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The Establishment of the Eastby Sanatorium
The proposal to build a tuberculosis sanatorium at Eastby for poor people from Bradford, had first appeared in the Leeds Mercury on 20th September, 1900. The Bradford Board of Guardians, who managed poor relief for paupers in the city, were looking for a countryside location to send their TB patients according to the Nordach ‘open-air’ method of treatment. The Board had been discussing the problem for three years, and as the annual number of such patients continued to rise, reaching 144 by 1900, they finally agreed to build a sanatorium on the hill above Eastby.
Several sites within 20 miles of Bradford were visited and expert advice sought – the short list coming down to Eastby and Grassington. Eastby was chosen for its sheltered position, good water supply, and access to a railway. Expert Dr Thurnham, who ran a well-known private clinic in Bristol, declared it the most suitable he had ever seen in England. [1]
The proposals drew much attention both locally and nationally – although the principles of TB sanatoria were now well established in Britain, these were all either charitable (offering a very limited number of places to the ‘deserving’ poor) or private and therefore inaccessible to poor people who could not afford the fees. The decision of the Bradford Guardians to build a sanatorium for the poor, and to support it through the poor rates caused a good deal of national interest and the experiment was keenly watched over the next few years by other Poor Law Unions. It was clear from the outset that the Bradford guardians would need to raise extra income to maintain the sanatorium and even before construction began, in order to find extra funds, Bradford offered to reserve up to 6 places each to patients sent by the Keighley and Skipton Unions, to be paid for out of Keighley and Skipton poor rates. The offer was accepted. [2]
The foundation stone for the hospital was laid in October 1902, by the chairman of the Bradford Board of Guardians, with the promise of 42 beds when the hospital was completed. The Duke of Devonshire leased a 20 yard wide strip of the neighbouring woods for the use of the hospital patients, and to provide shelter from extreme weather conditions. [3]
Opening Ceremony
The official opening took place in November 1903 . The newspaper reporter was in lyrical mood on that day writing:
“The first Poor Law Sanatorium. Bradford Guardians’ notable undertaking.
Scarp and scaur and fell, and a range of rolling moorland stretching out to the blue high-backed ridge of Rombald’s Moor faintly shimmering in the hazy distance; an unusual glint of sunshine to ring out the golds and russet browns of the autumn foliage, the dead greens of the chequered fields, in a harmony of subdued colouring. Behind, Eastby Crag clothes in dead bracken, to the right, the smoke of Skipton softened to a silver grey haze by the three miles intervening; and to the left more autumn tints n a wooded tract in which firs are predominant. Around all, the free moorland air, sweet and pure and free from taint of towns – unkind winds shut out on the north by Eastby Crag, on the left by the wood. Such is the situation (and such were the conditions yesterday when it was formally opened) of the new Bradford Poor Law Union Sanatorium at Eastby.” The writer described the wooden pavilions with their red-tiled roofs, “practically all doors and windows” (the latter deliberately without glass to ensure the full benefits of fresh air) reminding the writer of seaside bungalows, but they were only half-completed. There was still work to be done the grounds too, particularly the paths and muddy slopes, needed landscaping. [4]
[The full transcript of this report, with its description of the facilities, can be found in the appendices]
The ceremony was attended by Guardians and invited guests, including the MP from Bradford, and the Mayor of Bradford, the government inspector of Poor Law Unions, and the chairman of the Skipton Union. They were collected from Skipton railway station, and were driven to Eastby by horse-drawn transport. But they had to ‘scramble over country’ up Eastby Bank by themselves, as this hill was too steep for the horses. So many local people from Eastby, Embsay and Skipton turned up to watch proceedings, that a large number were turned away, having not realised they needed an admission ticket to get into the grounds. Rev. Charles Vernon Brown, vicar of Embsay-cum-Eastby, began the proceedings by reading prayers, before the ceremonial gold key was handed to Bradford M.P., Sir Francis Powell to open the door to the administrative building. There was already an open acknowledgement that the financial cost may prove be too much of a burden for the rate-payers, and that fee-paying patients may have to be taken in to compensate. The inevitable speeches which followed thus included the surprise public announcement that some private patients might be admitted.
Private sanatoria were already quite common across the country and on the Continent, but Bradford Board of Guardians were the first to offer specialist facilities for the working classes who were dependent upon the Poor Law system to provide medical treatment. Eastby Sanatorium was lauded as a unique innovation in English poor-law provision, and attracted the interest of an influential medical journal, “The Hospital”, which published a detailed description. [July 23 1904, p. 300];
“The Bradford guardians are to be congratulated on carrying out their scheme for providing accommodation for their consumptive patients,” it read. “… It is true that private and charitable sanatoria are springing up in all directions, and that in some of these patients are admitted at very low rates of board; but this is an example of what can be done for the very poorest classes by an entirely rate-supported institution.”
The buildings were described in some detail. There were two pavilions for the patients, and a separate block for the dining room, offices, and staff accommodation; The windows were large and corridors open to ensure full ventilation and access to fresh air. The architects had been advised that a veranda was unnecessary – the medical journal, however, was critical of the lack of a balcony for patients to sit outside. It was also critical of the practice of putting several beds in each room, but acknowledged that since this was a publicly funded building, costs had to be kept as low as possible.
[a full transcript of the Hospital Journal review can be read in the appendix].
In addition to offices, kitchen, washhouse, storerooms, living quarters for staff, ‘conveniences’, and common rooms, there were 10 rooms containing the 21 beds for patients (The original proposal had been for 42 beds). The whole complex had its own electricity generating plant.
The sanatorium attracted a great deal of attention in its early days and many representatives from other poor law unions paid visits. There was even interest from abroad. Within a few years of its opening an International Congress on TB in Washington, USA, asked to see the plans of Eastby Sanatorium. [5]
The Sanatorium was run by the Bradford Board of Guardians until 1921, then privately until 1940.
Medical Officers
Appointments were usually made on short term contracts often for one year, with a view to annual renewal. From the outset, high staff turnover proved problematic. The reasons for this are unclear as the numerous resignations were not accompanied by explanation in the minutes of the Board.
The doctors in charge were a Chief Medical Officer, and an assistant Medical Officer, who were resident on-site. But between 1903 and 1914 there were 9 changes in appointments of doctors, which made management of the hospital inconsistent. It is noticeable that the majority of the medical officers did not include their tenure at Eastby in their career resumés listed in the annual Medical Register, the official UK directory of doctors and surgeons, implying that they preferred to forget their time there.
The first medical officer to be appointed was Dr. Howard George Pesel, but he barely lasted a year at Eastby and left in August 1904, to become medical officer at other sanatoriums.
After him there were, in quick succession, 7 more appointments of Chief Medical Officer, until finally, Dr. Catherine Arnott arrived in 1914, to usher in a much more settled time until the outbreak of WW2, when her retirement due to old age left the institution once more in a vulnerable state. Similarly there were several Assistant Medical Officers before 1914. Some of the appointees included the following:
1903 -1904. Dr Howard George Pesel. Resigned after less than a year.
1904 – 1907 Dr. Hugh Bixby Luard. (not re-appointed)
1907 – Assistant Medical officer, William Lang Hodge resigned a month later.
In absence of applicants for the post, a succession of locums had to be hired until the appointment of:
1907 [October] Dr. Harris – Assistant Medical Officer (resigned after one week)
1907 – 1909. Dr. John Tatureau Crowe, Assistant Medical Officer (resigned in May)
Dr Crowe’s resignation reached the newspapers, as he sent an open letter to the Guardians. He had been the subject of an official investigation after charges were made against him regarding his management style. Despite being exonerated he had already decided, he wrote, to “be free for a time from all the cares and responsibilities appertaining to a large institution like this.”
Interestingly, at this point the Guardians considered appointing a lady doctor to be in charge, another innovative move by this Poor Law Board. The post was offered to Dr. Margaret MacDonald, then the assistant medical officer at Bradford Workhouse, whose contract there was due to expire soon [Bradford Daily Telegraph, 31 May 1909]. But she refused on the grounds it would mean accepting a lower salary (even though it came with free accommodation, food and laundry expenses). Dr Benjamin Holroyd Slater was appointed instead as the new Chief Medical Officer. [6]
Nevertheless by August the same year, Dr Slater appears to have left, as MacDonald was again offered the post – on the higher salary she had wanted – and this time she accepted. [7] In March 1910 Dr MacDonald contracted scarlet fever. Locum were hired to fill the gap in the hope she would return, but at the end of her year’s tenure, MacDonald resigned. [8]
In her place another woman was appointed, Dr Mary Kidd. [9] She too decided to leave after her first year’s contract had expired, and again the Board appointed another woman, Dr Ellen Beales as Chief Medical Officer (By coincidence, 2 years later she married Dr Benjamin Holroyd Slater, who had resigned so suddenly back in 1909 after less than a month in this same post,). Soon she was followed, in 1912, by Dr Clara Eglintine, who resigned within the year.
After her, a male doctor was appointed, but William Campbell Lyons did not last long in the post either. Originally from Londonderry, Ireland, he had begun his career as a surgeon at St. Luke’s Hospital, Bradford, where many pauper patients were sent by the Guardians. Having been there for three years, he was therefore a good candidate for the post of Chief Medical Officer at Eastby Sanatorium. But he soon left to work for South Shields Corporation, where he stayed for the rest of his career. [10]
The reputation of Bradford for hiring women in important medical posts was noticed by other authorities. At a meeting of the Board of Guardians for Warrington in 1913, a member had “insinuated” that the post of Assistant Medical Officer could be filled by a “lady doctor” but “the suggestion did not find favour” apparently on the grounds that “the nurses would not like the idea.” Mr McKinley warned the Warrington Guardians against appointing women as Chief Medical Officers. “I have particularly in mind the case of the Bradford Union Sanatorium at Eastby near Skipton. That institution was opened some ten years ago, with a lady resident doctor in charge… The Guardians persisted in this arrangement, although the medical officers were constantly changing; it was exceptional for one to remain much over twelve months. “ He noted that a male doctor had recently been appointed, despite having to pay a higher salary. But he admitted that a woman as an assistant medical officer would be acceptable. “A man continues the supreme authority, and one of the other sex would necessarily be subordinate, and it is more than conceivable that in such conditions she might render peculiar service.” [11] By 1912 the Guardians were increasingly uncertain about the effectiveness and economic viability of the hospital, but went ahead in April 1914 to appoint another female Chief Medical Officer: the remarkable Dr Catherine Arnott.
Nursing and Domestic Staff
Domestic staff also came and went in rapid succession, many of them also on one-year contracts which were often not renewed, and many others simply resigned, again for reasons not stated in the Board minutes.
Their names are less well recorded, but include:
1903 – Tom Marshall, handyman (non-resident)
1903 – Miss Rosetta Harris, of Shoreditch, was the matron, in charge of 4 nurses.
(trained at Kings College; had worked at Bethnal Green & Shoreditch; b. 1865 in Lee, Kent)[12]
1903 – Mrs Hettie E. Forman the cook, was assisted by 2 housemaids. (resigned after one year)
[possibly nee Harding; wife of Walter Forman; born Peckham 1873; By 1911 living in Bromley, Kent]
1904 – The next cook (name not recorded) resigned after just one month
1904 – Gertrude, housemaid (resigned)
1907 – Tom Thornton, gardener (resigned 1907)
1907 – Miss S. E. Hutton, Matron
1908 – Miss Margaret Cox, Matron (trained at Bradford Poor Law hospital and had been Sister-in-Charge at Eastby) ; Matron Cox resigned in 1909 on grounds of ill-health (immediately after the Firth case)
1907 – 1912 – Robert Rimmer the gardener
1907 to 1909 – Smith Firth, the handyman (“resigned”)
1908- Feb 1909 – Annie Martin, cook (resigned)
1908? – Miss Rosetta Harris, Superintendent Nurse; trained at King’s College London and had worked at Bethnal Green and Shoreditch
1909 – Miss Lee, matron
1909 June – Henry Blackman, handyman (fired in 1911)
1909 – Annie Greatorix, housemaid
1911- 1912 – Tom Thornton handyman (resigned)
1911 Dec –1912 July – Elizabeth Ruston, cook
1911 – Elizabeth Dickinson, kitchen maid
1912 June to Oct – Ethel Harvey, housemaid (resigned)
1913-4 – Agnes Mary Jones, 22 from Wales, housemaid – killed in cycling accident
Private Edwin Ellis (Duke of Wellington’s Regt.) was transferred from the 2nd Canadian General Hospital in France, where he had been treated for wounds to the face. [Bradford Roll of Honour, Bradford Daily Telegraph – 8 October 1917] Before enlisting he had worked at Eastby Sanatorium, and lived at The Rookeries, in the village.
1940 – Harry Fozard – dismissed after assaulting a girl employed at the sanatorium
There was also Harold Quarmby, teacher, who according to his obituary, spent three years at Eastby ( while himself recuperating from ‘a serious illness’) He died in 1939, aged 47.
Salaries were kept low by the provision of free board and lodging, which included laundry expenses (there were no facilities on site – all clothes were regularly sent to Bradford Workhouse to be washed, except for the handyman, who lived off the site.
The guardians were strict with these employees – they refused Firth’s request to have every other Saturday off, declaring his contract was to be on duty seven days a week; The gardener, Rimmer, was instructed not to partake of free meals at the institution (although the handyman was allowed 3 meals a day).
Despite the long history of resignations and sackings, the minutes of the Board of Guardians do not record any more staff resignations following Dr Arnott’s appointment in April 1914. The situation apparently stabilised under her management, perhaps partly due to the fact that after a couple of years she leased the sanatorium from the Board, which gave her a degree of independence from their supervision. In 1915 she took out her lease on the sanatorium and the Guardians took no further responsibility for staffing. She appointed her own assistant medical officers, including Dr Dorothea L. Baird (who left in May 1928 to become assistant medical officer at Greenock Corporation).
[Part four of this series will focus on some of the careers and lives of staff and patients]
The Patients
The first patients arrived on November 17th, 1903, Mr. W. Baldwin being paid to bring them up from Skipton railway station by horse-drawn traps. By May 1904 all 21 beds were occupied so the dining room was converted into a dormitory to accommodate 5 more. By March the following year the number of beds had been increased to 29 to cope with demand. The maximum number of patients soon reached 31.
In the regular Newspaper column “From the Town Hall Tower, by the “Oracle”, a journalist praised the work of the Board of Guardians. “When I was in the “House” [workhouse] the thing that struck me was the large number of consumption cases. Of course, the Guardians send all the hopeful cases, those in the early stages, to Eastby Sanatorium, where constant fresh air, proper food, and regular habits have established some notable cures.” Of the more advanced cases, who were sent instead to the infirmary in Bradford, the writer declared, “the mark of doom is on all their faces.” [13]
Eastby Sanatorium was always intended for those patients who were in the first stages of consumption, who would benefit from early intervention with the open-air treatment. Until 1909, the patients were all male as it was decided that priority should continue to be on male breadwinners, reflecting the Poor Law administration’s main focus on reducing the burden on the poor rates, rather than an emphasis on public health and social welfare. By June 1907 300 patients had been treated, 228 of them discharged to return home.
A year later there were 77 patients in the wards, Many were referred by the Bradford Poor Law Guardians, but by this time a larger number came as private patients. A few others were sent by the North Brierly Union, the Royal Infirmary at Bradford, Huddersfield Union, Keighley, Skipton, Settle and Pontefract. Over the following years patients also occasionally came from such places as Knaresborough, Blackburn, Steeton and Halifax. By July 1912, of the 27 patients resident in the Sanatorium on the day an inspection took place at Eastby, only 5 were found to have come via the Bradford Poor Law Union. This was partly due to the Guardians seeking patients from elsewhere to help pay for the sanatorium’s running costs. During the First World War the numbers of patients at any one time declined from around 20 in 1914, down to 8, which was not considered economically viable for the Poor Law Union. By this time the facilities for T.B. treatment provision at St. Luke’s hospital in Bradford was providing for many more patients than before, and the demand for specialist separate sanatoria was declining.
Life in the Sanatorium – Early Days
In their regular newspaper column “Jottings by an old journalist”, a visitor wrote in 1910:
“A Model Sanatorium. Stranded at Skipton one day, I walked into the country a little way, and pied on the horizon a picturesque block of re-roofed buildings. Inquiring of a native, I was informed that the place was the Bradford Union Sanatorium for pthisical {sic} patients. I determined upon a pilgrimage to it, and found it beautiful for situation near the village of Eastby, sheltered under a hill on the edge of extensive Moorland. I was shown over the place by the matron, and found there over 30 male patients in charge of a lady doctor. Most of the men were enjoying themselves in the open-air. There are pleasant arbours in which they may rest, and seats along the road in the direction of the moor and close at hand is a pinewood in which the Duke of Devonshire allows them to stroll at will. The dining hall in the institution grounds is open on all sides, and in the pavilion in which the patients seep all the windows are wide open day ad night. It strikes the unaccustomed beholder as severe treatment; but it is being more and more extensively and successful practises and the sufferers I saw at Eastby seemed to be doing well enough.” [14]
The same author wrote about Eastby again in 1911:
“… presents to appearance of a picturesque Swiss village. The patients practically spend the time of their sojourning, sleeping and walking, in the open air. Their work and exercise and all they do is systemised and regulated under the active supervision of a resident doctor. Divided into ‘light’ and ‘heavy’ gangs, they are daily set to gardening and other work ‘according to their several ability’, with intervals for rest, refreshment, medicine and so forth. “ [15]
In 1909 concern was expressed over the lack of educational provision for the 6 children (aged between 9 and 15) currently in the sanatorium. Two of them had been there over a year and were still unable to read and write. [Bradford Daily Telegraph, 29 Dec 1909] In response, there was some discussion about sending the children away from Eastby to cottage homes near the Bradford open-air schools, so that they could receive education and still have the benefit of convalescing in the open-air. On the other hand, praise was given to “the lady doctor” at Eastby Sanatorium who was found to have “a capacity of administration which was quite remarkable.” [16]
The Bradford Guardians imposed strict rules of behaviour upon the patients, with dismissal from the hospital for what they considered as serious breaches. Bad language appears to have been a common offence. Most of the rules were predictable for an Edwardian institution – no swearing, smoking, alcohol or gambling; no dirty boots from outside, no visits to the local pub, and no entry into specific areas (such as the boiler room). Naturally, patients were expected to obey all instructions and orders from the medical staff, and patients were occasionally sent home for breaking the rules. [17] The rules against spitting were due to the fear that this was one of the main causes of the spread of tuberculosis. Similarly, forbidding patients to close windows was due to the fundamental belief that fresh air was the foremost means of curing the disease.
The routine of each day, starting at 7 in the morning, was also set out by the Guardians. Patients’ temperatures were taken four times a day. Milk was given three times a day. Specific hours each day were set aside for writing, playing games, exercising and resting. Bedtime was at 8.30pm.
Frustration and boredom was probably responsible for many of the instances of “bad behaviour” which were occasionally reported to the Guardians – these included bad language, drunkenness, fighting, insubordination and disobedience. In 1907 the Chief Medical Officer, Dr. Luard, suffered a long illness, during which time a series of temporary doctors attempted to enforce the rules more rigidly, yet behaviour became worse. This led to an occasion when “practically the whole place was in a state of insurrection, …. [with a] wilful disobedience to rules”. The Guardians were particularly shocked to hear the situation had become so “bad”, that the patients even refused to do any garden work for a whole day because it had rained and the soil was wet! In consequence, Dr Slater, the Chief Medical Officer by that time, had discharged 3 patients for riotous behaviour, and 3 more for wilful disobedience to the rules of the institution. Some others had discharged themselves. [18]
A few later instances of a similar nature occurred, resulting again in the Guardians upholding the doctor’s dismissal of difficult patients. Amongst the patients were some children. In January 1911, having already discharged 3 men for drunkenness, Dr Slater asked the Guardians to allow corporal punishment of children, but did not seem to receive a definitive answer on the issue.
From June 1912, a good character reference was required before a patient could be admitted. But discipline was a recurring issue, and several patients were discharged. The garden work continued to be a bone of contention, and it was eventually conceded that the fault may lie with the gardener, whose own character was the subject of a report sent to the Guardians. His main failing appears to have been repeated instances of going out of bounds to visit the Masons Arms pub in Eastby (understandable for a man who was expected to work 7 days a week and never leave the hospital grounds), and the “lack of respect” he received from the patients. Those patients who were capable of physical labour were expected to work in the garden – this was considered an important element in the rehabilitation of TB sufferers, as well as a vital source of vegetables for the institution (despite repeated breaches by sheep from Mr. Smith’s farm, and local rabbits). Since the majority of the patients were from urban backgrounds – often the back-to-back houses of the inner city – many of them found the work irksome, and there were several instances of rebellion against the unfamiliar toiling on the soil. In 1913 it was agreed that hens cold be kept in the garden.
How effective was Eastby Sanatorium in curing tuberculosis?
The system for following up patients after they left the hospital was quite lax, and little information survives in the records about the long-term effectiveness of the treatment provided at Eastby, particularly since patients arrived suffering at different stages of the disease. It was recognised that many patients arrived in advanced stages of the disease, and that after discharge they returned to the very environment that has caused it in the first place.
1903-1907:
After three and a half years, a report presented to the Board by Dr Slater revealed that 228 patients had been treated, of which 200 had been discharged. He claimed 54 had been cured; 65 much improved; 2 had died. The remainder (22.5%) did not show any improvement or had worsened. He was concerned that, despite giving them instructions to update him every three months, it was difficult to keep track of discharged patients to assess their continuing progress months and years after their treatment. In July 1907 a concerted effort was made to find discharged patients. 151 were tracked down. Of these, nearly ¾ were free from the disease, and 50 were in good enough health to be fully employed. He emphasised the need to treat cases in their early stages, and to educate the patient on healthy living, with knowledge they could take home. [Bradford Weekly Telegraph – Friday 02 August 1907] This 33% success rate was considered very satisfactory, although some concern was expressed at the financial cost of the ‘experimental’ sanatorium.
1907-1908:
Of the 77 patients who left during the year 1907-1908, the majority were deemed to be cured or improved, with 20 (26%) unimproved or worse. Unsurprisingly, more detailed analyses showed that the earlier the disease was treated, the more successful the treatment.
1909 – 1910 :
The general infirmary in Bradford was anxious to offload as many TB patients as possible to specialist wards as admissions remained high. They had taken in 326 consumptive patients, over the year (from April 1909 to March 1910), the average stay of such patients being 11 weeks for men, and 8 weeks for women. 98 of these TB sufferers had died in the hospital. Yet only 14 places were available at Eastby.
1911-1912:
In 1911 the Guardian discussed methods for maintaining data on the progress of discharged patients, and considered finding a charitable organisation that would provide some form of after-care.
At Eastby, the turnover of patients was high, most staying for just a few weeks or months. A total of 64 new patients were admitted over the course of 1911-1912 (April to March). 60 of these were discharged – 47 diagnosed as improved or cured; 13 sent home as incurable ; 6 discharged on disciplinary grounds. Others left of their own accord.
The Poor Law Experiment
Eastby sanatorium was much talked about and admired, but few other Boards followed the example. The initial glowing reports of the work done at Eastby were soon offset by questions of cost to the rate payer – always foremost in the minds of the authorities when considering provision for poorer patients.
In 1905, Lancaster Rural District Council meeting to discuss proposals to extend their hospital provision, noted that: “There had been a great deal of talk in connection with the Skipton district and the Eastby Sanatorium which had been built by the Bradford Board of Guardians for about £200 per bed.” It was pointed out that the sanatorium was not yet complete and costs there would eventually would rise to over £300 per bed, which was considered excessive – “[it] was after all a wishy-washy affair.” [19]
In 1906, The Wharfedale Board of Guardians also put cost at the forefront when discussing an individual case brought to them of an unemployed married man with a family. His doctor had declared his case was “hopeless” unless he could receive specialist treatment at a sanatorium. Unable to afford the fees, the man had appealed for assistance form the Poor Law Board. The Guardians agreed “it is a pitiable case… Their sympathies undoubtedly were with the sufferer, but even when they are confronted by so desperate a situation as the saving of a man’s life, it would appear they cannot go beyond their legal limit.” They declared they had no legal power to spend the rates on sending a pauper to an external institution for the purposes of alleviating a health condition. They clearly saw their duty as limited to alleviating financial destitution. The newspaper report implied it did not agree stating that the poor man must “have felt he was receiving his death sentence.” Luckily for this individual a sympathetic lady read about the case, and paid for him to enter a private clinic. [20]
The newspaper understood that setting a precedent of using poor rates to pay for sanatorium would lead to great expense, “when we remember that one person in seven, or at the least, one person in eight, suffers from the dread disease of consumption”, but pointed out that they were willing to pay thousands of pounds for isolation hospitals dealing with such diseases as smallpox, scarlet fever and diphtheria. “We say it again: sixty thousand people die annually in England and Wales from consumption alone. What the Wharfedale Board of Guardians cannot do, evidently the Bradford Board of Guardians can. The Bradford Board have erected a sanatorium for consumptives at Eastby where excellent work is being done. “ The article noted that of the 695 Poor Law Unions in the country, the vast majority made no special provision for tuberculosis patients. Only 7 had set up separate buildings to provide treatment; 28 had set up special TB wards within their infirmaries; 16 provided isolation tents and chalets in their hospital grounds; 24 sent their patients to sanatoria run by other bodies; and 16 were currently considering providing specialist treatment facilities.
As the editorial continued to point out, the Wharfedale Guardians’ view, although typical, was very short-sighted – the man may not technically have been ‘destitute’ at the time of asking for help, but he and his family soon would be as the disease progressed and he ended up dying in the workhouse infirmary – where TB patients would often lingered for months or even years – at huge expense to the rate-payer. “The Wharfedale and other Boards of Guardians would do well to think this matter carefully over.” [21]
Bradford Guardians were also far ahead of many other Boards in recognising that patients who recovered would be returning home to the very conditions that caused their illness in the first place, although this proved a difficult issue to resolve. On recovery, former Eastby patients would be discharged home under the supervision of a Guild of Help, “a band of earnest workers to get into touch with the poor and try to lift them out of the degradation of poverty.” It was set up in Bradford with 500 enthusiastic volunteers, mostly ladies, who ventured into the homes of the city’s poor, but it was clear after a few years that retaining and recruiting suitable volunteers was difficult, as many found working in the slums disagreeable and demanding – they were supposed to provide friendship, advice on self-help, domestic cleanliness and personal hygiene, and assistance to find jobs, or even to emigrate. Occasionally small loans would be made to enable a worker to buy the equipment he needed to enter employment. Efforts to find light, open-air occupations for the former Eastby patients generally failed. The lack of funds made it a disheartening task since the Guild depended entirely upon charitable donations. Although the municipal sanitary inspectors and poor law relieving officers provided advice to the volunteers, this was not enough to keep the scheme running for long. [22]
At a meeting of the Bradford Guardians it was revealed there were no more vacant places for female TB patients paid for by the Guardians at the private sanatorium in Eldwick (nr Bingley; founded 1904, this was a group of private houses converted into a private sanatorium, at first only for female patients, and later for children only), nor at Gateforth sanatorium, at Hambleton, nr Selby (a former hunting lodge, since 1901 a hospital purchased by Leeds City Council, and rented out to the Leeds Tuberculosis Association, a charitable organisation). Eastby was declared to be a great success. A suggestion was therefore made that women could be sent there as well. But the Chair of the Board scuppered the idea: “[he] pointed out that when Eastby Sanatorium was established the object of the promoters of the scheme was to cure the consumptives who were breadwinners in the shortest possible time. The sanatorium was really an experiment in Poor Law.” [23]
Indeed not everyone in authority approved of this ‘experiment’. A Bradford journalist, under the pseudonym ‘The Oracle’, despaired at the attitude of Mr. Bagenal, the Local Government Board inspector, in July 1907:
“There is surely no doubt about the good work being done at the sanatorium for consumptives at Eastby. The place is kept constantly filled with patients, and many are returned to their homes able to resume work and bearing about them every sign of permanent improvement. The Local Government Board Inspector, however, is apparently not quite satisfied with the system pursued. In the first place, he thinks the burden of the cost should not be cast upon Poor-law authorities, and in the second he thinks the men patients are kept in the institution so long that they are in danger of deteriorating as workmen. Mr. Bagenal’s own idea is in favour of public dispensaries so that men could be treated while following the own employment. Surely the official goes astray here, for the essence of the treatment of consumptives is a constant flow of healing fresh air. How are they to get that while following their employment? ‘Personal effort, personal determination, and personal responsibility,’ says Mr. Bagenal, ‘are as important in the case of consumption as anything else in the world.’ [Bagenal claimed there was not enough evidence to support expenditure on similar schemes by other authorities] … In Bradford consumption has become a notifiable disease; but what is the use of notifying unless some special treatment is to follow? If the facts as to Eastby strike coldly upon the official mind, the statistics of the open-air treatment there and elsewhere certainly offer encouragement to others.” [24]
Cost was again the issue with the Bierley Board of Guardians who considered it too expensive to send their patients to Eastby. They also considered Eldwick “not as cheerful a resort as the new Workhouse Infirmary.” At Clayton, they therefore insisted patients enter the Workhouse despite the reluctance of many poor people to go in. [25]
Despite the cost of specialist TB sanatoriums, many advocates of the system argued that it was worth while to save the lives of thousands of working people. 1n 1905, 45,000 had died in Great Britain from phthisis and at any one time, there were about 200,000 suffering form the disease – 40,000 of them poor people. Yet there were only 1,000 available beds in sanatoria for the poor. However there was little agreement on how best to tackle the disease.
At the 34th Annual North-Western Poor Law conference in 1908, a passionate speech was given by G. MacFarlane, chairman of the Chorlton Board of Guardians. MacFarlane urged Guardians to consider the provision of free places at sanatoria as the best means of curing cases in their early stages, yet calls for these had fallen largely on deaf ears. He referred to the success of the Eastby Sanatorium in treating poor patients, and reiterated the principles of the sanatorium regime : high altitude; pure air; well sheltered location; constant medical supervision; being free from ‘excitement’; spending as much time as possible in the open-air; methodical, gradated exercise; an abundant and varied diet. Acknowledging that poor sanitation and housing were largely to blame, along with the medical profession’s lack of detailed knowledge about the disease, Macfarlane also blamed the beerhouse, as men would sit close together, spitting, coughing over each other and smoking.
Although the paper was apparently well received, the discussion which followed exposed the prevailing concerns over costs. Despite general support for the idea, the conference decided not to vote in favour of combining unions to spread the cost between them, but did agree (as usual) to set up a sub-committee to investigate a range of options and policies. [26]
Article notes
[1] Leeds Times, 22 September 1900
[2] Bingley Chronicle 9 Aug 1902
[3] Lancashire Evening Post; also in Leeds Mercury. 22 Oct 1902
[4] Yorkshire Post & Leeds Intelligencer, 4 Nov 1903
[5] Bradford Board of Guardians, Sanatorium sub-committee meeting minutes, 11th August 1908
[6] Leeds Mercury 17 June 1909
[7] Leeds Mercury, 26 August 1909
[8] Bradford Weekly Telegraph, 11 March 1910
[9] Yorkshire Post and Leeds Intelligencer, 25 Aug 1910
[10] Newcastle Evening Chronicle, 9 June 1939
[11] St Helens Examiner 20 Sept 1913
[12] Register of Nurses 1916-19
[13] Bradford Weekly Telegraph – 15 September 1905
[14] Widnes Examiner, 3 December 1910; also in St Helens Examiner
[15] Widnes Examiner – 22 July 1911; also in And Runcorn Examiner – 22 July 1911]
[16] Bradford Daily Telegraph, 9 Feb 1910
[17] Bradford Daily Telegraph, 12 Jan 1905
[18] Yorkshire Evening Post 19 Sept 1908
[19] Lancaster Standard and County Advertiser – 27 October 1905
[20] Wharfedale & Airedale Observer – 2 February 1906
[21] Wharfedale & Airedale Observer – 2 February 1906
[22] Sheffield Daily Telegraph – Friday 23 November 1906
[23] Bradford Daily Telegraph – Wednesday 24 July 1907
[24] Bradford Weekly Telegraph – Friday 26 July 1907
[25] Bradford Weekly Telegraph 21 Feb 1908
[26] Soulby’s Ulverston Advertiser & General Intelligencer, 1 Oct 1908
Appendices
Appendix 1 – Opening Ceremony
Appendix 2 – Hospital Journal
The next article (part three) in this series will follow the fortunes of the Sanatorium in its later years.
Jane Lunnon – EwE Historical Research Group, March 2024
Categories: All, History Posts
