- c 1937-1980 (Creation)
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9 boxes and 9 rolls
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During the early 1930s there was an acute shortage of general hospital accommodation in York. Most general services were provided by the voluntary York County Hospital, but this only had about 180 beds. In 1930 York Corporation became responsible for the general hospital accommodation at the City Infirmary, that is, the wards of the former workhouse or York Institution which was taken over after the abolition of the Poor Law Boards of Guardians under the 1929 Act and the transfer of their functions to local authorities (see under St Mary's Hospital). However, accommodation at the City Infirmary was poor: it housed mainly chronic and aged sick and was without surgical facilities.
In 1930-31 conferences were held between representatives of York Corporation and the York County Hospital with the aim of drawing up a joint scheme to provide for new general hospital beds either at the City Infirmary or at the County Hospital or both.
Although the economic situation was unfavourable, the York County Hospital embarked on an extension and modernisation scheme during the following few years (see under York County Hospital). In the meantime, York Corporation decided to apply to the Ministry of Health for an extension to the City Infirmary in order to provide beds for medical and minor surgical cases. The initial aims of the scheme were modest: the old Infirmary would be extended by about 180 beds so that pressure could be taken off the County Hospital which would continue to accommodate the main acute medical and surgical services for the City.
Plans were prepared in 1934 for the addition of three new blocks at the Infirmary: for 60 medical, 60 surgical and 60 children's beds. But between 1934 and 1938 the plans were extended and became more ambitious. The finalised scheme created a new City General Hospital, independent of the City Infirmary (although adjacent to it), with a separate address and entrance on Haxby Road. It would eventually comprise six large ward blocks with 360 beds, an administrative block, laundry, boiler house and kitchen. Building began in October 1938.
However, with the onset of war in 1939 less than half the scheme was completed: three ward blocks were built, for men, women and children, with admission block, operating theatre, X-Ray facilities, a massage and electrical department and other ancillary rooms and a boiler and plant house. The existing nurses home was also extended. But administrative, kitchen and laundry facilities had to be shared with the City Infirmary. Post-war building constraints meant that the remainder of the projected scheme was put on hold, and eventually superseded by other developments after 1948.
The new City General Hospital was officially opened on 5 November 1941 by Alderman William Wright, Chairman of the City's Health Committee. The hospital was administered by the Health Committee, under the general control of the Medical Officer of Health, and was in the full time charge of a Medical Superintendent, a Deputy Superintendent, Matron and and two Assistant Medical Officers. Consultants gave their services part time. By 1945 the consultant staff comprised three General Physicians (one with a special interest in children's diseases, one in skin diseases and the other in chest and heart cases), two visiting General Surgeons, one Eye Surgeon one Ear Nose and Throat Surgeon, with an assistant, and one Gynaecologist. An Orthopaedic Surgeon was shared with the York County Hospital. Some of the consultants were pure specialists, but others were GPs.
The hospital was intended for the treatment of acute illnesses amongst City residents; however, in 1942 and 1943 agreements were made with the East, West and North Ridings to treat patients outside the City boundaries and within these areas. All patients had fees levied on a sliding scale according to income, but subscribers to the York Hospital Contributory Scheme were eligible for treatment by means of the Scheme's voucher system. Twelve beds were set aside for private cases, and fees for these were between six and a half and seven guineas, with extra fees for operations and other treatments. Private patients were also allowed to use the services of their own doctors by arrangement.
The hospital was classified as a Grade 1 war time Emergency Services Hospital and took military patients under the Emergency Hospital Scheme. The Emergency Medical Service accommodation at Poppleton Gate and Poppleton Hall, which had been in the hands of caretakers since the beginning of the war, was annexed to City Hospital when the latter opened, and EMS patients treated at the hospital were transferred to the annexes as they became convalescent (see under Poppleton Gate Hospital and Poppleton Hall Hospital).
Opening under war time conditions caused problems for the new hospital. Although it was officially opened in November 1941 it was not able to admit patients until January the following year because of the difficulty of procuring the necessary furnishings and equipment.
On 1 January 1942 the first women's ward opened and a few women with serious illnesses were transferred from the City Infirmary. On 13 January a men's ward opened with a similar transfer. During February patients were admitted in small numbers. A children's ward opened in March and plans were made, with the arrival of equipment and the sterilising plant, to make the operating theatre ready for use: one or two trial operations were performed and the theatre was in full working order by the end of the following month. Three days after opening it underwent a severe test when on the night of 29 April York suffered a major air raid and the hospital received 52 casualties.
Patient numbers increased steadily during the remainder of 1942 as the remaining wards opened, the last one coming into use in early 1943. The hospital was running at full stretch by the end of its second year. It was recognised by the General Nursing Council as a complete training school for female nurses in November 1942 and for male nurses in May 1943.
130 beds were available in 1942, with an average daily occupancy rate of 90; in 1945 the full complement of 180 beds was in use, plus 16 beds for skin cases, and the average daily occupancy was 154. Total in-patient admissions were 1,843 in 1942, 3,092 in 1943, 3,067 in 1944 and 2,915 in 1945. Operations numbered 870 in 1942, 1,381 in 1943, 1,596 in 1944 and 1,655 in 1945. There was also a range of out-patient services: as well as general consultative medical, surgical, gynaecological and ENT clinics there were also special TB clinics, a chiropody clinic and a skin clinic. Admissions to the general out-patient clinics totalled 6,902 in 1945, while attenders at the skin clinic were 2,234. The X-ray and physiotherapy departments were also busy: attendances in 1945 were 5,108 and 21,230 respectively.
City General Hospital was built to the latest modern design standards. Wards were light and airy and well furnished with modern conveniences: each ward had its own self contained kitchen, a sun balcony and a visiting room; bedside facilities included lighting, radio and call systems. The operating theatre had ceiling panel heating, a special ventilating system and the latest equipment. The Hospital Survey, published in 1945, commented that it would be 'of the highest class when fully developed'. In the meantime there were some difficulties: for example the physiotherapy and X-ray departments were in temporary accommodation; administrative services had to be accommodated in other buildings on the site, rented from the Public Assistance Committee which ran the City Infirmary and Institution.
With two general hospitals in the City, the opportunity was taken to co-ordinate facilities. A York Hospitals Joint Advisory Committee was formed in 1940 with representatives from York Corporation and York County Hospital. The Committee recommended that street and work accident cases should be taken in alternate months by the County and City Hospitals, and the first patients taken under this agreement were admitted at City Hospital in July 1942. The opportunity was also taken by the City's Health Committee and Department to rationalise and further co-ordinate the local authority run hospital services in the light of the new accommodation and facilities. TB contact and follow-up clinics were located at the new hospital (see under Chest Clinic, York). From February 1943 the Superintendent of the City Hospital also became responsible for the administration of the Fever Hospital at Yearsley Bridge, and its Bungalow Hospital annexe at Huntington (see under Yearsley Bridge Hospital and Bungalow Hospital), thus providing a combined medical 'grouping' of over 600 beds. In addition, admissions to the City Infirmary were henceforth made through the admission department of the City Hospital to ensure that only patients with chronic illness entered the Infirmary.
The Corporation was very proud of its 'fine modern hospital' but its period of control was short lived and City Hospital entered the NHS under York A Group Hospital Management Committee in 1948. The loss of its hospital services was keenly felt, and Dr Catherine Crane, York Medical Officer of Health commented in her Report for 1948 that, after one year of the NHS, 'The hospitals are not in my opinion, giving a better service to the people than they were under the local authority and voluntary administration.'
York A Group inherited two general hospitals in 1948: York County Hospital and York City Hospital. One of the first tasks was to integrate their services and administration. For example, the two hospitals took emergency and casualty admissions on alternate weeks from 1950. Appointments and records staff were reorganised under a single Group Records Officer in 1951: this paved the way for the development of a single admissions system for the general hospitals (which by 1954 also included the Military and Fulford Hospitals as well as City and County and their annexes). Out patient clinics were divided between the general hospitals when further rationalisation of general hospital services took place in the mid 1950s: for example, the skin treatment centre at City was modernised in 1955 and all skin treatments were centralised there; ENT out patient services were similarly centralised at County Hospital in 1956.
Reorganisation within City Hospital itself took place. An end was put to the previous system of management: the offices of Medical Superintendent, Clerk and Steward were abolished, and when the Matron retired in 1953 her successor was given responsibility for City Hospital alone, rather than for the Grange and Bungalow Hospitals too.
Because the City was a new building, it did not need significant updating, but difficulties were caused due to its incomplete state. The kitchen at the Grange, which was also used by City, was found to be unsatisfactory and was re-equipped and reorganised. Many departments remained in unsuitable premises: for example, the Pathology Laboratory was housed in a room intended for a small ward and the pressure on its accommodation became so great in 1952 that the service nearly broke down and an adjacent side ward had to be taken over for use. The single theatre was inadequate for the hospital's needs and the accommodation for casualty and out patients was also limited. The decorative state was described as 'deplorable' in 1951 and a major programme of repainting was undertaken.
There were some minor structural alterations in the early 1950s: in 1953-4 day rooms on four wards were divided into sisters' duty rooms, and relatives' waiting rooms and a canopy was built over the ambulance bay. The Nurses Home was improved in order to attract more staff. Extensions were also made to the services of the X Ray, physiotherapy and pharmacy departments. Much additional equipment was also purchased for the hospital in order to bring it up to the desired standard.
Some Group services were centralised at City Hospital: the pharmacy department manufactured galenicals for the whole Group and the Group transport system was operated from a base at the hospital.
The early years of NHS administration were hampered by constraints on building, lack of capital, insufficient hospital beds and staff shortages. The City Hospital annexes of Poppleton Gate and Poppleton Hall were initially underused due to lack of staff. However by the mid 1950s their usage had improved, particularly for post operative patients, and in 1953 Poppleton Gate was purchased and the lease of Poppleton Hall extended.
By 1954 sufficient integration of the hospitals had taken place for York A Group to present its annual reports of developments under the headings of Group services rather than of separate hospitals. But much remained to be done. A major boost towards integration came with the opening of Fulford Hospital in 1954 which significantly increased bed numbers and space (see under Fulford Hospital). With a total of 734 general beds at Fulford, County, City and Military hospitals plus the three annexes of Poppleton Gate, Poppleton Hall and Deighton Grove, there was much more scope for a rational centralisation of services at particular premises. Thus, all beds for gynaecology and dermatology were concentrated at Fulford Hospital and plans were made to concentrate particular specialties at each hospital. The long term aim, achieved during the 1960s, was for the County Hospital to be the centre for general surgery, accident and emergency services and for ophthalmic, orthopaedic and paediatric services, and also the site of the main pathology and out patients departments. Medical work, meanwhile, was to be centred at City Hospital, which would also house the Ear, Nose and Throat department, as well as taking overflow general surgery and retaining some out patient services. All developments at City Hospital from the late 1950s were part of this overall scheme.
Thus, the accident and casualty department at City was closed in 1960-1; orthopaedic work was also transferred to County Hospital. The City children's ward was closed in 1967 as all paediatric services were transferred to County. The former children's ward became a medical ward and cardiatric monitoring unit, expanding the original small unit established at City in 1965. A resuscitation 'crash call' team had meanwhile been organised for the hospital in 1964. A new ENT ward and theatre was opened at City in 1968, thus freeing the former joint Eye and ENT ward at County to become an ophthalmological unit. In 1968 an intensive care unit was established at City: this was a three bedded unit with specialist equipment and staffing. In 1970 a new consultative out patients department was opened, with consulting, examination and treatment rooms plus an endoscopy suite and X Ray facilities. The old out patients department was adapted to provide a radio isotope department and a gastroenterology laboratory. At the end of these developments, City Hospital comprised four medical wards, a cardiac monitoring unit, an intensive care unit, two surgical and one ENT wards and an X Ray department plus the new out patients department and endoscopy suite.
Although only so much rationalisation could be achieved given the large number of different hospital buildings in York up to the mid 1970s, nevertheless integration was developed as far as possible. Where departments had to be retained at more than one site they were run as an combined service: for example, pathology, pharmacy, X Ray services, blood services and sterile supplies. City Hospital became the location of a central syringe service for the whole Group in 1962, under the new post of Group Chief Pharmacist. This paved the way for the establishment two years later, at Yearsley Bridge Hospital, of a Group Central Sterile Supply Unit for syringes, instruments, bowls and dressings.
Another function gradually integrated between the hospitals was nurse training, and the formerly separate nursing schools at City and at County Hospitals were slowly amalgamated. A single Principal Tutor was appointed to head classroom teaching at both schools in 1954, and from 1956 nurses from each hospital were grouped together for some lectures. By the early 1960s the two preliminary schools had been amalgamated and located at City, while classroom teaching for second and third year nurses was being undertaken in 'block' periods at County. On 1 January 1963 the City, County and Fulford Hospitals became one training school known as the 'York School of General Nursing', although nurses continued to gain their experience at all three hospitals until the opening of the District Hospital in 1976.
To reflect the rationalisation of hospitals on the basis of function, the old individual hospital house committees were replaced in 1970 by two larger committees to cover the predominantly medical and surgical areas of the Group. By this date, plans for a new, replacement district hospital for York were progressing. The 1962 White Paper A Hospital Plan for England and Wales had envisaged that after the new hospital was completed City Hospital would become a geriatric hospital, and developments during the 1960s took place with future conversion in mind.
The major structural alterations and additions to the City Hospital buildings between the late 1950s and the early 1970s were partly undertaken as a result of the rationalisation policy discussed above but also included some general improvements to staff and patient facilities. For example, a staff recreation hall was completed in 1959, the open verandas on the wards were enclosed to provide day rooms, new hospital boilers were installed, extensions were made to the X Ray department, and wards were upgraded. The new 32 bedded ENT ward and theatre of 1968 was one of the largest extensions to the building: this was a single storey L shaped ward, and provided a new hospital entrance at the junction of the new ward with the existing hospital corridor which was also extended to allow space for extra offices. It was noted that this new extension could be converted to a geriatric ward at a future date. The other major structural extension in this period was the out patients department of 1970.
Throughout this period, patient numbers reflect City's continuing role as a busy central general hospital. It had 180 beds in 1950 and in that year treated 3,595 in patients and 20,476 out patients and casualty patients, with 2,248 operations performed. In 1953 there were 4,230 in patients, 2,957 operations and 21,682 attendances at out patients and casualty. Bed numbers remained the same until the major extensions of the 1960s: there were 206 beds, including those in the ENT ward, in 1967. Out patient numbers in 1963 (after the transfer of casualty cases to County Hospital in 1961) were 15,176. It was noted in 1964 that general in patient numbers had increased by 30% since 1955, although the average length of stay had fallen, and out patient services had also increased. In 1973 there were 6,854 in patients and 27,078 out patient attendances.
City Hospital closed as a general hospital on 20 November 1976 after the opening of the York District Hospital which superseded all the existing general hospitals in the city.
In accordance with existing plans, the adaptation and conversion work for City's new function as a geriatric hospital began in March 1977. The conversion was in three parts. First, two new two storey sanitary annexes were built adjacent to the middle of each of the three main ward blocks. The main ward areas were subdivided into bays with from four to sixteen beds plus a number of existing single rooms. Secondly, ward 7 was adapted into a rehabilitation department with physiotherapy and occupational therapy services. Thirdly, the former out patients department was converted to a day hospital. The work also included major upgrading and refurbishment work to the premises.
Although City Hospital was intended to replace the services of old and inadequate St Mary's Hospital (which was on the adjacent site to City Hospital, and housed in part of the former workhouse premises), as well as replacing the geriatric wards at Fulford Hospital, the available apace at City was not quite enough, so some of the St Mary's premises had to be retained. While St Mary's closed as an independent hospital in May 1979, four of its wards were retained and substantially upgraded to become part of the new City Hospital; they were joined to the six existing City wards by a long link corridor. However, the work of upgrading the retained former St Mary's wards did not begin until May 1979 after the main part of the new City Hospital was opened. The future occupants of the upgraded wards were temporarily housed in other wards in the former St Mary's building which were due to be demolished after the completion of the whole City scheme.
City Hospital was reopened as a geriatric hospital between 7 and 14 May 1979; the official opening was performed by Harold Wilson on 6 July 1979. The new hospital was to have a total of 245 beds (including those in the four former St Mary's wards), plus a rehabilitation department and a 50 place day hospital. However, some geriatric beds were retained elsewhere: 60 at York District Hospital, 18 beds at Bungalow Hospital and 24 at Selby War Memorial Hospital, making a total of 347 geriatric beds in York Health District in 1979.
City Hospital remained the centre of hospital services for the elderly in York until the mid 1990s. In 1993, however, a major review of services for the elderly was carried out by York Health Trust. A new package of measures envisaged the development of services for the elderly within the community, and the centralisation of acute rehabilitation services for the elderly at York District Hospital, leading to the eventual closure of City Hospital.
Between 1993 and 1996 this policy was developed. Acute elderly services have all been transferred to York District Hospital where the existing four wards have been increased to seven: three of these are acute medical wards, two are rehabilitation wards, one is a stroke unit and one is a psychiatric/elderly assessment ward. Meanwhile, many elderly services are now housed in a community setting. Two new Community Rehabilitation Units for the Elderly (CRUES) were opened in early 1996, incorporating in patient, day, rehabilitation and respite care: Whitecross Court CRUE is situated on part of the City Hospital site, while St Helen's CRUE has been built jointly with Meadowfields Community Unit for the Elderly (a unit for confused elderly) at Nelson Court off Tadcaster Road, at the south end of York. The new CRUES complement existing facilities for the elderly at St Monica's Hospital in Easingwold and at Selby War Memorial Hospital and have been designed to provide care for the elderly in their own houses if possible or else in a community setting.
Patients and services at City Hospital were gradually transferred to York District Hospital, and to the CRUEs between 1993 and 1996, and City Hospital was closed on 6 September 1996. The site was sold and the buildings have been demolished.
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