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Developments in patient care
Chapter 5, development in patient care notes on each era
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Developments in patient careMEDIEVAL
- St John’s hospital in Chester was set up in 1190 for the care of “poor and
silly persons”
- No lepers, lunatics, pregnant woman basically no one allowed in
- The church runs the hospital
The role of the church and monasteries from the medieval period up to the mid-
16th century
- Essentially religious institution who role and functions were very different
from what we expect from modern hospitals today
- Health of the soul over health of the body
- Almost all medieval hospitals run by church and building of the
monasteries during 12th century onwards led to an explosion in the
number of hospitals set up between 12th and 14th century
- Most monasteries included an infirmary in its layout, such as that of
Tintern Abbey on the Welsh border
- 1100 hospitals were set up during the medieval period
- St Leonards in York 1287 could accommodate 225 patients
Different Types of hospitals
- Leper Hospitals, common incurable, contagious disease during the
medieval period
- 13-`14th brought a growth
- Inflicted horrible deformities on victims, had to wear special clothes, had
to ring a warning bell as they walked, not allowed to marry
- Feared lepers as people thought they were being punished by God
- Built on outskirts of town to limit mixing with the rest of the population
- Provided with lodging and food but no treatment
Almshouses
- Care homes
- Basic nursing but no medical treatment
- Very small
- Sometimes just a priest
- Gave shelters to travellers and the poor, with accommodation for a few
nights
- Contained widows with young children or single pregnant women
Christian Hospitals
- Set up, paid for and run by the church and they looked after the poor as
well as the sick
- Did not treat sickness but aimed to make the patients as comfortable as
they could
- People who were constantly ill were not allowed in as they distracted from
the main purpose of the hospital which was to pray and attend religious
services
, - Provided basic nursing, clean and quiet conditions, regular meals and
warmth
- Only few doctors
- Religious institutions, referred to as house of God
- Supposed to spend most of day praying and confessing sins
- Believed they were poor and sick because they have sinned and now they
need to repent
EARLY MODERN
Impact of the closure of the monasteries
- When Henry VIII ordered the dissolution of the monasteries in the 1530s it
resulted in the closure of many hospitals and this had a dramatic impact
upon patient care. The church now ceased to be a supporter of hospitals
and that role now had to be taken on by voluntary charities
- In some areas town or city councils stepped in to take over the running of
alms-houses that looked after the elderly poor and the hospital, which took
care of the poor in general. In providing royal funds it proved to be the
first occasion when occasion when secular support was provided for
medical institutions
The creation of royal hospitals in London
- Across London a total of five major hospitals were endowed with royal
funds during the mid- sixteenth century to enable them to continue to
administer care for the sick and poor of the capital.
- St Bartholomew’s Hospital- The dissolution of the monasteries left St Barts
in a difficult position as it took away it income. Petitioned to the king and
granted corporation of the City of London. Hospital served the poor of the
area of the West Smithfield
- St Thomas Hospital, originally founded by a mixed order of monks, nuns
provided shelter and treatment for the poor, sick and homeless in the area
of Southwark.
- Christs hospital, Christs hospital was founded in 1553 by Edward VI in the
old Greys Friars buildings in Newgate, in response to calls from the bishop
of London to provide for the poor. It offered shelter, clothing and food to
fatherless children alongside rudimental education
Endowed Voluntary hospitals outside London
- The creation of voluntary hospitals did not just take place in London. In
towns across the country it was left to the local councils to organise
endowments to keep their hospitals open. In Norwich, for example, when
Henry VIII ordered the closure of the monastery of St Giles and with it, its
hospital, the town council petitioned the crown
- The hospital was re-founded by a royal charter granted in 1547, which
handed control of the hospital to the town corporation. 4 women were to
be employed to make beds, wash poor people. Began to employ medical
staff.
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