Hospital: Chorlton Union Workhouse, Withington

THE NEW HOSPITAL AT THE WITHINGTON WORKHOUSE – Yesterday Mr T Clowes, the chairman of the Chorlton Board of Guardians, laid the corner stone of the new hospital at the Withington Workhouse. When the new hospital was completed it would accommodate 500 persons, giving each nearly 1,300 cubic feet of air, which was about 1,000 feet more than their present hospitals allowed to those who were in them. It would be built on the pavilion principle, which is far better than any other, and would consist of five detached structures, 100 feet apart, so as to allow through ventilation. The pavilions would be joined by a long corridor. The cost, without the furniture, would be about or a little over £17,000, and with the furniture about £20,000. The money had been borrowed to be repayable over a period of twenty years in equal instalments. … The present hospital scheme was for five pavilions but the scheme in its entirety comprised the building of eight pavilions.

The hospital will be erected from designs by Mr Worthington, and the building from the surface has been contracted for by Messrs Warburton Brothers. The foundations, which were commenced about May, have been put in by Messrs Griffiths and Johnson. Two of the pavilions are to be finished by June, and the other three by the end of September [5 January 1865 page 3]

THE PAVILION HOSPITAL, CHORLTON UNION WORKHOUSE, NEAR MANCHESTER - The Chorlton Union is one of the largest and most populous unions in the kingdom. It contains an area of 11,540 acres; and the population, which was 169,570 in 1861 (the last census year), is now upwards of 180,000 - a larger population in fact, than any of the great metropolitan parishes, with the exception of St. Pancras, which has a population of 198,783, though the area of that parish is only 2,710 acres, or less than one fourth of the Chorlton Union. The guardians, about ten years ago, erected a large workhouse containing accommodation for about 1,200 inmates (originally certified by the Poor Law Board for upwards of 1,500). The hospital consisted of detached blocks, placed at the extreme ends of the main buildings, arranged on the common but objectionable plan of a central corridor, with wards placed on each side. The growth c£ the population of this district, however, progressed at a rate so enormous that the workhouse building (though extravagantly large when erected a few years ago) forced upon the guardians the absolute necessity of further accommodation. The hospital had become frightfully over crowded, the total inadequacy of the space had compelled all kinds of infectious disorders to be indiscriminately mingled in the wards, and not unfrequently it had become necessary to put hospital cases in the body of the house. The new hospital was commenced in 18C4, and is now completed; several of the wards having been occupied by patients for some months. On reference to the plan (see lithographic illustration), ;it will be observed that the building consists of five oblong blocks or pavilions, connected at the southern end by a long open arcaded corridor of communication. Each pavilion is three stories in height, and contains on each floor a ward 124ft. long and 24ft. wide, with beds for thirty-two patients. At the southern or entrance end are a spacious open staircase, a nurses' room 12ft. by lift., a ward scullery 12ft. by 10ft., a water-closet for the use of the nurse and attendants, and a hoist to raise food to the upper  stories ; at the northern end of the wards are two small projecting wings, one of which contains two water-closets for the patients, a sink for cleansing the bed-pans, and a closet for brushes, &c. ; the other contains the bath rooms, lavatories, dust shoot, foul linen shoot, &c., &c. All the above accommodation is repeated on each of the three floors; so that there are in each pavilion three wards of 32 beds each, making a total of 96 beds in each of the five pavilions, or 480 beds in all, with the several   minor rooms just enumerated. The heights of the wards arc as follows: 14 feet d inches clear ground floor. 14ft. „ first „ Average 15 feet „ top „ The top ward is somewhat higher than the others, being partially in the slope of the roof. The number of cubic feet of air space to be allotted to each patient, being of the first importance, was a subject of the most careful and anxious consideration. All thought of adopting the old standard was abandoned. It appeared desirable that such an air space should be allowed as would be likely to effect the most expeditious cures, and the most rapid removal of cases from the parish books. It was ultimately determined that each inmate .should have an air space of 1,350 cubic feet, or thereabouts ; which is more than double the minimum space required by the Poor Law Board, and about three times that allowed in several of the larger metropolitan workhouse hospitals. Second only in importance to the cubical air space per patient, is the distance to be maintained from pavilion to pavilion. In order to put myself in possession of the best information on this point, I determined to visit some of the best European hospitals. In January, 18G4, I made a minute inspection of the great hospital at Bordeaux, so graphically described by Mr Roberton, in his paper "on the defects" of hospital construction and ventilation. (Read -March, IS.'iG.) The Bp.aees between the pavilions here is barely 50ft., which the medical director and the architect, to whom I had the advantage of introductions, were of opinion was too small. At the Hospital Lariboissiere, Paris, the distance between the pavilions is 65ft. ; but here, also, I found, from the principal architect of the Parisian hospitals, that the interval was too small, and that in any future hospitals which might be erected by the Government, a considerable increase would be made in this respect. At the Hospital St Jean. Brussels, built about '25 years ago, and probably one of the earliest examples of a hospital erected on the principle of detached blocks, I found the distance not more than 3'2ft. At the new Herbert Hospital, at Woolwich—the best example of a military hospital in this country—the distance is 64ft. This great national institution has been erected, at an enormous expense, on a site where land was not of high value; and it is much to be regretted that this distance was not considerably greater, as the arrangement of the buildings is in most other respects admirable. At the new St. Thomas's Hospital now in course of erection at Stangate, opposite to the Houses of Parliament, the pavilions are to be 125ft. apart, which, considering its situation, surrounded by houses, except on the river side, will probably be found not too much to ensure a tolerable circulation of air about the buildings. Taking into consideration the above precedents, and that the site of the proposed Chorlton Hospital was in the open country, it was thought that 100ft. would be a sufficient interval ; and this distance was accordingly determined after long and repeated discussion. Moreover, .at the Chorlton Hospital the pavilions are more completely detached and isolated than in any other case I know,—the air circulating completely round them, and through the open arches of the corridor, without interruption from galleries or screens. Too much importance cannot be attached to this point, as the health of the inmates must largely depend on the free admission of fresh pure air. The complete isolation of the blocks also prevents the spread of infectious disorders from one building to .another, which it is well known among medical men is no uncommon occurrence in many of our hospitals. The cubical air space was thus fixed at 1,350ft. per patient, the spaces between the pavilions at 100ft., the height of the wards respectively at lift. 6in., 14ft., and 15fD , and the nature of the site seemed to suggest that the buildings should be placed in line, with one long corridor at the south end. The general outline of the plan was thus laid down ; the details have been worked out with regard to the best sanitary result, although the buildings have been constructed on the most economical principle consistent with durability. The ventilation and warming of these large wards was a subject which naturally involved considerable difficulty. Of course the first essential of good ventilation is the provision of a proper allowance of air space ; but with the most ample provision m this respect, it is necessary to have the means of changing the air contained in any hospital ward. There are various contrivances employed to admit the outer air in such places and in each a manner as to keep up an unceasing movement in the upper stratum of the ward, and a constant displacement of the f ml gases which rise to the top of any room containing a number of persons, and above all in a hospital ward constantly occupied, daily and nightly, by diseased inmates. The great difficulty is, of course, to accomplish the object without causing currents, and I have attempted to do so by arrangements which I will endeavour to make intelligible. In the east and west walls, or the long sides of the wards, are placed a series of Large windows 4ft. Sin. wide, and extending from 2ft. 9in. above the floor to the ceiling. These windows are in all cases facing one another, and are divided in their entire height into three subdivisions. The lower portion, for about three-fourths of the whole opening, consists of an ordinary double-hung sash; the upper fourth is pivoted, and works on a swivel with cords, to open at any desired inclination. On the top of this swivel light, and, in fact, forming a portion of it, Ls a continuous hopper-shaped frame, made of cast iron. This frame extends the entire width of the window. It is glazed at the front and ends, but a space at the top is left open .about 2in. wide and the full length of the frame. This long narrow opening is covered with fine wire gauze, and admits a constant but imperceptible stream of the outer air, which is continually passing across the ward close to the ceiling, towards the corresponding opening in the opposite window. A slightly upward direction is given by the sloping form of the hopper, in order that the air may be thrown towards the centre of the apartment, and be so distributed as to avoid down currents. Any or all of the three divisions may be opened more or less, at the discretion of the attendant ; but when all are opened to their full extent, the ward will in a very short time be flooded with fresh air. Besides this, however, there is the opportunity of obtaining a current from the two extreme ends of the ward, and flushing the upper part with fresh air without opening the doors. This Is effected by means of a glazed louvre, about 6ft. high and 4ft. wide, placed at the entrance end, over the door from the staircase ; antl at the other, or balcony end, by means of a large swivel window, similar in arrangement to those already described. The louvre, which is worked by a very simple mechanical contrivance with lever and screw ; may be adjusted to admit more or less air as required, but practically they are very rarely closed. There are also, at various points in the walls, air shafts or flues discharging above the roof level: and the ventilation is further assisted by a considerable number of small air grids or channels built in the walls, at short intervals, close to the ceiling. These grids have a sloping lip on the inside, projecting about 5in. from the wall, with an inclination of about 45 degrees, to prevent the air falling at once in a cold volume to the lower part of the ward. A corresponding grid is placed in the opposite wall in each case, and the air appears to take a direction generally across the ward, near to the ceiling. The air being thus admitted in very small quantities and at very numerous places, diffuses itself without perceptible draughts, and displaces the gaseous portion of the contained air which naturally rises to the top. The form of the small air channels is such that they would hardly be observed if not pointed out, and are, therefore, not likely to be wilfully obstructed, especially as they are close to the ceiling, aud therefore, out of reach. In the floor of each ward, at a distance of 6ft. from the outer walls, are a number of hit-and-miss gratings, with galvanised iron horizontal tubes or flues, to conduct the fresh air to the foot of the beds, should it be required in foul cases, or when it may not be desirable to open the windows. On the ridge of the roofs are revolving ventilators of large diameter, to promote the ventilation of the top wards, which are partly in the roof, so that the windows do not reach the highest part of the ceiling. The warming is effected entirely by means of large open fireplaces, three in each ward. They are placed in the positions marked on the plan; are 5ft. wide and 5ft. 6in. high to the upper part of the opening. An iron hood partly closes this opening; but in the hood is a large circular hitand- miss grating, so that when the fires are burning brightly the grating may be opened, and a stratum of air up to about 5ft. 6in. high be drawn off up the chimney. Practically the flues draw so effectually that it is very rarely necessary to close these gratings. The entire sides and backs of the fireplaces are built of firebrick, the inclination of the sides being at an angle of about 45 deg. ; so that the heat is reflected at a corresponding angle across the ward, and no difficulty has, I believe, been experienced in keeping up a proper temperature. The fire is contained in a basket of plain wrought-iron bars, all unnecessary metal being avoided. At the extreme northern end of each ward are the small rooms containing the baths, water-closets, &c., and between these projecting wings is an open air balcony for the use of patients who may be convalescent. The access to this balcony is through the largo window in the end wall, so that an infirm patient who cannot go down stairs may take the air without fatigue- A widely extended view over green fields is obtained from these balconies. The water-closets are contained in the left wing, and are extremely simple in construction and very inexpensive The entire basin and seat are of earthenware, without wooden seats or fittings. The cleansing is effected by means of a chain attached to the door, which raises the valve and flushes the basin each time it is used. A sink or trough for emptying the bed pans adjoins, and has a similar earthenware basin with a lead receiver on the top, flushed by means of a hand-pull. The divisions between the closets are of sawn slate slabs about 7 feet high, with a framework of cast iron; non-absorbent materials generally have been used wherever possible in this department. In each wing is a small angle fireplace. The baths and lavatories .are contained in the right wing, and the fittings here are generally of the best description. The drainage is entirely outside the buildings; and in no case is a drain brought within the walls, except to receive the descending soil pipes or waste water pipes. It is throughout of glazed earthenware. In the three principal chimney stacks in each of the five pavilions there is a special flue built, discharging above the roof, to which the drains are connected for ventilating purposes. This flue ia entirely independent of any other, but is placed between two smoke flues, which by their heat cause an upward current in the intermediate flue, and by this means the drainage is ventilated at fifteen points. On the top of these flues charcoal boxes will be placed, to destroy any gases which may rise from the drains. The cost of the five pavilions with the corridor as above described, including the gas and water supply and the various fittings referred to, has barely exceeded £23,000. Perhaps it would hardly be fair to describe this as representing the entire cost of a complete hospital for 480 beds, as the kitchens, stores, and administrative department generally are common to the workhouse buildings and the hospital, and to a large extent were in existence before the new pavilions were built ; but making allowance for the probable cost of such buildings, and for the value of the land, £30,000 would be, perhaps, a reasonable sum at which to estimate the cost of such a hospital, with its own independent administrative department. This would give the cost of such a complete detached establishment at the rate of about £6U per bed. The Chorlton Workhouse Hospital has no architectural pretensions whatever; but the most careful regard has been given to all those sanitary arrangements which it was thought might contribute to the alleviation of the sufferings of the inmates. [Building News 17 May 1867 page 339-340]

Reference    Manchester Guardian 5 January 1865 page 3 – foundation stone
Reference    Building News  17 May 1867 page 339-340