Federated Hospital: 1961-1987.

In 1805 Dr Steevens’ Hospital had (due to its precarious finances) followed the custom of similar hospitals in petitioning the Irish parliament for a grant in aid for that year – a grant which soon became an annual feature. We see here the copy of the 1806 act which mentions this new departure for the hospital.

Act of George III, dated 1806.

As Kirkpatrick (1924) notes, by 1829 there were seven Dublin hospitals being supported by government grant: ‘These were the Westmorland Lock, the Meath, Cork Street Fever Hospital, the Rotunda, the Hospital for Incurables, the House of Industry Hospitals, and Steevens’. Parliament, concerned that hospitals elsewhere might be disadvantaged by this scheme, set up a Commission which reported in 1856 (the South Report), which in the case of Dr Steevens’ Hospital, recommended the setting up of a Medical School, and, more generally, greater supervision of the seven hospitals. By 1885 the idea of an amalgamation of the seven hospitals was being floated but did not come to pass. The idea was again floated during the 1920s and 1930s but, given the economic difficulties of the 1930s, was not implemented and in any event the Irish Hospital Sweepstakes (1930) seemed to solve the financial problems of the voluntary hospitals. However, by the early 1950s the economic underpinning of the hospitals had changed and, as Gatenby (2006) tells us, medical professionals of Sir Patrick Dun’s, the Adelaide and Dr Steevens’ proposed reform of the system, a reform which led to the setting up of a parliamentary act which would have far reaching consequences for not only Dr Steevens’ Hospital but also for the six hospitals with which it would become federated in 1961: the Adelaide (1839), the Meath (1753), Mercer’s (1734), the Royal City of Dublin, Baggot Street (1832), the National Children’s Hospital (1875) and Sir Patrick Dun’s (1808).

This act, entitled ‘Hospitals, Federation and Amalgamation Act’, became law on 8 July 1961. It stipulated that a Central Council be set up to control the capital expenditure of the seven hospitals. In addition the new Central Council had the right of appointment of all medical staff in the newly Federated Hospitals, who would now be assigned to work in one or more of the hospitals. The Central Council was also given the difficult job of centralising the pathology services for the hospitals. At the same time, the federation enabled and encouraged the development of specialised units, to avoid unnecessary duplication of scarce resources. As Hennessy (2006) notes, ‘The Federated Dublin Voluntary Hospitals represented a laudable attempt at creating an integrated and co-operative hospital group and while there were inevitably tensions and stresses in the system, it was, on the whole, highly successful.’

Perhaps the most important task allocated to the Central Council was the planning of a new hospital. The subsequent Fitzgerald Report of 1968 advocated that the Federated Hospitals should be divided between St Vincent’s and the site of St Kevin’s Hospital (now known as St James’s). It further noted that ‘our hospitals are too many, too small and too independent of each other’, a scenario which meant that the clinical specialisation necessary for high quality care was not possible. By 1971 the Department of Health was focussing on developing St James’s Hospital as the site of a new hospital which would replace some of the federated hospitals. While some of these (and in particular Dr Steevens’) hoped they might continue to exist as separate entities, the writing was on the wall for such small hospitals with the Fitzgerald Report’s declaration that ‘we consider the small hospital of less than 200 beds with one surgeon and one physician is no longer capable of adequately meeting public needs… we recommend that the broad policy should be to establish General Hospitals of not less than 300 beds.’ Any hopes of surviving as a separate entity were dashed by the recession of the 1980s which resulted in the closure of Dr Steevens’ as a hospital in 1987.

Sources

Daly, Mary E. (1999), ‘‘An Atmosphere of Sturdy Independence’: the State and the Dublin Hospitals in the 1930s’ in Malcolm, Elizabeth and Jones, Greta, Medicine, Disease and the State in Ireland 1650-1940 (Cork University Press), pp. 234-252.
Gatenby, Peter (2006), ‘The beginning of the Federated Dublin Voluntary Hospitals’ in Fitzpatrick, David (2006), The Feds. An Account of the Federated Voluntary Hospitals 1961-2005 (Dublin), pp. 19-24.
Kirkpatrick, T. P. C. (1924; reprinted 2008) The History of Doctor Steevens’ Hospital Dublin, 1720-1920 (Dublin).
Fitzgerald Report (1968). Outline of the Future Hospital Scheme. Report of the Consultative Council of the General Hospital Services (Dublin).