Print

What are we doing?

When we began this journey in 2011, as a small group of friends committed to Barts and its heritage, we saw ourselves as a support group for those who were responsible for that heritage: the Barts NHS Trust and the Barts Charity.

We little thought that we would be the sole champion, fighting for the survival of the historic buildings, art and archives of the country’s oldest working hospital, founded in 1123.

We have made significant gains, but we were not able to achieve everything we wanted such as restoring the symmetry of Gibbs ’original design.
This is a summary of our battle. We remain vigilant as we face the next challenge: to deliver a Heritage Trust worthy of this great asset and, ideally, to have completed the Restoration programme in time for the 900th anniversary of Barts in 2023.

Sir Marcus Setchell, Chairman

Protecting the Barts Heritage Site

What is the Barts Heritage Site?

St. Bartholomew’s Hospital has led the provision of healthcare in London for almost 900 years. No other hospital in the country begins to match this record. The Great Hall is the central jewel in the crown of its magnificent if yet unrecognised Heritage Site, consisting of the Grade I listed ancient monument status Gatehouse (1702), the North Wing (James Gibbs 1738), the Parish Church of St. Bartholomew’s the Less with its 12th Century tower, The East and West Wings (James Gibbs, 1752, 1758), the Fountain and Square (1859) and the adjacent Grade II listed Victorian Hardwick buildings.

What was the North Wing Used for?

The Great Hall was built to house the financial and management functions of the Hospital, which has provided free healthcare for the poor of the City of London since 1123. The costs of running the Hospital were not borne from taxes, insurance or private investment, but by voluntary donations from benefactors. The Governors’ Hall was designed as the place for its meetings and as a venue to welcome and attract donors. Patient care was provided in the other wings of the Hospital. After the inception of the National Health Service in 1948, many of the rooms around the Great Hall were used as administrative offices and meeting rooms. In more recent days with the formation of large NHS Trusts, administration has transferred to modern office blocks more suitable for electronic hi-tech management.

Current Usage

The Great Hall continues to be used for all kinds of large gatherings such as educational, cultural, social and fund-raising activities. The building also houses a uniquely valuable collection of Archives, and a small museum. The smaller rooms continue to be used for meetings, but there is potential for greater usage.

Why is the Great Hall under Threat?

This important cultural Heritage site is administered by the National Health Service. Ever rising  healthcare costs inevitably mean that care and conservation of the Heritage buildings are of low priority. Recent news reports suggest that the Barts Health NHS Trust faces a £93 million deficit. The Trust itself recognises that there is a £4 million backlog maintenance requirement.  As a  result of this inevitable  low priority, the buildings and contents are now  AT RISK.   

 

THE BACKGROUND

2009 Options Study: This was commissioned by the then Barts and The London NHS Trust at a cost of £100,000. Hopkins Architects were appointed following open competition to review options for the North Wing and associated heritage buildings which were outside the PFI contract. The study, presented to the Trust in Autumn 2009 identified issues and suggested solutions to make the Great Hall work as a free standing venue with compliant fire escapes; lifts for disabled access; new catering arrangements and access; adequate lavatories and cloakrooms and improved arrangements for the Barts Archives. Importantly, it proposed service bustles at each end to incorporate new stairs and lifts which would restore the original Gibbs symmetrical design. Between 2009 and 2012 there was an approach from Maggie’s Cancer Charity to the Trust. It is not known who made the approach or WHY and WHEN the Trust decided to set aside the Options Study it had commissioned and offer the space to Maggie’s. It is not known whether the decision was made by, or reported to, the Trust Board in full knowledge of its Heritage responsibilities.

HOW THE FRIENDS BECAME INVOLVED

2012: Friends of the Great Hall and Archive of St. Bartholomew’s Hospital formally set up as an unincorporated charity. Its aim is to raise awareness of, and support those responsible for the unique architectural, art, archives and medical history of Barts. Their funds are lodged as a Special Purposes Fund with the Barts Charity.

Mid-2012: It became known that the NHS Trust had agreed that Maggie’s could build a new centre at the east side of the North Wing, knowing that most of Barts cancer services were to transfer to UCLH.

In 2012: The Chairman and Vice-Chairman of the Friends ask Hopkins to review the 2009 options. The possibility of forming a Heritage Trust to relieve the NHS Trust of its heritage responsibilities is explored at a private meeting with the Chairmen of the NHS Trust and the Barts Charity.

2012-2013: Hopkins produce a Masterplan for the heritage buildings, and identify a site for a free-standing Maggie’s Centre.

January 2013: The Trust arranged for Maggie’s to present their plans. No member of the Trust was present and instead of the plans there was a marketing presentation about the Maggie’s philosophy. IT WAS MADE CLEAR BY THE FRIENDS THAT OBJECTIONS WERE NOT TO A CANCER CARE CENTRE BUT TO THE SITING OF THE BUILDING. Maggie’s claimed not to know about the sensitivity of the site or the 2009 Hopkins Options nor did the lead oncology clinician at Barts. The Friends and Hopkins try unsuccessfully to meet Maggie’s several times.

15 April 2013: The Trust CEO chairs a meeting of the Trust,the Friends and Maggie’s. He states the Barts mission: to become an outstanding cancer and cardiology centre and protect its heritage. He asks the Friends and Maggie’s professional advisers to look for a “Third Way”. Maggie’s refuse to delay their planning application until the results are known. Hopkins produce possible solutions but Maggie’s do not and say compromise is not possible.

4 June 2013: Maggie’s plans are refused (11:8) because of “concerns over the proposed landscaping and design of the Maggie’s Centre (and) unresolved issues in respect of how the future of the North Block would be safeguarded”. The application is withdrawn before the Committee can agree reasons for refusal.

16 July 2013: Meeting of the Chairmen of the NHS Trust, Barts Charity, the Friends and Hopkins Architects. The Trust declares support for the re-submission of the Maggie’s scheme.

20 - 21 November 2013: Maggie’s plans exhibited at Barts. The scheme is largely unchanged since its rejection and withdrawal.

16 - 17 December 2013: The Hopkins plans are exhibited at Bart’s. The plans are submitted by Hopkins on 20 December 2013.

12 February 2014: Maggie’s, the Friends and Hopkins present their plans, separately, to the NHS Trust Board, including the non-execs.

13 February 2014: Sir Michael Hopkins is advised that the Trust Board would be supporting Maggie’s application.

28 March 2014: NHS Trust/Insalls Architects submit plans for toilets and disabled access at western (wrong) end of North Wing,

30 March 2014: Maggie’s submit revised Planning Application.

29 April 2014: Friends/Hopkins plan is approved UNANIMOUSLY. 15 May 2014: Friends launch campaign to Save Barts Great Hall

17 July 2014: Maggie’s plans are approved 11 to 10. Insalls/NHS plans for basement toilets and main entrance to be at west (wrong) end are approved by 12 to 6.

23 July 2014: With advice from lawyers, SAVE Britain’s Heritage and other heritage experts, the Friends of the Great Hall engage lawyers to advise on the case for Judicial Review.

7 August 2014: Counsel engaged and the case for JR prepared.

20 August 2014: Pre-Action Protocol letter and draft letter of action is submitted to City of London.

29 August 2014: Claim at Court and Permission to bring Judicial Review lodged at High Court.

1 September 2014: The City of London Legal Department propose that all parties should consider an Alternative Dispute Resolution (ADR) mediation process between the NHS Trust, Maggie’s (the Interested Parties), the City (The Defendants) and the Claimant (Sir Marcus Setchell). After advice from lawyers and others, the Friends agree in principle to “stay” their case at Court and proceed to ADR.

5-30 September 2014: There are extensive negotiations to select a mediator, agree terms of reference of the ADR and a timetable.

1-28 October 2014: Position Statements, and a Statement of Common Ground are prepared, and revised drawings produced by the relevant architects. A mediator is appointed.

7 November 2014: Mediation meetings begin. After lengthy negotiations, agreement is eventually reached. Essentially the contents and amenities of the Hopkins bustle, crucial for the long-term viability of the Great Hall, (disabled access, lift to all floors, fire escape stairs, lobbies on all levels and basement toilets) are incorporated within the Maggie’s building, but functionally, decoratively and physically separate from their areas.

4 December 2014: An Agreement Settlement is signed and a Media Statement issued which summarises the amended plans to be re- submitted to the City Planning Department.

24 February 2015: Amended plans approved by City of London Planning Committee. Minor internal amendments by the NHS Trust to the west end Pathology Block plans also approved.

25 February 2015: First meeting of NHS/Maggie’s Project Group Membership includes Marcus Setchell and one other member of the Friends as directed in the Agreement Settlement. Outline construction timetable presented.

26 February 2015: Notice of consent subject to conditions issued by City of London.

Print

The Hogarth Murals

The Great Hall of The North Wing is approached by way of a grand staircase, The Hogarth Stair, the walls of which were decorated by William Hogarth (1697-1764). Although often referred to as murals, they are in fact canvases. 

Hogarth was an 18th Century artist, well known at the time for his paintings and engravings. These were typically of every day scenes and not the more common portraiture of the time. His paintings and engravings were studies of everyday life, perhaps more accessible in this regard and commonly resembling caricatures. However, they always carried a moral lesson, with the best known being that of 'A Rake's Progress', a series of paintings that tell of the moral decline and tragic end of an extravagant nobleman. His paintings here are altogether rather different and represent a significant departure for the artist. Hogarth was born in Bartholomew Close, which now contains many of the medical school buildings. He was incensed to discover that an artist from the continent (The Venetian, Jacopo Amigoni) had been approached to provide artwork for The North Wing's staircase and offered to do so free of charge. His paintings depict The Pool of Bethesda and The Good Samaritan. These devotional paintings were unusual for Hogarth, as he described himself:

“Before I had done anything of much consequence in this walk (painting modern moral subjects), I entertained some hopes of succeeding in what the puffers in books call ‘the great style of history painting’. So without having had a stroke of this grand business before, I quitted small portraits and familiar conversations, and, with a smile at my own temerity, commenced history painter, and on a great staircase at St Bartholomew’s Hospital, painted two Scripture stories, 'The Pool of Bethesda' and ‘The Good Samaritan', with figures seven feet high.”

The Pool of Bethesda was started in a studio in St Martin's Lane before being hung on the staircase in 1736, whilst The Good Samaritan, completed in 1737, was painted on site, with scaffolding erected so that the artist could reach the full height of the canvas.

Engravings of these magnificent pieces seldom do the originals justice, which, if only for the sheer scale need to be seen in person and in context for their full effect. The arches and landscape that surround the pool, where the sick have gathered to be cured by Jesus, are strongly reminiscent of Italian art of the same period but the individuals depicted are strikingly original and the portrayal of Christ is often considered to be one of great dignity. This might be explained by the fact that although we know that the figures were painted by Hogarth, George Lambert, who made his name from painting scenery at Covent Garden, is thought to have painted the landscape in the later painting and possibly in both.

These invaluable works of art need protection and ongoing care. 12 years after their completion, it is noted in the Governors' minutes that they were already in need of cleaning. This entry in the minutes determines that Hogarth was to be consulted as to how this would best be done. The artist had them cleaned at his own expense two years later in 1751. Hogarth had specifically requested that the completed canvases never be varnished. Unfortunately we know that nobody listened as when they were cleaned in the 1930s, seven coats of varnish were removed! As an indication of how much dirt the paintings accumulate, when they were again cleaned in the 1960s it was only then that the inscription in the foundation stone in the second tableau was discovered.

Pool of Bethesda

The paintings are still used as an educational tool as the characters portrayed are thought to be patients from the hospital, many of whose conditions are recognisable to the trained eye. None of the illnesses  are exaggerated, perhaps unusually for an artist known for caricatures, and reflect a handful of illnesses that would have been seen regularly at the hospital at the time, in different sexes and age groups.

The central protagonist is the man unable to reach the pool to be healed on account of a chronic ulcerous wound on his leg. The painting shows a scene from The Gospel According to St John, in which a man that has been unable to walk for many years is healed by Jesus. Much like St Bartholomew's temple on The Tiber in Rome, Jerusalem's Pool of Bethesda was thought to have healing properties. On occasion, the water would become disturbed and this was believed to be by an angel, who can be seen at the top of the painting, departing having made a pass over the water. Whomever entered the pool after the waters had settled again would be exposed to its healing properties. The man unable to walk was alone and no one would help him to the pool's edge. Jesus took pity on him and healed him without the need of the water's powers. So here he is, beneath Jesus' kindly gaze. His physical stature has often been remarked upon and more recently it has been suggested that he is suffering from Myotonia Congenita, causing enlarged but weak muscles and ulcerous wounds. Others hold that it is a reflection of the influence that Hogarth took from the classical style of painting. Behind him is a mother holding a child with rickets, depicting the pronounced forehead, curved spine and inflamed joints of the disorder as described in the 18th Century. The fidelity of this portrayal may reflect Hogarth’s friendship with John Freke, a surgeon at Barts that trained Percivall Pott’s mentor, Edward Nourse. Freke had written on the subject of rickets in 1748 and may have provided Hogarth with the information and possibly even a model for its accurate portrayal. Although a diagnosis of rickets certainly makes sense, others have suggested the differential diagnosis of congenital syphillis - common in Hogath's time and an illness that would also fit the bill.

Detached from these figures, at the top left of the painting is a man with gout, whose arthritic and sore hand seems to have been accidentally hit by the cane or staff of the blind man next to him. Behind and in between these two is a character that has always been thought to be suffering from jaundice. More recent observations have suggested that the diagnosis is melancholia or major depressive disorder. A good doctor will tell you that jaundice and depressive disorders are common together and that one is certainly not exclusive of the other! Also in this group is a woman with an inflamed breast, again possibly a reflection of his connection to Freke who had written on breast cancer and its surgical treatment, whilst others have suggested she is suffering from mastitis. The left of the painting depicts obesity and emaciation, or hypertrophy and atrophy, in a young girl and an elderly woman respectively. At the feet of this group to the left is a young man. His prominently curved spin, crutch and bandaged limbs have led to suspicions that he might be suffering from rickets.

On the right hand side of the painting is another group. To the far right, bathed in light, seemingly from the buildings own windows, is an elderly man that doesn't look at all well! This unfortunate chap has been the subject of varied clinical observations over the years. Some have explained his crutch by way of a tuberculous arthritis of the knee, whilst others have paid more attention to his swollen tummy. The latter observation may be ascites, which occurs in a number of different conditions but here has been attributed to cancer of the liver or a disseminated malignancy, called carcinomatosis. To his right is a poorly attired young woman. The general state of undress of this young lady and her wanton pose, has led many to assume that she is not only a prostitute but potentially modelled on a famous one of the time! Regardless, she seems to be someone of means as her maid appears to be providing the tough looking gentleman at the back with financial recompense for restraining the lady with the baby, so that her mistress can get in front of her in the queue. There is not a huge amount to go on in terms of a clinical examination here, however, there is the suggestion of psoriasis affecting her knees and one elbow, which combined with a possible arthritis of one knee and her chosen profession, might point to a diagnosis of gonorrhoea.

Good Samaritan

The Good Samaritan depicts the biblical story with the Samaritan pouring oil and wine into the wound of the injured man, a first century practice that continued unitl the 16th century. In the foreground Hogarth has added a dog, licking a wound on its leg, presumably sustained during the traveller's attack. In the background we can see the priest, who having ignored the victim at the side of the road, has continued on and now has a man lying prostrate at his feet.

Rahere lays the foundation stoneRahere dreamscloisters copy

Rahere also appears, asleep and dreaming alongside a tableau of the laying of the hospital’s foundation stone and the depiction of a sick man being carried on a stretcher into the old cloister of the hospital, where he is met by the brethren of St Bartholomew. The depiction of the old cloister is probably accurate as, having been born and raised in Smithfield, Hogarth would have seen it for himself when he was younger, before it was replaced. The decorations surrounding the canvases were added by Hogarth’s students and include the medallions of Galen and Hippocrates and baskets of flowers. These embellishments frame the canvases in a more typically Georgian style.

 Guided tours of The Hogarth Stair in The North Wing are avaiable on request.

Larger versions of the images on this page can be seen in The Gallery of Images.

 

Print

Barts Today

What happens at Barts today?

Today, Barts remains a teaching hospital of international renown in the centre of London, on the same site upon which it was founded 890 years ago. Substantial redevelopment has taken place in the past 10 years, with the renovation of old buildings and the addition of new ones that pay respect and homage to the Gibbs design of the hospital. The fountain in the quadrangle has also been painstakingly restored after many years of neglect. The medical school continues to thrive as a world class centre for research and both under- and post-graduate education.

The Hospital itself continues to treat patients, with inpatient facilities primarily dedicated to cancer and cardiac care, whilst the outpatients department delivers health services to a wide variety of specialties. Partnership opportunities with the neighbouring University College Hospital have also been developed to ensure the future of clinical services in Smithfield, although their precise make-up are yet to be finalized.

The Archives are still present in The North Wing, representing a nine century old repository of medical records and documents relating to everything from 16th Century monarchical despotism to the rise of medicine with social conscience – something demonstrated in earnest by the hospital since its foundation.

St Bartholomew-the-Less remains an active parish church within the walls of the hospital with regular services.

Cock Lane, once home to The Royal College of Surgeons building for the dissection of dead criminals is now home to The Barts Charity. This charity is independent of but closely allied to the NHS Trust and medical school and tirelessly supports excellence in healthcare by funding research and clinical development projects that the NHS might otherwise not be able to support.

As active and lively as the hospital is today, the buildings that represent its glorious 18th Century rebirth, returning Phoenix-like from the flames of the fire of London and the threat of bankruptcy that followed, are in grave danger. The staggering artwork and primary source historical documentation are no safer. The formation of the NHS has meant that the management of these historical monuments has been neglected and they continue to fall into a shameful state of disrepair. They are at-risk. Nearly 900 years history of medicine and social conscience in London is at-risk. We must save it. We have a duty to do so.

 

 

Contact The Friends

Write to us at:

Friends of the Great Hall & Archive
of St Bartholomew's Hospital
Ground Floor
12 Cock Lane
London
EC1A 9BU

The Barts Charity

We are working with Barts Charity, Registered Charity No 212563 barts_charity