History of Old St Thomas' Hospital

St Thomas’ is one of London’s oldest hospitals. It has been providing shelter and relief to the sick and needy since the twelfth century.

St Thomas’ is one of London’s oldest hospitals. It has been providing shelter and relief to the sick and needy since the twelfth century. Founded as part of the Augustinian Priory of St Mary Overie (meaning over the river), it was renamed The Hospital of St Thomas the Martyr following the canonisation of Thomas a Becket in 1173. This is now in the vicinity of Southwark Cathedral.

Map of 16th century Southwark. London Metropolitan Archives.

A fire destroyed the Priory in 1212 and soon afterwards the hospital obtained a new site on the east site of what is now Borough High Street. This was a two-storeyed building offering care and hospitality for up to 40 people, predominantly the sick poor and needy and travellers. The Hospital would remain on this site for nearly 650 years.

 Southwark at this time was a suburb with an unsavoury reputation for vice and immorality, In the early fifteenth century, Richard ‘Dick’ Whittington set up a refuge at the Hospital for unmarried mothers, and in 1535 it was visited by Thomas Cromwell who called it ‘the bawdy hospital of Southwark’, perhaps in connection with the care of patients with venereal disease. The hospital’s master, Richard Mabbott, allegedly kept a concubine and had sold the church plate.

 At the Dissolution of the Monasteries in 1540, St Thomas’ was closed by Henry VIII and Beckett was decanonised.

‘In view of the sick, poor men lying begging in the streets of London and their annoyance of the King’s subjects’,  the buildings were granted to the Lord Mayor and citizens of London by Edward VI in 1551 and were renamed the  Hospital of St Thomas the Apostle.

The new royal Hospital was governed by a General Court of Governors, who were representatives of the City of London, and headed by a Hospital president. The governors’ role was to oversee the general management of the hospital as well as assisting senior medical staff with the admission of new patients on ‘taking in day’, the one day of the week they were received.

It was the governors, not the medical staff, who decided which patients should be admitted.

Patients were expected to attend a daily service in the chapel and if they did not went without food. They were also punished for gambling, swearing and drunkenness.

Between 1693 and 1709 the hospital was rebuilt as an elegant classical structure constructed around three courtyards. This was largely at the expense of of President Robert Clayton. The rebuilt St Thomas’s could accommodate more than 400 patients and had nineteen wards, four of which were ‘foule’ wards for venereal patients. The rebuilding also replaced the medieval church with the church which is now houses the museum.

St Thomas' Hospital in the 18th century.

Clayton was helped by his rich friend Thomas Guy who founded the adjacent sister hospital, Guy’s, which admitted St Thomas’ ‘incurables’: patients with infectious diseases and ‘lunatics’.

In 1752 new rules were drawn up: no patient was to be admitted more than once with the same disease, there was to be no suspicious talk, entering the wards of the opposite sex and that no more than one patient was allowed in a bed.

The original intention of the Hospital was to admit all ‘deserving’ cases free of charge, although it was not unusual for patients to make a small donation towards their treatment. However, by the eighteenth century most patients were required to pay fees for their treatment, in addition to providing some form of deposit to cover burial costs if they died in hospital. 

Whilst governors had the authority to waive fees for the poorest patients, in practice the majority of patients who could not pay had to seek financial support from their parish or approach private patrons.

An important eighteenth century was the introduction of operating theatres. These were located on the top floor to ensure they received the maximum benefit of daylight. The male theatre was built in 1751 and the female theatre in 1821. Operations had to be swift: anaesthetics weren’t used until 1847 and antiseptic surgery was not introduced until the 1860’s.

The Male Operating Theatre at St Thomas' Hosptial, before 1862.

Florence Nightingale opened up her school for nurses at St Thomas’ in 1859, emphasising dedication, discipline and a strict moral code.

 In the same year the site of the Hospital was acquired by the Charring Cross Railway following Parliament’s decision to extend the London Bridge railway line from Greenwich across the River Thames.

St Thomas’s left Southwark in 1862 and most of its buildings were demolished.

Although major advances in medicine took place only after the Hospital had left the area. surviving Hospital records suggest recovery rates were high and the level of patient mortality was relatively low. However  hospitals were not the first port of call for the sick. Throughout the period most sick people received assistance in the home.  

Surrey Zoological Gardens, 19th century.

The hospital moved to the former zoological buildings in Surrey Gardens, Lambeth, (about a quarter of a mile from today’s Kennington Underground Station).It was far from perfect. There was no ventilation or heating and the kitchen doubled as the operating theatre. The giraffe house became a cholera ward and the elephant house the dissecting room.

A suitable permanent site was found at Stangate in Lambeth, at the foot of Westminster Bridge where work began in 1865. Queen Victoria opened the new hospital six years later.

Medicine developed rapidly at the end of the nineteenth century. Specialist departments were opened in the fields of dentistry, eye surgery and electrical therapy. In 1896 it was chosen as the location for the first demonstration of x-rays in a London hospital.

St Thomas’ Hospital remains on this site. It offers some of the highest quality healthcare in the world and specialises in liver and kidney and incompatible organ transplant.

St Thomas' Hospital in Lambeth, 19th century.
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