hospitals and dispensaries. With the development of towns in Ireland from about the 9th century temporary houses began to be set aside for the victims of epidemics; most permanent hospitals appear to have been lazarettos, for the care of lepers. Many houses of
religious orders also contained general hospitals or infirmaries. The largest was probably the hospital of the priory of St John the Baptist without Newgate in Dublin, an
Augustinian foundation established in the mid‐1180s. By the early 14th century this hospital had 155 beds, but at its suppression in 1539 only 50 remained.
With the
dissolution of the monasteries, the sick were left with only small leper, plague, and poor houses. It was not until the more settled conditions of the early 18th century that the Protestant elite in the towns began to build substantial institutions for the care of the sick poor. Hospitals then proliferated. In
Dublin eight appeared in 40 years, including Jervis Street, Dr Steevens's, Mercer's, the Incurables', the Lying‐in (later
Rotunda), the Meath, the Lock (later Westmoreland), and St Patrick's for the mentally ill (see
insanity and the insane). In
Cork the South and North Charitable Infirmaries opened during the same period. But
Belfast lacked a general hospital until 1817, when Frederick Street (replaced in 1903 by the Royal Victoria) opened, and
Limerick until the opening of Barrington's in 1831. Most of the above were so‐called voluntary hospitals, largely financed by donations, fund‐raising, and investments, and run by the Protestant upper and middle classes.
Early in the 19th century new Catholic female religious orders (see
nuns), supported by a reviving church and a growing Catholic middle class, also began to open voluntary hospitals. The Sisters of Charity established St Vincent's in Dublin in 1834, while the Sisters of Mercy opened the Mercy in Cork in 1857, the Mater Misericordiae in Dublin in 1861, and the Mater Infirmorium in Belfast in 1883. As well as nursing in Catholic hospitals, female religious began to nurse in
workhouse infirmaries from the 1860s and soon dominated the Irish
nursing profession.
Fear of the spread of infectious diseases among the poor also prompted the state to play a major role in the establishment of Irish hospitals from the late 18th century onwards. In 1765 an act was passed to facilitate the opening of county infirmaries, while other acts in 1807 and 1818 made provision for fever hospitals. In 1805
grand juries were empowered to fund dispensaries. Most of the 130 workhouses built in the decade after 1838 contained an infirmary for the house's pauper inmates.
The medical disaster of the
Great Famine persuaded the state to develop the dispensary system further. The 1851 Medical Charities Act divided Ireland into over 700 districts, each with at least one salaried medical officer and in many instances also a midwife (see
childbirth), under the control of the
poor law guardians. The workhouse infirmary system was also significantly expanded in 1862 when the sick poor, not solely the destitute, became eligible for admission.
This system of voluntary religious hospitals and government infirmaries and dispensaries operated into the 1940s with minimal change in both the
Irish Free State and
Northern Ireland, although the Free State did replace poor law guardians with local authority boards of health in the 1920s. In 1946, however, Northern Ireland hospitals were placed under the jurisdiction of a new Hospitals Authority, although the Mater in Belfast, the only Catholic voluntary hospital in the province, remained outside this system until 1972. In the Republic free hospital care was extended to the majority of the population from 1953.
In 1968 a report criticized the Republic's network of 169 hospitals, many of which were small, ill‐equipped, and inadequately staffed. As a result a major consolidation of hospitals began, which saw the closure of many of the country's smaller and older hospitals and their gradual replacement by larger regional and general hospitals.
See
medicine;
health services.
Bibliography
Barrington, R. , Health, Medicine and Politics in Ireland, 1900–70 (1987)
Fleetwood, J. F. , The History of Medicine in Ireland (2nd edn., 1983)
Elizabeth Malcolm
