Clackmannanshire, like most other areas of the world, have seen improvements in the health of its residents over the centuries. This is down to an improvement in the understanding of what can cause ill health, as well as advances in science making diagnosis and treatment more effective.
For many years health was something people either had or didn't have. If you were lucky, you had a good “constitution” which resulted in you having fewer illnesses, and if you did have one you would tend to recover more quickly. The opposite of this were those with weak “constitutions” who found it hard to fight illnesses, they tended to catch every illness that entered their town or village and even a relatively mild infection could result in their death.
When it came to wounds there was little care available, except that some people would wrap the wounds in a bid to keep them clean. Anyone who had an open wound would more than likely develop a severe infection and this could be fatal, but again their “constitution” would be the deciding factor in many peoples eyes. Those who lived a “cleaner” life had a much higher chance of survival, as they may have had access to boiled water and clean clothes to help wash out and cover the wound. For those less well off, they often didn't even have a spare rag to cover the wound.
Injuries often left people with physical disabilities. A broken bone would be left to heal on its own and could result in a useless limb or long term severe pain as well as an inability to continue working. Many people who may have had a reasonable life, working, paying their rent and having enough money for food could see this swept away after an injury if they could no longer work, to the point that they and their family may end up homeless and begging in the street, unless other members of the family could compensate for the lost wage.
There was no understanding that the environment we lived in or the work we did could have an affect on health. For instance, there was no understanding that drinking dirty water could result in deadly infections or a babies inability to grow and thrive. Many would die from the effects of dirty water which may have typhoid in it or bacteria which could cause gastrointestinal illnesses which would result in severe diarrhoea and vomiting in many cases resulting in dehydration and in some cases death. There was no understanding that working in pits could damage lungs and whole families were known to work in the same pit, so there was a tendency to see the other members of a family with horrific coughs and then the younger members of the family developing it as they grew up too. These coughs of course today we know are caused by severe damage to the lungs by the coal dust but they had no idea.
In each village, town etc. there were often women who would spend their “working” life delivering all the babies of the village, usually learning the process of labour by her own experience or the experience of the women she knew. A good “wifie” would undoubtedly deliver many healthy babies over the years. If she was known to have a good success rate she could charge more for her services. Unfortunately sometimes a “wifie” would have a bad reputation as she would have more infants die at birth or soon after, therefore she often charged less and was used by those who couldn't afford a better “wifie”. Some families couldn't even afford her services, so female members of the family would deliver the baby hopefully without any complications. Sadly many infants died at or soon after birth, and babies with deformities were sometimes abandoned to die, or no matter how much care they were given they still didn't live very long.
Most villages would have someone who knew about the plants, flowers, herbs etc. that grew around them and could use these to help treat the villagers who were ill or injured. This was the start of Homeopathy medicine, which still to this day is used by some, and was to eventually be the roots of modern medicine. Unfortunately, these people were sometimes treated with suspicion - especially if their treatments worked. Depending on the local population, and sometimes in particular the local “Holy Man”, these people would be cast as Witches and Warlocks, as no one understood how they knew what treatments to use and why their “potions” worked. At various points in time these people were tried in “Witch Trials”.
Throughout the 1800's there were many great advancements in the understanding of illness, diseases and environment. In 1848 the first Public Health Act was put in place, this lead to the establishment of a General Board of Health in Britain, which was responsible for advising on public health issues such as epidemics and disease prevention. There were also local boards who were responsible for local issues such as refuse in the streets, bad paving, water and drainage. The Medical Officers reported once per quarter to the General Board of Health informing them of deaths and disease in their area, they also sent a more detailed report annually and in this report they would make suggestions of required changes.
In 1868, the provision of Health Care in Clackmannanshire improved for those who could afford to pay for health care as the 11th Earl of Mar paid £300 towards the construction of a hospital at Ashley Terrace, Alloa, latterly named Clackmannan County Hospital. This hospital provided Medical and Surgical Care on two wards and was the responsibility of the Local Authority. There was a second separate area to the hospital with two wards which was overseen by Mrs Bain, where people with “fevers” were cared for. From the information I have found, the Medical and Surgical care had to be paid for, whilst the Fever section seems to have been funded by Voluntary Contributions. Lady Mary Anne Erskine, the Earls wife, was the hospital Patron.
The County Hospital 1868 - internet picture
In his 1891 report, the Medical Officer says that he has identified the need for an Infection Control Hospital and that the Burgh and County Council are in discussions about this. He comments that the current hospital provision is only adequate as long as there is only one infectious disease in the County at any one time.
The Medical Officer also reported that sanitation varied greatly across the county as did the supply of water. He identified that in Tillicoultry, a sewage system was desperately needed, as at that point the drainage of sewage was via open surface channels and privies were still in use. During the previous year he was dealing with an issue related to the smoke nuisance especially in Alloa due to the number of furnaces at work. He researched into different types of furnace which would reduce or eliminate the smoke and recommended that the Vicar's Furnace be tested as it was claimed to be a totally smokeless and more cost effective.
In 1895, Clackmannan County Infectious Diseases Hospital otherwise known as the Combination Hospital was opened, on the site of what we know today as Clackmannanshire Health Care Centre or Sauchie Hospital. The land which was part of Parkhead Farm, was donated by the 12th Earl of Mar Walter John Francis Erskine. The hospital cost just over £8300 and was believed to be the first of its kind n Scotland. The site was chosen as it had a “natural fall towards the south west, and the buildings are to be placed so that the wards will have as much of the sun as possible”.
The wards were inspected by the Doctors and Matrons via air tight windows within their rooms, this meant they limited their exposure to any infections. The wards were ventilated by external windows and were heated by open fires. Over the years a variety of buildings were added to the hospital:-
1899 the Lodge at the gates was added.
1901 a Laundry Block was added.
1914 a Doctors Room and Cubicles for servants was added.
1916 a TB Pavilion and huts were added.
1938 a North Block was added.
1970/80s another block was added.
In 1899 the County's Accident Hospital was built to replace the old hospital in Ashley Terrace, as it was deemed too small. This was funded by Miss Catherine Forrester who was a Patron, she paid for the construction and the equipment. By the 1900s this hospital had 19 beds but this quickly tripled.
Postcard of the County Hospital - internet picture
Clackmannan County Hospital Ward - colourised (internet picture)
Clackmannan County Hospital Ward - colourised (internet picture)
Staff on a break - internet picture
The Ochil Hills Sanatorium above Milnathort, although not within Clackmannanshire, did serve Clackmannanshire's health needs. The Sanatorium opened on 16/01/1902 and was a very large building built over 3 floors. The Sanatorium was for those who could afford to visit in a bid to recover from Tuberculosis, as fresh air, rest and good nutrition were believed to improve the chances of surviving the illness. The Sanatorium charged 5 Guineas per week, a not inconsiderable sum back then. The facility took patients from Fife, Stirlingshire, Clackmannanshire and also kept some beds available for Glasgow patients. The Sanatorium later became a convalescence home, and eventually closed in 1987. By 2001 it was largely derelict, it was eventually demolished.
At the start of World War One it became clear that there was a need for extra hospitals for the recuperation of soldiers after injury or illness. This became more acute as the war progressed, as soldiers also experienced the horrific effects of chlorine & mustard gas attacks. The British Red Cross oversaw the setting up of Auxiliary Hospitals all over the UK, in many cases in Manor Houses. Many such houses were offered to them in Clackmannanshire, all of which were turned down until Arnsbrae House, between Cambus and Alloa, next to Braehead Golf Club, was offered by its owners Dr James Younger and his wife Annie Thomson Paton. They also allowed the House staff to remain at Arnsbrae to help in any way they could. The House Staff worked alongside members of the Red Cross's Voluntary Aid Detachment (VAD) and were overseen by a Commandant. It was their responsibility to arrange the transfer of the men from Military Hospitals, and assist with the nursing and feeding of the men. There were also Nursing and Medical staff present who were overseen by a Matron. The house was fully adapted, equipped and staffed before the first patient arrived.
The UK government paid Auxiliary Hospitals a grant per week per solider of L1 4s 6d. This grant was to cover all costs for treatment, care and food etc. The soldiers who arrived at the Auxiliary Hospitals were those who were recovering from relatively minor injuries, illnesses of were recuperating after being transferred from a Military Hospital. The soldiers at Arnsbrae therefore found the less military atmosphere, the gardens and geographical placing of Arnsbrae a treatment in itself. As their health improved they were free to walk around the area and were easily identified by the “Hospital Suit” uniform of a blue jacket, with white lining, blue trousers, white shirt and red ties. Once fit to return to duty, the men went to Military establishments for some refresher training, those who could not return to the battle were presented with a Pin which symbolised that they had served their King and Country.
Many locals would provide support for Arnsbrae Auxiliary Hospital, some would provide food which the hospital cooks would make into nutritional meals for the men, others would help by providing transportation or by giving some time to generally help where they could, for example reading to blinded soldiers. Arnsbrae Auxiliary Hospital closed in 1919 shortly after the war had finished and the need for the extra beds had at last diminished.
In the 1920 Medical Officers report, there is mention of a small Smallpox Hospital that sat on high ground near Collylands, which is an area of land between Sauchie and Alva on the north and south as well as lying currently between Glenochil and Fishcross, West to East. The hospital was placed there as at the time there were no villages nearby, undoubtedly any of the surrounding villages was either much smaller or possibly didn't exist (like Glenochil) at the time.
Former location of the Smallpox Hospital that was in use for a short time
Locations of the three hospitals - OS Map
This hospital was of wooden construction and very basic. There was a total of 12 beds over 2 wards, also on the site were rooms for the Nurse's, the maid and a Kitchen as well as a Duty Room, small wash house and mortuary. There was no hot water system and the toileting facilities were basically commodes which were emptied by the nursing staff. There was a bath which was wheeled to the patient and undoubtedly the water for it would have to have been boiled in the kitchen, then taken to the ward. A constant issue with the hospital seems to have been that no matter what repairs were undertaken, rain always made its way in. The Medical Officer had suggested in their report that the hospital was not appropriate for use and had asked an Architect for a report on how this could be remedied, he had also suggested that making an arrangement with the Smallpox hospital which covered Stirling might be an idea, as the Collyland one was often closed as there hadn't been many cases of Smallpox and it was difficult getting nurses to staff the hospital due to its primitive facilities.
The various villages within the County eventually had a General Practitioner's (Doctor's) practice each, the doctor would charge for consultations or visits, and for the costs of any treatments or medicines used or dispensed. When this service started the G.P.'s usually lived within the village that they served and would provide 24 hour care for the local people. In many ways this worked well as the populations grew to trust good G.P.s and the G.P.s generally knew about the populations health. For many years the only time a different G.P. worked in a village was if the local one was on holiday or if they were taking over the practice. As village and town populations grew, G.P. practices grew or multiplied. In some villages G.P.s would work together. This benefited the G.P.'s in that they could cover the out of hours care between them, usually taking it in turn to have time off whilst the other was on call. Some villages would have G.P.s who would compete against each other for patients, under these circumstances all the live generations of one family would usually all see the same Doctor.
As developments were made in immunisations, antibiotics, surgical procedures and a general improvement to health and hygiene, as well as various new acts of law put in place involving places of work, sanitation etc, it became easier to prevent or treat ailments and injuries which could have caused life long issues or death previously. The advances in surgery also meant that ailments such as appendicitis were less life threatening if identified earlier. Pregnancy also took less lives of mothers and babies as more was understood about the process of pregnancy and delivery, the formal training of midwives helped greatly with this area of health care.
In 1948 when the NHS was established, both the remaining hospitals were taken under its control. Shortly afterwards, GP's came under the NHS and care was now free to all and was easier to access, in many cases dealing with health issues before they became serious. GP's weren't always happy about this new system for them as it many in many cases they would be paid less by the NHS per patient they saw than they had previously charged. An ambulance service was developed at the formation of the NHS and this meant people who required the care of hospital could be rushed there whether or not they had vehicles.
Of course the NHS also provided a lot of other elements of care for the population including Dental care, maternity care, district nursing etc. Of course almost all of these services had been available previously, but only to those who could afford it.
Clackmannan County Hospital in Ashley Terrace, eventually became a hospital for those who had Mental Health issues (previously these patients had been sent to Glasgow for treatment). The Mental Health Service for Forth Valley was centralised at Bellsdyke Hospital near Larbert but the Clackmannan County Hospital provided care for some patients closer to home, especially if they required longer term care. The patients from this facility were either transferred to the new Mental Health Unit at the Clackmannanshire Health Care Centre or to the new Mental Health Unit at Forth Valley Royal Hospital.
Clackmannan County Infectious Diseases Hospital, also known as the Combination Hospital, became a Care of the Elderly Facility known as Sauchie Hospital until it was replaced with the Clackmannanshire Health Care Centre which opened in 2009.
There are now two inpatient units, three GP practices, day therapy unit, a Mental Health Resource Centre as well as access to outpatient clinics all within the complex. A variety of professionals use the facility as their base including Health Visitors and Physiotherapists. Some classes are given there including baby massage. Since the invention of the Covid Vaccine there has regularly been a vaccine centre in the upper outpatient area.
This means that Clackmannanshire now has access to some hospital services much closer to home, helped by the fact that many of the counties bus routes pass by the centre, making it easier for people to get to it. An Out of Hours GP Service is now based here, this does mean that at night or over the weekend or during holidays people may be asked to attend an appointment there if they are unwell and call NHS24 which at night is more difficult due to the lack of buses plus the fact that few people will call a GP out of hours if they didn't feel significantly ill. There is however the possibility of the on-call GP going to the patient if need be as they have transportation and a driver for more serious call outs. The GPs from the various county practices provide the cover for the Out of Hours Service.
The only original parts of the old hospital left are the Lodge and the entrance gate pillars.