Essential Comforts | Blogs from the Archives

Every year, the Trust Archives welcomes researchers who are using our collections to uncover new stories and contribute to new understandings of our history. Over the last several years, researchers working on a collaborative research programme called 'Border Crossings' have used our collections as part of a project looking at the history of charity and voluntarism in the NHS across the UK. 

Today, we are delighted to share a seasonal guest post from one of the Border Crossings team, Hannah Blythe, looking at the role of charity in funding Christmas celebrations in the NHS. It's a story that continues today, with Barts Charity supporting Christmas activities and gifts at the hospitals that make up Barts Health. 

The NHS epitomises nationalised healthcare, famously being funded through general taxation and delivering treatment free at the point of access. The Service has always derived most of its budgets from the Exchequer, but its economy is more mixed than popular narratives suggest. Indeed, charity has been present in the NHS since its birth. The presence of voluntarism in a nationalised service appears incongruous and poses questions about resource allocation, values, and patient experience. The Border Crossings project therefore uses contemporary and historical perspectives to investigate the role of voluntarism in the NHS’s mixed economy.  

We have explored the records of three teaching hospitals – St Bartholomew's Hospital (also known as Bart’s), the United Sheffield Hospitals (USH) and the Royal Infirmary of Edinburgh (RIE) –  to establish how this border operated in practice in the early NHS, between its foundation in 1948 and a major reorganisation in 1974. While each hospital’s board harnessed charitable money for their institution’s particular needs, they had certain avenues of voluntarism in common. Christmas celebrations were consistently treated as key charitable comforts.  

Every year, charitable money was spent on Christmas festivities for patients. The St Bartholomew's Hospital Board of Governors frequently paid for festivities out of their large endowment. For example, in 1959, five guineas were granted to each ward sister for Christmas entertainments for patients; twenty-guineas was granted to the Sister in Charge of the out-patients’ unit for a children’s Christmas party, and twenty pounds were provided for a Christmas party for children being treated as in-patients.   The hospital also had a small dedicated Children’s Christmas Fund.  Money was put aside at Bart’s to ensure that Christmas cheer reached patients whose treatment coincided with the festive period.

Published reports form the USH and RIE show that Bart's was not alone here. The USH's Governors distributed annual reports, a key function of which was promoting the good works done through hospital charity. (Bart's had ceased to publish its own annual reports at the outbreak of the Second World War). These publications include financial accounts, involving breakdowns of endowment expenditure. The image below shows a list from the 1961 USH annual report, detailing the amounts spent on Christmas festivities alongside other types of ‘welfare and amenities’. A substantial sum was spent on convalescent services, while smaller amounts were dedicated to telephone trollies and patient libraries, for example. From 1957-58 to 1972-73, between two and eight percent of the charitable money spent on ‘patients’ welfare and amenities’ at the USH went on Christmas festivities. In these years, annual average such expenditure was £431 (deflated to 1949 prices).         

Similarly, the Managers of Edinburgh’s Royal Infirmary advertised their use of a Comforts Fund for the benefits of patients and staff. Their 1960-61 report, for example, noted that most years the Fund’s two principal uses were ‘extra fare and amenities’ for the wards at Christmas, plus radio and television equipment for year-round entertainment.  

Hospital voluntarism was not confined to monetary expenditure. Christmas festivities attracted voluntary action from a variety of groups. For example, members of Sheffield Rotary Club dressed as Father Christmas to deliver gifts to patients. In 1959, it was reported that a Rotarian named Eric Winks had played the role of Santa Claus at the Children’s Hospital annually for thirty-one years in a personal tradition that long pre-dated the NHS.   In Edinburgh, a voluntary Women’s Maintenance Council formed a ‘Santa Claus Fund’, for which volunteers knitted throughout the year ‘quantities of socks, bedsocks and babies’ jackets’ to be distributed to patients as Christmas gifts. 

Staff also benefited from Christmas philanthropy. Staff Christmas festivities were a mainstay of the USH’s annual accounts breakdowns, and proved a high priority for ‘staff welfare and amenities’ expenditure. Between 1957-58 and 1972-73, the percentage of this category of endowment spending that went on Christmas festivities ranged between eleven and fifty-eight percent. There was an average annual spend of £1,549 (deflated to 1949 prices). This extract from the 1961 accounts shows that here Christmas festivities expenditure came second only to improvements to nurses’ accommodation in 1960-61.  
 

Christmas philanthropy for staff extended beyond decorations and celebrations, and involved small acts of personal and work-based support. Administrators at Bart’s managed a series of small dedicated funds, in addition to the hospital’s large endowment. One of these pots of money was the William Goldstein Staff Benevolent Fund for providing relief for ‘distressed’ lay staff and their relatives.   Christmas grants were made from this fund, indicating administrators’ intentions to spread Christmas cheer through financial relief for staff of limited means.   Christmas staff welfare attracted volunteering as well as expenditure. For example, the RIE’s 1963 report praised the ‘valuable help received… from members of the Jewish Community, who worked in a voluntary capacity on Christmas Day, New Year’s Eve, and New Year’s Day in the kitchen and various departments of the Royal Infirmary’.   This became an annual tradition in which volunteers relieved the workload of domestic, catering and laundry staff on festive days. 

Christmas continued to attract charitable money and labour in British teaching hospitals following their nationalisation. While the amounts of expenditure on Christmas may have been relatively modest, it is clear that festive celebrations and philanthropic gifts were seen as an essential addition to hospital life, key to raising staff morale, alleviating financial pressures of the season, and bringing comfort to hospital patients. In reality, Christmas was treated as an essential comfort, highlighting that Bevan’s border proved a somewhat artificial division between essential and non-essential, predicated on a narrow conceptualisation of health that neglected wellbeing and emotional comfort. 

Image 1: Father Christmas hands a present to a girl at the St Bartholomew's Hospital Outpatients' Department Children's Party, 1951 [Barts Health NHS Trust Archives, SBHX8/2138]

Image 2: List of Christmas expenditure shown in the published accounts, 1961 annual report for United Sheffield Hospitals [Sheffield City Archives, NHS28/1/2/1/5, p42]

Image 3: Breakdown of categories of expenditure shown in the published accounts, 1961 annual report for United Sheffield Hospitals [Sheffield City Archives, NHS28/1/2/1/5, p42]

 

Hannah Blythe is a Research Fellow at the London School of Hygiene and Tropical Medicine (LSHTM), where she works on the Border Crossings project. She is a health humanities researcher with interests in charity, the NHS and mental health, and prior to joining LSHTM she completed a PhD on the history of mental health charities at the University of Cambridge.