History of Health Care in Tayside


Prior to the creation of the National Health Service

Prior to the creation of the NHS, Tayside health care combined elements of voluntary, municipal, private and government provision at both the hospital and community levels. Philanthropists and social reformers made the most significant contribution and hospital provision relied heavily on public subscriptions.

The Montrose Lunatic Asylum, Infirmary and Dispensary, founded in 1781, was the first mental hospital in Scotland. Prior to the advent of asylums, mentally ill patients were either cared for by relatives or incarcerated in jail. The Dundee Lunatic Asylum was originally established as part of the Dundee Infirmary and supported by voluntary contributions from c.1810. Baldovan Hospital was established in January 1855 as an orphanage, hospital and place of education and training for “imbecile” children. As such, it too was the first hospital of its kind in Scotland. In order to be granted admission to an asylum, a Petition was legally required to be submitted to the local Sheriff, usually by a relative or an Inspector of Poor, accompanied by 2 medical certificates before a warrant could be granted. Inevitably, such a system of admission could be open to abuse or misinterpretation, however a large number of those patients admitted were sooner or later discharged and deemed ‘cured’. Nevertheless, conditions within these asylums were not always conducive to recuperation and some illnesses were incurable, so many died in these institutions after decades of incarceration.

The Dundee District Board of Lunacy was created in 1899 and it purchased Westgreen Asylum from Dundee Royal Lunatic Asylum in 1903. In 1929 the Board was taken over by the Health Department of the Local Authority under the Local Government (Scotland) Act.

The Poor Law Amendment Act of 1845 provided the framework upon which welfare services could be built. Each parish was to be administered by an annually elected Parochial Board and an Inspector of the Poor. The 1845 Act ensured the care of the feeble-minded and destitute, provided medical assistance and educated pauper children. The Parochial Boards and the poor preferred outdoor relief, i.e.provision for clothing, food, fuel, rent, education and medical assistance, to being taken into a poorhouse. However, the Parochial Board of Dundee adopted a resolution in 1852 to provide a poorhouse for the Parish. It opened on the south of Clepington Road in 1856 for the accommodation of paupers, including the physically and mentally ill. It was renamed the East Poorhouse after the amalgamation of the Parochial Boards of Dundee and Liff and Benvie in 1879. The Liff and Benvie Parish Poorhouse, latterly known as the West Poorhouse, was erected on the north side of Blackness Road and opened in 1864. In 1893 a purpose built poor hospital was built alongside the East Poorhouse, which was later renamed Maryfield Hospital.

Dundee Royal Infirmary had its origins in the Voluntary Dispensary founded in the city by public subscription in 1782. The Dundee Women’s Hospital also developed from a dispensary for women and children, set up in the 1890s for the treatment of women by female doctors and operated as a private charitable concern until it was taken over by the NHS in 1948.

The Dundee Eye Institution was established in 1836 by Dr. Cocks, a practitioner in the city, to provide a free service to those who could not afford ophthalmic treatment. Similarly, the Dundee Dental Hospital was opened in 1914 in Park Place, Dundee, following a public appeal for funding, to provide surgical aid to “persons in poor circumstances suffering from diseases or irregularities of the teeth”.

Dundee health care may have been well served by philanthropists and social reformers, but it was not until 1889 that the Local Authority opened King’s Cross Hospital, the first permanent fever hospital in Dundee.

The Public Health (Scotland) Act 1867 permitted local authorities (burgh councils and parochial boards) to appoint medical officers of health and to levy a general rate on householders for public health purposes. Only a few local authorities appointed full-time medical officers of health, however. The Local Government (Scotland) Act 1889 made it compulsory for county councils to appoint county medical officers of health in order to monitor and oversee the provision of improvements in the health of the county. Shortly afterwards the same requirement was extended to burghs with the Burgh Police (Scotland) Act 1892. The Public Health (Scotland) Act 1897 authorised the Local Government Board for Scotland to compile regulations concerning the duties of medical officers of health. These included the isolation and treatment of those suffering from infectious diseases and the identification of the causes of such diseases.

Section 27 of the Local Government (Scotland) Act, 1929 empowered County Councils and the Town Councils of large burghs to provide ordinary general hospital accommodation in addition to their existing statutory duties to provide for the treatment of infectious diseases, tuberculosis and the sick poor. For this purpose local authorities were authorised to submit for the approval of the Department of Health for Scotland, schemes for the reorganisation and extension of hospital facilities in their areas.


NHS & the Eastern Regional Hospital Board

As a result of the National Health Service [NHS] (Scotland) Act 1947, the NHS came into being on 5 July 1948. It was formally vested in the Secretary of State for Scotland [SSS] operating through the Department of Health for Scotland [DHS]. It aimed to meet all health needs free of direct charge to the citizen. The Eastern Regional Hospital Board was established to manage hospital provision in the counties of Dundee, Angus, Perth and Kinross on a regional level through Hospital Boards of Management. It operated from headquarters in Dundee and its services were also used by the North and East Fife hospitals. The board consisted of three areas of management; each concerned with one or more hospitals, grouped as to type and geographical region.


Boards of Management

Dundee General Hospitals Board of Management was established in 1948 as the body of the National Health Service responsible for running the Royal Infirmary, the Royal Victoria Hospital, Armitstead Convalescent Home, The Bughties, the Constitution Road Clinic, the Deafness Clinic, the Eye Institution, the Infant Hospital, the Orthopaedic and Rheumatic Clinic, the Gerard Cottage Hospital, Kings Cross Hospital, Maryfield Hospital, the Sidlaw Hospital and the Dundee Women’s Hospital, as well as the Mobile Mass Radiography Unit and the Special Appliance clinic. The first new hospital to be inaugurated under the control of the Board of Management was Ninewells Hospital, which was opened in 1972.

Dundee Mental Hospital Board of Management was the body in charge of operating mental health provision in Dundee from 1948 to 1974, when the administration was transferred to Tayside Health Board. As such it was responsible for the management of Royal Dundee Liff Hospital, which was also its administrative centre, Strathmartine Hospital, and the Armitstead Children’s Hospital. The 1963 Mental Health Act allowed patients to attend mental institutions on a voluntary basis for the first time, whereas previously all patients had to be certified.

The third Board of Management established in Tayside in 1948 was the Dundee Northern Hospitals Board of Management.


Primary Care Trusts

New Primary Care Trusts were created in 1999, designed to bring together the planning and development of primary and community services through a network of Local Health Care Co-operatives. Two trusts were created in Tayside.


Tayside Primary Care Trust

Tayside Primary Care was established on 1 April 1999. Trust Headquarters were located at Ashludie Hospital, Monifieth. The Trust aimed to provide primary care, community and hospital based services and supporting services to a population in Tayside of approximately 400,000. A number of the Trust's services were delivered in partnership with other statutory and voluntary organisations and the Trust had close links with, and provided teaching facilities for, both the University of Abertay and the University of Dundee.


Tayside University Hospitals NHS Trust

Tayside University Hospitals NHS Trust was established on 1 April 1999 to provide a comprehensive range of general and specialist acute services to the whole of Tayside and North-East Fife. Several acute services were provided on a wider Regional and National basis. The Trust provided services at Ninewells Hospital and Medical School, Dundee Dental Hospital and School, Perth Royal Infirmary, Stracathro Hospital & Armistead Child Development Centre.

The Trust provided acute services for a population of around 470,000 within a geographical area of approximately 3,175 square miles, and was a major health service provider and focus for medical, nursing and midwifery education.


NHS Tayside

The above NHS Trusts were superseded by 'NHS Tayside' from 1 April 2004, following the National Health Services Trusts (Dissolution) (Scotland) Order 2004. NHS Tayside Board headquarters are based at King's Cross, Clepington Road, Dundee. It provides primary care and secondary care services across Tayside with full supporting services to a population of approximately 400,000. A number of NHS Tayside services are provided in partnership with other statutory and voluntary organizations, and it has close links and provides teaching facilities for the two Universities in Dundee.

No doubt this latest administrative change will not be the last in the history of NHS Tayside.


Sources:

National Health Service in Scotland: Annual Report, 1998-1999

Tayside Primary Care / Tayside University Hospitals Trust

Lothian Health Services Archive

Dundee City Archives

Friends of Dundee City Archives



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