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St Bartholomew's Hospital

St Bartholomew's Hospital, also known as Barts, is a hospital in Smithfield in the City of London, England.
Early history
It was founded in 1123 by Raherus or Rahere (died 1144, and entombed in the nearby priory church of St Bartholomew-the-Great), a favourite courtier of King Henry I. The Dissolution of the Monasteries did not affect the running of Barts as a hospital, but left it in a precarious position by removing its income. It was refounded by Henry VIII in December 1546, on the signing of an agreement granting the hospital to the City of London, which was reaffirmed in the Letters Patent of January 1547 endowing it with properties and income. The hospital became legally known as the "House of the Poore in West Smithfield in the suburbs of the City of London of Henry VIII's Foundation", although the title was never used by the general public. The first superintendent of the hospital was Thomas Vicary; sergeant-surgeon to Henry and an early writer on anatomy.[1] Upon the foundation of the National Health Service in 1948, it officially became known as St. Bartholomew's Hospital.
It is the oldest surviving hospital in England and has an important current role as well as a long history and architecturally important buildings. The Henry VIII entrance to the hospital shown in the photograph is still the main public entrance; the statue of Henry VIII is the only public statue of him in London. On an adjoining wall, William Wallace is honoured with a plaque (unveiled 1956[2]), marking the site of his execution in 1305.
The main square was designed by James Gibbs in the 1730s: of the four original blocks only three survive, this includes the block containing the Great Hall and two flanking blocks that contained wards. The first wing to be built was the North wing, in 1732. It is the North Wing that contains the Great Hall and the Hogarth murals. The South Wing followed in 1740, the West Wing in 1752 and finally the East Wing in 1769. In 1859, a fountain was placed in its centre along with a small garden.[1]
St Bartholomew's Hospital has existed on the same site for almost 900 years, surviving both the Great Fire of London and The Blitz. Its museum, which is open Tuesdays to Fridays each week, shows how medical care has developed over this time and explains the history of the hospital. Part-way around the exhibition is a door which opens on to the hospital's official entrance hall. On the walls of the staircase are two stunning murals painted by William Hogarth, The Pool of Bethesda (1736) and The Good Samaritan (1737). These are worth a visit in their own right but can only be seen at close quarters on Friday afternoons. Hogarth was so outraged by the news that the hospital was commissioning art from Italian painters that he insisted on doing these murals free of charge, as a demonstration that English painting was equal to the task. The Pool of Bethesda is of particular medical interest, as it depicts a scene in which Christ cures the sick: display material on the first floor speculates in modern medical terms about the ailments from which Christ's patients in the painting are suffering.

Hogarth's "Christ at the Pool of Bethesda" mural
The room to which the staircase leads is the hospital's Great Hall, a striking double-height room in Baroque style. Although there are a few paintings inside the Great Hall, nearly all are on movable stands: the walls themselves are mostly given over to the display of the very many large, painted plaques which list, in detail, the sums of money given to the hospital by its benefactors. These make diverting reading: the visitor should note that some of the amounts, which are expressed in pounds, shillings and pence, are odd because they are the remains of an estate after all other bequests have been settled; others look strange because they were given as round amounts of guineas, a guinea being twenty-one shillings (£1.05 in decimal currency). When translated into pounds and shillings these give some odd-looking results: for example fifty-five guineas would be listed as £57 15/–.
With the dissolution of the monasteries, the precincts of the hospital were designated an Anglican parish, with the parish church of St Bartholomew-the-Less – a unique situation amongst English Hospitals. This is the only survivor of Bart's original five chapels, which failed to survive the dissolution by Henry VIII. The church has a 15th century tower and vestry, and its links to the hospital can be seen not only in its early-20th century stained glass window of a nurse, a gift of the Worshipful Company of Glaziers, but also in the plaques and commemorations that adorn the inside of the building.[3]
Throughout the whole of the 19th century, the Hardwick family were major benefactors of the hospital. Thomas Hardwick Junior (1752–1825), Philip Hardwick (1792–1870), and Philip Charles Hardwick (1822–92) were all architects/surveyors to Barts. Philip Hardwick was also employed in the rebuilding of the church of St Bartholomew-the-Less in 1823 and also contributed the fountain in the courtyard.
By 1872, St Bartholomew's contained 676 beds. About 6,000 in-patients were admitted every year, besides 101,000 out-patients. The average income of the hospital was £40,000, (derived chiefly from rents and funded property); and the number of governors exceeded 300.[1]

Threatened closure

In 1993 the controversial Tomlinson review of London hospitals was published and concluded that there were too many hospitals in central London. It recommended that the service should be delivered closer to where people lived. Barts was identified as a hospital with a catchment area that had a low population[4] and the hospital was threatened with closure.[5] A determined campaign was mounted to save the hospital by the 'Save Barts Campaign', supported by staff, residents, local MPs and the City of London, the argument being that a general hospital was needed here, to provide for the needs of the City's daily transient workforce of over 300,000 people.
Some facilities were saved, but Accident and Emergency (A&E) closed in 1995,[6] with facilities relocated to the Royal London Hospital; a hospital in the same Trust Group, but a couple of miles away in Whitechapel. A 'Minor Injuries unit' was established at Barts for small cases (which often represent a significant part of the workload of A&E services); but urgent and major work goes to other hospitals.[6] Concerns about the lack of a local service rose, with the terrorist attacks of 11 September 2001 and 7 July 2005; with the City remaining a significant terrorist target.
A plan was formulated for Barts to develop as a centre of excellence in cardiac care and cancer. This development, again came under threat in a review of the PFI funding in 2006, leading to the 'Save Barts' campaign continuing.[7] These problems were resolved, and new cancer care facilities are scheduled to be opened at Barts in 2010; and new general wards at the Royal London site in 2016. Barts continues to be associated with the medical school's significant research and teaching facilities at the Charterhouse Square site.
The Queen Mary wing has now been demolished, and it is planned to retain the fa├žade of the George V building within a new hospital building, for completion in 2015. Patients will be accommodated in single rooms, and four-bed bays. A new main entrance will be established on King Edward Street. The Gibbs Square will be refurbished and car parking removed from the area.[8]
Barts, along with the Royal London, Mile End Hospital and London Chest Hospitals, is part of Barts and The London NHS Trust. There are 388 beds in Barts, 675 beds in the Royal London & 109 beds in the London Chest Hospital.

Medical schools

In 1843 St Bartholomew's Hospital Medical College was established to train medics although considered to have been started by John Abernethy when the hospital built a theatre for his lectures at the beginning of the century.[9] In 1995 the college, along with that attached to the Royal London, merged into Queen Mary, University of London but maintains a distinctive identity to this day. It is now known as Barts and The London School of Medicine and Dentistry. It occupies some space at the Barts site in Smithfield, with a presence a short walk away at Charterhouse Square. The main preclinical teaching domain of the medical school is in Whitechapel at the award-winning Blizard Building.
The present School of Nursing and Midwifery was formed in 1994 from merging the Schools from St Bartholomew's Hospital and the Royal London Hospital to become the St Bartholomew School of Nursing & Midwifery. In 1995 the new School was incorporated into the City University. Both Schools have a strong and respected history dating back over 120 years and have produced many nurse leaders and educators. Since 2008 the School has been incorporated into the School of Community & Health Science, City University.

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