St Thomas' & Guy's Hospitals

The area of Bankside and Borough has a proud heritage of hospitals that dates back 900 years. The first hospitals were the Lock Hospital in Kent Street and the hospital which formed a part of the Augustine Priory at St Mary Overie though it is difficult to say which of these two hospitals was established first as both probably date back to the early twelfth century.

The concept of what a hospital is has evolved over the centuries to what we understand a hospital to be today. In medieval times a hospital fulfilled one of more of four different functions as follows:

- a refuge for lepers;
- an almshouse;
- a place where pilgrims and the poor were offered shelter; and
- a place where the sick poor were treated and cared for. (Carlin)

The Lock hospital fell under the first of these four categories and offered sactuary to those suffering from leprosy though there may have been instances of mis-diagnosis and some of those admitted were suffering from the later stages of syphilis. The City of London wanted to isolate lepers in order that the healthy did not contract the disease and the establishment

St Thomas entrance courtyard1

Entrance Courtyard to Old St Thomas' Hospital

of Lock Hospitals on the outskirts of London was more to do with containment than treatment of the disease. The hospital in Kent Street was dedicated to St Mary the Virgin and St Leonard and until the Reformation was administered by the monks from Bermondsey Abbey. After the Reformation, the City of London ordered that two aldermen and 2 commoners who were governors at St Bartholomews Hospital were to be appointed annually to ensure good order and maintenance of the Lock Hospitals in Kent Street and Hackney.

Leprosy in England had peaked in the 12th and 13th centuries but by the 15th century had virtually disappeared. The Lock Hospital was then used to treat patients with venereal diseases, and other hospitals by that name opened throughout England for this purpose. The Lock Hospital in Kent Street closed in 1760.

The Augustine Priory of Mary Overie was founded in 1106 and probably included a hospital as a part of the Priory, if not at the very beginning then not long afterwards. It is probable that this early hospital would have both offered accommodation to pilgrims and poor vagrants and also tended to the sick poor which would have obeyed the first precept of the Augustine order: Before all things dearest brethren let God be loved, then your neighbour.

In 1207 the Priory and hospital were destroyed by fire and in 1223 Peter de Rupibus, Bishop of Winchester, re-endowed a new hospital with 344 and a call to the pious of the diocese to provide funds for its maintenance by way of donations and bequests. Those who offered alms to the hospital would be rewarded by a 20 days indulgence. The new hospital combined both the hospital of St Mary Priory and the almonry of Bermondsey Abbey and was situated to the east at the north end of the approach road to London Bridge described as a more commodious site where the air is more pure and calm and the supply of waters more plentiful. It was possibly at this time the hospital was dedicated to St Thomas a Beckett who had been canonised as Thomas the Martyr in 1173.

The new hospital was able to accommodate 40 patients. In these early days they would have slept on rushes as beds were not introduced until the end of the 13th century and even then it was common for each bed to accommodate two or three people. Whilst the hospitals work was carried out under the direction of the Master and brethren, the actual careing of the sick was carried out by lay servants, nuns and lay sisters. Much of the treatment would have been limited to bed rest, warmth, maintaining cleanliness and eating sufficient food. Surgery was conducted by a layman as the brothers were not allowed to shed blood and a lay apothecary was employed to mix potions and medicines.

The hospital received many bequests and donations. In the early 14th century, Richard Whittington, Lord Mayor of London, built a chamber of eight beds for unwed mothers but he ordered that whatever happened in the chamber was to be kept secret lest it spoil the womens chances of marriage. 200 years later, Thomas Cromwell, chief minister to Henry VIII described the Hospital as the bawdy hospital of St Thomas in Southwark and in 1538 the King ordered the hospital to be closed. By now, the hospital had received many bequests and owned extensive properties in Surrey, Sussex, Kent, Middlesex, Cambridge and the City of London which were seized by the King. The closure of St Thomas and the other hospitals in London was a great loss to the people of London and Sir Richard Gresham petitioned the king to restore the [three] hospitals founded of good devotion by ancient fathers, and endowed with great possessions and rents, only for the reliefe, comfort and helping of the poore and impotente people lying in every street, offending very clene person passing by the way with their filthy and nasty savors.

St Bartholomews Hospital was reopened but Henry VIII died before St Thomas could be restored. Edward VI, his son and successor, granted a charter to the City of London for the rights and administration of five hospitals in London that were designated as follows:

St Bartholomews and St Thomas for the sick
Christs Hospital for sick children
Bethlem Hospital for the insane
Bridewell Hospital for the correction of malefactors vagrants, strumpets and idle persons for finding them work. (Stow).

In particular, Edward VIs charter decreed that the said hospital in Southwarke should in future be the place and house for relieving and sustaining the poor there and shall be called the poorhouse in Southwarke. St Thomas reopened in 1553, now rededicated to St Thomas the Apostle.

The hospital had been rebuilt to accommodate 258 patients in 1507 prior to its closure. A treasurer, hospitaller, clerk, butler, steward and surgeons were appointed upon its reopening and in 1566 Henry Bull the first physician was appointed. There were between 15 and 25 lay sisters employed. The hospital was now a secular institution and it seems the compassion of the brethren was missing. No pregnant women were now admitted as the hospital was said to have become a lying in place for prostitutes, preventing the admittance of other patients: the hospital had been built for the relief of honest persons and not of harlottes. Patients were punished if they did not attend the daily service and for dicing, gambling, swearing and drunkenness. Patients who had been treated for foul diseases (venereal diseases) were flogged on discharge as a warning, and 12 lashes were administered to a nurse who was found to be drunk on duty despite previous warnings.

In 1635 the hospital had about 280 beds and this number increased to about 450 by 1800. The intervening years had seen the rise of parish relief for the poor in the form of indoor and outdoor (workhouse) relief. St Thomas was now able to concentrate on healing and caring for the sick. Medical and surgical knowledge were growing and in 1703 the hospital appointed Dr Richard Mead who became the most eminent physician of his time. William Cheselden joined the hospital at about the same time and is said to have been one of the greatest surgeons to have practised at St Thomas.

To meet the growing demand for beds, the old building had been demolished and rebuilt and two wings added, one of these paid for by a Governor of the hospital, Thomas Guy. A printer by profession, he had made a fortune from the South Sea Bubble and, at the same time as paying for one of the new wings, he leased some land from St Thomas where a new hospital, Guys Hospital, was built for incurable and mental patients who were denied admittance to St Thomas. Guys Hospital opened in 1724 but sadly the great benefactor Thomas Guy died just before the first patients were admitted. The two hospitals complemented and collaborated with each other and as medical education developed, Anatomy and Surgery were taught at St Thomas and Medicine at Guys. The poet John Keats studied at Guy's in 1815 to 1816.

Thomas Guys will stipulated that Guys Hospital was to admit all types of patients and have its own governing body. Although the two hospitals had worked together harmoniously for many years, the medical schools separated in 1825. Its been suggested that this was caused by arguments between the two sets of governors and what amounted to a personality clash between the treasurers of the two hospitals. The final breach occurred when a riot broke out in St Thomas Hospital Operating Theatre, the police called and six medical students arrested. The cause of the riot was that a lapsed ticketing system for students of both hospitals to view operations was, without warning, reintroduced. As a result of the separation, St Thomas Medical School suffered a great decline for many years.

A plan of St Thomas Hospital dated about 1853 is available on the website for The Old Operating Theatre. The only buildings that still stand today are St Thomas Church and the row of buildings from the Treasurers House to the Treasurers stable facing onto St Thomas Street (below).

London Bridge Station opened in 1836 and by 1847 there were schemes to extend the railway to Charing Cross and Cannon Street which necessitated building the railway right across the site of St Thomas Hospital. This was viewed as catastrophic to the survival of the hospital and despite litigation the hospital was compulsorily purchased for just under 300,000. Many sites were considered, including moving the hospital out into the country, but finally the present site in Lambeth opposite the Houses of Parliament was selected. Queen Victoria lay the foundation stone in 1868 and three years later the hospital opened. The hospital in the meantime had moved temporarily into accommodation at Surrey Gardens in Kennington, which had previously housed a zoo, a music hall and a pavilion. 200 beds were sited in the music hall, a laboratory was housed in the pavilion and the elephant house became a dissecting room.

Florence Nightingale was a huge influence on choices that were made regarding relocation and rebulding of the hospital. She had opened the first nursing school at St Thomass in 1860 and had persuaded the hospital administration that it would be preferable for the whole site of the hospital to be compulsorily purchased rather than just those parts needed for the building of the railway. She also made a large contribution to the design of the new hospital which accommodated 588 patients and comprised six parallel ward buildings, linked by other buildings at right angles. A new nursing school, Nightingale House, was built within the grounds.

The hospital suffered horrendous bomb damage during World War II and three ward blocks were eventually demolished as a result. New buildings, including a 13 storey ward block, were completed in 1975.

Guys Hospital remained in Southwark and has expanded over the centuries, most notably the 34 storey tower built in 1974. As is to be expected, there was intense competition between Guys and St Thomas but, reflecting changing times and changing attitudes, the two hospitals began to work more co-operatively together. In 1993 the two hospitals merged and the Guys and St Thomas NHS Trust was created.

Edward VI

Statue of Edward VI that was part of a stone gateway erected at the site in Southwark in 1682. The statue is now in the grounds of St Thomas' Hospital, Lambeth.

St Thomas Street
Thomas Guy

Statue of Thomas Guy in the forecourt of the hospital.

Guy's Crest

Guy's Hospital coat of arms displayed on the entrance gates to the hospital in St Thomas Street

Sources:
Martha Carlin 'Medieval English Hospitals' in L Granshaw & r Porter (eds)The Hospital in History (1989) London
Ida Darlington (ed), Survey of London, Vol 25(1955)London
Charles Graves,The Story of St Thomas's 1106-1947 (1947) London
Christopher Hibbert and Ben Weinreb, The London Encyclopaedia(2008) London
G Q Roberts,A Brief History of St Thomas's Hospital (1920) London
www.guysandstthomas.nhs.uk
Lost Hospitals of London website (www.ezitis.myzen.co.uk)