Sick Kids hospital: At the forefront of child medicine for last 150 years

As the Sick Kids reaches a landmark anniversary, staff celebrate the pioneering role of the Capital institution

THEY were the "unfortunate little creatures" who were afflicted by horrendous diseases.

Among the poorest sections of society and too feeble to attract attention, their hope for recovery often turned to a wish for death.

It was exactly this kind of suffering by sick children in the 19th century that prompted Edinburgh doctor John Smith to pen a public letter in February 1859, stressing the need for a dedicated children's hospital in the area.

"No colours are too strong to paint the sufferings of young children amongst the lowest and poorest classes of the population, when afflicted with disease", states the letter, which appeared in the Evening News' sister paper The Scotsman.

"When starvation, helplessness and neglect – nay, perhaps brutality – are added to bodily illness, the picture may become a painful one, but it is one to which we must not shut our eyes."

His appeal prompted businessman George Barclay to make the generous offer of 100 towards the establishment of a children's hospital in Edinburgh. The donation was to kick-start what later became known as the Royal Hospital for Sick Children.

On Monday the hospital will celebrate a very special landmark – its 150th birthday.

The hospital has played a pioneering role in the world of paediatrics for a century and a half, breaking new ground in treatment, helping establish women at the forefront of the medical profession and creating the very role of paediatric nurse – ultimately saving countless young lives.

It was Mr Barclay's kind donation that led to the public meeting at the Freemason's Hall in George Street in May 1859, at which a motion to establish a hospital for the relief of sick children was met with unanimous approval.

It was also agreed that the hospital would become a training school for medical students and nurses.

The hospital was the first of its kind in Scotland and one of a tiny number in the world at the time. The remarkable step was also accompanied by the groundbreaking decision to teach paediatric medicine as a separate subject – a controversial step for the Victorians.

Rowena Conrad, a paediatric nurse at the Sick Kids since 1985, explains: "Paediatric medicine was part of women's medicine so it wasn't seen as a separate subject in its own right at the time."

Nevertheless, the constitution for the new hospital was ratified later that month. A large building on Lauriston Lane was swiftly transformed into a hospital with 20 patient beds, and the doors opened in February 1860.

More than 150 children were admitted and treated in the first 11 months of the hospital opening but it quickly became a victim of its own success, with many poor languishing and dying children refused admission due to a lack of beds, or because they were fever patients.

In May 1863 Meadowside House took shape as the new and enlarged Edinburgh Hospital for Sick Children.

The first permanent surgeon to work at the hospital was a true medical pioneer, Dr Joseph Bell, who was part of a dynasty of surgeons and provided the inspiration for Sir Arthur Conan-Doyle's Sherlock Holmes because of his powers of observation.

He developed a number of new techniques at the hospital, often putting his own life on the line in his relentless efforts to help children recover from a range of horrific diseases.

Mrs Conrad, 46, who has researched the history of the hospital, adds: "He developed a pipette for sucking out the membrane from the throats of children with Diphtheria in the 1880s. He was putting himself at high risk of contracting Diphtheria because if you're sucking out somebody else's toxins, it is a matter of great timing not to end up swallowing it."

In July 1864 Dr Bell contracted Diphtheria and was critically ill for a month. He was too weak to even dress himself for several months afterwards. Mrs Conrad added that "his gait remained abnormal for the rest of his life".

Years after he had recovered from the bacterial disease, Dr Bell and Mrs Booty – the matron at the hospital – together pushed the boundaries in medicine, leading to paediatric nursing becoming recognised as a profession in its own right for the first time. Working with the support of Florence Nightingale, they established a three-year nursing programme that still forms the basis of specialist training right to this day.

Mrs Conrad says: "In the 1880s they established the curriculum for what is now the Registered Sick Children's Nurse training."

Dr Bell was also influential in the opening of the dedicated children's surgical ward at the hospital in November 1887. Following the opening, an increasing number of children attended the hospital for their surgery, rather than the Royal Infirmary.

Meanwhile Mrs Booty wasn't the only woman to play a pivotal role in the running of the Royal Hospital for Sick Children. Following a major outbreak of typhoid in 1890, in which a nurse died and concerns were raised that the hospital building was no longer clean, a new hospital was built in Sciennes.

The outbreak of the First World War saw 11 members of medical and surgical staff on military operations and, as a result, a new generation of professional women was born.

The hospital, alongside other institutions, helped push women to the forefront of the medical profession in a way that would have been unimaginable just a few years earlier.

In 1916 women were welcomed on to the medical team at the hospital. The resident surgeon was Dr Gertrude Herzfeld, an Austrian Jewess, known affectionately to the nurses as "Gertie".

Over the last 150 years the hospital has been the first in the country to introduce increasingly sophisticated surgical techniques, as well as developing separate specialisms within children's medical care.

One such first came in 1928 with the opening of the first children's ear, nose and throat ward in the country. "It was a dedicated area where nurses would develop specialised skills and children would have similar conditions, such as tonsillitis and ear infections," explains Mrs Conrad.

In March 2004 the Edinburgh hospital became the first in Europe to install a new hi-tech 400,000 operating system which allows more keyhole surgery to be performed.

This was followed shortly after by a hi-tech baby pod – the first of its kind to be used in Scotland.

The hospital has also established an international reputation in the treatment of childhood cancers, thanks largely to the work of consultant paediatric oncologist, Hamish Wallace.

Dr Wallace, who has been at the hospital since 1992, says: "There are a few special things that come to mind that have happened since I've been here.

"One of those is the new wing at the hospital, which opened in the mid-Nineties. It included four brand spanking new state-of-the-art operating theatres and a fantastic intensive care unit."

Over the last 150 years the hospital, which has around 150 beds, has treated more than five million children.

With the new Royal Hospital for Sick Children due to open at Little France in 2013, Dr Wallace says there will be a number of advantages to the new site.

The 53-year-old comments: "One advantage of the hospital moving to the new Royal Infirmary at Little France is that within 100 feet of the children's hospital, we can use a new fantastic imaging centre which has the latest MRI and CT scans in the world."

A year of celebrations is planned for the hospital's 150th anniversary. There will be a party at the hospital on Monday, with magicians, clowns and face painters touring the wards to entertain the children.

Other activities planned for the year include a summer garden party, birthday card competition and a photography exhibition capturing a year in the life of NHS Lothian's children's services.

So just how important is the Royal Hospital for Sick Children to the people of Edinburgh?

"It's hugely important," says Tracey McGregor, clinical nurse specialist in renal care. "We need to have a separate paediatric hospital and that needs to be in the Capital.

"We treat the families as a whole, not just the sick children, and just to be a wing in a district general or adult hospital wouldn't be acceptable. We need a separate children's hospital."

Creating the 'perfect' hospital didn't come cheap at end of 19th century

WHEN the Royal Hospital for Sick Children was opened in Sciennes in 1895, it was described as "one of the most perfect hospitals in the United Kingdom" by Hall Blyth, the chairman of directors.

The opening followed a major outbreak of typhoid in the Capital in 1890, with many children admitted to the hospital – situated at Meadowside House – with advanced symptoms.

Towards the end of the outbreak a nurse died and staff were worried that the hospital was no longer clean.

Meadowside House was thoroughly inspected with a report concluding that the building was inadequate for the needs of the patients and staff. The directors chose to demolish Meadowside House and build a new hospital.

They soon found the Trades Maiden Hospital, a school for girls which had been founded by Mary Erskine and had recently moved from Sciennes to the Grange.

However the old school building wasn't suitable and architect George Washington Browne then designed a hospital with an estimated building cost of between 20,000 and 23,000.

Lady Jane Dundas donated 6,500 to build and furnish one wing, naming it the Lady Caroline Charteris Memorial Wing after her sister. She also endowed 12,083 to pay an annual income to fund the wing in perpetuity.

Colonel W Lorimer Bathgate, one of the directors, endowed enough to fund another ward – the Bathgate Ward – in memory of his sister Thomasine, and another director left enough money to fund a ward which was named after him – the Mackay Smith Ward.

The final bill for the hospital was 52,500.

Princess Beatrice officially opened the hospital on behalf of her mother, Queen Victoria, the hospital's patron, on 31 October, 1895.