Park Prewett Hospital

Beginnings

Park Prewett Hospital was one of a number of large psychiatric hospitals inspired by the Victorians and embodying many of their values. The institutions were not unlike the large country houses of the time, being situated in large grounds, often with a farm attached, and being a good local employer.

The fact that the site of Park Prewett included a farm was no accident, as many inmates of the asylum would be expected to work there, fresh air and hard work being a remarkably good therapy.

Although not opened until 1921, the ‘second county asylum’was first proposed in 1898. This came about following concern that Knowle Hospital in Fareham had reached the limits for its expansion, and that a new location in the north of the county would be more suitable. The committee of visitors of the Hampshire County Council asylum, chaired by Mr. W.H. Deane had narrowed it down to two sites in the vicinity of Basingstoke, Winklebury Farm and Park Prewett Farm.

At this time, the London architect George T. Hine, who had already designed a number of asylums, was called in for advice. Although both sites were favourable, Park Prewett was chosen, although the provision of a line of trees to serve as a windbreak was recommended. A suggestion for which we may be thankful, even today.

The Council bought Park Prewett Farm of 300 acres, part of the Vyne estate, for £30 an acre. In November 1899 Mr. Hine’s firm, Hine and Pegg was appointed as the architect. Although held in abeyance for some years while demand had dropped, the building was firmly back on the agenda by 1908, and preparations for building began in 1910. It was announced in the Hants and Berks Gazette of 16 August 1913 that the tender for construction from Thomas Rowbotham had come in at £258,777.

The main building was to consist of 15 wards housing 804 patients and 100 in admissions. In addition there were to be 10 villas for various types of patient and a private wing for 100 patients. In all, accommodation for 1300 patients, 167 nurses and attendants.

On 11^th July 1913, the Joint Asylum Committee had been very pleased with progress on the foundations and the bridge over the railway line being built to service the hospital was complete. Incidentally, this LSWR branch line served both in the construction of the site, and to bring coal and other supplies twice weekly up until its closure in September 1950. The line was not suitable for passenger traffic owing to its steep gradient (up to 1 in 53) and tight turns. The gradient was such that the loco had to be at the rear to prevent runaways should a coupling break. When tested for passenger use at the start of the second world war during the only confirmed run, the coach buffers were fully compressed, and one of the coaches got stuck in the bank of the cutting on its return journey.

By the summer of 1914 a number of one storey buildings were ready for roofing. Even the water tower had reached a height of 50ft. Of course 1914 was not a good time to be building, and labour soon dried up. This was somewhat relieved by the army requisitioning the hospital in September 1915 and deploying some of their own men.

Park Prewett thus opened in 1917 as a military hospital – Number Four Canadian General Hospital. This designation came from the Canadian Army Medical Corps unit, newly returned from Salonica as part of support for the Gallipoli campaign.

The hospital remained in military hands for two years, and then the long process of conversion back to the original purpose could commence. Finally, in August 1921, the hospital opened, accepting its first patients in the week beginning the 29^th.

The Hospital Opens

Four wards opened to begin with, many of the others were still full of the furniture acquired from the military and although the hospital was more or less ready it still bore many traces of its wartime experience and took some time to settle down to peacetime use.

Mr. Hines’s brief had been to produce ‘a plain building’, and it was indeed quite utilitarian but the proportions were generous and designed to please – even the façade had a secret – one of the windows above the front door is blind, only there for the sake of symmetry.

The design of the main hospital was symmetrical with two main entrances. The front door opened into a long corridor with administrative offices on either side and doctor’s quarters above. The corridor led to a central hall from which the other entrance door opened. The porter’s lodge was here and the hall was used for all the general business of the hospital; The dispensary and the path lab opened form it. Behind it was the main (assembly) hall and behind that the kitchen. From the entrance hall corridors led to the wards which formed wings on either side of this central block; one side for men and one side for women. The wards were built round an open rectangle; On their outward side each ward opened onto its own airing court surrounded by iron railings discretely covered by laurel hedges.

On the women’s side of the hospital were the laundry and the sewing room and on the male side the shops of the tailor, shoemaker and upholsterer. Behind the tradesman’s shops was the engineer’s yard, including plumbers, carpenters, painters, electricians and the tinsmith.

The main hall was very much the centre of hospital life, with its large high vaulted roof and well sprung floor, including a stage and an orchestra pit it was ideal for concerts dances and all kinds of entertainment.

During the 1920’s and 30’s there was very little therapeutic care, although patient’s often recovered there were many for whom the hospital was their life. There were few drugs prescribed, apart from paraldehyde, with its characteristic smell of stale whisky. A breakthrough in psychiatric treatment came with the introduction of malarial treatment for neurosyphilitic patients. Insulin shock treatment also came into use in the 1930s, and later on there was a major development with the discovery and introduction of therapeutic electro-convulsive therapy..

In the early days of Park Prewett, nurses worked a thirteen hour day often dealing with difficult patients. At mealtimes patients ate at long trestle tables using enamel plates and mugs with the so called lunatic knives and forks designed to prevent their use as weapons or for self harm.

By 1936 the patient population was already over 1300 and apparently set to go on rising, it was decided to build four more wards. Idsworth and Kingsclere on the female side and Vernham and Winchester on the male side. in February 1937 the proposals were accepted to provide the 128 new beds. Building work began in January 1938 and was scarcely complete when war broke out.

The Second World War

A week before the outbreak of the second world war, on Sunday 28th August 1939, all but eighty of the 1400 patients were evacuated as far as Gloucester and Wales as well as nearer locations such as Knowle, Dorchester and Salisbury. Largely successful, the evacuation did have some problems including a broken down bus on the way to Devises but the patients and their carers finally arrived in the early hours of the next day. From this point, the hospital was taken over by the Emergency Medical Service to provide 2000 beds for civilian and service casualties. A number of London hospitals (St. Mary’s, The Westminster, St. Thomas’s, Tite Street and the West London) were offered wards in Park Prewett, away from the bombing for their own staff and patients. The Matron and her assistants remained as well as a number of staff nurses who were given new roles. Four male and four female nurses stayed to look after their own patients as well as help the huge influx with their new surroundings.

The transformation to a general hospital was no small task. There was little equipment there and they now needed six operating theatres with ten tables, and a dental theatre at Rooksdown with five chairs. Originally there was no gas on the estate, which was needed for the sterilisers, so pipes needed to be laid. The hospital was extended to one with around 3,200 staff, including some 700 nurses. Much labour that was originally does by patients now had to be done by the staff.

The general hospital staff took a bit of getting used to by the Park Prewett nursing staff, who were used to a more strict regime. The first new arrivals swept through the hospital taking any food and supplies they wanted. The matron had observed this and the next morning they were called in one by one to her office and returned much chastened. There was no more such trouble. The arrival of medical students also was a novelty and some ran riot in enjoying their freedom, but they were removed from living-in after one particular party in March 1940 when much damage was done.

An American unit set up an Orthopaedic centre of 5 wards in 1940 as the obstetric wards received their first patients. One of the villas was used as a delousing station for mothers and children from London where they stayed for 48 hours while their clothes were fumigated.

Air raid precautions were maintained throughout the war including fire watching from the tower. The hospital was never hit, but the town was bombed during a daytime raid in August 1940, just missing the station when it was crowded with workers returning from the paper mills in Overton.

The hospital was used as a casualty clearing station with generally between seven and nine hundred patients, and by the end of 1943, over 31,000 patients had been treated. many D-Day casualties where treated here, with some 12,000 between then and the end of October 1944. The hospital was praised by the Ministry for its efficiency and received visits from The Princess Royal in August 1944 and the Duchess of Kent in February 1945. Sir Alexander Fleming even made a film in the hospital on the uses of Penicillin.

Rookdown House

Rooksdown House, which had opened as a Private Patient unit in 1930 was unlike the rest of the hospital. It was comfortably furnished, including billiard and reading rooms, and private rooms or even suites for those with the ability to pay. The war changed all that and it initially housed a dental theatre and a nurses home. It then housed the Plastic Surgery Unit until 1959, for much of the time under the command of Sir Harold Gillies, reopening as Rooksdown Hospital in 1960.

Harold Gillies

Sir Harold had pioneered the use of plastic surgery in the First World War and had become a consultant adviser to the Ministry of Health. The story goes (according to Reginald Pound’s biography) that he and Sir William Kelsey Fry, the dental specialist and long time friend, drove down from London in September 1939 to view Rooksdown. As they entered, a young nurse greeted them with the cry “Ye Gods, a man at last!”. Sir Harold retorted “Obviously this is the place for us” and recommended that Rooksdown be commandeered for the purpose.

Sir Harold was a remarkably talented individual. Aside from his gift for Plastic Surgery, he was a musician, an artist and in his younger days, an athlete. He was a rowing blue a Cambridge, a famous golfer and an excellent fly fisherman. It was even said he may have chosen Rooksdown on the basis of the proximity to the river Test. This is more likely than the golf connection – The hospital golf course (later developed into Weybrook Park) had not been built at this time.

Gilles was born in New Zealand of Scottish émigré descent, but returned to England for schooling and university at Cambridge. In 1914 he was assistant to Sir Milson Rees, a leading ENT surgeon, where he assisted in an operation on the Prince of Wales as well as meeting Sir Frederick Treeves, court physician, known for his friendship of Joseph Merrick (The Elephant Man). At the outbreak of the first world war, Gilles joined the Red Cross and went to France as a general surgeon. He worked with a Franco-American dentist, Valenteer where the then Captain Gilles was impressed with the work on repairing Jaw wounds with bone grafts. Through this and seeing a German book on Plastic Surgery he became interested in this kind of work. He then saw Hippolyte Marestin operating in Paris and became a mission for him to continue this on his return. He initially worked at Aldershot in 1916 and pioneered work for which there was little guidance except their own experience. In August 1917, the unit moved to the Queen’s hospital in Sidcup, where it expanded and remained in operation until 1929.

The Plastic Surgery unit at Rooksdown opened in February 1940 and continued here until 1957, when it moved to Queen Mary’s at Roehampton. Sir Harrold was obliged to retire at the age of 70 in 1952, although as Emeritus Consultant Plastic Surgeon, continued to practice, albeit unpaid.

Sir Harold is remembered locally in the Rooksdown Parish with ‘Gillies Drive’ named after him.

Post WWII

 After the war’s end in May 1945 the Committee immediately began to find out how to revert the hospital to its intended function as a mental hospital. The EMS seems to move out rather slowly and Rooksdown would remain as a plastic surgery unit for some time. The mental side was put under control of Knowle as a annexe under the Principal Medical Adviser. The hospitals that had been accommodating the patients were overcrowded and wanted to get back to normal occupancy. Early in 1946, three villas and seven wards returned to psychiatric use, all on the female side providing 309 beds and reducing the overcrowding at Knowle. By the end of 1946, it was getting back to normal with the return of demobilised staff and a total of 680 patients, although there were also still 300 EMS patients. There was much to be done in a time of shortages and austerity, and the returning Dr. Atkin who was now in charge introduced art and music as therapy and set up an occupational therapy department. At the end of 1947, the EMS finally left and the hospital was back to normal use, except for Rooksdown. Dr Thomas, who had been in charge of the hospital since the end of ward noted that under the EMS, 68,227 inpatients had been treated with a mortality rate at the busiest time of just one percent.

Care was now more therapeutic than custodial, with ECT, Insulin and now Leucotomy (introduced to Park Prewett in 1947). Following a management committee meeting in July 1948, new kitchen and laundry equipment, heating for the Villas and Nurses homes and many other repairs and new furnishings were instigated. Staff shortages were a problem, with volunteers making up the numbers in occupational therapy.

Changes in care in the 1950’s saw the end of patients being locked up and by 1957 there were only three locked wards, and soon after they were all open. Behaviour Therapy started as ‘Habit Training’ in 1956. The hospital year stared with a New Year’s Eve dance, and an Annual Ball in January, and the patient’s has a fancy dress ball and a pantomime. There was a concert and an art lecture each month. Football and Cricket were played, there was a sports day and a garden party and excursions for patients. The Christmas festivities saw a ward decorating competition.

Tranquilisers were introduced in the early 1950’s, and their calming effect enabled the more troubled patients to take part in hospital life, including the therapeutic social ‘Renaissance’ club which gave patients more autonomy in their own affairs. A new mental health act came into force in 1959 providing for more informal admissions to psychiatric hospitals. A Ministry of Health circular, just before that was published with the findings of the Royal Commission on Mental Health. This proposed that services be geared to support in the community and away from hospital care unless special facilities only available in hospital were required. Rooksdown Hospital for the treatment of nervous diseases was reopened in 1960 after the closure of the Plastic Surgery unit, and was specifically limited to 3 months stay. An alcohol treatment unit was opened there in 1961 and was one of the first of its kind.

The 1970’s was the decade in which Park Prewett began to face outwards to the community rather than inwards to itself. Park Prewett set up a complete community service, including discharges being looked after in the community and providing support to avoid admissions in the first place. They helped manage community clinics and day centres throughout Basingstoke and North Hampshire, sharing staff and expertise. They rented eight houses as sheltered accommodation and within the hospital grounds, Greenlands and Hollies villas became rehabilitation units, allowing patients to lead independent lives. In 1979, the farm cottages were converted for the use of discharged patients, they being supported by Social Security rather than hospital resources.

Friday April 3rd 1981 was a dark day for the hospital as the Main Hall was burnt down. From a few wisps of smoke to its destruction in the space of an hour. Fortunately it had not spread, and within a week the funds had been allocated to rebuild it to its original specification. It was reopened on 16th November 1983 by Lord Denning, recently retired as Master of the Rolls. The internal decorations were a big improvement on what had gone before.

The 1983 Mental health Act gave patients increased rights to appeal detention and by this time treatment in the community was the norm and some of the large psychiatric hospitals were already closing. In 1984 a draft plan for moving psychiatric services to the community was drawn up. At this time the hospital had some 600 beds and the plan was to reduce these to 300 by 1994. The hospital finally closed its doors in 1997.