Hektoen International

A Journal of Medical Humanities

Workhouse to hospital

Orla McAlinden
Kildare, Ireland


Carleton House
Carleton House

Carleton House, in Portadown, in the heart of Northern Ireland, was built as the townhouse dwelling of George Montagu, Viscount Mandeville, sixth Duke of Manchester. It is an imposing, three-story Georgian building on the Armagh Road, opposite a long stretch of terraced red-brick housing unimaginatively called Carleton Street. Montagu resided there when he visited his large estates in and around the town—acquired on his marriage in 1822 to Millicent Sparrow of Tandragee Castle. Modest by the standards of his English dwelling, it is by any reckoning an impressive and extravagant pile of red bricks.

The building was a source of great pride to the town. Within a stone’s throw stand the deferentially named Mandeville, Millicent, and Montagu Streets; the town’s people quick to acknowledge its connection to this influential, titled family.

In 1917, almost a century after the erection of Carleton House, the people of Portadown were fortunate to have a building of such magnificence and impressive provenance to house their first hospital facility. The endless casualties of the Great War had revealed to the British authorities a huge lack in medical facilities in every part of the Empire. In Ireland, even the very word Hospital was associated with shame and stigma. Hospitals at that time were almost entirely for the use of the poor and destitute. The Hospital had often been established in the premises of the old County Workhouse. The shame of one’s relative being cared for in a rudimentary fashion, or, far more likely, dying from neglect in the county home was enormous.


The middle- and upper-classes, therefore, received their care from private doctors in the privacy of their own homes. Wealthy women were confined, swathed in clean, starched linen in their comfortable bedrooms, with the anxious husband safely downstairs, or, for preference, out of the house entirely. Tonsils and adenoids were removed in the nursery; tumors on the dining room table.

Between these two extremes, care was largely unavailable to the ordinary impoverished worker, the deserving poor. Post-war governments spearheaded the creation of new forms of institutional care, the Voluntary Hospitals, the forerunners of the National Health Service.

In Armagh city, even the most cursory glance at the foreboding, grey stone exterior of Tower Hill Hospital (now Armagh Community Hospital) revealed its sinister past. It had a dark history as the county workhouse and fever hospital. Established in 1820, hundreds if not thousands had perished behind its prison-like doors during and after the great Irish famine. It brought fear to the heart of those carried there for aid and shame upon their relatives almost a century later.

In nearby Portadown, as the Great War dragged onwards, the medical authorities turned their eyes upon the impressive, and attractive, Carleton House—the home, at that time, of a wealthy linen manufacturer. Carleton House had no shameful, negative associations in the collective consciousness. The new hospital thrived.

I was the fourth, and the last, of my mother’s six children to be born in Carleton House. My brothers were delivered in the newly built Craigavon Area Hospital, which assumed responsibility for maternity duties in the region in 1973. My youngest brother’s arrival was complicated, with huge loss of blood, ending in an emergency caesarean section and a fortnight of recuperative care for mother and child. One cannot imagine a successful outcome in those circumstances in the Georgian grandeur of the Carleton Home under the care of a General Practitioner, no matter how skilled.

Miss Elizabeth Brown was the formidable and feared Matron of the Carleton Home; her hospital was spotless and she ruled her nurses with military discipline.

My mother and the other recuperating women rose each morning from their fresh, clean beds to spend the day in chit-chat with their ward-mates. Full make-up and hair-do was required. Matron frowned and chastised any new mother too through-other to put her best face on. The women were expected to dress smartly too; lying around in soiled nightclothes was not tolerated. Every four hours I was presented to my mother, like a new doll, along with a bottle of milk, and she handed me back, with pleasure, to the nursery nurses afterwards.

Matron understood that many of her ladies would return to homes lacking in laundry facilities, full of unruly older children, and currently being run by husbands barely capable of peeling a potato. Her ladies deserved a good rest.

After fifty-five years, shortly after my birth, the blinds were lowered on the windows of Carleton House. Ironically, the old building stands today, outwardly unchanged, but fulfilling (under the auspices of the South Ulster Housing Association) the remit intended—but never realized—by the original founders of the Workhouse movement. It has been converted into spacious, well-appointed apartments for the safe and dignified housing of the vulnerable elderly.



ORLA MCALINDEN, MVB MSc(Sci) HDipEd, is a new writer of creative narrative non-fiction. She qualified as a veterinary surgeon from University College Dublin in 1996, and has a keen interest in the history and folk-history of medicine. Her work has been published in The Chattahoochee Review, Ragnarok, the Fish Anthology, and in on-line journals, and has won/ been shortlisted for several international awards. Workhouse to Hospital is an abridged extract from her unpublished memoir “Union Jacks and Rosary Beads. A Catholic childhood in Northern Ireland.” Her work can be sampled at http://orlamcalindenwrites.wordpress.com.


Summer 2014 |  Sections  |  Hospitals of Note

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