Historians uncover new evidence in NGH archives to rewrite the story of how hospital paediatric care began

Researchers into the history of child health have used Northampton General Hospital's (NGH) archives to uncover new detail into the origins of English paediatric hospital care.

Previously many historians believed that there was very little hospital care for children prior to the founding of specialist institutions such as The Hospital for Sick Children at Great Ormond Street in London in 1852.

Where voluntary hospitals existed before this they were often paid for by contributions from local employers and aimed primarily at curing workers so they could get back to work.

It was thought that this meant children were not accepted as patients – or indeed in many hospital charters banned – so that the limited resources of early hospitals could focus on this goal.

But now new research pioneered by researchers from the Archive Northampton General Hospital, the University of Northampton and the University of Toronto Mississauga in Canada, has shown that children were actually commonly admitted to the early voluntary hospitals in England from the very beginning.

The team who worked together to deliver the research were Prof Andrew N. Williams, (visiting Professor of Child Health and Medical History at the University of Northampton and a former paediatric consultant at Northampton General Hospital), Mr Fred O'Dell, an archive volunteer at NGH, and Professor Madeleine Mant of the University of Toronto Mississauga (lead author), supported by five undergraduate students, Mollie Sheptenko, Judy Chau, Bryce Hull, Mia Taranissi, Maryam Khan and a master’s student, Charlotte Parry.

Together they authored "Little lives—reading between the lines: insights from the Northampton Infirmary Eighteenth Century Child Admission Database," which has just been published by Medical History, one of the world's leading history of medicine journals.

Prof Williams said: "In our rare surviving hospital archive we have demonstrated that more than 4,000 named children, aged 13 years and under, were treated for described conditions as inpatients and as outpatients at Northampton Infirmary (now Northampton General Hospital) between 1744-1801.

“After 1804 patient ages are not recorded. But it is highly probable that the total figure for Northampton Infirmary exceeds 10,000 children up to 1852.

“Our research suggests that several thousands of children were annually seen in voluntary hospitals in the 18th century regardless of regulations that in many cases banned them.

"This paper shifts the paradigm from the previous stale, and now erroneous, narrative that hospital child health care began in the mid-19th century with the opening of the first children's hospitals.

"Indeed, the first patient admitted to the Northampton General Infirmary on 29 March 1744 was Thomasin Grace, a 13-year-old girl, who was cured of scald head (ringworm) and who stayed in hospital for 101 days.

"In Northampton, in its first year of operation, our archives show that children as young-as two were seen in outpatients and were admitted to hospital from eight-years-old.

"This paper clearly shows a long history of a local hospital delivering important care to large numbers of children."

NGH archive volunteer Fred O'Dell gathered documents from the NGH and county archive which were then sent to Professor Mant’s team to be compiled into a working database.

He said: "Our work helps paint the picture of what the Northampton Infirmary was doing at this time, its leading figures, and how care was actually delivered - even though hospital rules and statutes essentially banned children.

"The reality was that many children from all over the county were taken in and treated."

Professor Mant from the University of Toronto Mississauga became involved when Prof Williams came across her previous 18th century research into The London Hospital.

Prof Mant said: "It was exciting to build on both my own and Prof Williams earlier research.

“This was a tremendous opportunity to work together and for our students to be involved and be credited as co-authors in ground-breaking historical research published in one of the world's leading journals.

“It was wonderful to see the students grow and present so well at different conferences on their research.”

The database is being prepared for publication on the Harvard Database – to be freely available for scholars worldwide.

Prof Williams said: "There is so much still to find out. We would very much welcome the help of local genealogists and historians to explore the later recorded lives of the patients after they left the care of the Northampton Infirmary.

"For example, our research has shown that the Infirmary's first patient, 13-year-old Thomasin Grace, was later married in London and on her wedding day she signed her own name; so during her inpatient stay she probably learned to read and write.

“Further research will help us to paint a much richer picture of what life was like in 18th century Northamptonshire and further afield."

University of Northampton Professor of Molecular Medicine, Karen Anthony, says: "We are proud to support this fascinating, new piece of medical history research. Andrew and the UK and Canadian teams have illuminated previously unknown chapters in the development of child and adolescent healthcare in the England, research that places Northamptonshire near the centre of this vital evolution in paediatrics."

The University of Toronto Mississauga financially supported all of the students involved in the research. These included Charlotte Parry who flew to Northampton last May to continue work at 'ground zero'.

The students presented the work at the Society for the History of Children and Youth Conference at the University of Guelph and got up at 5am to present by Teams to a University of Northampton Research conference.

Interesting facts from the NGH Archive:

• Northampton Infirmary was the ‘county hospital’ in the 18th century and took children from all over the county before Kettering General Hospital opened in 1897
• The hospital was originally a large town house rented for £30-a-year
• It was established in 1743 with 30 beds, increased to 60 in 1773, and 70 by 1782. Northampton General Hospital now has 790 beds.
• Between 1744 to 1801 the number of patients 13 and under treated were 4,163 and of these 56% were male and 43.3% female
• Conditions children were treated for included worms, dropsy (oedema), whooping cough, skin infections (abscesses, boils, ulcers), limb paralysis, and digestive diseases
• The admittance of child patients with infectious diseases was forbidden – but exceptions have been found in the archives.