'E' Block, 1938-39

© City of London/London Metropolitan Archives

Gate Lodge, c.1934

© Chris Dorley-Brown

New Nurses' Home, c.1937

© City of London/London Metropolitan Archives

By the 1930s former poor law institutions were almost exclusively occupied by the aged and infirm, vagrants, unmarried mothers and the sick. With the passing of the Local Government Act in 1929 many poor law infirmaries, including the Hackney Union Infirmary, were modernised with their associated workhouses closed. Under the provision of the Act, which came into operation on the 1 April 1930, all the functions of the Hackney Board of Guardians* were passed to the London County Council (LCC) empowering them to manage and convert the Hackney Union Infirmary and Workhouse into a general hospital.

In the same year the Socialist Medical Association (SMA), founded by a number of Labour party members, was formed with the aim of creating a socialised medical service. In 1931 their first publication For a Healthy London expressed their desire for a free medical service, open to all; and formed the basis of a health manifesto, which they used to great success in the LCC elections of 1934. This election saw the first Labour victory in the history of the LCC, and the start of a 23-year reign for the Labour party in county council government. The SMA health manifesto claimed that London’s ill health was due to poverty, bad sanitation and inadequate medical care and treatment.

In the 1930s healthcare provision was provided by a myriad of organisations, which resulted in a chaotic system. Hospitalisation was not covered by health insurance and patients paid fees, which were usually means tested by the resident almoner (a medical social worker who was responsible for patient welfare and after-care).

In Hackney it took four years before all the healthy ‘inmates’ were moved out and the workhouse closed. Indeed from 1869 there had been a distinction between the workhouse (which was later called the Hackney and Homerton Central Institution) and the infirmary which was evetually changed its name to Hackney Hospital. From 1934 the former workhouse buildings were used as hospital accommodation, but this was administered separately from the existing infirmary. It took a further four years until this provision was amalgamated within the infirmary under the control of one matron in 1938. Up until 1934 the LCC had been led by the Municipal Reform Party – a local party allied to the parliamentary Conservative party. This may explain why changes at Hackney were slow and not implemented until 1934 when the ideals of the SMA and Labour party were put into practice.

“Seeing health as ‘every bit as important as education’ SMA members were appointed to a range of LCC committees when Labour won control, and were able to put some of their ideas into practice, such as increasing the allocation of resources to municipal hospitals, improving conditions and pay of nurses and other medical staff, providing outpatient facilities at most hospitals for the surrounding community and ridding hospitals of any Poor Law connotations”. (Gardener, J, The Thirties, 2010)

These ideals were put into practice at Hackney with a change of name and a range of new buildings, including a gate lodge with outpatient facilities that faced onto Homerton High Street, a nurses’ home, and a maternity wing on the site of the old lunacy wards. These buildings were modern, clean and domestic in scale, and gave the impression that improvements in local healthcare provision were afoot.

Notes

* The Boards of Guardians, created by the Poor Law Amendment Act 1834, replaced the parish Overseers of the Poor established under the old poor law and among many functions administered workhouses.