HOSPITALS OF INVERNESS
It is not surprising that Inverness, for long Highlands’ largest and richest town, should establish the Highlands’ first general hospital. However, opening the Northern Infirmary in 1804 was ambitious – it was only the sixth town in Scotland to do so.
Despite its city status, Inverness is a relatively small settlement but this ambition to match the larger towns and cities of Scotland continued and landed the Northern Infirmary managers in many a funding crisis over the years. Their greatest success was the rebuilding of the Infirmary in the 1920s making it one of the most modern in Scotland and few, if any, Scottish hospitals managed to achieve such a transformation at this time.
The Northern Infirmary was seen as the provider of health care for all of Inverness and the surroundings although it’s late 18th century ambition to be the hospital of the whole Highlands (hence the name Northern rather than Inverness Infirmary) had possibly to wait until the 20th century. Surprisingly by modern standards, the Infirmary took all fever cases except cholera but it was not until the 1970s that it had a separate fever building and also a separate sanatorium. The inadequacy of both - with rising national standards – led to the purchase of Culduthel which opened as a fever hospital on Christmas Eve 1917. Meanwhile the Citadel Hospital continued with cholera, smallpox and TB patients. The Citadel closed in the 1930s. Culduthel continued until 1989 by which time infectious diseases were confined to less than half a ward at Raigmore!
Inverness had a municipal doctor by 1680 for ‘attending and visiting the sick and diseased persons of this brugh’ and parish doctors attended the poor in Dunbar’s Hospital when it became the Poorhouse in 1846. In 1861, the Poorhouse moved to Muirfield and the numbers of sick increased over the years with over 60 sick beds in the 1930s. By then, Muirfield Hospital as it was then called was overcrowded and under resourced. Under the NHS it continued as a hospital mainly for elderly chronic sick until it closed in 1986.
From at least 1915, the Burgh supported the health of mothers and children through assistance to local child welfare groups. Few maternity cases went to the Infirmary which apparently only dealt with ‘difficult’ births but had an obstetrician on the staff from at least 1914. By the 1930’s, despite increasing public concern about childbirth mortality and adequate provision of maternity facilities, the Burgh seems to have had no strategy other than try to persuade the Infirmary (unsuccessfully) to receive cases and, eventually, in 1941, was forced to open Rosedene as the area’s first maternity hospital. Until then, the only alternative to home births was a nursing home – if you were well off – such as Rossal, St Margaret’s or Viewhill. The Ida Merry Home (1927 – 1940) specialised in maternity and took the ‘wives of working class men’. The poor and destitute had only the poorhouse which was also where most unmarried mothers landed up. Outside Inverness the three-bed Families Maternity Hospital at Fort George was remarkable in being the first maternity home in the area – opening before the First World War.
During the First World War, the Infirmary treated mainly naval personnel and Hedgefield and Leys Castle served as temporary Red Cross hospitals. The Infirmary’s role in the Second World War was reduced when, in 1941, Inverness was chosen for one of Scotland’s seven new Emergency Medical Services (EMS) Hospitals and, by the early 1940s, there was over 500 beds at Raigmore, far outstripping the RNI’s peacetime complement of just over 200.
Over the years, hospital doctors increasingly specialised and, by 1950, seven Highland consultant doctors were based in Inverness including surgery, orthopaedics, general medicine, obstetrics, Ear, Nose and Throat (ENT), ophthalmology and dental surgery. Raigmore Hospital contained specialist services from the start notably orthopaedics and soon provided much needed maternity facilities which were essential in coping with the post war baby boom and the growing expectation of hospital births.
From then on, the story is of expansion at Raigmore and transfer of services and departments from the RNI and from Culduthel when it closed in 1989. The RNI meanwhile developed into the present community hospital. Raigmore Hospital continues to provide a degree of specialty which is unprecedented in an area which has the largest catchment area (larger than Belgium) with the lowest population density of any hospital in the United Kingdom.
There has been much change over the past three generations and there has been virtually a social revolution which has much influenced access to hospital care. The rights of the poor, and of other groups such as unmarried mothers, to equal medical attention have been much enhanced and town councillors, magistrates and church ministers no longer dominate decisions on an individual’s social welfare and health care. Expectations have risen to a point that the system appears to be in constant financial crisis. However, even a cursory glance at the Infirmary records reminds us that health care has always been under financed and that no matter how much we have anticipated it over the years, we have still to find the ‘magic potions’ which will satisfy, if not reduce, our continually rising health care demands.
The omissions and problems over the years must not, however, allow us to understate the successes of the Inverness area which continues to offer an effective, advanced medical service to an area the size of Belgium but with a population of less than the average UK city. The success of this can be judged by noting that, a century ago, the Highlands was so comparatively poor in health services that special government intervention was required. Today, by contrast, many Highlanders would judge themselves better off than many parts of Britain in terms of medical provision.
The Hospitals of Inverness book was published in 2017 and contains many more details.