What is a Hospital: Part 1

QE Hosp Birmingham

The New Queen Elizabeth Hospital, Birmingham, opened in 2010

The central concern of the project European Healthcare before Welfare States, and by definition this blog, is comparative history. Over the past ten years I have gradually extended my efforts to compare, from a range of English towns and cities through my work on England and France to the complex multinational range involved in this venture. As I have noted elsewhere, comparison is a difficult but rewarding task. One of the key difficulties is understanding and managing difference – difference in practice, in priorities, in constraints and even in nomenclature. It was a growing awareness of the differences bound up in the word ‘hospital’ that prompted these opening posts for the European Healthcare blog.

For most people the word hospital conjures up an image of a large, probably new, probably white, building filled with busy doctors and nurses and a plethora of high tech equipment (like the new Queen Elizabeth Hospital in Birmingham pictured above). The object of the hospital is to cure the patient as quickly as possible and the presence of long-stay patients with stubborn or incurable conditions is is seen as a disruption to the true purpose of the institution. But this monolithic vision is relatively recent, largely a product of the wave of hospital planning that swept the western world in the 1960s and reinforced by television’s penchant for the hospital soap. In historical terms ‘hospital’ is a complex and messy term applied to a multitudinous range of institutions with an equally diverse set of objectives of which cure was, for the most part, a bonus.


In this series of posts I aim to explore the many ways in which we can understand the meaning of hospitals in the past. Indeed, a caveat is immediately necessary as I am primarily considering these institutions in the modern period – since around 1800 – and won’t touch on medieval and early modern uses of the word to describe locations of hospitality, refuge and care. Evidence will be drawn from my own research into medical care institutions in Great Britain, France, Czechoslovakia, Hungary and Poland and international attempts to bring together information on health institutions, including the League of Nations Health Organisation’s Yearbook 1924-30 and Nosokomeion, the Quarterly hospital review of the International Hospital Association that ran from 1930 to 1940.

Beaujon 1934

In the next post we will consider what factors might help to define an institution as a hospital – things like size, range of functions, facilities, patients, length of stay and even the name. The third offering will assess the purpose of the institution – curative or caring; general or specialist; patient profiles; free or compulsory. It will also reflect on the influence of religion, nation and empire, charity, and the role and power of doctors in determining what a hospital was or might be.