fonds NHS/BOO - Bootham Park Hospital Archive

Identity area

Reference code

NHS/BOO

Title

Bootham Park Hospital Archive

Date(s)

  • 1777-1999 (Creation)

Level of description

fonds

Extent and medium

4.33 cubic metres

256 boxes, 1 wrapped item, and 47 rolls.

Context area

Name of creator

(1777-2015)

Administrative 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.

Archival history

Immediate source of acquisition or transfer

The archive was deposited at the Borthwick Institute in 1995 as part of the transfer of York Health Archives to the Institute from their temporary home at Clifton Hospital. Further additions were made to the archive in 1996, 1997, 1998, 1999, 2000, 2005, 2006, 2009 and 2010.

Content and structure area

Scope and content

Administrative records, comprising Quarterly Court of Governors minutes, 1831-1948; Committee of Governors minutes, 1821-1948; draft committee minutes, c.1870-1916; Intermediate Committee minutes, 1900-1902; Hospital Staff Representative Committee minutes, 1951-1961; Bootham and Naburn House Committee minutes, 1965; annual reports, 1783, 1815-1932, 1939; rules and regulations, with related papers, c.1800-1914; clerk’s (later secretary’s) letter books, 1869-1917; deputy group secretary’s files, 1949-1964; hospital secretary’s files, 1962-1975; general correspondence and papers, 1857-c.1984; visitors’ reports, including commissioners in lunacy (later Board of Control) reports, 1846-1957, governors’ reports, 1875-1909, York A Group house committee visitors’ reports, 1951-1971, lady visitors’ reports, 1814-1905, and consulting physician reports, 1842-1862, 1883-1902; medical superintendent’s report books, 1842-1886, 1897-1907, 1936-1948; papers of Dr H. de Burgh Warren, Consultant Psychiatrist at Naburn and Bootham Park Hospitals, 1971-1986; chapel books, including chaplain’s report books, 1831-1892, 1933-1960, registers of services, 1949-1973, and chapel service books, c.1861-c.1933; printed material relating to York Lunatic Asylum and Bootham Park Hospital, including notices of meetings, programmes for events, press cuttings and articles on the history of the institution, 1874-1990s; printed material concerning lunacy, including reports, pamphlets, and related papers, 19th century-1954; photographs relating to the hospital and its staff, 19th century-1998.

Land and building records, comprising plans and drawings, 1849-20th century; deeds and papers, 1816-1963.

Financial records, comprising general ledgers, 1879-1908; expenses ledgers, 1856-1923; cash books, 1867-1949; monthly cash account books, 1880-1886; secretary’s cash account book, 1927-1931; bought day book, 1908-1923; farm account book, 1827-1916; arts and crafts account books, 1932-1949; financial summaries, annual accounts and balance sheets, c.1813-1947; bank books and related papers, 1831-1879; papers relating to subscriptions, donations, bequests and special funds, 1772-1948; papers relating to investments, stocks and shares, 1835-1917; insurance policies and valuations, c.1815-1938; papers relating to tax and duties, 1870, 1912; papers relating to patient accounts, including account books, maintenance contracts and correspondence, 1823-1975; salaries and wage books and related papers, 1822-1963.

Stores and equipment records, comprising inventories, 1891, c.1929; papers relating to provisions, 1878-1919; other goods and equipment, 1826-1932.

Establishment records, comprising papers concerning staff appointments, 1857-1908; registers of staff, c.1900-1923, c.1950-1970; nursing records, 1905-1960s.

Patient records, comprising admission forms and reception orders, 1846-1919; admission registers, 1777-1960; medical registers, 1907-1948; removal orders and orders for transfers, 1889-1903; discharge, transfer and deaths registers, 1845-1948; case books and notes (with some gaps), 1863-1970; voluntary boarders’ case books, 1895-1932; indices of patients, 1870s-1964; registers of mechanical restraint and seclusion, 1890-1954; weekly report books, 1845-1944; daily numbers books, 1935-1960; registers of dysentery and diarrhoea, 1946-1958; registers of patients’ doctors, 1937-1952; post mortem notes, 1941-1959; registers of deaths and undertakers, 1955-1970; ward report books, 1912-1961; papers and correspondence concerning patients, 1863-1970; day hospital records, including admission book, register of attendances and daily report books, 1961-1966; occupational therapy records, including attendance register, book of goods received, referral forms, and related papers, 1950-1990s.

Accruals

Further accruals are expected.

System of arrangement

Conditions of access and use area

Conditions governing access

Records are open to the public, subject to the overriding provisions of relevant legislation, including data protection laws. Many of these records contain sensitive personal and confidential information which is likely to be restricted under data protection legislation and the terms of deposit. For records less than 100 years old, please contact the Borthwick Institute via email or letter.

Conditions governing reproduction

A reprographics service is available to researchers subject to the access restrictions outlined above. Copying will not be undertaken if there is any risk of damage to the document. Copies are supplied in accordance with the Borthwick Institute for Archives' terms and conditions for the supply of copies, and under provisions of any relevant copyright legislation. Permission to reproduce images of documents in the custody of the Borthwick Institute must be sought.

Language of material

  • English

Script of material

Language and script notes

Physical characteristics and technical requirements

Finding aids

A typescript finding aid, to file level, is available for consultation in the searchroom of the Borthwick Institute.

Allied materials area

Existence and location of originals

Existence and location of copies

Related units of description

For related material held by the Borthwick Institute, see The Retreat archive which includes sermons, annual reports, rules and regulations, letters, pamphlets and news cuttings relating to the early history of York Lunatic Asylum. The Atkinson Brierley Archive also contains some plans of the Asylum, whilst the archives of Clifton Hospital contains a draft copy of the controversial 1861 Agreement between the York Asylum and the Corporation under which the Asylum took the York City pauper lunatics. Information about the development of the hospital post-1948 can be found in the archives of York ‘A’ Group Hospital Management Committee and its successors; this includes minutes and annual reports.

York Explore also hold additional material relating to the hospital, including sermons, rules and regulations, pamphlets, plans and correspondence, as well as microfilm copies of local newspapers, the 'York Courant' and the 'York Herald,' which contain references to the development of York Lunatic Asylum.

Related descriptions

Publication note

Anne Digby, 'From York Lunatic Asylum to Bootham Park Hospital,' Borthwick Papers No. 69 (York, 1986)

Notes area

Alternative identifier(s)

Access points

Place access points

Name access points

Genre access points

Description control area

Description identifier

Institution identifier

GB 193

Rules and/or conventions used

ISAD (G): General International Standard Archival Description, International Council on Archives (2nd edition, 2000); Rules for the construction of personal, place and corporate names, National Council on Archives (1997).

Level of detail

Dates of creation revision deletion

2015-07-27

Language(s)

  • English

Script(s)

Sources

Accession area