St. Bartholomew’s Hospital, London, United Kingdom
Dr. Mas Ahmed
Queen’s University Hospital, Essex, United Kingdom
St. Batholomew’s Hospital courtyard with the Fountain as it stands today
There is something about St Bartholomew's Hospital, something - it may be in its age, its history or its associations - which creates towards it and, in its strength, a unique feeling among its members.
The words of the matron at St Bartholomew’s Hospital, Isla Stewart, in the late ninteenth-century capture the vast historical wealth this hospital possesses. Now an internationally renowned teaching hospital, St Bart’s is one of the oldest hospitals in the world and has provided healthcare at the same site in London for almost 900 years.
The hospital was founded in 1123 by the legendary Rahere, a former court jester and favorite of Henry I, who later became a Prior in the church. It was during a pilgrimage to Rome that Rahere became ill and, praying for his life to be spared, he vowed to set up a hospital for London’s poorest citizens. Rahere did indeed recover from his illness and on his return to London he encountered a vision of St. Bartholomew. He was instructed to found a church and a hospital at Smithfield, which would be named after the Saint. The hospital and the church were united in caring for the sick for the next 300 years but the two had become separate institutions by the early 15th century. Throughout this time St Bart’s fulfilled Rahere’s intent, operating as a hospice which provided care for the sick and poor, including children and prisoners from Newgate prison. The Canons of the church also provided care for the homeless of the City.
The reign of Henry VIII brought about the dissolution of the monasteries in 1539, leading to the closure of the Priory at St. Bartholomew’s. This was also a time of uncertainty for the future of the hospital and prompted the people to petition the king to grant it to the City of London. It took six years for King Henry VIII to act on their request and initially he only gave the City parts of the hospital. In 1546, persuaded by his surgeon Thomas Vicary, the king finally signed a charter granting St. Bart’s to the City, although it was to be called ‘The House of the Poore in West Smithfield in the suburbs of the City of London of Henry VIII’s Foundation’ – a lengthy title which, although seldom used by the hospital, remained on legal documents until the NHS was formed in 1948. The King also agreed to supply St Bart’s with properties and income. The hospital had become one of four Royal hospitals administered by a board of governors and belonging to the City.
In 1569, Dr Roderigo Lopez was appointed as the first official physician at Bart’s. This successful doctor from Portugal acquired patients that included the wealthy and famous. This led to him becoming chief physician to Elizabeth I in 1586. However he became the center of a catholic conspiracy and after being accused of plotting to poison the Queen was executed in 1594.
The Fire of London in 1666 led to financial loss for hospital leading to several wards being closed. However it was rebuilt in 1729-1770 to the designs of architect James Gibbs. Unfortunately most of the medieval buildings were demolished during the rebuilding and the only one remaining today is the tower of the Church of St. Bartholomew the Less. The North, East and West wings built by Gibbs all remain today and are grade I listed, as is the Henry VIII gate which dates back to 1702. The Fountain in the Square (Figure 1) was built in 1859 and other buildings have been added since, including those of the medical school and nurses’ accommodation.
Since the beginning of the hospital, training for doctors and surgeons has been available at Bart’s, and medical students were first recorded in the seventeenth century. The medical school developed gradually since then, recognized in 1822 and officially established as a medical college in 1845. The two medical colleges at Bart’s and The Royal London Hospitals merged to form Bart’s and the London School of Medicine and Dentistry, and with Queen Mary University of London in 1995. It is now a world class center for medical education and research.
The hospital also boasts some magnificent art. The North Wing of the hospital contains the Grand Staircase, painted in 1734-37 by William Hogarth. His two spectacular paintings of the biblical scenes The Good Samaritan and the Healing at the Pool of Bethesda aptly convey the longstanding spirit of the hospital to serve the sick.
St. Bartholomew’s has been the home to many notable figures in medical history. William Harvey, famous for his discovery of the circulation of blood, was appointed physician at Bart’s in 1609. Later on Percival Pott, who lent his name to both the ankle fracture and spinal disease, was designated hospital surgeon. The spirited surgeon John Abernathy later took this position and was responsible for founding of the medical school. After starting to lecture medical students at his home, he became renowned for his unique teaching style and his lectures were so well attended that he was able to persuade the hospital governors to build a “Surgeon’s theatre” in 1791. A Theatre Suite was opened in his name in 1993, and is the most technically advanced in Europe. James Paget, considered as one of the founders of pathology, held this position at Bart’s in 1847. Elizabeth Blackwell, the first women to appear on the UK medical register, enrolled at St. Bart’s in 1850. Another influential woman at Bart’s was Ethel Gordon Manson, who became a matron here in 1881 and was a pioneer of nursing as a profession in its own right.
In 1992 St. Bart’s was merged with The Royal London and the London Chest Hospitals to form Barts and the Royal London hospital NHS Trust. This was after the Tomlinson Report called the viability of Bart’s hospital into question. Over one million people signed a petition to save the hospital at its Smithfield site. Bart’s now remains a specialist cancer and cardiac hospital and continues to lead in innovation and technology. It was the first hospital in the UK to use mega-voltage radiotherapy. The Bart’s Day Surgery Unit which was the first of its kind in Europe opened in 1991. In 2010 a state-of-the-art cancer center which includes the latest specialist gamma knife technology opened at Bart’s. Above the entrance to the pathology museum at Barts, which dates back to 1726, an inscription reads “Whatsoever thy hand findeth to do, do it with thy might” and seems to speak of the excellence this hospital has shown in almost 900 years of medical discoveries, education and, perhaps most significantly, adhering to the original vision of the court jester – to care for the sick and poor in the heart of London.
- Friends of the Great Hall & Archive of St Bartholomew's Hospital. Accessed on January 6, 2015. http://www.bartsgreathall.com/index.php/st-barts/history-of-barts
- British History Online. Accessed on January 8, 2015 http://www.british-history.ac.uk/old-new-london/vol2/pp359-363
- Keir Waddington, Medical Education at St. Bartholomew's Hospital 1123-1995 (Boydell & Brewer, 2003).
Rebecca Green is a 4th year medical student at Barts and the London School of Medicine and Dentistry.
Dr. Mas Ahmed is a Consultant Paediatrician at Queen’s University Hospital in Romford, United Kingdom.