IRIS CLAPP turns the spotlight on nearly 200 years of hospital services in Colchester.

The name is straight out of a Gothic novel.

It conjures up Gothic images, too - gargoyles, tall towers, shadows and genuine fear at what might go on behind its walls. This, then, was Essex Hall in Colchester circa 1859, the Eastern Counties Asylum for Idiots, Imbeciles and the Feebleminded, only the second of its kind in England. The first was Bedlam.

But there was a difference. At Essex Hall, the "inmates" were patients and they were not always locked away. Teaching and training took precedence, and it was at Essex Hall where the term "special care" came into common use.

By the beginning of the 20th century Essex Hall - financed privately and with cash from Essex, Suffolk, Norfolk and Cambridgeshire county councils - had become the Royal Eastern Counties Institution for Mental Defectives. There was still a whiff of the Gothic about the place, but that was beginning to pass. Colchester was starting to get a name for itself as a pioneer in what was to become mental health services.

By the time Essex Hall's "annex", Turner Village, was opened by the then Duke of Kent in 1935, the institution had nearly 2,000 beds in centres across north Essex. Meanwhile, the other arm to Essex's mental health revolution, Severalls - then called the Essex County Mental Hospital - had opened in 1913 with 1,800 beds, research facilities and county council funding.

They became part of the NHS on July 5, 1948, as did all Colchester's hospitals - Essex County Hospital, Colchester Maternity Hospital, St Mary's Hospital, Myland Hospital and Military Hospital.

Today, only Essex County Hospital and Colchester General Hospital, opened by the Queen in 1985, remain. Most of the acute services are now at Colchester General while non-acute have been centralised at hospital outpatients' clinics and the North East Essex Primary Care Trust building.

The catalyst for this "centralisation" was the 1990 NHS and Community Care Act. But while it may have radically changed how the health service is "managed", the real revolution was in 1948.

Until county councils began to take over responsibility for hospitals in the 1920s, they were managed by boards of guardians. Finance was ad hoc - normally bequests from the wealthy and whatever the borough or rural council thought appropriate from the rates. For the majority, receiving even the most basic treatment depended on where you lived and how philanthropic your neighbours.

Then there were the GPs. Throughout the first half of the 20th century, the general premise was people paid what they could for treatment and medicine, with the better-off effectively supplementing those with less money.

But this health "system" was no good to the destitute - children, men, women and the elderly, below the poor, with no home, no job, no future - who were not welcome anywhere, not even Essex Hall.

To survive, they had to go to the workhouse and the workhouse infirmary, built in 1837, a year after the Poor Law Act made such miserable places statutory. Colchester's eventually became St Mary's Hospital, a "public assistance institution", and when it closed in 1993, it had been the town's geriatric hospital for five years.

There were also geriatric wards at Myland Hospital before it closed in 1989. But that was not why it had been built. It began life as the Infectious Diseases Hospital and was a response, in part, to the Contagious Diseases Act 1867 (an attempt to limit the spread of venereal diseases in Army towns "by the compulsory treatment of infected prostitutes") and the growing number of cases of smallpox, cholera and tuberculosis. The future Myland Hospital was the borough's isolation hospital and, in 1936, it became Essex's smallpox centre.

Until the Second World war, some of its patients were serving soldiers. Colchester Garrison's Military Hospital had been looking after its own since 1856, but not when it came to infectious diseases. By the late 1960s, the Military Hospital was taking civilian patients to ease Essex County Hospital's waiting lists.

Essex County Hospital had opened in 1818 as a "general infirmary for the poor", thanks to the foresight - and cash - of a group of eight men led by the Archdeacon of Colchester, Joseph Jefferson. It had been one of the first "purpose-built" hospitals for the poor (as opposed to the destitute) in the UK.

In 1948, along with Colchester's seven other hospitals, Essex County Hospital became part of the NHS. Healthcare - paid for by direct taxation - was ostensibly free and everyone's right.

Now that was revolutionary.


  • Essex and Colchester Hospital (renamed Essex County Hospital, 1907): 1818-present
  • St Mary's Hospital (initially town's workhouse hospital), off Balkerne Hill: 1837-1993
  • Infectious Diseases Hospital (later Myland): 1884-1989
  • Royal Eastern Counties Institution (mental health services): Essex Hall, near North Station (1859-1985); Turner Village, off Turner Road (1935-1995)
  • Severalls Hospital (mental health services): 1913-1997
  • Colchester Maternity Hospital, Lexden Road: 1932-1997. Relocated in 1997 to Colchester General Hospital
  • Military Hospital, Colchester Garrison: 1856-1978 (reopened briefly in 1991 during the Gulf war)
  • Colchester General Hospital: 1985-present.