CHARITABLE INSTITUTIONS.
BY C.E. MATHEWS.
=The Birmingham General Hospital.=--At the commencement of the second
half of the last century, Birmingham was a small manufacturing town
with a population but little in excess of 30,000 souls. At that time
no medical or surgical relief could be obtained by its suffering poor
except at the Infirmary attached to the Workhouse. But in November,
1765, Dr. Ash, an eminent member of the local medical profession,
called a meeting of the principal inhabitants “to consider the
advisability of establishing a general hospital for the relief of the
sick and lame.”
A public meeting was held at the Swan, November 21, 1765, which
resulted in “Benefactions” £1,555 18s. 0d. and “Annual Subscriptions”
£424 10s. 0d.
Little was done (other than the creation of a building debt) until the
year 1779, when this great charity fairly entered upon its long career
of humanity, usefulness, and honour.
Its income in those early years was scanty, its patients few and far
between, it had no endowment whatever. It was a privileged institution,
that is, except in cases of extreme urgency, its benefits were given
only to the holders of subscribers’ tickets.
During the year 1885, 3,545 in-patients and 38,501 out-patients were
treated at this Institution. Its subscription list amounted to £5,448;
the income of its endowments reached the respectable figure of £2,787,
and the total income from all sources, ordinary and extraordinary, was
nearly £15,000.
It is still in theory a privileged institution; but more than
two-thirds of the in-patients, and more than half of the out-patients
were admitted in 1885 as “accidents and urgent cases” without
recommendation.
In recent years enormous improvements have been made both in the laws
and in the administration of this Hospital.
The old system by which every Governor had a vote in the election of a
Medical Officer has been abolished, and vacancies for the much coveted
position of Physician or Surgeon to the charity are now filled by a
sufficiently large and representative Committee.
The legacies, which are very numerous, are funded to the extent of one
half of their amount; and the annual reports are models for clearness
and accuracy of information.
A great extension of the hospital work has recently been made. A branch
Hospital for chronic cases has been established by the munificence of
Mr. John Jaffray, and has recently been opened by the Prince of Wales.
The Endowment Fund of this department already exceeds £30,000, and
special subscriptions have been obtained amounting to nearly £500 a
year.
The great Triennial Musical Festivals, which in late years have ceased
to be peculiar to Birmingham, were first established in connection
with the Birmingham General Hospital. A Committee of the Governors is
specially appointed to carry out these important undertakings, and
they have spared no effort in procuring the finest music from the
ablest Composers, rendered by the foremost artists of the time. The
Elijah of Mendelssohn, the Eli and Naaman of Costa, the Light of the
World of Sullivan, the St. Peter of Benedict, and the Redemption and
Mors et Vita of Gounod, are some of the great works first produced at
Birmingham under the management of the “Orchestral Committee,” whose
aim has been on the one hand to obtain the perfection of music, and on
the other to augment the income of the Hospital.
These Festivals have been held since the year 1768, and have resulted
in a net profit to the Hospital of over £120,000. Since the year 1849,
the gross receipts at any Festival have never been less than £10,000,
and in one year they exceeded £16,000. In the year 1885, when the last
Festival was held, the gross receipts were £13,715, and the net profit
accruing to the Charity was £3,500.
=The Queen’s Hospital.=--This great Hospital is the second general
Hospital in Birmingham. It was founded in the year 1840, in connection
with the Birmingham School of Medicine and Surgery; a School which in
1843 became incorporated under the name of the “Queen’s College.”
It has an unusually large acting Medical and Surgical Staff consisting
of three Physicians, four Surgeons, one Physician for Out-patients,
two casualty Surgeons, an Ophthalmic Surgeon, a Dental Surgeon, and
an Obstetric Officer. It was established as a privileged Institution,
but in the year 1875 the regulations then existing were changed, and
it became a Free Hospital. From that time no privileges of any kind
have been given to subscribers, and the suffering and deserving poor
have been received and treated without any conditions or qualifications
other than the urgency of their need of relief.
There is no doubt that since the Hospital became free, it has gained
greatly in public confidence and popularity.
The In-patients treated in 1885 were 1,944, the Out-patients were
24,063. Some years ago it had a considerable endowment, but great
enlargements and improvements of the Hospital were necessary, and
were carried out a few years since at a cost of £26,000, of which sum
£10,000 was taken from the endowment, and the remainder was raised by
an active and intelligent Committee. The present endowment is only
about £5,000. The annual income from all sources may be taken at
£8,000, and the annual expenditure is about the same, though there
is no doubt that with a larger income the Committee could provide
in the present buildings a great increase in the number of beds,
and so materially reduce the average cost per patient. The ordinary
income of a medical charity is derived from subscriptions, donations,
legacies, and the income resulting from investments. By the laws of
many charities legacies are invested, and the income only of such
investments is applied to the annual purposes of the charity.
The Queen’s Hospital has not been able to take this course; all
legacies paid in any year being applied to the general purposes of the
institution.
In the year 1885 the income of the Hospital was made up as
follows:--From Subscriptions £2,648, from Donations £256, from Legacies
£1,621, from Registration Fees £852, from Income of Investments £197;
but these figures amount in all only to £5,574, and it has been stated
that the income of the Hospital is about £8,000 a year. How then has
the balance been obtained? In England there is no compulsory rate in
aid of our charitable institutions. M. Guizot left it on record that
when he first visited this country nothing surprised him more than
the constant recurrence of the words that met him at every turn in
London--“supported by voluntary contributions.” But the income arising
from “ordinary sources” was rarely sufficient to enable Hospital
managers to cope with the responsibilities thrown upon them without
incurring constant deficits and sometimes financial disaster.
Twenty-five years ago some Birmingham men, amongst whom the late Rector
of Birmingham (Dr. J. C. Miller) deserves most honourable mention,
grappled with the difficulty. The various Clergy and Ministers of
Religion, assisted by prominent lay townsmen, determined to organise a
general Collection once a year in all the Churches and Chapels of the
town and neighbourhood, for the benefit of the local Medical Charities.
Thus originated “Hospital Sunday.” It was resolved that every third
year the whole collection should go to the General Hospital, every
third year to the Queen’s Hospital, and every third year that it should
be divided among the smaller Medical Charities in certain proportions
based upon the number of patients relieved.
“Hospital Sunday” became immensely popular, and the example set by
Birmingham was imitated by the metropolis and by the larger towns and
cities of England. Since its establishment up to last year the medical
charities of Birmingham have received from the Hospital Sunday Fund the
enormous subsidy of £124,430.
From this source the Queen’s Hospital has received, up to the year
1884, £42,188; its triennial collection amounted to £4,356 in 1881,
and to £4,181 in 1884. But the year 1873 witnessed a new departure.
It was felt that it was not enough to make collections only from the
habitual frequenters of churches and chapels, most of whom might be
assumed to be regular subscribers to the various charities or donors
to their funds. It was felt too that the great body of the artisan
population were able and willing to do something for the support of the
great institutions founded almost wholly for their benefit; and thus
“Hospital Saturday” became a friendly but formidable rival to “Hospital
Sunday.” Once a year collections are made in all the manufactories and
large workshops in the town and district, and up to, and including the
year 1885, the hospitals have been subsidised from this welcome source
to the extent of £46,800. Not only so, but these annual collections
are steadily growing in amount, to the great credit of the industrial
population and to the lasting benefit of the charities of the town.
It is interesting to note the increasing annual amount the Queen’s
Hospital has thus received. In the year 1880 it was £670; in 1881,
£711; in 1882, £852; in 1883, £931; in 1884, £1,056; in 1885, £1,135,
and the accounts for the present year shew a large increase on any
figures hitherto recorded.
=The Birmingham General Dispensary.=--This Institution is the oldest
medical charity in Birmingham except the General Hospital. It was
founded in 1794, and has deservedly enjoyed a very large share of
public confidence. It is a strictly privileged institution. Every
subscriber has so many tickets for his subscription, and has also the
power of procuring supernumerary tickets. There are of course no beds,
all patients being attended at their own homes. Accidents or urgent
cases, such as sometimes put great pressure upon the resources of a
general hospital, are here extremely rare. There is, therefore, no
debt. The services of the medical staff can be purchased at a rate
sufficient to cover the cost. Consequently the subscription list has
always been large, the finances invariably prosperous, the revenue
always in excess of the expenditure. So great has been the success of
this institution, that the managers sometimes hardly know what to do
with their money.
The income for the year 1885 from all sources was considerably in
excess of £6,000. The whole expenditure was under £5,000, and the
managers were able out of the income of the year to put by £1,500. The
income from investments alone was £608. There was a considerable sum
on deposit, and a large credit balance at the Bank. There is a central
dispensary in Union Street, and branches at Camp Hill, Aston, and
Ladywood, all with Resident Surgeons attached.
In former days it had a large midwifery and vaccination department,
but the former was abandoned in 1869 and the latter in 1870. The
dispensary, therefore, now addresses itself only to the ordinary
medical treatment of the sick poor. All the medical officers, including
the consulting officers, are paid for their services. The patients who,
in 1871, numbered 10,570, had increased in 1885 to 21,888.
=The Orthopædic and Spinal Hospital.=--This small but useful
institution has existed since the year 1817. It has three
Acting-Surgeons, and one Assistant Surgeon. The Surgeons attend daily
and give gratuitous advice to the deformed poor. Ordinary cases are
admitted without letters of recommendation, but in the numerous cases
where supports or instruments are required, subscribers’ tickets are
necessary to cover the cost. The instruments supplied in 1885 cost
upwards of £500. The new cases in that year were 1,654, the attendances
7,439. The total expenditure was about £1,400.
=The Eye Hospital.=--The Birmingham and Midland Eye Hospital is one
of the best special Hospitals in the provinces. It has not only been
of incalculable service to the poor of the town and neighbourhood,
but it has founded an important school of ophthalmic science in the
Midland district. Diseases of the eye cannot be adequately dealt
with at general hospitals. Where the delicacies and difficulties
of any disorder are such as to require minute manipulative skill
and practitioners of great experience, a special Institution is
imperatively necessary. This Hospital has had a really splendid career.
It was founded in 1824, and commenced its operations in a humble
manner in Cannon Street. It then migrated into improved premises in
Steelhouse Lane. In 1861 it found a third home in Temple Row, and in
1884 a new Hospital was erected and opened in Church Street capable of
accommodating 70 beds.
The acting Medical Officers of the Institution (exclusive of House or
Resident Surgeons) are by the laws to consist of not less than four and
not more than six Honorary Surgeons, so that ample provision is made to
secure the adequate surgical treatment of the present patients and of
any probable increase in their number.
In order to insure the maximum of surgical ability every acting Surgeon
is bound to resign his appointment on his attaining the age of 55
years, or on becoming physically unable to discharge his duties in an
efficient manner.
In the year 1885 there were 925 in-patients and 13,461 out-patients.
590 operations were performed during the year on in-patients alone.
The annual income is large, but as yet hardly adequate to meet the
requirements of the new Hospital. The income for 1884 was £3,807, and
the expenditure £3,213; but the income for 1885 was only £3,098, whilst
the expenditure was £4,187.
=The Lying-in Charity.=--This is a small but most useful and deserving
Institution. It was founded as a Lying-in Hospital in the year 1842.
Its original managers attempted to deal not only with lying-in cases
in the wards of the Hospital, but also with the ordinary diseases of
women, and with children. The Institution was never successful, chiefly
because it attempted too much. As a rule no Institution devoted to more
than one speciality succeeds. Moreover, when the statistics of Lying-in
Hospitals came to be examined, it was discovered that there was a
great difference in the mortality of patients treated in Hospitals and
of patients treated at their own homes. In the year 1874, the system
of the charity was remodelled, a large building was abandoned, and
patients were attended only at home. The change has proved eminently
successful. Four competent Midwives are regularly employed, all of
whom have large experience. The medical staff consists of a consulting
Surgeon and four acting Surgeons who are called in in cases of
difficulty or danger. The competence of the Midwives is best tested by
the fact that the services of the members of the honorary medical staff
are only required on an average once in 44 cases.
In the year 1885, 931 cases were attended at a cost of less than £500.
Few institutions in Birmingham have in recent years done better work at
a more reasonable cost than the Lying-in Charity.
=Free Hospital for Sick Children.=--This Hospital has been one of the
most successful ever founded in Birmingham. It is a general Hospital so
far as regards disease, but a special Hospital so far as regards age.
It was founded in 1861, and was opened for the reception of patients on
the 1st January, 1862, and during that year its income and expenditure
were about £700. In the year 1885, its in-patients were 713. Home
patients, 27. Out-patients, 12,692. Its income and expenditure exceeded
£4,000.
Few local institutions have ever enjoyed greater popularity. The
Charity from its very name appeals to a very wide circle, and the
administration has been marked by foresight and discretion. Not only
was it the first Free Hospital in the town, but it was established on
principles then considered novel, but which have since in part at least
been adopted by other local institutions.
For instance, the tenure of office of physicians and surgeons is
limited, and the medical officers, though absolute in their own
department, cannot sit upon the Board of Management.
Again, at this Hospital, first in Birmingham, was an honest effort made
to limit the relief given to the _Hospital population_ only, that is to
those who were above pauperism, but below the capability of paying for
medical advice. Here too, the system was first adopted of paying the
Junior members of the Medical Staff, and here also was the principle
first laid down of vesting the election of medical officers of the
charity in a large and representative Committee. This rule has been
almost unanimously followed by other local institutions.
The Hospital has a dispensary and out-patient department in the
centre of the town, an in-patient department with detached fever
wards in Broad Street, and a convalescent department with separate
management, many miles from the town. 151 children were received in the
convalescent home during the year 1885.
The work of the Committee of Management of this Hospital is
supplemented by the kindly aid of a large Committee of Lady Visitors,
and by a Special Committee of Ladies for the management of the
Convalescent Home.
=The Ear and Throat Hospital.=--This is a small institution, having
for its object the treatment of diseases of the ear and throat. It has
lately been reconstructed upon a new basis. It is rather a dispensary
than a hospital, having no in-patient department. Tickets can be
obtained by patients desiring the advice of the Medical officers. The
subscription list is under £100 a year, the income being made up by
contributions from the Hospital Sunday and Hospital Saturday Funds,
together with the amount realised by the sale of supplementary tickets.
The total number of cases treated during the year 1885, was 2,398.
=The Dental Hospital.=--This institution was founded in 1860, and
should rather have been termed the Dental Dispensary than the Dental
Hospital. It has five honorary dental surgeons and four honorary
administrators of anæsthetics. Thus the advantages and resources of
modern dentistry are placed within the reach of those who but for
this institution would undergo much preventable pain. Every fitting
applicant suffering pain is entitled to advice and attention, but
special operations are performed only upon patients who have a
recommendation from a Governor.
There were 9,453 patients in 1885. The expenditure was less than £300.
=The Sanatorium.=--This Institution was founded in 1866, and has proved
a most valuable supplement to the work of our local hospitals. It
enables convalescent patients to obtain rest, pure air and nutritious
diet at one of the most healthy and beautiful spots within a reasonable
distance of Birmingham.
Some years ago a fund had been raised for relief of distress in the
cotton districts, and when the distress had subsided a considerable
portion of the fund remained undisposed of. With the consent of the
donors £4,500 was devoted to forming a nucleus for the Building Fund of
the Sanatorium. The work was completed in 1873. The total cost of the
site, buildings, and furniture was £16,800.
The institution receives 40 male, and 40 female patients, and every
possible effort is made to provide for their health and their amusement.
No privileges are given to subscribers; but patients are received
either from the Medical Charities in Birmingham, or from the general
public, on the recommendation of a medical practitioner.
The income and expenditure are about £2,000 a year. The charity applies
all donations exceeding £10 to a deposit or investment fund, and ten
per cent. of the amount of the fund so created is withdrawn each year
for the current purposes of the institution.
=The Homœopathic Hospital and Dispensary.=--This hospital is supported
by the friends of the system of homœopathy. It has one honorary
physician and five honorary surgeons. It is a general hospital, and
has departments for in-patients, out-patients, and home patients. The
in-patient system is different from that of most general hospitals, a
certain number of beds being reserved for patients who can afford to
pay for the benefits they receive. Again, all in-patients are admitted
at the discretion of the medical staff, so that as regards this
department the hospital is free, no subscriber having the privilege of
ensuring a bed. Subscribers have tickets for out-patients and for home
visits. This provision for visiting patients at their own homes is of
great value in connection with this Charity. The in-patients in 1885
were 167. The home-patients 584. The out-patients 18,752.
The expenditure for 1885 was £1,640. The income £1,380, leaving a
deficit of £260.
Ladies as well as gentlemen serve on the Committee of Management.
=The Hospital for Women.=--This is a valuable and important
Institution. When the Lying-in Hospital gave up the treatment of
women’s special diseases and devoted itself exclusively to midwifery,
there was an opening for an institution for the reception and treatment
of women afflicted with diseases peculiar to their sex.
Two classes of patients are admitted. Paying patients who contribute
the whole or part of the cost of treatment, and general cases, which
are admitted without any subscriber’s ticket of recommendation. The
expenditure for the year 1884 (no report has been issued for 1885) was
£1,736. The income was £1,466, leaving a deficit of £270.
During the same year the out-patients were 3,299, and the in-patients
294.
The acting Medical staff consists of five Surgeons, one of whom is a
lady. It will be obvious that in a Hospital of this character many
operations of cardinal importance are constantly performed. No fewer
than 217 operations were performed during the year 1884.
=The Skin and Lock Hospital.=--This Institution was opened in 1881 for
the treatment of skin and lock diseases. There was ample room for it,
no special department for cases of this kind existing in any of the
general Hospitals of the town.
During the year 1885 nearly 2,000 cases were treated. The income of
the year amounted to £1,081, and the expenditure only to £624. The
Committee of Management, however, are desirous of erecting a Hospital,
and thus be enabled to deal with serious cases as in-patients. A
site has been secured for this purpose in John Bright Street. It is
estimated that £5,000 will be required. £1,200 of which has already
been obtained.
The Hospital is conducted on the free system, but some patients are
received on payment of a sum sufficient to cover the bare cost of their
treatment.
=The Deaf and Dumb Institution.=--This Charity is an educational
establishment. It was founded nearly three quarters of a century ago
for the instruction of deaf and dumb children. 70 boys and 58 girls
were on the books during the year 1885. The Charity is supported by
voluntary contributions, supplemented to a considerable extent by
payments on behalf of the inmates.
Children are admitted by election, and the election takes place at
the Annual General Meeting. Every Governor is entitled to one vote
in respect of a donation of £10, or an annual subscription of £1.
1s. Children admitted without election pay £25 per annum. Elected
children pay £10 if they come from Warwickshire, Worcestershire,
or Staffordshire; £15 if they come from other Counties, and £20
if maintained by Boards of Guardians. The system of education is
excellent. Children are taught not only by means of the manual alphabet
but by articulation and lip reading, in cases where that system can be
advantageously employed.
The Institution is placed in a healthy and beautiful situation in
Church Road, Edgbaston.
The income for the year 1885 was £2,726, made up as
follows:--Subscriptions £461, Legacies £804, Donations £63, Interest on
Investments £400, Payments for Pupils £986, Sundries £12. Total £2,726.
The expenditure was about £100 in excess of the income. There is no
rule as to funding legacies. The charity does excellent work and is
deservedly popular.
=The General Institution for the Blind.=--This Institution has been
of immense benefit to the town and neighbourhood. The buildings
are handsome and commodious, and are situated in a charming part
of Edgbaston, about two miles from the centre of Birmingham. The
Charity was founded thirty-eight years ago. The expenditure in 1885
was a little in excess of £4,200, whilst the income, including sales
of materials manufactured by the inmates, reached the large sum of
£6,270. The subscriptions and donations amounted to £778, Legacies
£2,119, the interest on investments was £734. Payments by Pupils £765,
Sales £1,874. Here too the legacies are not funded. But the large sum
received from legacies in 1885, together with the balance in hand at
the commencement of that year, enabled the managers to invest over
£2,000 out of the year’s income.
46 males and 32 females were in the Institution in 1885, and 257 adult
blind persons were visited and taught at their own homes.
Great efforts are made by the managers to find permanent employment
for pupils who have been taught at this excellent charity. Many pupils
are turned out fully competent organists, and many become professional
piano tuners, and follow the trade of basket making.