The new women’s block at Killingbeck Sanatorium, Leeds
from the Opening brochure, Leeds Corporation, 1936
In recent months I have become interested in the politics of hospital building. This grew out of the first CHPHMblog post, Pie in the Sky, which examined the conflict surrounding a planned new hospital in Lille in the 1930s. My recent research on this theme – specifically comparing three projects in interwar England and France – has highlighted the limited nature of research in this area. There are a couple of standard architectural histories concerned with leading names and iconic buildings and a very useful piece by Jonathan Hughes (The “Matchbox on a Muffin”) that provides an overview of mid-twentieth century developments. But these works underestimate the level of innovation in British hospital design in the 1930s and have little or nothing to say about the emerging breed of municipal architects. This post will explore one contribution from the public sector which combined modernity with up to date therapeutic approaches and, most importantly, value for money.
Architect’s impression of the new Seacroft complex from Opening Brochure, 1904
Leeds Corporation’s Killingbeck Tuberculosis Sanatorium was, like many others, originally opened as a smallpox isolation unit. A part of the huge Seacroft infectious disease complex opened in 1904 at a cost of £250,000, the smallpox provision was rarely used for its original purpose and, following the 1911 National Health Act, it became the City’s TB institution. During the Great War it was a military hospital but by the 1920s it was acting as the City’s main sanatorium providing 80 beds for women, 92 for men and 54 for children. In 1933 it was reported that the women’s beds were housed in old wood and corrugated iron blocks ‘intended as temporary structures but have been in use for 30 years. They are very unsatisfactory and becoming dilapidated and are no longer weatherproof.’ [TNA MH66 711]
Clearly new and adequate accommodation for women was essential. Pressure on sanatorium beds had been growing as the therapy placed more emphasis on longer term treatments – the average length of stay doubled from three to six months between 1925 and 1935. Moreover, women were particularly resistant to the longer stays, with the result that they did not put themselves forward for sanatorium care. Thus, while waiting lists for women were relatively small this was ‘believed to be partly due to the fact that it is more difficult to induce women to stay for long periods in hospital and also to the very inferior quality of the accommodation for women’. [TNA MH66 711] However, by 1935 the Medical Officer of Health was anticipating the completion of a block for females which would be ‘a boon alike to patients and staff and will greatly strengthen the tuberculosis organization on the institutional side’ and the 100 bed unit opened the following summer.
The restored Zonestraal Sanatorium
Sanatorium architecture lent itself to modernist forms. Fresh air and sunlight were still essential parts of the therapy and as a result most sanatoria were on isolated sites often in elevated locations. They were also ideally placed to take advantage of the new building materials favoured by the international modernist movement – concrete, glass and steel. Many of the early institutional icons of the International movement were for TB sufferers like Alvar Aalto’s Piamio Sanatorium in Finland and Bijvoet and Duiker’s Zonestraal Sanatorium, the latter proving particularly influential in 1930s Britain – for example in the Lister Wing of the mutualist Benenden chest hospital in Kent, designed by Sir John Burnet, Tait and Lorne in 1937.
Sanatoria were primarily the work of local authorities, many keen to demonstrate their emerging power and radicalism. The sanatorium offered the opportunity to tackle the condition many on the left felt epitomised urban poverty. Tuberculosis was identified with poor housing, overcrowding, inadequate nourishment and smog with cities like socialist Sheffield utilising its TB policy to mitigate the effects of these on the city’s children. Thus when council’s, especially Labour councils, commissioned new sanatoria or even extensions, they used this as an opportunity to make a clear modernist statement.
Glamorgan County Council’s Iconic TB Sanatorium, 1936
The most famous of these interwar experiments in municipal modernism was Pite Son and Fairweather’s Sully Sanatorium for Glamorgan County Council completed in 1936. In this case the whitewashed concrete and glass complex with its angled central buildings was the work of an established private practice. However, less famously a number of impressive extensions or complete hospitals were designed by Borough Architects and Engineers. As extensive as Sully and in some ways more impressive, is Harefield County Sanatorium designed by Middlesex County Council architect, William Thomas Curtis (1930-46) which opened in 1937. Curtis has acquired a bit of a reputation for his 1930s school buildings and for the Bowes Road Complex at Arnos Grove which included a swimming pool, library and health centre in the style of Peckham. The Killingbeck Sanatorium joined this growing strand of municipal modernism in its style, use of materials and interior design.
Middlesex County Council’s Harefield County Sanatorium
The new ward block was to house 100 female patients with the plans put in the hands of City Engineer, J E Acfield. It was designed to conform to the requirements of light and air as it was placed on high ground with a south south west aspect which ensured ‘all the rooms get abundant sunshine’. Much like Sully and Harefield the linear, two storey block was ‘straight in the centre with wings brought forward at an obtuse angle’. Both floors had balconies with the first floor stepped back to avoid overshadowing the ground floor. In keeping with the style and the requirements for light and air, the block was steel and brick with pre-cast concrete floors and room partitions each finished in wood or tiles. Most importantly the window frames were steel, ‘specially designed to give free access of air and presenting in front a large area of glass’. Each floor had fifty rooms made up of 16 one bed, 24 two bed, 4 four bed and 4 five bed rooms – a clear departure from the Nightingale ward – and each room had access to the balcony through French windows.
First Floor Balcony, Killingbeck Sanatorium Opening Brochure, 1936
The modern styling extended to the furnishings and interior décor, with each room including a built in wardrobe (convenient for long stay patients), electric lights above the bed, a plug for wireless headphones and a control for the modern light signal which replaced ‘ the old and obsolete electric bell’. Moreover, ‘The furniture throughout is of tubular steel, upholstered in hygienic materials of a colour in keeping with that of the rooms’. Indeed, ‘The colour scheme of the whole building has been selected to be as bright and attractive as possible; on the exterior blue, and the interior, cream and red with sepia paneling in the bedrooms. This homely and attractive ideal, clearly hoping to appeal to reluctant women patients, was reinforced in descriptions of the public rooms with the sitting rooms ‘designed so as to ensure an abundance of light and air and at the same time to give that feeling of comfort and homeliness so essential in an institution where the period of residence has to be so long’. The Health Department concluded by expressing the hope that ‘in their new quarters the women patients will have greater comfort and the brighter surroundings will be an added incentive to them and to the staff to persevere in their efforts to bring the fight against disease to a successful issue’.
A bedroom in the new block from the opening brochure
Clearly Acfield and the builders were able to pull off a modern building, drawing on the latest technology and therapeutic ideals but also making use of freely circulating ideas of best architectural practice. Acfield was an engineer, not an architect, yet he captured the essence of municipal modernism at Killingbeck, and for a fraction of the cost associated with major extensions in the voluntary sector – the new block coming in at just £27,500 for building and furnishings or a mere £275 per bed.
The Opening ceremony with Sir Kingsley Wood, Minister of Health, Leodis Archive, Leeds Libraries
The block was opened in July 1936 by the Minister of Health, Sir Kingsley Wood, who was supported by the Lord Mayor and the Labour chairman of the Tuberculosis Committee, Councillor George Brett. When Labour went to the polls four months later defending a slim majority on the Council, one of their key campaigning issues was health, and especially the extension at Killingbeck. In one full page advertisement headed ‘Efficient Municipal Hospital Services for All is Labour’s Aim’ they included a large picture of the new accommodation over a legend stating ‘Labour built this beautiful block for tubercular women patients at Killingbeck Sanatorium, to replace the miserable tin huts which existed under Tory rule’ [Leeds Weekly Citizen, 21 Oct 1936] Indeed, it would seem Labour were more interested in improving TB accommodation than developing the recently appropriated General Hospital, possibly reflecting a desire to win the battle against disease with modern architecture and technology.
Campaigning on health, Leeds Weekly Citizen, 21 October 1936
Acfield’s building was eventually listed in the 1990s but not in time to prevent its decay and ultimate demolition. The fact that it was the work of a little known municipal engineer, rather than an iconic metropolitan architect, allowed owners and authorities to let it fall into such disrepair that it became impossible to save. Yet it was an remarkable expression of municipal modernism in the international style which deserves to be better known and its place in architectural and urban history appreciated.