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In the 1530s, following his dispute with the Pope, Henry VIII ordered the dissolution of all monasteries in England and Wales. This had a dramatic impact on patient care as the monasteries had been the main providers of medical care for many centuries. In some towns and cities, councils stepped in and took over the running of hospitals.

In London, the city authorities sent petitions to Henry VIII and his son, Edward VI, asking them to keep open the city’s hospitals. Both kings gave endowments for the running of five hospitals, including St Bartholomew’s and St Thomas’. Like medieval hospitals, these provided mainly for the poor sick, as rich people could afford doctors.

Though the royal endowments of land were not that generous and the hospitals were always short of money, this was an important development. For the first time the state, in the form of the king, had provided money for medical care.

Outside London, local councils had to find endowments to keep their hospitals open. In Norwich, the council took over the infirmary of St Giles monastery. It began with just four women providing basic care, but by the end of the 16th century had added a barber (who let blood), a surgeon and a bonesetter to its staff. However, many poorer areas, including large parts of Wales, were not so fortunate. In 1665 there were only four small hospitals, with just 36 beds, for the whole of north west Wales. These were effectively almshouses and none of them had a resident doctor.

The Enlightenment

The 18th century was the period of the Enlightenment. Medical societies, for example at Edinburgh University in 1737, encouraged new scientific methods and many new hospitals were opened. The Industrial Revolution created great wealth. Some wealthy businessmen, eg Thomas Guy, a London printer, donated money to open new voluntary hospitals to treat the growing population.

Eleven new hospitals were opened in London and a further 46 across the rest of the country, eg Addenbrookes Hospital in Cambridge and the Bristol Royal Infirmary. Slowly, hospitals began to change from places which gave only basic care to the sick to places that attempted to treat illness and carry out simple surgery, eg removal of gallstones and setting broken bones. Some also became centres of training for doctors and surgeons. Treatment was normally free. The 18th century also saw the emergence of dispensaries such as the Finsbury Dispensary in London in 1780, which provided medicines.

Voluntary hospitals in Wales

In Wales, a number of voluntary hospitals opened in the early 19th century. The General Dispensary and Asylum for the Recovery of Health opened in Denbigh in 1807. Swansea opened an infirmary in 1817 and Cardiff in 1837. Despite being Wales’ largest industrial town in 1830, Merthyr Tydfil did not get a hospital until 1887.

Specialist hospitals

Alongside these general infirmaries there were also a number of specialist hospitals set up during the 19th century. Perhaps the most famous is Great Ormond Street Children’s Hospital, founded in 1852.

Isolation hospitals were also established in order to treat infectious diseases. To protect Cardiff from infectious ship-bourne diseases, an isolation hospital was built on Flat Holm island in 1883.