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Our Heritage

Manchester Institution For Curing Diseases Of The Eye

William James The founder of the institution now known as the Manchester Royal Eye Hospital was William James Wilson. Born in Leeds, after qualifying in medicine he was apprenticed to surgeons in Lancaster, Chester and London, where he developed an interest in ophthalmology. He became a Member of the Royal College of Surgeons in 1813 and moved to Manchester to set up practice.

 

At the time, the only provider of eye surgery was the Manchester Infirmary, and the surgeon best-known locally for his eye expertise had recently died. The precedent of specialist eye hospitals had been set elsewhere, with institutions in London, Exeter and Bristol already in existence for a few years.

Wilson canvassed local opinion, and having gained support, arranged an inaugural meeting at which the supporters gathered.

Premises were now needed, and one of the supporters of the Institution owned a house "near the top of King Street" which had some spare rooms. These were rented for the sum of £25 per annum, and the Manchester Eye Institution was open for business. Financial support was provided firstly by annual subscription from those who would become Governors and Trustees, and secondly from donations. The history of the Eye Institution's first decades would be a story of constant striving for enough funds to support an organisation which became immediately popular amongst patients, the cooperative societies and workhouses who often funded them. A 'collector' was appointed, whose task it was to ensure that the subscriptions were collected and accounted for. This was a full-time occupation, mostly on horseback.ered to declare open the Manchester Institution for Curing Diseases of the Eye. The meeting was held on Trafalgar Day, October 21st 1814, the 9th anniversary of the famous battle. The inaugural announcement was published as follows:

 

Announcement

 

Demand Grows & Addresses Change

The uncovered need for specialist eye care was so great that within only a few months of its opening, Wilson declared to the Board that he alone could no longer cope with the workload. In due course the second post of Honorary Surgeon to the hospital was appointed, and filled by Samuel Barton. He would go on to become one of the most long-serving members of the Honorary Medical Staff. Together these two doctors serviced the patients of the Eye Institution without fees, and later in 1815 the first annual report was composed. A brief summary of activity in the minute book showed:

Activity summary

 

The minute reads:

Discharged cured  702

Relieved 97

Incurable 18

Remain on the books 188

Total 1005

 

This, the first record of patients treated, was the beginning of an inexorable rise in numbers during the following decades, accompanied by constant efforts to generate enough revenue to support their care. At the end of 1815 a full annual report was published, showing that the newly-founded Eye Institution had already treated 1885 patients, more than three times the number treated at the Manchester Infirmary (whose surgeons would continue to offer eye care for nearly 100 years after the formation of the Eye Institution, in competition with it). The report incorporated a breakdown of the eye diseases treated, giving a fascinating insight both into the prevalence of various conditions at the time, and into the methods of diagnosis:

Breakdown

The total benefactions during 1815 were £195, but unfortunately the expenditure was £202, resulting in published appeals for greater support. Patient numbers gradually increased, and ultimately became too difficult for two surgeons to deal with, and a third, John Windsor, was appointed in 1818. The premises too became inadequate, firstly alterations were necessary, secondly larger premises were sought. In 1822 the Eye Institution moved to rooms within a new house at No. 35 Faulkner Street.

In May 1827, after serving the Manchester Eye Institution for 13 years, William Wilson resigned his position at the Eye Institution. Messrs Barton and Windsor did not however want a third surgeon, and instead arranged for the appointment of two Assistant Surgeons, who would provide a greater part of the care necessary. This arrangement, of two Honorary Surgeons and two Assistant Surgeons, continued for some years. During this period the available rooms in the house in Faulkner Street again proved inadequate, and the Eye Institution moved to No. 7 Princess Street, again simply a small house, used for hospital purposes. The next expansion, in 1835, would be to take in addition a front room at No. 13 Princess Street, and in due course the whole hospital moved over to this address.

The rather peripatetic nature of the Manchester Eye Institution in its first twenty years was problematic, but very gradually the funding became more secure and in 1838 the Board considered for the first time that it was possible to purchase a house. This was at No. 3 South Parade, one of a row of houses facing the Church of St. Mary. It was bought for £1,333, with an £800 mortgage. The suitability of this and adjacent premises as small hospitals was clearly not just noted by the Board of the Eye Institution - next door would be the Lying-in Hospital for Women, which would later take the name of the church opposite, and become Saint Mary's Hospital.

Site map old

 

Manchester Eye Hospital

This momentous occasion of a house purchase (even though supported by a large mortgage) was marked by a change in name. The organisation until then known as "The Manchester Institution for Curing Diseases of the Eye" would be renamed as the ManchesterEye Hospital.

This new building clearly provided advantages, and yet the patient experience was still decidedly Victorian. Patients queued in the rain in the back yard, until funds were found to erect a shed, to make their sometimes long wait rather less uncomfortable. A list of creditors submitted to the Board during the following year gave an example of costs:

 

Sam Foster .... rent due 24 June 2..2..0
Mary Parry Leeches 7..5.10
R & J Clough Candlesticks etc 7..3
Tomlinson & Leigh Fire-irons etc 2..2..3
Rt Hughes & Son lettering 3..3.0
W Hatton Barber 1..1
J Slack Filtering machine 1..5..0
R & W Johnson Brushes 10..0
Smith & Ingle Paper 10..0
Gale Barker & Wardle   Drugs 3..0..6
Leese Jones & Co.  Coals Quarterly bill to June 24 5..13.7½
Jn Ward  Quilts & Blankets 2..18..0
Patients board to June 27 8..0..3
House sundries & Salary of T Bradbury to 24th June 15..8..5


For those who needed to be inpatient, the cost of board was 3/6d per week, payable in advance! The salary of the resident House Steward (and his wife, the Stewardess) was £70 per annum, with board, and two servants were permitted, with pay of £8.10s per annum and board equivalent to 6s weekly.

In 1862, for the first time, a House Surgeon was appointed to the hospital staff, and although not resident, working full-time for the Hospital. The rules for patients at the time were strict:

Every InPatient shall on admission bring a change of linen to the Hospital.

The Patients shall conduct themselves quiet and orderly and in all respects obey the directions of the House Surgeon and the Matron.

The breakfast, dinner and tea time for the InPatients shall be respectively 8¼ o'clock 12 o'clock and 6¼ o'clock. Prayers shall be read at 10am and 6pm

The InPatients who by their respective Surgeons are allowed to be up during the day shall as a rule repair to Bed at 8½ o'clock at night.

Those InPatients who by their respective Surgeons have been ordered to exercise in the open air, without any particular time being assigned for it, shall only be allowed to absent themselves from the House between 10 and 12 o'clock am and between 1 and 5 respectively from 1st October to 31st March 4 o'clock pm

No more than two persons at a time shall be admitted to visit any Inpatient and such visits shall only take place on Wednesdays and Saturdays between 2 and 5 o'clock pm.

By Royal Appointment

In 1865 the Hospital moved away from South Parade, selling No. 3 for £2,800 (property inflation was not just a 20th century phenomenon) and buying instead No. 24 St. John Street, a house that nevertheless required considerable extension, alteration and refitting. The number of inpatient beds was doubled from 25 to 50. It was felt appropriate to seek Royal status, and in due course the Home Secretary confirmed Her Majesty's approval. Henceforth it would become The Manchester Royal Eye Hospital.

The Royal Eye Hospital is shown below in St. John Street, late in the nineteenth century. It is the tallest building on the right side of the street, near the far end. St. John's Church, still there in this photograph, was demolished in the early 20th century. The building occupied by the Royal Eye Hospital still stands, and has been used, as so many others in the street, for private medical practice.

 

St John Street

Building 5

 

Nelson Street

Building 3

 

The hospital at St. John Street served well for nearly twenty years, but throughput increased inexorably and in 1879, four cottages behind No. 24 in Artillery Street were purchased for expansion to 65 beds. Predictably this proved inadequate, and the medical staff proposed the need for a further increase of inpatient space to 100 beds, which could only be achieved by a substantial new build, and owing to the space needed, outside the city centre.

After investigation, a site south of the city in Chorlton-cum-Medlock was decided upon, at that time a well-to-do residential area. A special appeal obtained funds for the purchase of land, and a design of the architects Pennington & Bridgen was chosen, and the hospital was opened for business in 1885.

The hospital is seen here shortly after its opening. The House Staff, including House Secretary, nurses and House Surgeons, together looking after 100 inpatients, gathered for a photograph in 1895.

The outpatient entrances (one for men, one for women) were on Nelson Street. However, for many years after its opening, 24 St. John Street was retained as an additional outpatient facility in town. During this period, the Manchester Royal Infirmary Board was becoming increasingly dissatisfied with the position and facilities of the old hospital in Piccadilly, and were themselves looking for land for new premises. They chose to move next door to the Royal Eye Hospital in 1906, purchasing all adjacent land and thus effectively preventing Eye Hospital extension (which was again becoming necessary). Hard negotiation followed, ending in the Royal Infirmary releasing a band of land to the south of the Eye Hospital on the Oxford Road Frontage, in exchange for the handing over of all clinical eye services, and undergraduate ophthalmology teaching from the Infirmary to the Eye Hospital. This transfer of responsibility and lectureships, together with the building of teaching facilities, represented the final acknowledgement by the MRI, some 92 years after the creation of the Eye Hospital, that it was the latter which was the natural centre for ophthalmology care and education, and at this time ophthalmology effectively ceased at the MRI. The Eye Hospital extension was completed in 1910, creating the frontage so well known to alumni today:

Building 3


The Great War and World War ll

The Great War closely followed, the Hospital coming under the strain firstly, of losing staff to war service, and secondly losing 50 beds to the care of the war wounded, whilst dealing in 1917 with 39,000 outpatients and over 2,000 inpatients. Immediately after the war the practicalities of running St. John Street became insuperable and in 1920 it was closed after being used for over 50 years.

Instead, three houses opposite the Oxford Road hospital were purchased for use as additional outpatient space and staff quarters. In due course however, the inevitability of inadequate space supervened and the decision was made to commission an entirely new outpatient building on Nelson Street, to include a residence for nursing staff. This was occupied in 1937, and of course finished to the most modern style, being tiled floor-to-ceiling.

The pictures show the new frontage in 1937, together with what would nowadays be styled a "triage" area. The Second War followed, with similar effects to the Great War on staff losses and the secondment of beds to military casualties. On the night of 23rd December 1940 the hospital was bombed, killing two staff members and causing substantial damage. Temporary closure was necessary but part reopening was possible by the following April, with 160 beds.

 

Building 1 Building 2



National Health Act 1946

The end of the war was followed rapidly by the National Health Act in 1946, which transformed the structure and funding of health services. The new Northwest Regional Hospital Board grouped together the MREH, MRI, St. Mary's Hospital, the Dental and Foot Hospitals, which in 1948 became The United Manchester Hospitals.

Further pressure on space, especially for the University and Orthoptic departments, led to the purchase in 1956 of Lister House, on Nelson Street. This initially became the base of the University Department, also housing orthoptic beds, consulting space and staff accommodation, later evolving in the 1970s into a glaucoma unit of 20 beds, with hospital library and offices. During the 1960s and 1970s, the Manchester Royal Eye Hospital was the busiest provincial eye hospital in the country, and of the 300 consultant ophthalmologists in England in 1965, some 50 had been trained there. The Orthoptic School was opened in 1965, rapidly achieving national recognition.

Building 2

Lister House is shown here later, in 1975, with the stylish cars of the staff at the time. Some five years later, this author commenced his long relationship with MREH as an elective medical student, at which time the hospital had just under 200 inpatient beds, for 7 consultant surgeons. The succeeding 23 years have been typified by political change and organisational turmoil, accompanying the spiralling costs of healthcare, in association with breathtaking advances in the technology of ophthalmological medicine and surgery.

In 1974 the new Manchester Area Health Authority amalgamated the United Manchester Hospitals with a wide range of community services and health centres with the aim of rationalising primary and secondary care. In 1983 the Griffiths report demanded managerial restructuring, so that at MREH as at all other hospitals, consensus management by the triumvirate of Senior Consultant, Matron and Hospital Secretary, disappeared to be replaced by a General Manager. Further organisational change included the purchaser/provider split and the creation of Healthcare Trusts; MREH became a part of the enlarged Central Manchester and Manchester Children's Hospitals NHS Trust (thankfully shortened to CMMC!) in 2001, and foundation trust status was gained in 2009. Manchester Royal Eye Hospital is now a part of the Central Manchester University Hopsitals Foundation Trust, amongst the largest hospital sites in the UK and providing education for the clinical students of Manchester University, which houses the largest medical school in the UK.

In 1987 the Chair of Ophthalmology was reconstituted after lying fallow for 14 years, and Professor David McLeod was its occupant. His arrival was followed not only by the reinvigoration of both laboratory and clinical research (later reflected by the appointment of two Wellcome Trust Senior Research Fellows, then the only senior ophthalmological fellows in the UK) but by major improvements to postgraduate education at MREH. Research and academic activity remain at the forefront of MREH, and this has been recognised by the appointments of several professors as leaders in both clinical and research ophthalmology (including ophthalmic genetics): currently Professors Bishop, Black, Henson, Lloyd and Stanga.

Following the creation of the National Health Service in 1948, all buildings, originally created and kept by public donation, were effectively nationalised; at this point, investment in upkeep and development by evolution, virtually ceased, and the declining state of the buildings became an increasing problem. Lister House, initially declared unfit for habitation in the 1960s, was eventually vacated and demolished as late as 1995. The main hospital building was unsuitable for redevelopment and of declining state; inventive refurbishment permitted adaptation during the 1980s and 1990s, facilitated by the declining need for inpatient beds as new surgical techniques permitted shorter inpatient stays and some day-case surgery. The outpatient building became similarly unsatisfactory despite cosmetic alteration. It was clear that the buildings of both MREH and MRI were rapidly becoming unsustainable and a large-scale rebuild was planned. The Strategic Outline Case for a new building was made in 1996.  The immensely complex and expensive new build, requiring Private Finance Initiative funding and ultimately including new hospitals for the Mental Health Trust and the Manchester Children's Hospitals, would be created on the same island site, requiring the continuing provision of all services during the building process. Fortunately the Eye Hospital was able to remain in its Oxford Road premises during this time. The new building was occupied in 2009, 13 years after the initial application to rebuild.


£500 million redevelopment

The new Manchester Royal Eye Hospital occupies a part of the large new building which also provides a new Saint Mary's Hospital for women, a new Royal Manchester Children's Hospital, and a substantial replacement of the Manchester Royal Infirmary. Its frontage is on The Boulevard, a new road running through the island site.

The hospital now has 35+consultant ophthalmologists providing a comprehensive range of sub-specialty expertise, and the hospital therefore attracts tertiary referrals from the North of England, North Wales and beyond. There are two consultant ophthalmic pathologists and two consultant optometrists. There are five operating theatres on site, and a sixth serving the outreach cataract service at Withington Community Hospital.

The hospital performs more than 5,000 cataract operations per year. Outpatient services include anterior segment and retinal clinics with 24 consulting rooms, the Macular Treatment Centre, 6 laser rooms including Pascal retinal laser, optometric and contact lens services, a dispensing optician, a bespoke orthoptic and paediatric clinic, a Vision Science Centre, a comprehensive ophthalmic imaging service, an ocular prosthetics department and emergency services including the Emergency Eye Department. The Manchester Eye Bank provides a service for retrieval and processing of donor eye tissue for the North of England, and a ward provides inpatient services for those undergoing complex surgery. The hospital even has a ward and consulting suite for private patients.

New inside

Our facilities were officially opened by Her Majesty The Queen in 2012.

Manchester Royal Eye Hospital has, over two hundred years, developed and maintained a well-deserved reputation for excellence. The hospital and its consultants attract both secondary and tertiary referrals not only from the Northwest of England, but nationally and internationally. It is one of the busiest eye hospitals in the world. The hospital is well-equipped to provide a high level of service well into the 21st century and beyond.