From Manor House to Medicine
The History of Botleys Park & St. Peter's Hospital
Towards the end of 2011 work began on demolishing The Ramp at St. Peter’s Hospital, and with it disappeared a part of history.
Originally built in the 1930s as part of the war effort, The Ramp housed draughty wards which became the centre of the modern hospital that St. Peter’s has become. As a result of this latest phase of development rooms had to be cleared, space had to be made, and so a number of objects relating to life at the hospital were given to Chertsey Museum.
The site of St. Peter’s Hospital was once home to Botleys Park, one of many large country estates built across the borough in the 18th century. This exhibition highlights some of the steps taken from stately home to state of the art healthcare.
The early history of Botleys Park is sketchy and confused. In 1319 the manor belonged to John de Butteley, son of Gilbert de Butteley, whilst later sources state that it was owned by John Manory of Chertsey. His son, Thomas, transferred ownership to Richard Merland, Thomas Purvoche and Henry Wykes in 1505. At some point shortly after this Richard Merland and Thomas Purvoche relinquished ownership of it to Henry Wykes. By this time it was known as Botlese Park in Chertsey.
It seemed that the manor passed from owner to owner with some regularity with some owners being more well-known than others. In 1541 King Henry VIII purchased the manor from Sir Roger Cholmeley, Knight and Chief Baron of the Exchequer. This change of ownership continued up until the mid 18th century when, in 1763, Mrs Pleasance Hall transferred it to Joseph Mawbey Esq. Mawbey was one of a number of politicians who settled in the Borough of Runnymede during this time, tempted by the rural idyll that was close enough to London to be able to travel to Parliament in a day.
Originally born in 1730 on the Derbyshire/Leicestershire borders, Mawbey moved to Surrey when he was approximately 10 years old to live with his uncle, Joseph Pratt, and train to be a minister in the Church. However, due to family bereavement a young Joseph became a partner in his uncle’s distillery in Vauxhall, eventually becoming joint owner with his brother on the death of Pratt in 1754.
His uncle’s death also saw Mawbey inherit considerable land in Surrey and become County Sheriff in 1757. He became further involved in both national and local politics becoming MP for Southwark in 1761, and chairman of the Surrey quarter sessions in 1770. As a politician, he was not highly regarded, and was described by Walpole as “vain, noisy, and foolish”. His lowly start in life meant that he was always going to be a bit of an outsider in Westminster and often his pig-keeping was the butt of parliamentary jokes. Alas, he was no better received in the county. When he stood to represent Surrey at Westminster in 1774, George Onslow, of Clandon, wrote ‘Every gentleman of every party united against ... Sir Joseph ... so the county will not be disgraced, thank God.’ Needless to say, Mawbey was heavily defeated. However, it was Sir Joseph who gave us the classical Palladian-style mansion of Botleys when he bought the estate in 1763 and rebuilt the old house.
After Sir Joseph Mawbey’s death in 1778 the mansion passed to his son, Joseph, who died in 1817, leaving one daughter, Anna Marie, who married John Ivatt Briscoe, the local Member of Parliament. The estate of Botleys, comprising Botleys Park and mansion, Foxhills and France Farms, was sold by order of trustees in July 1822. Foxhills and France Farms were sold to John Ivatt Briscoe whilst Botleys Park and mansion were sold to David Hall.
Once again Botleys Park changed hands frequently until it was purchased by Robert Gosling in 1839. In 1851 there were eight members of the Gosling family living there, including Robert Gosling and his wife Georgina Vere Gosling, four unmarried daughters and the two youngest sons. The Goslings employed over twenty members of staff in the house alone, most of whom were not native to the district.
The 1844 tithe map shows that, in addition to owning Botleys Park, mansion and offices, Robert Gosling owned several cottages at Botleys and the surrounding area as well as arable, grass and woodland. The Gosling family remained at Botleys until 1931 when it was sold to London County Council, reputedly for £30,000.
19th Century Mental Health
Records dating back as far as 1670 show that private mental health facilities or “madhouses” were in existence but it was not until a century later that there was any attempt to inspect and regulate them. At this time mental health treatment had not been developed and so conditions which we recognise and treat today were considered signs of madness. Those displaying symptoms were locked away from society and very often left to die in squalid and inhumane conditions. Over time society would use these institutions as places to lock away those who they felt weren’t “like them”, including those with what we would now consider to be low level learning difficulties. Melancholy, wilfulness and “possession by evil spirits” could be reasons for committal to the madhouse. Husbands who could afford to pay a sympathetic doctor could have their wives imprisoned at the madhouse with no just cause other than they would not obey their spouse. Whilst inside an inmate had no legal redress and no means to fight for their release as they were refused contact with any visitors.
It wasn’t until the 18th century that the science of psychiatry really began to develop, and with it came changes in the way that society treated the mentally ill. The 18th century was a time of great reflection and “enlightenment” resulting in the questioning of society, and changes in science which saw the belief in evil spirits regarded as superstition. Doctors and scientist began to understand about the workings of the brain and the nervous system, and so began the slow progress of mental health treatment.
The 1774 Lunacy Act saw the beginning of regulation with medical certificates from two separate doctors being required before a person could be committed, madhouses had to be registered and annually inspected, and a register of all inmates had to be held by a central authority. The Act was a huge step forward although it did not stop sane people from being detained. Neither did it give Magistrates powers to release people, although having regular inspections made it easier for them to petition for release. Following an assassination attempt on George III in 1800, the Criminal Lunacy Act was passed, followed eight years later by the County Asylum Act which saw the building of new institutions specifically for the criminally insane. This began a process that saw patients with mental health issues being assessed and sent to different institutions depending on the nature of their condition.
At the turn of the 19th century insanity came to the fore with the monarch’s illness widely reported as George III suffered bouts of insanity from 1788 until his death in 1820. Shortly after this Alexander Morison, a physician and inspector of the Surrey madhouses, started lecturing on mental diseases, the first formal lectures on psychiatry. However, despite this new found interest in the causes and treatment of mental illness, it was not the 1833 Madhouse Amendment Act that was responsible for the way patients were treated during the Victorian era, but the 1834 Poor Law. This Act was responsible for the increase in the number of asylums and other similar institutions, as most of those who found themselves settled or permanent residents in the workhouses were those who could not fend for themselves: children, so more orphanages were built; the sick, so more hospitals were built; or those with mental illness or learning disabilities and so more asylums were built.
Throughout the latter part of the 19th century there were various attempts to improve the condition of those detained in asylums, and various Acts of Parliament passed by champions of the cause such as Lord Ashley, Earl of Shaftesbury. Despite this there was no distinction between those who were suffering from mental illness such as schizophrenia and those who were mentally disabled or had learning difficulties until the 1886 Idiots Act which enabled the building of “idiot asylums” or “mental deficiency colonies”.
Each hut had 30 beds, fifteen along each side, with three coke stoves down the middle which attempted to heat the ward. The huts were built in two rows up a hill with the strip of land in between them being known as The Ramp. Patients’ meals were brought over from the kitchens at Botleys Park mansion, and served on a large table in the middle of each ward. One of the huts was used as an operating theatre with room for three operations to be carried out at the same time, and one was reserved for German prisoners of war.
Several London hospitals were evacuated here, including St Thomas’s, St James’s Hospital, Balham, The Bolingbroke, The Belgrave and The Evelina. All staff retained the uniforms of their own hospitals, so there was much variety in colour and style. Every Monday, during the early part of the war, it was obligatory for all staff to wear their gas masks to and from lunch in order to grow accustomed to moving around in them, which must have been an unnerving sight.
In addition to evacuated London hospitals, convoys of sick and wounded were admitted from France. In fact, the first wounded soldier from the War was admitted to Botleys. At this time there were 1,400 war hospital beds and 1,050 beds for other patients. The wounded would be transported by train to Byfleet Station; with the railway sidings being used as a terminal from hence they were transported to Chertsey by road. As a result of the injuries the hospital was treating it developed a specialist orthopaedic surgery centre and became a leading centre for nerve injuries.
In 1940 there were four instances of bombs falling in the grounds, but apart from windows breaking, no serious damage was done. On the 28th May 1940, Her Majesty the Queen visited the War Hospital to see the wounded soldiers evacuated from Dunkirk.
The Recreation Hall at the hospital was used frequently for weekly dances for patients and fortnightly shows. Celebrities such as Lupino Lane, Kenneth Horne, Richard Murdoch and Claude Dampier and others played at Botleys. Apart from the hockey field, all playing fields and recreation grounds were given over to cultivation. The reduced garden staff were joined by Land Army Girls who lived at Murray House.
The hospital itself was never bombed, but one night in February 1944 ammunition dumps in the woods close to the edge of the estate were hit by incendiaries and blew up. The blast shook the area for many miles around and broke every pane of glass at Botleys. Blast damage to the mansion, though not obvious, was considerable. For some years it was supported with beams extending from the basement through to the roof. Flying bombs or ‘Doodlebugs’ frequently passed overhead on their way from London. They often failed to make their target and fell in the local area.
Just before D-Day the hospital was visited by the Minister for Health to ensure that all arrangements for the reception of battle casualties had been made. The hospital was converted from a ‘base’ to a Transit Hospital and from the 8th June to the 1st November 1944 convoys of casualties were admitted direct from the battlefields of Normandy. During this period 14,000 wounded were received. Immediate treatment was given, and all who could travel were transferred further north the day after admission.
The NHS Years
Until 1948 there was no national health service,as we know it today, and only those who could afford to pay for a doctor and the treatment had access to healthcare. As early as 1920 the government was examining the possibilities of a system of health provision for all. The two world wars were instrumental in this process, showing what could be achieved with the national Emergency Medical Services network. A review of health provision in the 1920s and 1930s showed just how the quality of care varied across the country, and how there were an almost total absence of specialist services.
Britain was in a desperate state after the Second World War with economic disaster looming, so it took a lot of persuasion by politicians to convince the nation that they could afford to launch a national health service. However, despite reservations from professionals, politicians and the public, the NHS started on 5th July 1948 based on the founding principles which are still in place today: that it should meet the needs of everyone, be free at the point of delivery, and that it be based on the patients’ needs and not their ability to pay. Hospitals, whether they be municipal or voluntary, were brought together under regional hospital boards. Family doctors, dentists, opticians and pharmacists were no longer self-employed but were paid by a central Executive Council, and local health authorities took over the running of immunisation and maternity clinics and community nursing.
By 1947 the hospital was split from Botleys Park Colony and became St. Peter’s Hospital, its name derived from Chertsey’s Church. Botleys continued to function as a hospital for the mentally ill and not only had nursing staff but occupational therapists, social workers, psychologists, physiotherapists and speech therapists on hand to work with the patients. New patients were first taken to the Hospital Block for a full physical and mental assessment. The block was the hub of the hospital which contained an operating theatre, dental room, laboratory, x-ray department and pharmacy.
Patients at Botleys Park were classified into four groups determined by their age and levels of intellectual and physical disability. The first group of patients were young adults who were physically able but had some learning difficulties. These had generally been referred to the hospital for rehabilitation after “failing in the community”. Nursing for these patients concentrated on learning skills needed to care for themselves back in the community, such as “regular habits, good manners and satisfactory personal hygiene”. To enable this, patients worked in the laundry and needlework rooms, or worked in the farm or tended to the hospital grounds. The second group of patients were adults who had some learning difficulties but also suffered from physical conditions such as epilepsy. These patients required long-term care in sheltered accommodation. Their routine was more regimented. The third group were those, adults or children, who required continuous care and nursing due to either physical or mental conditions which prevented them from doing much for themselves. The final group were children who “cannot satisfy the educational requirements of normal school” due to physical conditions which affect their learning abilities.
Whilst at Botleys Park adult patients, where possible, were given simple jobs such as taking in laundry from the town, packing compost and folding polythene sheeting. The money earned from this went towards their care and any treats or personal items they wished to buy. Over time, and with changes to medical treatment and the perception of how to treat patients with special needs, there was a move away from institutionalising those with learning difficulties and so by the 1980s Botleys Park was used solely for psychiatric patients.
St. Peter’s Hospital
The new St. Peter’s Hospital came in to existence in 1947, and until the formation of the NHS the following year, was run by Surrey County Council. The nurses and consultants who had come from St Thomas’s Hospital, London at the start of the War remained at Chertsey until 1947 when they were recalled to London. This left a real shortage of staff at the hospital, which served the local areas of Chertsey, Egham, Walton-on-Thames and Woking, and so a Training School for nurses opened to try to bridge the gap. Compared with the modern hospitals of today, care was very primitive during the early years of the hospital. Instruments were sterilised by nurses using a fish kettle over a gas ring, and any breakages had to be paid for – for example, 6d was taken out of a nurse’s wages if she broke a thermometer.
St. Peter’s Hospital expanded from the huts originally built to house the war casualties, and over time more huts were added until they reached the top of the slope. The Ramp, the area in between the two rows of huts, was covered over to make a central internal corridor, but aside from this little else changed until the 1970s. In the first nine months of operation under the new NHS it cost £314,079 to run the 403 bed hospital. In these early days there were no specialist services at St. Peter’s. For example, there was no accident and emergency department with a dedicated team of nurses until 1962. If there was a sudden influx of emergency cases, staff were called away from the general wards leaving other patients without nursing care. However, when the Accident Centre was opened, it was unlike anything else in the area and became the prototype for similar centres across the county.
Over the last 40 years St. Peter’s has undergone almost continuous expansion and development to create the state or the art hospital it is today. This modernisation started with the opening of a maternity unit in 1970 which now serves the whole of North West Surrey, but it wasn’t until 1981 that The Ramp ceased to be the main focus of the hospital. At this time the new Outpatients block, the McLeod Centre, was built and the main entrance to the hospital was moved from The Ramp to the current site.
Throughout the 1990s further expansion was needed to meet the growing demand and changes in medical practice and treatment. In the early 1990s Botleys Park Colony closed and the remaining patients were transferred to the new Abraham Cowley Unit. The Blanche Heriot Unit opened in 1991; a new ward block was added (1992); the orthopaedic centre opened (1998); the intensive care unit was built (1998) and finally, in 1998 St. Peter’s merged with Ashford Hospital to form an NHS Trust.