staff needed and an advertising campaign was launched.

In 1973, there were 307 staff against an establishment of 501, i.e. a serious staff shortage.  A

Staffing included 4 psychiatrists including Dr Joan Bickley who was also head of the Hospital.

(It is almost impossible to work out reliable patient to staff ratios with such patchy information available.  Much of the general information refers to staff shortages.)

10 Patient numbers and details (see 3)

11 Funding and fees

In 1939, the colony had cost £530 K to build.

Cost per patient was £5.73 in 1955, £6.84 in 1957 in 1961 £8.50 and about £17 in 1972.

For the Annexe at Murray House, costs were £5.60 in  1957, £7.15 in 1961, i.e. cheaper!

The costs for 1983 Murray House costs were £737, 000.  Closing it would fund a 24 bed ward for psycho-geriatric patients at Ottershaw Hospital. (SHC 6206/9/2)

12 Education provision

Workhouses were required to provide 3 hours education per day in reading, writing, arithmetic and Religious Instruction. Later in the 19th C, training became more relevant in the workhouse to enable the young people to become employable.

The 1861 Census for Chertsey Union Workhouse shows a schoolmaster and a schoolmistress on the lists (about 80 children).  The 1861 Census also shows a schoolmistress, but numbers have gone down to 54.  By the time of the 1911 Census, there is a separate boys school for 88 boys. Those aged 11-13 are described as scholars while older boys were being trained for different occupations, for example Gardener (Pupil), Clerk (Pupil) and Carpenter (Pupil).

The Board of Guardian Minutes of 1881 refers to stationery costs for the school (13s 10d).

In 1913, was officially declared that no healthy child over 3 should be in a workhouse.

A school for 200 children with 4 classrooms with windows open to the playground in 1939. Lessons included physical training, music and eurythmics and a percussion band.

The standing sub-committee (B) at the time reported ‘the children are so happy and the nurses endeavour to find occupation for each child.  The children are deeply attached to the nurses who are most kind and attentive to them.’  And in later that year ‘The nurses make every effort to help the children to speak and read with speech-training lessons

In 1946, the Nursing Times article (E) describes the nursing generally as one tenth bedside, the rest educational.

By the 1970s, the school was run by the Local Education Authority.

Makaton was taught to deaf children and adults from the 1970s.

13 Workshop and Skills Training

An Artisan’s workshop trained men to make brushes and brooms, mats, wire-netting, sash cords, coat-hangers, boxes, picture frames, medicine chests, notice boards, benches chairs and oak stools.   Tailoring and upholstery were also taught to males, while females did needlework and dressmaking.

In 1947, an Engineering and Structural Maintenance Department was established providing an apprenticeship scheme for higher grade patients.

Adult girls did embroidery, knitting and making rugs

14 Facilities

Workshops for metal and woodwork, brush making etc.

Football and cricket pitches.

Farm, large gardens and grounds.

Recreation Hall seating 750 with stage, cinematographic facilities, a library and chapel space at the back plus a large courtyard.

15 Activities

Indoor games included draughts, billiards and darts team games, keep fit classes and folk dancing.

Weekly entertainments, cinema shows, concerts and dances with occasional plays from local theatrical groups and pantomimes put on by the staff at Christmas time, were laid on in the Recreation Hall.  The dances were very popular amongst the staff and inmates – the females had to walk from Murray House (about 30 minutes) in the dark when there were blackouts in the war.

Art and clay modelling

Outdoor activities included log sawing, chopping firewood, border gardening and physical training.

There are football and cricket pitches, netball, hockey and rounders for the girls. and allowances are made for sport expenditure.  it was planned that annual sports days would be held each July.

At Murray House the standing sub-committee noted that ‘the pleasant gardens were being worked by patients and the day rooms and dormitories had been decked out in pretty colours.  The patients embroidered their night-dresses and made quilts and bags and made rugs.’ (April 1937)

Black and white photos of patients (D )and staff from 1978/9  and later show patients on holiday, one bedridden man being wheeled outside in Switzerland or Austria, a number in Teignmouth in Devon where they had been taken on holidays with carers – some in wheelchairs and some in beds on trolleys. One was in the front patio garden of the Victorian looking hotel having tea.  Another was patients and carers dressed in hula skirts and bras (over their clothing)!

The Royal wedding was celebrated with a party outside with bunting round the hedges and a bouncy castle for children. Many of the men had deformed hand shapes from their disabilities.

A visit to Chessington Zoo in 1982 showed patients in trolley bed, wheelchairs or standing with many carers. All smiling, having a good time.

16 Relevant Acts

1834 Poor Law Amendment Act reversed the trend of paying relief from the parish to able-bodied poor people  by mainly restricting help to those in workhouses.  It meant local unions of parishes building larger  workhouses.

1927 Act graded mental defectives as idiots, imbeciles and feeble-minded or morally defective.

1929 Local Government Act dismantled the Boards of Guardians transferring the Poor Law functions to the County Councils.

1933 The Mental Deficiency Act transferred the care of mental defectives from the Metropolitan Asylums Board to the Borough Councils.

1959 Mental Health Act abolished the distinction between psychiatric and other hospitals and the term’Mental Handicap’ was introduced to replace ‘Mental Subnormality’. The terms of admission were altered so that compulsory detention (‘sectioning’) was only allowed under extreme conditions if the patient was likely to harm himself or others or be subject to serious exploitation (‘grave incapacity’).

1948 National Health Act