Company Servants' welfare
GWR Medical Fund Society (Swindon) 1847-1947
A model for the NHS
That Swindon can be thought of as being the birthplace of the NHS is not far fetched. In 1942 the Beveridge Report Social Insurance and Allied Services introduced the idea of universal coverage based on a social insurance model and eventually, on 5th July 1948, the National Insurance Act of 1946 came into effect. It was the first time anywhere in the world that completely free healthcare was made available to all and brought hospitals, doctors, nurses and dentists together under one national service. Until the NHS was formed, it was down to the individual or their family to pay for medicine and the attendance of a doctor. Those involved with the GWR Medical Fund Society long thought that it was a role model for a future which would see health care provided by the state. The society’s Annual Medical Report for 1916 said '...State Medical Service will undoubtedly be an ideal for the future but our present Society, properly organised and worked, could be made a model in miniature for a State organisation.' This was a view shared by Nye Bevan who, after visiting Swindon to see the health provision being provided, is quoted as saying '...There it was. A complete health service in Swindon. All we had to do was expand it to the whole country.' The birth of the NHS saw the end of the GWR Medical Fund Society after 101 years of service to the community with many of its services being replaced by those provided nationally and others being taken over by the local authority.
Members of the Society were issued with a membership book which listed some of the services offered and the times of availability. The blank pages inside were used to record prescriptions issued to the member. Our example belonged to C.G.Rayer(?) of the Loco Department at Swindon. It doesn't record when he joined, but does note that he was born in 1920 so it is possible that it dates from the early to mid 1940s. The inside pages are blank, so he was never ill enough to warrant a prescription being issued, and maybe he was a member for a relatively short time before the Society was wound up.
A Century of Medical Service
A small book was published by The Great Western Medical Fund Society in 1947 to celebrate their centenary. It was written by Bernard Darwin who sought to give an overview of its history and then went on to describe a tour of the facilities as they existed at the time. The NHS had not yet been formed, but the time when the Medical Fund would no longer required to provide a universal health service to the employees of Swindon Works and their families was clearly foreseen. The book also contains a selection of photographsClick or tap to see a gallery of some of these photographs which provide a lasting record of some of the facilities supported by the Society.
Background - 1843-7
Swindon Works first opened in 1843 and workers were attracted there from many parts of the country. To house them the company built a block of about 250 terraced cottages and other accommodation on land south of the railway. Speculative builders added to these and so New Swindon, a large and tightly packed community, grew. Poor sanitation and drinking water from wells meant that disease was common. The threat of cholera together with typhus and smallpox added to the serious accidents taking place inside the works to create a growing need for some form of health provision. The GWR had started a Provident Society as far back as 1838, but employees at Swindon Works were not eligible to join and had to pay their own doctor's fees. 1847 was a time of financial crisis for the GWR and the number employed at the works was severely reduced causing extreme finacial hardship to those who had lost their jobs. It is against this background that the Great Western Railway Medical Fund at Swindon came into being.
Many men had left the area looking for work elsewhere, but many also stayed hoping that when things improved they could return to the works. In the autumn of 1847 Daniel Gooch, who was Locomotive Superintendent in charge of the Swindon Works (who incidentally never actually lived in Swindon), wrote a letter to the secretary of the GWR outlining the situation and proposing to the company that an arrangement should be enabled which provided for the services of a doctor to both those still in employment and those who had been made jobless, to be paid for by the subscription of those still at the works. The Directors agreed with the proposal and also that a doctor be allowed to live rent free in a cottage owned by the company and be paid a £30 allowance by the company for his time and consumables.
The first encumbant was Dr. Stuart Keith Rae. It was he who had most often been called upon to attend accidents within the works and, as his fees were to be met by the unfortunate injured party, did not always get paid for his services. Doctor Rea moved into a three-storey former shop on the corner of London Street and High Street (Emlyn Square), which was to be his home, surgery and dispensary. Stuart Keith Rea was the brother of works manager Minard C Rea, which may have accounted for his services previously being so readily called upon. He was apparently a popular and hard working doctor but his career was cut short when he died in 1848 from tuberculosis, contracted from one of his patients.
Thus, in December 1847, The Great Western Railway Medical Fund at Swindon was founded. The aim of the new medical fund was stated as being to '...provide medicine and attendance to the men employed in the Works of the Great Western Railway at Swindon and their wives and families...' Its constitution changed a bit over the years but essentially the fund was always overseen by a small panel of employees from the works who undertook their unpaid duties in addition to their full time work. Membership of the fund was mandatory for all, with subscriptions being deducted from every man's weekly wage. The subscription varied from 4d (four pence) for a married man earning more than £1 to 1½d for a boy earning less than 10 shillings. In 1873 the Medical Fund was registered as a statutory friendly society with five trustees and the rules amended to conform to the Friendly Societies Act. Whilst the fund and its facilities always remained independant, the GWR paid it an annual grant which also covered the use of the hospital as a first-aid station.
In the decades after the fund’s formation, its remit expanded from merely administering medicine and attending accidents into a proactive body campaigning for, amongst other things, improved sanitation in the town. In 1853, minutes of one of the society’s meetings show requests for improved and increased paving and for the keeping of fowl and rabbits to be prohibited on account of the unsanitary conditions they created. While in 1859 the post of 'Keeper of Lime, Brushes and Invalid Chair' was created. Thereafter, lime could be obtained free of charge by any fund member in order to cleanse their cottage’s floor, walls and drains.
During the late 1850s, as the population grew, so did the calls on the resident doctor which led the Society to subscribe to hospitals in order to get 'letters' by which patients could be sent to them from Swindon. The first three being St. George's, St.Mary's and Bath hospitals. The situation would eventually be eased by the opening of a cottage hospital in 1871.
The Society always kept a keen interest in the welfare and hygiene of their members and in 1860 their minutes recorded that leave had been given to put 'the shower and slipper bath' in the bath room at the Mechanics' Institute. A year later more ambitious projects were put in hand as there were to be eight new shower baths and Turkish baths located on land behind the Mechanics' Institute. They were later moved to a yard at the back of the Barracks which had been built by the GWR in 1855 as accommodation for single men, but when this building was converted into a Wesleyan Chapel in 1868 the fund built 32 new baths on a piece of land between Taunton Street and Faringdon Road.
The Cottage Hospital
Unknown photographer, from A Century of Medical Service, published 1947
The Cottage Hospital
During the period 1859-60 there were growning fears that Napolean III might be planning an invasion of Britain. Workers at the railway works formed the XI Wiltshire Volunteer Rifle Corps as part of the national response to this threat. These volunteers had been drilling on open ground in Emlyn Square and by 1862, the GWR company approved the construction of an armoury and drill hall for their use on the same site at the heart of the railway village. As built, it consisted of a large hall with a single storey armourer's shop and orderly's room to the rear. Railway workers' cottages abutted the building on either side and in 1866 a further row of cottages was added to the rear of the armoury.
A number of serious accidents were being suffered by GWR workers in the works, and the company recognised that there was a real need for a hospital to treat them. In February 1871, Joseph Armstrong, then Superintendent at the works, petitioned the directors suggesting that the armoury should be converted to a hospital and one of the adjacent cottages given over to a nurse’s home. The directors approved the plan and, with the company covering the £130 cost, the building was converted to a cottage hospital, with a four bed ward, operating room, post-mortem room, and a reception accessed to the rear. A door was created between the ward and the nurse’s cottage to the east. The cottage attached to the west side of the armoury was given over as a dispensary and consulting room, with first-floor accommodation for the dispenser. The hospital was provided with a formal garden between the building and the road to the south, with flower beds, paths and a fountain.
The hospital was opened in December 1871 with its future secured by a trust fund of £2,000, £1,000 from Sir Daniel Gooch, and the rest from the Medical Fund. There would also be a £20 a year grant from the GWR and an increase in subscriptions to the GWR Medical Fund. The medical staff was increased to two surgeons and two qualified assistants and it was stipulated that the hospital was for accidents only, not for general diseases, and would be the first aid dressing station for the company.
Undated postcard courtesy of M. Haddock
Not strictly part the Medical Fund story, Park House does however play an important rôle in the welfare of works staff and was for a time leased by the fund. Overlooking Faringdon Road Park, Park House was built in 1876 as a home and surgery for the GWR's chief medical officer. This substantial three story house was the GWR village’s doctor’s surgery, treatment rooms and living quarters at its peak providing health care for 14,000 Swindon Works employees and their families. It was rented by the GWR Medical Fund Society in 1908 as a home for some of its medical staff and it later became the Company’s medical centre where men seeking employment with the GWR were examined. Park House is now a Grade II* listed building and since 1984 has been divided into serviced offices.
The fund’s membership and concerns continued to expand in the second half of the 19th Century as it assumed more areas of responsibility. In 1869 a small swimming baths situated within the works was opened for the use of members.Washing facilities were created with eight baths in the Mechanics Institute, later moved to a yard at the back of the Barracks. When this building was converted into a Wesleyan Chapel in 1868 the fund built 32 new baths on a piece of land between Taunton Street and Faringdon Road.
As the result of an accident in 1878 when an employee lost both legs when he was run over by a train, the Society arranged for a false pair to be made made by craftsmen from the carriage and wagon works. Thereafter artificial limbs, hands and feet would be made within the works and supplied whenever required.
A dentist and undertaker were appointed by the fund in 1887. An amendment to the Great Western Railway Act was necessary in 1888 to take it back out of the Friendly Societies Act when it threw its baths open to non-members on payment of a fee. Later, as a result of the National Insurance Act of 1911, the Society became an Approved Institution and the subscriptions had to be made made voluntary.
Milton Road building
Unknown photographer, from A Century of Medical Service, published 1947
New buiding and facilities
It was the arrival of the facility in Milton Road, almost opposite the cottage hospital, that was to be the most ambitious project to date. The land on which the building stands was bought for £999 in 1885, with construction starting six years later in 1891 and the grand opening following in 1892. The site was to eventually offer a truly comprehensive health and wellbeing package as it was home to a series of consultation rooms, a sizeable dispensary, a dental surgery, a waiting hall and Turkish and Russian baths, alongside the impressive large and small swimming pools. The water for the pools was apparently taken from the GWR's own supply at Kemble, heated in the works and then returned there, providing a constant supply. The large pool was frequently covered over with boards to transform it into a impressive indoor event space. In his 1947 book, Bernard Darwin wrote that '...the big bath has done its bit in more ways than one. It by no means stands idle when it is closed, but makes a splendid hall with a gallery running round it. It is used for roller skating and makes an admirable ballroom.' It was pressed into service as a military hospital during the first world war, and as a casualty clearing station during the second.
In 1921 the dental department was re-organised by Dr. J.M.AcMillan, one time Dean of Glasgow Dental School, who became the first full time dental surgeon. A consulting surgeon was also appointed that year, and in 1922 a consulting pathologist. In the decades to follow, the society continued offer more services adding departments of physical medicine, with its own full time medical officer and qualified masseuse, and ophthalmology in 1930. A chiropody department, a skin clinic, and a psychology clinic were added in 1942, followed by a paediatric clinic in 1944. Even a hairdressing salon had been set up in 1899, but falling custom led to its closure during the 1920s.
Plans for new hospital in GWR Park
Courtesy of Network Rail
Plans for a new hospital
It would appear that the Medical Fund Society had plans prepared in the early 1920s for a new large hospital to be built on the corner of Faringdon Road and Church Place, opposite Park House. This single storey building was to be arranged as three arms off a large central hall. The central arm would have contained an operating theatre, kitchen, staff and office accommmodation, and male and female isolation wards each having two beds. The other two arms were mirror images of each other, one for female and the other for male patients. Each housed a 16 bed adult ward, a 4 bed childrens ward, and a 4 bed medical ward. A corridor connection linked the end of the central arm to a separate outpatients block with its own operating room, male and female recovery rooms, pathology lab and dispensary, massage and electric treatment room! and waiting room. Its location would have been in one corner of the Great Western Park and meant the removal of a bandstand and a lodge by the entrance to the park in Church Place, the latter providing the site for a small mortuary. The scheme did not progress past the planning stage.
Temporary extension of 1927
Unknown photographer, from A Century of Medical Service, published 1947
The park had its origins in 1844 when land to the west of the new Railway Village, between Faringdon Road and the church was purchased by the GWR from Lt. Col. Vilett, a local landowner, for use as a cricket ground. A pavilion was built on the north side of the site and the New Swindon cricket team played there from 1847. Landscaping of the cricket field took place in 1871-2 when the entrance lodge was built and formal gardens were laid out on the eastern side of the park. The park, which was under the control of the Mechanics Institute Park Improvement Committee, was never exclusively for employees of the GWR. In 1925, The Park was made over to Swindon Corporation for use as a public park in exchange for some land to build a carriage workshop on the north side of the town.
The ambitious plans had therefore to predate 1925 and, possibly as a result of the new hospital not going ahead, a temporary single storey structure was erected in the garden of the Cottage Hospital in 1927. This provided much needed space and meant that ward capacity could be increased to 42 beds, with an X-ray department and a blood donor service also being added. Further building in 1936 provided a new surgical out patients' department and minor operating theatre.
Membership of the fund provided for a wide range of services free of chargs, but a patient would have had to pay a proportion of the cost for some items supplied, spectacles, artificial limbs and dentures for instance. It is interesting to note that in 1945 it was reported that the dental department was particularly busy with up to four dental surgeons carrying out a total of 10,000 extractions and 2,000 sets of dentures made on site.
The NHS took over the Milton Road centre in 1948. The pool and changing rooms were modernised in 1963, and again in 1986 after Thamesdown Council took it over and funded a major refurbishment. The building is now grade II* listed and operates as the Health Hydro, still boasting its 33m 4 lane swimming pool, gym, and Turkish Baths.
The Cottage Hospital itself did not close until well into the 1960s. The 'temporary' extension was demolished and the listed building is now used as a community centre.