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The 1985 reopening of Mildmay Hospital

After the formal closure of Mildmay by the NHS in 1982, it reopened as a voluntary charitable hospital in 1985, with an eventual focus on providing care for people with HIV/AIDS.

A working group set up by Tower Hamlets Health Authority in 1980 examined the position of Mildmay in relation to the needs of the community.  In 1982, it was determined that in place of the existing 62 beds and the Accident and Emergency and Outpatient services, there should be three units to meet the needs of local people, which were not being properly catered for in the community.

The first of these priorities was chronically sick young and medium-term recuperative patients. The second priority was the continuation of the care for handicapped children. The third priority was for day surgery. In addition to the three priorities above, Mildmay would continue as a teaching hospital for GPs. All of these things Mildmay was doing effectively up to this point.

 

Unfortunately, almost as soon as the decision was made, Tower Hamlets Health Authority decided that this was not financially sound and that the hospital should be closed. So began the process of running down the services ward by ward.

 

A second proposal was quickly put together and put forward, stating that Mildmay could continue as a community hospital and continue with GP Training. Whilst this was being considered, in January 1983, there was a march from Mildmay to Trafalgar Square by over 400 supporters. This got the necessary reprieve for the gradual shutdown of the wards and in March 1983, it was decided that further time for consideration was needed.

On 14 July 1983, the day of decision came for the Health Authority and it was once again decided that Mildmay Hospital should close.

The Hospital Advisory Committee sought a meeting with the Secretary of State, Norman Fowler. The meeting, when it finally took place on 3rd November, was with the Minister for Health, Kenneth Clarke, who was responsible under Mr Fowler for the NHS and all health policy issues. Mildmay would have to wait for a further four months before a decision was made. When it was eventually made, it did not go in Mildmay’s favour and the decision was again made to finally close the hospital and stop treating patients. So began the closure of the remaining wards and services. It is now not clear when the hospital wards finally closed, but it was probably late 1983 or early 1984. 

 

The committee of supporters however were not finished. They decided that if the NHS did not want Mildmay then they would put in a proposal to continue as a wholly voluntary hospital outside of the NHS. Within a month, the Minister gave a positive response, subject to both the Regional Health Authority and the Health Authority in Tower Hamlets' approval the Friends of Mildmay would be allowed to continue to run the hospital voluntarily.

 

In early 1985, through voluntary support, the hospital began to be refurbished and the bank balance grew through donations. On May 2 1985, the Minister announced, in answer to an arranged Parliamentary Question, that he was now able to approve the reopening of Mildmay on a voluntary and charitable basis, outside the NHS, to be funded partly by Churches and Christian charities.

 

In October 1985, the hospital reopened. Initially providing GP services, but then eventually as a hospital nursing home. There was a thanksgiving service at St Paul’s Cathedral on 20th November 1985.

Fowler

Hansard
May 2, 1985

House of Commons: Written Answers: Social Services

Mr Tom Sackville

asked the Secretary of State for Social Services whether agreement has been reached on the transfer of the Mildway Mission Hospital in Shoreditch, to the hospital's League of Friends; and if he will make a statement.

Mr. Kenneth Clarke

Yes. In May 1984 the principle of leasing the hospital to the League of Friends on a concessionary basis was agreed, subject to the fulfilment of a number of conditions relating to use and assurances of adequate financial support. The North-East Thames regional health authority has negotiated with the League of Friends on our behalf and we are satisfied that the conditions and assurances sought have been met. We have therefore agreed to lease the hospital to the friends on a long-term basis at a peppercorn rent. The hospital will be run in accordance with the original Christian objectives for which it was established last century. It will provide a range of services, including nursing home beds, GP beds and day facilities for the elderly. It will, I believe, complement NHS services in Shoreditch in the same way as other voluntary or religious foundations have complemented the work of the National Health Service since its inception. We wish the Mildmay well in its new role.

Hansard is an edited verbatim record of what was said in Parliament. It also includes records of votes and written ministerial statements. The report is published daily covering the preceding day, and is followed by a bound final version.

Hansard Kenteth Clarke

Peter Frymann, who joined the Board of Mildmay at that time, shares his recollections.

"I'm going to pick up from the book by Derek Taylor Thompson, The Birth and Rebirth of a Unique Hospital, at paragraph 51, which is where I came became involved.

In April 1984 Helen Taylor Thompson contacted me to see if I would be interested in getting involved with Mildmay with a view to preparing a business plan or feasibility study for the Mildmay Mission Hospital as a voluntary charitable Hospital. This I did, and this document was indeed put to Kenneth Clarke, who was Health Minister under Norman Fowler, Secretary of State for Health.

What impressed him more than anything, was the fact that in the 1948 National Health Services Act, there was a stipulation that the Minister of Health or his successor was responsible for maintaining the denominational nature of hospitals where that was appropriate. Mildmay was one of six hospitals covered by this provision, and it was pointed out very strongly to Kenneth Clarke, that closing a hospital was definitely not maintaining its denominational nature. The Hospital Advisory Council, in that sense, offered to do the job for him if he would grant a lease at a peppercorn rent to the HAC to reopen the hospital. Those were the legal grounds on which the hospital was reopened in 1985."

Princess Alexandra officially reopens Mildmay

On the 19th May, 1988, Princess Alexandra visited Mildmay to officially reopen the hospital, as shown in this brief clip.

"One of the great heroes of the hospital, mentioned in the book, is actually Dr Kenneth Buxton. He was chairman of the League of friends, having been a medical director at the hospital. He it was who persuaded the League of friends in 1984 that without the hospital in operation the raison d’etre of the nursing home had gone. Accordingly, the only way to support the hospital they were all committed to was to close the nursing home, to sell it and donate the proceeds back to the hospital.

It was that donation of that £300,000 that gave the hospital reserves, which enabled it to sign the contract for the redevelopment of the ward for caring for people with AIDS. The contract might have been £300,000 but the cost worked out at £600,000. In part, the increase was down to the developing level of knowledge in the Local Authority and their changing requirements.

Later, Helen Taylor Thompson asked me whether, if we'd known in advance it would cost so much, we would have signed the contract. I replied that it was a matter of faith that we did sign that contract. I also pointed out that if we hadn't signed the contract we would almost certainly have lost the hospital because we have not been able to open, providing services that agreed with the DHS strategy and priorities. That was one of the terms of the lease that we should work with the DHA to complement them or not compete with them.

I remember in 1984 we had lots of meetings with the local community and representatives of it, to assess the support locally for the Mildmay. Indeed, there was a lot of support.

A lot of people said that even though they are a  Christian hospital, they would not push their Christianity, but it was the love that came through.

 

There was a lot of support locally, provided in the form of pubs that collected change to donate to Mildmay. One of the local businesses, which supplied leather goods, offered to provide a jacket or something if a patient needed it. And we had one AIDS patient, a young lady who had been a drug addict who desperately needed some clothes, and she was absolutely thrilled to be given a superb leather jacket from this company (whose name I can't remember).

One of the most useful features of the hospital in the early days was the roof garden; because so many people with AIDS enjoyed working with the plants - because they were working with something to do with life.

I remember that as a board, we decided that if we didn't know enough about AIDS, we would organise a time when, board members and one or two other volunteers could meet with one or two patients, just to discuss their experience of living with AIDS and living within Mildmay. The person we spoke to said that the day he was diagnosed with AIDS was one of the most liberating days in his life because it meant he knew that he was going to die and it meant that he focused on what was important in his life. So often we can go through life, too busy to think about what's important, But he said that they made him realise what was important and made him free to pursue the important things in life and not the fripperies."

A photo of the now demolished Spencer House Family Care Centre in Austin Street
Spencer House Family Care Centre in Austin Street

"Other people who were involved at the hospital in the 1980s included David Brownnutt, who was pastor of the Free Church next to the hospital, the Reverend Eddie Stride, who was the vicar of Shoreditch parish church.

In paragraph 92 in his book, Derek Taylor Thompson talks about the gathering in Buxton Hall when Bishop Maurice Wood gave an address at the dedication service. One of the comments he made about AIDS was seeing it as the 20th century equivalent of leprosy in the Bible, in terms of people's attitude to sufferers."

"It's also interesting to note that, whilst Mildmay was closed because the NHS said there was no place within the current NHS for a unit the size of Mildmay, within 10 years, it was cited in Hansard, as the model of care for people with AIDS in the UK."

"In the late 1980s the Hospital Advisory Council in whatever name you want to call it used to meet once a month to conduct the appropriate business.

In the early years, we would take something like three hours. And as I had a full-time job. I said to Helen Taylor Thompson that this was just becoming unacceptable. In 1989 I started working for a training organisation and I borrowed two training videos called “Meetings, Bloody Meetings” and “More Bloody Meetings”. When we implemented some of the techniques, we found that we were conducting far more business in little more than an hour per month. That was a real blessing, and it meant that the meetings became much more professional and business-like and the business of the hospital was well conducted.

I was involved throughout the Centenary Appeal and the building of the new unit designed to care for mothers and children. It is interesting to note that one of the first patients was a man in his 20’s and his mother, who came to stay with him. Not quite what everybody expected, but the hospital has always catered for the unexpected.

During my time with Mildmay, its Christian ethos and heritage were always very strong. The faith was never aggressively pushed to patients and visitors, but it was always there when questions were asked by patients. Many did ask those questions and found a faith (and peace within themselves and with others) before they died. One early patient with AIDS was so ill on arrival that Dr Veronica Moss wondered how they were still alive. A few days after arrival, they spent time with the Chaplaincy Team and made their peace with God and died a few days later.

My involvement with Mildmay ended in 1997 when I moved to Zambia on a three-year contract. It meant that I was unable to attend the opening of the Mildmay unit in Uganda, but I can certainly look back with a lot of pride and satisfaction. The fact that we took Mildmay from being a defunct and dead hospital to being a world leader in the care of people with HIV/AIDS and in research for healthcare for people with AIDS, with units both in the developed and the developing world, remains an enormous source of satisfaction to me personally."

Peter D Frymann

September 2021

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Diana, Princess of Wales, on one of her many visits to Mildmay, chats with a group of HIV nurses and care staff.
Evening standard
Diana shakes hands with an AIDS patient

An article from The Standard:

"Aids sufferers given new life by Diana clinic’s pioneering work"

"Two-thirds of patients at a leading HIV hospital made famous by Princess Diana go from "death's door" to living full and lengthy lives thanks to pioneering treatment.

The Mildmay clinic (sic) in Shoreditch, originally a hospice, treats the most advanced types of Aids-related illnesses by using a combination of drugs and therapy to help pull sufferers back from the brink.

The breakthrough in treatment, announced on World Aids Day, will give hope to an estimated 86,500 Britons living with the condition.

Simon Rackstraw, medical director of the clinic which is run by charity Mildmay International, said: "The patients we see are suffering from the most advanced, extreme form of the disease and we are making them better. They are coming to us with Aids-defining illnesses and in many cases, three months later, they are on their way home."

Mr Rackstraw, a specialist in HIV medicine, who is also a consultant at Barts and the London NHS Trust, added: "When Mildmay opened in the Eighties it was very much a hospice. Life expectancy was very limited. If they weren't dying at the clinic, they were sent on to a nursing home. With advancements in treatment and also with our focus on rehabilitation, patients are getting better."

Many patients at Mildmay suffer from HIV-related neurocognitive impairment, the effect of the virus on the brain. They are very frail, having lost the ability

to walk, speak and feed themselves and need 24-hour care. The hospital, which opened in 1988, is the only specialist HNCI rehabilitation unit in Europe. It offers counselling, occupational therapy, physiotherapy, speech and language therapies, chaplaincy and mental health services.

 

About 50 per cent of Mildmay patients died in the 10 years from the mid-Eighties. But with advancements in anti-retroviral drugs, which suppress the progression of the disease, combined with specialised rehab services, patients are living longer. In 2008/09 there were only two deaths at the hospital.

The unit attracted global attention in 1989 when Princess Diana shook hands with a patient. It was widely regarded as a defining moment in breaking down the stigma around Aids in Britain."

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