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The voluntary hospital movement

From church to charity

While the church had been the main driver in the establishment of hospitals until the beginning of the 18th century, thereafter modern philanthropy (often based on commerce, as in the case of Guy's) dominated.

In the early to mid-18th century, a number of hospitals were founded for philanthropic (and reputational) reasons, with the objective of improving the lives of the poor and to contribute to the prosperity and health of the nation. Leading physicians and surgeons encouraged a group of wealthy patrons to establish a hospital.

Westminster Hospital established after the arrival of refugees

France's persecution of Protestants (the Huguenots) led to refugees fleeing to England. Many settled in Shoreditch and Spitalfields, where hospital care as they had known it in France was lacking. The Huguenots were familiar with the French system of creating and sustaining hospitals through donations from wealthy citizens.

Charles II had ordered funds for the refugees to be collected in each parish and William III's wife, Queen Mary, founded the Royal Bounty for refugees' aid. The fund was used to help care for the old and sick and to support new arrivals.

In 1708, Jacques de Gastigny left £1,000 in his will to benefit the refugees. His executor built the first hospital, which was incorporated by Royal Charter in 1718. It originally accommodated 80 people but grew by 1760 to accommodate 234.

Westminster Hospital, founded in 1720, is often cited as the first example of a voluntary hospital in England (although the Huguenot hospital was founded on similar principles of philanthropy). Over the next few decades, further hospitals were founded, such as the Bristol Royal Infirmary in 1735 and the Royal Infirmary of Edinburgh in 1729.

New hospitals during the 18th century


  • 1720 – Westminster Hospital (for relieving the sick and the needy).
  • 1727 – Guy's Hospital (for people who St Thomas' was unable to cure).
  • 1734 – St George's (for relieving poor, sick and disabled people).
  • 1739 – The Foundling Hospital (for the care of infants abandoned by their parents).
  • 1740 – Moorfields (for the sick and injured East End poor).
  • 1745 – The Middlesex Infirmary (for the sick, lame and cancer patients).
  • 1747 – The Lock Hospital (for the treatment of venereal disease).


  • 1729 – Royal Infirmary of Edinburgh (for the treatment of the sick poor).
  • 1735 – Bristol Royal Infirmary (for the relief of the sick).
  • 1752 – Manchester Royal Infirmary (for the treatment of the sick poor).
  • 1766 – Addenbrooke's Hospital (for the relief of the sick).

Black N.
The lost hospitals of St Luke's.
J R Soc Med.
2007; 100(3): 125–129.

London Lives.
London Lives; nd.

Voluntary Hospitals Database.
The voluntary hospitals in history.
Voluntary Hospitals Database; nd.

Lothian Health Services Archive.
Royal Infirmary of Edinburgh.
Lothian Health Services Archive; 2013.

Hospitals and related institutions in the Manchester area.
The Manchester Medical Collection: Sections 3–16.
University of Manchester Library. 2002; GB 133 MMC/9.