I must have walked past this building thousands of times over the years. I’d always admired its exterior, whose 18th century aesthetic still fits perfectly with the rest of Bath’s modernised Georgian motif. The stonework might be slightly mottled and tarnished by years of pollution, and its being surrounded by coffee shops and high-end clothing outlets *almost* detracts from the majesty the building exudes, but the Royal National Hospital for Rheumatic Diseases, nestled right in the North Somerset city’s centre still looks beautiful. I remember the public outcry when it was announced that a large chunk of the building had been sold, and subsequently leased to a novelty Mexican food chain; this building is a part of this city, not just for the patients treated within it, but for all of the residents of Bath.
Despite admiring it from the outside, I’d never consciously considered its interior. I’m not sure how many people actually have, to be honest; those I questioned had either never looked past the front doors, or had simply “heard it was quite nice” through the grapevine. I recently had the opportunity to begin to learn echocardiography at the RNHRD in Bath, and whilst I was waiting for my superiors to arrive I decided to have a look around, as it was clear from stepping through the front doors that it was a building steeped in history.
The main foyer is rather breathtaking: the original marble floors are still a prominent feature just past the reception area, paintings, such as that which is the header on this article adorn the walls and connecting the ground and first floors are beautiful, finished wood staircases that look like something out of Disney castle. I had to stop for a moment just to take it all in. Having spent a fair amount of time in hospitals, I had assumed that they (for all intents and purposes) look pretty similar; white walls, long corridors with small, commissioned pieces of generic mixed media/ abstract work hung at eye level along them, and that style of lino flooring that evokes memories of the school gymnasium, squeaking underfoot at the slightest hint of moisture on one’s shoes. Now, I’m not saying this is a bad thing (far from it), but the RNHRD has a unique character. It has charm and detail that I’ve only found in stately homes and upscale galleries. It also has history to rival these places.
The funding for the hospital was procured predominantly via a public subscription set up by Richard (Beau) Nash in 1732. Names such as Lord Palmerston, Mr Jeremiah Pierce, and Dr William Oliver are listed as donors, as well as other local and national figures, and as a result of their capital, the building, constructed as a hospital for the sick poor opened in 1742. Built using stone gifted by local legend Ralph Allen, the then Bath General Infirmary was the first hospital to offer treatment to the entire UK, leading many to view it as a foundation of the National Health Service devised in 1948.
Locals, or those fond of UK trivia will likely already be aware of the hot springs on which Bath sits, and these were utilised in the hospital for therapeutic purposes (interestingly, Bathonians were, for a time at least, not permitted to become patients of the Infirmary, presumably because they as residents, already had a right of access to the spring waters), and these were made available to patients on condition that a fee be paid upon admission. For English patients, this was around £1.50, which later became £3, and for those from Scotland and Ireland, £3, which became £5. These sums were either paid for by the patients themselves, or on their behalf by wealthy benefactors, and covered the cost of treatment and the return home, or, in the worst case, mortality and the subsequent burial arrangements.
Patients were taken to the bath sites via hospital sedan chairs (designed by surgeon Archibald Cleland, subsequently dismissed for improper conduct in 1743), and impelled to wear brass badges that both identified the patient number and their ward, and to prevent drunkenness whilst out of the hospital grounds. Local landlords were forbidden from serving alcohol to patients, as it was detrimental to their recovery. Failure to adhere to this rule would have risked their licence, so it was likely seldom flouted.
The hospital was initially far smaller than its current size, with new wings and blocks being added throughout the years, including the top floor in 1793 (costing £900), renovation efforts and the implementation of additional units continuing well into the tail-end of the last century.
When the building was being extended in the late 1850’s, a Roman pavement was discovered during the foundation digging. It is dated as hailing from between AD60 and AD410 and is still in place at the bottom of the stairs to the basement level. The mosaic is still part of a larger floor and runs underneath much of the building itself.
Given the tenure of the building within the city, it has seen its fair share of conflict; as well as being used to treat the wounded during the Jacobite Rebellion, the Crimean War, South African War and both World Wars I and II, it suffered damage due to ordinance during the latter conflict in 1942 wherein it received a direct hit. Despite this, however, the roughly 200 patients still within the confines of the hospital were uninjured.
As far as treatment goes, the hospital has been a specialist rheumatology centre since it opened, and continues to operate as such. It offers treatments for pain management, chronic fatigue and utilises hydrotherapy as it did when it was concieved. It also functions as a research centre in these areas, encompassing both in-house studies and those of a more national variety. In addition, and I feel rather interestingly given its history with servicepersons, the centre offers specialist support to ex-military personnel, regardless of the time of onset of condition, and provides pain-management and post amputation complication therapy amongst other things.
Royal Patrons have presided over the RNHRD since its foundation, with the current President being Camilla, Duchess of Cornwall, who has been in the position since 2006. The first, in 1745, was Frederick, Prince of Wales. In 1991, the RNHRD became an NHS Trust, and was upgraded to an NHS Foundation Trust in 2005. In February 2015, the hospital was acquired by the Royal United Hospital (RUH), Bath, which now manage the centre.
The Royal National Hospital for Rheumatic Diseases truly is a wonderful hospital, and the patients who use its services do so over a number of years, crediting it with a “family feel”. Whilst researching this article, I spoke to a volunteer at the hospital, who told me of her time as a patient, both in and out, and her desire to provide a friendly ear to current service users. She told me that volunteers had relaxed her when she herself needed the hospital’s facilities, and it was that, combined with the care she was provided that inspired her to give back to the trust.
The family feel of the RNHRD was in jeopardy whilst the hospital was under considerable financial strain, but its acquisition by the RUH allowed it to continue to function with only minimal service absorption by the Royal United. This continued service will surely help the current patient base, and will enable the hospital to remain the part of the city that it has been since its conception.
Rather wonderfully, the hospital contains a museum, situated in the chapel, which outlines the history of the building and the staff and patients who have used it throughout the years. Many of the photographs found in this article were taken in the museum, and it’s full of information about the building and its history; well worth a visit if you’re in the area!
Thanks to the museum staff at the RNHRD for taking the time to talk to me and allow me to take photographs. Without them, I wouldn’t have been able to write this article.
If you’re eager to explore more, head over to Medical Heritage or visit the RNHRD homepage, and if you’re local to Bath, then be sure to drop into the Bath Medical Museum, situated within the RNHRD.