GOVERNMENT AND ADMINISTRATION OF HOSPITAL: Visitors' Committee minutes, 1908-1948; Visitors' Committee books, 1923-1948; annual reports, 1911-1912; general statement books, 1971-1956; general ledgers, 1880-1948; other administrative records 1870-1960, including medical journals, 1900-1931.
LAND AND BUILDINGS: contracts and specifications for building works, 1895-1924; property acquisition, 1872.
STAFF RECORDS: staff medical examination books: males, 1926-1953; staff medical examination books: females, 1926-1954; returns of officers' salaries, 1870-1949; monthly wages: attendants and servants, 1870-1919; weekly wages: attendants and servants, 1919-1948; weekly wages: female attendants and servants, 1944-1948; weekly wages: male attendants and servants, 1944-1948; weekly wages: renovations, 1882-1910; weekly wages: premises and maintenance staff, 1870-1919; pay and emoluments registers, 1906-1919; staff service registers: males, 1921-1948; staff service registers: females, 1921-1948.
PATIENT RECORDS: registers of admissions, 1870-1963; case books 1870-1944; Indexes of patients, 1870-1962; registers of discharges, removals and deaths, 1870-1966; other patient records, 1870-1980, including post mortem books, 1870-1941, and medical registers, 1907-1948.
CHAPLAINS' RECORDS: chaplains' journals, 1870-1953; order of services in the chapel, n. d.
ENTERTAINMENT RECORDS: posters for theatrical performances, 1872-1879.
|Administrative / biographical background:
The Lunatics Act 1845 (8 & 9 Vict. cap.100) set up a central body, the Commissioners in Lunacy, which had authority over all asylums in England and Wales and inspected them twice yearly. The Act also compelled all counties to provide asylum accommodation for their 'pauper lunatics'. There had not previously been any legal requirement for counties to provide any care for the mentally ill, who had usually been cared for at home, or in prisons or workhouses. Berkshire's Court of Quarter Sessions made an agreement to house their mentally ill patients at the Oxfordshire asylum at Littlemore, but by 1867 this was no longer adequate for its needs. It therefore formed a union with the Boroughs of Reading and Newbury to build its own asylum close to the village of Moulsford, in the parish of Cholsey, and known at first as the Moulsford Asylum. The local magistrates were responsible for the new asylum, and appointed a Committee of Visitors, including representatives of each of the bodies in the union (Berkshire, Reading and Newbury) to oversee its creation and management.
The Asylum was designed by Charles Henry Howell of Islington (1824-1905), the leading asylum architect of the 1870s and 1880s, and consulting architect to the Commissioners in Lunacy. The land was bought and building work began in 1867 and by September 1870 it was completed and the first patients were transferred from Littlemore. The asylum was designed to accommodate 285 patients but was almost full to capacity within the first year. In 1876 Oxfordshire decided to buy out Berkshire's remaining share of the beds at Littlemore, making it essential to expand the hospital to accommodate the extra patients. C. H. Howell therefore extended the asylum between 1878 and 1880 to accommodate 609 patients, additional staff cottages were built nearby, and outbuildings such as the chapel and bakery were enlarged and improved.
The Lunacy Act 1890 (53 & 54 Vict. cap.5) transferred local responsibility for asylums from the magistrates to the County Councils, but the Lunacy Commissioners still had nationwide responsibility until 1914 when the Board of Control was set up to manage the provision of care for both 'lunatics' and 'mental defectives', following the Mental Deficiency Act 1913 (3 & 4 Geo.V cap.28).
In 1896 the Borough of New Windsor joined the Berkshire union, and the asylum was expanded again to a capacity of 800. The building work took place between 1898 and 1901, and the architect was George T. Hine of Westminster (1842-1916), the new consulting architect to the Commissioners in Lunacy. Electricity and telephones were installed at this time. In 1897 its name was changed from Moulsford Asylum to the Berkshire Lunatic Asylum.
In its early years the hospital was a virtually self-sufficient community with its own bakery, laundry, chapel, farms and gardens. It was run by the Medical Superintendent, with the support of Assistant Medical Officers, and nursing and clerical staff. In addition the hospital employed a wide range of auxiliary staff including a farm bailiff, gardeners, an engineer, a baker, a shoemaker, skilled and unskilled workmen, seamstresses, laundresses, cooks and housemaids. Most of the staff lived in nearby cottages, and in addition to wages they received various 'emoluments'. These could include a number of cooked meals, uniforms, board and lodgings, or an allowance of farm produce to take home, so that staff had virtually everything they needed provided for them. This was fortunate because nursing staff were expected to work from 6am to 8pm, six days a week, and from 6am to 6pm on Sundays.
The farm and kitchen gardens provided male patients with an early form of occupational therapy. They could also work in the shoemaking and tailor's workshops, whilst female patients worked in the laundry or kitchens, and sewed most of the clothes worn by patients. Both male and female patients worked cleaning the wards and dayrooms. Encouraging patients to work not only helped to keep costs down, it was also seen as an essential part of 'the moral cure,' providing a way of motivating patients and rehabilitating them into outside society.
Whilst effective medical treatment for mental health problems was initially almost non-existent, 30 - 40% of those admitted between 1870 and 1875 were discharged recovered, usually within a year. Pauper patients were frequently admitted from the workhouse or from their own homes in a dire state of physical health, often suffering from malnutrition, and the hospital offered them rest and a nourishing diet, which was often enough to restore both their physical and mental health. The hospital also held regular services in the chapel, had a lending library managed by the chaplain, and offered a varied programme of entertainments, including sports, games, music, dances, and theatrical performances.
During the First World War additional patients were transferred to the asylum from other hospitals, such as the Sussex County Asylum, when these were taken over as military hospitals. This also happened during the Second World War, when the hospital reached its greatest size, accommodating over 1,400 patients, as patients were transferred from Brookwood Hospital in Surrey, Great Yarmouth Naval Hospital, Norfolk, and Hill End Hospital in St Albans, Hertfordshire.
Throughout the Second World War there was a shortage of suitable male staff, which meant that women were hired for secretarial and clerical positions previously held only by men, and from 1945 a female Doctor joined the staff for the first time.
At some point between 1915 and 1920 (the exact date is unclear) the hospital changed its name from Berkshire Lunatic Asylum to Berkshire Mental Hospital, and in 1948, when it was incorporated into the National Health Service the name was changed again to Fair Mile Hospital. Under the NHS Fair Mile was run by Berkshire Mental Hospitals Group Management Committee, which was part of the Oxford Regional Health Board until 1974. See P/HA 2 for the records of the Management Committee.
By the 1950s medical understanding of mental illness had greatly increased, as had an understanding of the social issues that could accompany it, and Fair Mile was able to offer the new 'physical therapies' for mental illness, such as deep insulin therapy and electro convulsive therapy, as well as employing a number of qualified psychiatrists, psychologists, therapists and social workers. The hospital had always struggled to recruit and retain enough staff, and despite the new opportunities available, including a structured three-year training programme, this continued to be the case, meaning that nurses were often recruited from abroad.
From the 1960s onwards more effective methods of medical and psychological treatment and the move towards community care meant that the hospital gradually decreased in size, accommodating only 200 patients by the end of the century. Under NHS reorganisations in 1974 Fair Mile was managed by the Oxford Regional Health Authority and from 1994 it was managed by West Berkshire Priority Care Services NHS Trust. In 2003 Fair Mile was finally closed as it no longer provided appropriate accommodation, and the remaining patients were transferred to alternative facilities at Prospect Park, Reading, which is managed by the Berkshire Healthcare NHS Trust.
1870 - 1886 Dr Robert Bryce Gilland
1886 - 1892 Dr J Harrington Doughty
1892 - 1918 Dr James William Aitken Murdoch
1918 - 1920 Dr Edwin Lindsay Dunn
1920 - 1938 Dr Walter Woolfe Read
1938 - 1946 Dr Hugh Astley Cooper
1946 - 1949 Dr William Ogden
The Fair Mile collection contains a complete set of the statutory patient records from 1870 to 1944, some patient records to 1966, and a very small number of later patient records, up to 1980 (D/H 10/D). There is a complete series of Chaplain's journals, recording services given, and the chaplain's other activities, from 1870-1953 (D/H 10/E1), and a series of staff records, recording medical examinations and salaries and wages until 1948 (D/H 10/C). There is a very small number of records relating to the lands and buildings, from 1895-1924 (D/H 10/B). The surviving administrative records are scanty. These consist only of: the Visitors' Committee minute books 1908-1948 (incomplete) (D/H 10/A1); the Visitors' records of inspection 1923-1968 (D/H 10/A2); the Medical Superintendent's general statement books (D/H 10/A4) containing monthly statistics on patient numbers, and notes on items of interest every month, and a small number of other administrative records.
Patient records have been arranged into series according to the type of information they contain: admission records; casebooks; indexes; registers of discharges, transfers, and deaths, and other patient records. They have been further divided into sub-series to reflect major legislative changes governing the format of the records.
The legislative background to the statutory patient records is complex. Under the Lunatic Asylums and Pauper Lunatics Act 1853 (16 & 17 Vict. cap.97) compulsory pro forma admission registers were used (D/H 10/D1/1/1 for pauper patients and D/H 10/D1/1/2 for private patients), and also registers recording patients' removal from hospital by discharge, transfer or death (D/H 10/D4/1).
Under the revised Rules of the Commissioners in Lunacy 1906 these were superseded by four new forms of register. These new registers were described as civil registers (admission registers for pauper and private patients, D/H10/D1/2), medical registers (completed upon admission, and containing medical information about patients, previously included in the admission registers, D/H10/D5/7), registers of deaths (D/H10/D4/2/2), and registers of discharges, departures and transfers (D/H10/D4/2/1).
The Mental Treatment Act 1930 (20 & 21 Geo.V cap.23) radically altered admission procedures to mental hospitals, allowing patients to be admitted voluntarily for the first time. From 1930 the civil registers were divided into three concurrently running sets for voluntary patients (D/H 10/D1/3/3), temporary patients (D/H 10/D1/3/4), and certified patients (D/H 10/D1/3/1-2).
Subsequent to the operation of the National Health Service Act 1946 (9 & 10 Geo.VI cap.81) these admission records were then merged together again as general registers (D/H 10/D1/4), and the registers of deaths, and of discharges, departures and transfers merged to become one series again (D/H 10/D4/3).