More than 60 years of service to community health
The original Cottage Hospital was at the junction of Baltic Road and Quarry Hill. It is still used by the health service providing mental health services and family planning clinics. Planning for the new hospital started in 1897. The land was donated by Messrs Catchpole, Potter, and Powell and in 1900 Mr Osmond d’Avigdor Goldsmid of Somerhill (who later became a Baronet early in 1934) encouraged the building of the hospital. It was built in 1902 as a Memorial to Queen Victoria’ fifty years on the throne and opened by a local M.P., Captain Boscawen. It was originally called the Queen Victoria Cottage Hospital, but the name fell out of use in the 1970’s as the same name is given to the community hospital in East Grinstead which used to be under the same management as TCH.
Money was raised by public subscription to pay for the building and it was funded by legacies, endowments, and subscriptions, as well as a Hospital Pay Day Fund which was started in 1919 and obtained contributions of one penny a week from employees of local firms and businesses. This entitled the employees to be treated at the hospital for no fee. The idea for this type of funding came from Mr H.J. Benham, the manager of the London County, Westminster and Parrs Bank. In 1920 the Fund had receipts of £421 and 72 patients were treated at the hospital.
There was a yearly Hospital Sunday Parade in the High Street of Tonbridge when money was collected. In addition, there was the annual Alexandra Rose Day Appeal. The Hospital Sunday collection and the Hospital Pay Day Fund continued till 1948 though the yearly Hospital Sunday Parade ended at the outbreak of the Second World War. The hospital initially had two male and two female beds. In 1907 the number of beds increased to 12. In 1912 private beds were added to bring the total to 18 beds. The six doctors of the town gave their services voluntarily. The operating theatre was opened in 1903 and Sir David Salomons presented an X-Ray apparatus in 1914. However, the big problems for the patients, visitors and staff were the cramped conditions and the traffic noise from Quarry Hill. Visiting was only allowed twice a week but it was possible to talk to patients from the tops of buses as they crawled up Quarry Hill! In 1929 there were calls for a new hospital. Dr. Bunting complained that he could not use his stethoscope because of the noise. A possible site for a new hospital was Marlfield House in The Drive.
In 1889 an Isolation Hospital was built in Vauxhall Lane on the present site of TCH. The two main worries at the time was the need to isolate patients with smallpox and scarlet fever. There were four wards and up to 24 patients could be admitted to the hospital. In 1933 the Tonbridge Urban and Rural Councils amalgamated the two isolation hospitals onto the Capel Hospital site. On laying the foundation for the new hospital in 1934, Sir Osmond d’Avigdor Goldsmid noted that Deakin Leas would be extended to be one field away from the hospital. His Somerhill Estate owned the TCH site and the land at the top of Deakin Leas. The estate is now called the Hadlow Estate and still owns the TCH site. The lease on the Vauxhall Bridge Wood site changed from Tonbridge Urban District Council to Queen Victoria Cottage Hospital on 29th September 1935 for the sum of £600 with the guarantee of a new lease from the Somerhill Estate for 85 years at an annual rent of £25. The lease ends on 29.9. 2020.
The cost of conversion of the hospital was £10,300 which was carried out by J. C. Elkington. An extra £1,000 was needed for X-Ray equipment. £6,300 was raised in cash as part of King George V’s Silver Jubilee Appeal and promises and Sir Edward Meyerstein gave a cheque of £5000. He was a philanthropist of hospital charities. He lived at Morants Court, Chevening, Sevenoaks and worked on the London Stock Exchange.
Opening of the new hospital
The new hospital had 30 beds when it was opened by the Marchioness of Camden on 23rd October 1935. She was a daughter of the 3rd Marquess of Abergavenny of Eridge Castle and wife of the 4th Marquess Camden of Bayham Abbey, Lamberhurst. The design for the hospital showed three main wards for men, women and children (the latter was called the Princess Margaret Rose Ward and had five cots) as well as six private beds. There was an operating theatre and mortuary and post-mortem room. The Matron had a sitting room and bedroom. In the garden was a cottage to the east of main buildings (on the site of the Portakabin building) for a caretaker and porter. Later an X-Ray unit was installed and a gift of £860 in memory of Charles James Rae paid for some of the equipment. The hospital was very modern with central heating, dimmer switches, electric clocks, each bed had electric plugs and emergency help bell. There were emergency gas light fittings, and fire hydrants. The kitchen had a ‘Frigidaire’ refrigerator and enamel surfaces. However, after the building work was completed, there was a debt of £5000.
Summary of building works since opening
The major building work at TCH includes the Day room constructed in 1960, the extension of X-Ray department in 1970. Dr Stuart Forsyth was Chairman of the Steering Group for the Day Centre which opened in April 1979. It initially looked after 22 patients a day for five days a week with voluntary drivers providing the transport. The Goldsmid Car Park for 12 cars was made in 1986. Surgery was stopped in the hospital in October 1987, while the Xray equipment was removed in 1988. In 1990, following on the closure of the Hildenborough Vitasan Physiotherapy Clinic, a new physiotherapy department opened using the area of the old operating theatre and X-Ray Department. The Day Centre closed in 2011 and became a gym.
Recent history of the hospital
In 1980 there were 29 beds, with 20 GPs on the medical staff committee and six visiting consultants (General Surgeons, Orthopaedic Surgeons and Gynaecologists). Surgery at the hospital closed in 1982 and the X-Ray department ceased in 1988 on the retirement of the radiologist. The equipment was moved to Queen Victoria Hospital, East Grinstead.
In 1994 the conservatory was added. In 1997 the haemodialysis unit’s caravan at the western end of the hospital site was moved off the site and replaced by a Portakabin to house the Doctors Out of Hours service called TTDOC. In 2000 the new Goldsmid Ward increased the number of beds to 30. It was designed to allow a second floor to be built. In 2011 a new car park was built for 40 cars.
Reviews of the hospital
There have been quite a number of reviews of Community Hospitals locally which have affected TCH. The first review was by Tunbridge Wells Health District in 1981 who recommended admission and discharge policies, better standards of care and record keeping, better communication between all health professionals and to maximise the use of all facilities.
Local community successfully fights radical changes
In January 1988, Tunbridge Wells Health Authority sought to close the hospital for one year and then reopen TCH as an acute rehabilitation facility for elderly mentally infirm patients. A Steering Committee under the leadership of District Councillor Jill Hutchinson and Mr Christopher Everett, the Headmaster of Tonbridge School was set up to fight the plans. A petition signed by 23,000 people was presented to the Junior Health Minister, Mrs Edwina Currie. The GPs of Tonbridge, with the potential financial support of the League of Friends of TCH, took the matter to Judicial Review in a case entitled Regina v Tunbridge Wells Health Authority Ex Parte Goodridge and Others. Judgement was given by Mr Justice Hutchinson on 18.4.1988. His reasons for granting the application were that a decision by a district health authority temporarily to close a hospital involved a ‘substantial variation’ in the provision of health services and could not lawfully be made without first consulting the relevant Community Health Council unless, having considered that matter, the authority was satisfied that, in the interest of the health service, a decision had to be taken without allowing time for such consultation.
In December 1988, in a consultation document entitled ‘The Future Role of Community Hospitals in Tunbridge Wells Health Authority’, it was noted that of the six community hospitals which they managed, TCH is in an unrivalled geographic location for future development.’ Their philosophy was to provide in community hospitals ‘medical care not requiring high technology support.’ Beds would be used for care of the elderly including continuing care, care of cases discharged from the acute hospitals, and terminal and respite care. The hospitals could be a base for outpatients, community staff, and the day centres should become Day Hospitals.
1988 Petition to save the hospital. David Green treasurer.(Right) Peter Norton, Membership Secretary, Mrs Kathleen Thorogood, vice chair, Mrs Marion Ward- secretary.
In January 1989 TWHA issued a consultation document entitled ‘The Rationalisation of the District’s Services to allow future provision to be made within allocated funds.’ At the time there were 28 beds in TCH, of which nine were for continuing care under a consultant geriatrician. It was proposed that the number of continuing care beds be increased to 20 as Emily Jackson House was closing in Sevenoaks. The GPs were to have admitting rights to 8 of the beds of which 2 were available for terminal care. The Day Centre was designated a Day Hospital and it was proposed to have a physiotherapy and occupational therapy department to serve both inpatients and outpatients. Also, in March 1989 the South East Thames Regional Health Authority published a consultation document on Community Hospitals. In September 1997 West Kent Health Authority published a consultation document ‘The Future of Community Hospital Services’ in and around Tunbridge Wells. It noted that TCH had 27 beds with 17 continuing care beds and 10 beds where GPs had admitting rights. The services at the hospital at the time included Physiotherapy, Occupational Therapy, and Chiropody. It was proposed to increase the number of beds to 30, with no continuing care patients but possibly a number of consultant-led elderly rehabilitation beds. The continuing care patients were no longer admitted after 1.8.1998. Community Services at the hospital would include Outpatients, GP out of hours base, crisis assessment team, evening and night nursing service, and Speech and Language Therapy.
Major reorganisation of the hospital’s services
In November 1998 the provider of services Invicta Community Care NHS Trust produced development plans for 1998-2004. It noted the same services as in 1997 except the addition that TCH was now the base for the local District Nursing Service and Community Liaison Manager. A Clinical Medical Officer had been appointed to look after all the consultant beds and help with the GP Beds. It was noted that the Day Centre was closed on a Wednesday. The plan was for 30 beds, an enhanced physiotherapy and occupational therapy service for the inpatients. The re-provision of X-ray services was recommended and the opening of a thriving outpatient service. It was recommended again that the Day Centre become a Day Hospital. It was proposed that the Hospital should be developed to contain two 15 bedded inpatient units with mixtures of 1, 3, and 4 bedded areas and a central nurse’s station. It was envisaged that the Outpatients, Day Hospital and Doctors Out of Hours service would move to the eastern part of the Hospital (presumably in the area of Primrose and Somerhill Wards.) The Phase 1 development resulted in Goldsmid Ward being completed in 2000 with 15 beds and 15 beds in the other two wards. Phase 2 was pencilled in for development in the next 4 years. It was to be located adjacent to Goldsmid Ward in the space occupied by the Portakabin housing TTDOC.
Financial difficulties at Trust threatens number of beds
In January 2006 the 30 bedded Hospital had 15 beds closed due to the financial problems of South West Kent Primary Care Trust. The West Kent PCT Community Hospital Strategic Review in May 2007 recommended that TCH stay with 15 beds for community rehabilitation and that a specialised renal unit be housed on the site. The report noted the small amount of money needed to address backlog maintenance. A vigorous campaign was launched to increase the number of beds and a petition of 17,000 signatures was handed to West Kent PCT. A study of admissions showed that the demand for the Hospital was higher than expected and in January 2008 it was proposed that the number of beds be increased by 6 to 21. Later the number increased to 24. (The old provision of 30 beds was felt not to be possible because of the higher standards in preventing cross infection). In 2010, the local GPs withdraw their services from the Hospital which was then looked after exclusively by a clinical medical officer.
Stroke Rehabilitation Unit moves to TCH
In November 2010 it was proposed without formal consultation that a 12 bedded stroke rehabilitation unit be housed in TCH. The number of community rehabilitation beds decreased in June 2011 to 12. The Stroke Rehabilitation unit moved from the Kent and Sussex Hospital to Somerhill and Primrose Ward in September 2011 after £400,000 had been spent upgrading the eastern half of the Hospital. The unit was managed by Maidstone & Tunbridge Wells NHS Trust. The old Day Centre became a gym, and the Conservatory became a Day Room exclusively for the Stroke patients. Subsequently two extra beds opened in the Goldsmid Ward to provide 14 community rehabilitation beds and a new day room. In November 2012, NHS West Kent apologised for not carrying out the correct involvement and consultation process in 2011 which breached the Department of Health guidance on Section 242 of the NHS Act 2006 and Kent County Council’s Health Overview and Scrutiny Committee noted that, in their view, there had been a substantial variation in service which was a breach of Section 244 of the NHS Act 2006.
Further changes and the Stroke Rehabilitation Unit moves again
The Stroke Rehabilitation Unit moved to the Tunbridge Wells Hospital at Pembury in March 2016. In the following 11 months, there was uncertainty of how the 12 vacated beds would be used. The use of Somerhill and Primrose wards varied in this time. From March-July 2016 the wards contained some patients who were weight bearing and some non-weight bearing and initially 10 then 12 beds were open. The two wards were then closed for 2 months due to the fact that the beds were being maintained on non- recurrent finance. In September 2016, 8 beds were opened for general rehabilitation because of winter pressures. In March 2017, the lead manager of the hospital became a physiotherapist and the two wards were opened for self-caring patients in a therapy led service with no State Registered Nurses. Initially 6 beds were opened which over a few months increased to 12 in October 2017. Then, in late 2017, the lead manager stopped managing Goldsmid Ward and the therapy led service started to use staff nurses as needed and the type of patient moving to the therapy unit’s two wards became more complex. The Out of Hours service moved to Tunbridge Wells Hospital at Pembury in 2018. In 2019 one bed was reserved for patients requiring intravenous ambulatory care.
In March 2019, the therapy led service ceased. The whole hospital was now under nursing management with one in-patient physiotherapy department rather than two. In October 2019, TCH wards started to admit up to 12 or more patients who had had an operation for a hip fracture, a service which had been provided in the Tunbridge Wells Hospital at Pembury. West Kent CCG apologised for not having organised an informal consultation.
This history was mainly based on the work of Pat Mortlock supplemented by work by David Green. There is a Brief History of Tonbridge Cottage Hospital by Pauline Warren and Rena Pope which was produced in 2009. A Study of General Practitioner Hospitals in Tunbridge Wells District (1980) also provides some other details of the history.
Warders Medical Centre has some material on TCH which was rescued by Dr. J. M. T. Ford when there was a clear out many years ago. There is an admission book, and the minutes of the Medical Staff Committee. The practice also has a book recording the operations that Dr. Herman carried out at TCH.