Bootham Park Hospital

Identity area

Type of entity

Corporate body

Authorized form of name

Bootham Park Hospital

Parallel form(s) of name

Standardized form(s) of name according to other rules

Other form(s) of name

  • York Lunatic Asylum, 1777-1904
  • Bootham Park, 1904-1952
  • Naburn and Bootham Park Hospitals, 1952-1988

Identifiers for corporate bodies

Description area

Dates of existence

1777-2015

History

The hospital was purpose built. The first meeting to establish an asylum and open a subscription for this purpose was held on 28 August 1772 and work began on the building, which was designed by John Carr, early in 1774. The main block remains intact and is now a grade 1 listed building, but has lost its original small circular colonnaded turret from the centre of the roof: this was taken down in 1939 and its redundant base in 1951. More recently, the chimneys have been removed.

The first patients were admitted on 1 November 1777. Initially there were 15 patients, rising to 32 by 1783. The catchment area was the whole county of Yorkshire, although in 1783 patients were said to be accepted from >every part of His Majesty's dominions'. Fees were charged from the beginning: initially 8/- per week for all patients, including paupers who were paid for by their parishes.

The York Asylum is best known for the notoriety it gained during the period 1780 to 1815 when well publicised scandals arose over its bad management and ill-treatment of poor patients. These controversies have been extensively covered by historians. A number of complex issues were involved. First, critics were concerned at the extent to which the asylum had become a 'closed' institution in its early years, under the control of its single physician. This concern came to the fore when a member of the Society of Friends died in the asylum in 1790 without being allowed visits from her co-religionists. This led the Quakers to establish their own asylum, the York Retreat, which opened in 1796.

Secondly, much of the criticism of the asylum focussed on how far the charity had deviated from its original stated aim of accommodating >poor lunaticks'. Grading of fees was introduced in the 1780s. In 1781 non-paupers were charged the lower rate of 6/- while paupers continued to be charged at the rate of 8/-. Of more concern was the acceptance of more affluent patients in the 1780s: by 1788 there were eight different classes of patients, with the highest fees being ,1 or more per week. Many of the fees paid by wealthier patients went to the physician rather than the institution. In 1789 a group of critics established Lupton's Fund to subsidise the fees of poorer patients, but this fund remained under-used in its early years.

The later and most bitter stages of the controversies at York Asylum saw the pioneering and influential mild methods of treatment employed at the Retreat contrasted with the increasing allegations of ill-treatment of patients at York Asylum. The disputes thus came to reflect many of the current debates about the care and treatment of lunacy. Part of the problem arose from the fact that at a time of inflation, when fees were worth less in real terms, more patients had been taken to compensate, and the asylum had become very overcrowded, with insufficient checks on staff and conditions. From 32 inmates in 1783, numbers had risen to 68 in 1788, 137 in 1803, and 199 in 1813. There was much evidence of mismanagement of the asylum administration and finances, with governors knowing little beyond the asylum's public face. The later stages of the disputes saw a battle for reform spearheaded by Godfrey Higgins, a West Riding magistrate, and Samuel Tuke, the grandson of the founder of the Retreat. Their efforts attracted much publicity, not least because evidence was presented about the York Asylum to the Select Committee on Madhouses which was then sitting.

The reforming party gained control of the asylum in 1814 and the institution thereafter underwent significant change in its government and finances. However, a range of patients continued to be taken after 1814, including paupers, the poor and middling classes and the wealthy. After 1824 'refractory' or violent patients were also taken and these were housed in a separate wing. The fees of the poorest class of patients were lowered in 1815 to 4/- per week and better use was made of Lupton's Fund (other similar funds were established later: Wake's Fund in 1842, the Lancelot Foster Fund in 1914 and the John Joseph Hunt Fund in 1929). The highest class of patients in 1815 paid ,2 per week, but the largest number of patients, including paupers, paid 12s per week. The grading of fees represented graded facilities and accommodation, and this remained the case throughout the period 1815 to 1948. For example, in 1855 there were four classes of patients: those paying between 4s and 10s per week, those paying between 10s and 15s per week, those paying from ,1 to ,3 per week, and those paying between ,20 and ,140 per annum. Most patients were in the two lowest bands. In 1920 charges ranged from ,4 14s 6d per week up to over 8 guineas per week, plus additional charges for a special nurse.

In 1818 the new West Riding pauper lunatic asylum at Wakefield was opened; although it took some patients who might otherwise have been sent to York, it did not affect numbers at the York Asylum. A more significant change came after the 1845 Lunatics Act which made the provision of asylum accommodation for pauper lunatics by counties and boroughs compulsory. Under this Act, York Asylum became one of a small number of registered asylums for the care and cure of the insane, which were partly supported by charity and partly by patients' fees. As such it was intended to cater for private patients, including those of modest means, but not for paupers. York City's pauper lunatics were duly removed from York Asylum to the North and East Ridings Pauper Asylum at Clifton, opened in 1847, after a contract was made between these county authorities and York Corporation. However after the North and East Ridings Asylum became full in the early 1860s York Corporation contracted with York Asylum (despite opposition from some of the asylum governors) to sent its pauper lunatics there once more. The paupers were accommodated in newly built separate wings, away from the private patients. This contract arrangement continued until 1906 when the York Corporation finally opened its own City Asylum at Naburn. York Lunatic Asylum changed its name to the more respectable 'Bootham Park' in 1904. After 1906 it accommodated middle and upper class patients only.

Even with the addition of York's pauper patients between 1861 and 1906, the hospital remained small in comparison with the large county institutions. Between 1820 and 1920 it accommodated around 150 patients at any one time, although this figure fluctuated. For example, in January 1875 there were 183 patients resident, of which 133 were private and 50 were paupers. In November 1895 there was a total of 136 patients, of which 86 were private and 50 were pauper. In 1920 it was noted that there was room for 150 patients, but during the 1920s and 1930s the hospital was under-used and numbers dropped to between 90 and 100 residents at any one time.

The York Asylum was a well respected and well managed hospital after 1815. There was much development of land and buildings and great effort went into the creation of attractive surroundings both within and outside the hospital.

The present block plan was largely created in the nineteenth century. There were originally other buildings behind the main block, including a wing which was burnt down at the height of the asylum controversies in 1814. One of the first tasks of the reformed asylum management body was to replace this wing with a new building, completed in 1817, running parallel to the main block at the rear. This was used to house female patients while males were accommodated in the front building. In the 1820s the various buildings and wings were connected by long passages containing services as well as accommodation for high status patients. Also in the 1820s a detached wing for the 'refractory' patients was added to the north west. There were extensive additions in the mid- to late nineteenth century which filled in the space between the earlier buildings as well as extending the block plan to the west and east. These additions included a new wing for the refractory ward in 1851-2, new and separate wings on the west side for York City's pauper lunatics in 1861-2, the medical superintendent's house, connected to the main block on the east side in 1862-4, and the recreation hall in the centre of the asylum in the 1870s. In the grounds, a large chapel was built in 1862-4. The interior of the asylum was completely altered and refurbished in the 1880s. In 1908 a further addition for high fee paying female patients was added between the 1817 wing and the medical superintendent's house. Between 1913 and 1920 houses in nearby Union Terrace were purchased to provide nurses' and other staff accommodation.

Like other such institutions, the York Asylum acquired a large estate and farmland during the nineteenth century. Land was purchased largely between the years 1815 and 1860 and included the seven acre field in front of the asylum (previously held on lease), and a large area of fields at the rear, (now the site of York District Hospital) as well as two farms, one nearby on Haxby Road and one slightly further away on Stockton Lane. The asylum estate comprised 33 acres in 1853. The Stockton Lane farm was sold in 1925 and the Haxby Road farm in 1931.

Therapy in the nineteenth century centred largely on occupation and work, with the use of sedatives to calm patients and the occasional use of restraint, particularly for refractory patients. Lower class male patients at the asylum worked on the farm or gardens or did various jobs around the building, while females did domestic and household work. Higher class patients were kept occupied by reading, writing, drawing, music and other such tasks. There was also a varied programme of entertainments and activities for patients, which successive medical superintendents emphasised as having real therapeutic value. A good environment was also viewed as an aid to recovery so decorations and furnishings were steadily improved.

In the early twentieth century, the hospital took increasing numbers of private voluntary boarders. For example, of the 49 patients admitted in 1924, the high number of 28, or nearly 60%, were boarding voluntarily. In 1939 85% of admissions were voluntary or temporary (the 1930 Mental Treatment Act introduced the three classifications of 'certified', 'voluntary' or 'temporary').

Various new treatments were additionally tried in the period between 1900 and 1948. At the turn of the century, the then medical superintendent, Dr Hitchcock, undertook pioneering and well publicised work in treating cases of acute mania without the use of drugs. The new treatments of the 1920s, 1930s and 1940s were also introduced at Bootham Park: malarial therapy in the 1920s, insulin treatment and electro-convulsive therapy in the 1940s, and pre-frontal leucotomy operations from 1944 onwards.

In 1948 Bootham Park was included in the new National Health Service. The hospital had been underfunded and under-used in the 1930s and early 1940s, so in the early years of the NHS the buildings and facilities were considerably upgraded and the accommodation better utilised and extended so that the bed complement rose from about 130 in 1948 to 172 by 1950. There were about 100 patients resident in 1949, but by 1950 there were about 140 patients. Numbers were further increased later: in 1960-1 the bed complement was 214 with an average bed occupancy of 197.

In 1948 the catchment area was initially decided as being any part of Leeds Region for private patients, while NHS patients would be admitted from Wetherby Rural District. York NHS patients were meanwhile accommodated at Naburn Hospital (the former York City Asylum). However, Bootham Park was amalgamated with Naburn Hospital in 1952, and from that date until 1988, when Naburn closed, both shared a joint catchment area and services and facilities were shared between the two sites. After 1945 the number of full private patients at Bootham Park declined. By 1955 Naburn and Bootham Park together had a bed complement of 629 and an average occupancy of 598.8. By this time most admissions were voluntary (termed 'informal' after the 1959 Mental Health Act): 90% of admissions at the two hospitals were voluntary in 1956, and 540 out of 573 patients at the hospitals were in the informal category in December 1961.

There were structural and functional changes to the Bootham Park building in the 1950s and 1960s. There were major renovations of wards and staff facilities; a new out-patients building was completed in 1958; a new neuro-psychiatric unit was opened in 1966, with 20 beds, and out-patient facilities, which provided special neurological investigations for patients from the North and East Ridings as well as York. From the mid-1950s, Naburn and Bootham Park were included within the comprehensive York Mental Health Service. This pioneering scheme combined the mental health responsibilities of York Corporation and York 'A' Group Hospital Management Committee and thus integrated community and hospital services for psychiatric patients. As part of this scheme, an innovative new day unit was opened at Bootham Park in 1962, and a pre-discharge unit was opened in Union Terrace in 1960.

In the 1960s and early 1970s, the facilities at Naburn and Bootham Park were also complemented by the opening of the Child Psychiatric Unit at Fairfield Hospital in 1963 and the conversion of Deighton Grove Hospital to psychiatric use in 1971.

Since 1948 Bootham Park has also provided accommodation for York's local NHS management, within the main central block. This has entailed some changes in the use and functions of space within the building. There have also been many other functional changes in various parts of the hospital since 1948: for example, the former medical superintendent's quarters are now used for other hospital services, and the redundant chapel now houses the health education department. Much of the former estate of the hospital has been redeveloped for NHS use and has provided sites for York District Hospital, for student nurses' accommodation, and for other York Health Trust offices and departments. The large field in front of the hospital has, however, remained intact, and is an impressive setting.

In the 1980s a new strategy was put in place by York Health Authority to rationalise psychiatric services. For many years in-patient beds had been reducing as a result of new treatments increasingly delivered in community settings. The strategy involved the eventual closure of Naburn Hospital, in 1988, and of Clifton Hospital, in 1994, so that of the three NHS mental hospitals in York 'A' and 'B' Groups in 1948 only Bootham Park now remains open. Today much psychiatric care is located within small units within the community: in small specialist mental health units, in residential rehabilitation units, in community units for the elderly, and within a network of day services. However, Bootham Park continues to offer acute psychiatric hospital care as well as providing a central base for the psychiatric facilities of York Health Trust. This is a role which was confirmed by a major review of psychiatric services in 1995. A significant upgrading of services at Bootham Park was undertaken in 1995-6, including refurbishing of wards and facilities, the provision of a new centre for occupational therapy and physiotherapy, a new base for the elderly mental health teams, and the provision of a 24 bed elderly assessment unit, opened in September 1996. Since 1997 there has been an acute ward review and development plan with the aim of reshaping, redesigning and modernising facilities according to modern therapeutic care models and modern expectations of care and accommodation. Modernisation is an ongoing challenge because of the Grade I listed status of the building. A new facility, created in the late 1990s, has been the Chantry Suite within the 1817 wing: this contains patient centred facilities away from the ward environment, including space for patients and their visitors, and a women-only lounge.

In September 2015 the hospital was declared unfit by the Care Quality Commission and was subsequently closed.

Places

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Internal structures/genealogy

General context

Relationships area

Related entity

Naburn Hospital (1906-1988)

Identifier of the related entity

Category of the relationship

associative

Dates of the relationship

Description of relationship

Related entity

Wellbeloved, Charles, 1769-1858, Unitarian minister, archaeologist and antiquary (1769-1858)

Identifier of the related entity

Category of the relationship

associative

Dates of the relationship

Description of relationship

Related entity

York A Group Hospital Management Committee (1948-1974)

Identifier of the related entity

Category of the relationship

hierarchical

Type of relationship

York A Group Hospital Management Committee controls Bootham Park Hospital

Dates of the relationship

Description of relationship

Access points area

Occupations

Control area

Authority record identifier

Institution identifier

GB 193

Rules and/or conventions used

ISAAR(CPF): International Standard Archival Authority Record for Corporate Bodies, Persons and Families, International Council on Archives (2nd edition, 2003); Rules for the construction of personal, place and corporate names, National Council on Archives (1997).

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Dates of creation, revision and deletion

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Script(s)

Sources

K. A. Webb, 'From County Hospital to NHS Trust: The history and archives of NHS hospitals, services and management in York, 1740-2000' (York, 2001)

Maintenance notes

Created by Sally-Anne Shearn, July 2015.
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