A Necessary Public Service to Uphold: Kingston General Hospital and the Hospital Funding Crisis of 1867

The following post was written by the Museum of Health Care’s 2017 – 2018 Curatorial Assistant, Agnes Ladon.* Agnes recently completed her PhD in Art History at Queen’s University, specializing in Canadian historical art and material culture.

rotatingbanner
Figure 1 Kingston General Hospital – The new Watkins wing. Courtesy of KHSC – KGH Archives Site

The change of government following Confederation in 1867 had unforeseen consequences for a number of institutions in Canada. Among the effects of the establishment of the British North America Act in 1867 was the transfer of matters such as health care to the newly created provinces. Legislation passed in 1867 made it necessary for hospitals to apply directly to the province for funding to offset operational expenses—a process that was unfortunately difficult, as the administrative machinery responsible for distribution of hospital funds was not yet established.[1] As a result, hospitals did not receive their annual grant, placing Canada’s public hospitals—many of which were already operating under a strained budget in the years preceding Confederation—in a precarious position.In 1867, Toronto General Hospital was forced to temporarily close its doors after years of financial mismanagement; other hospitals had to reduce the number of patients they could admit and even had to dismiss staff in order to make ends meet.[2] For many hospitals operating in Ontario at the time, the future seemed uncertain. Although Kingston General Hospital (KGH) was lauded as one of the most economically managed hospitals in Canada in the 1860s, it, too, like other hospitals in the provinces, was greatly affected by the transfer of governmental responsibility in 1867.[3] The loss of KGH’s annual grant from the newly formed government in 1867 not only greatly impacted the hospital, but the Kingston community as well. Recognizing the growing value and importance of the hospital to the community, KGH’s Board of Governors and members of the community rallied to save the hospital at this critical juncture in the history of health care in Canada, when the idea of supporting public hospitals was still in question.

The opening of KGH in 1845, which was responsible for patient care that encompassed an area as far east as Cornwall and as far west as Cobourg, was an important development for Kingston and its surrounding community. During the mid-1800s, a rising number of illnesses and infectious diseases had a devastating effect on the Kingston community and its immigrants. The cholera pandemic of 1832 killed 90% of infected Kingstonians, and the makeshift hospital which was built to contain the disease proved insufficient and ill-equipped.

While traditionally the care of the sick occurred in the patient’s home, the hospital not only helped accommodate and isolate patients during epidemics, but it also provided care for those in the community who lacked the means to pay for medical care by providing food, shelter, and other necessities to treat the sick.[4] By 1867, KGH was also equipped to carry out relatively complex surgeries, such as cataract removal. [5] KGH was also important to medical students studying at Queen’s Medical College: The hospital provided senior medical students and new graduate doctors the opportunity to gain invaluable hands-on clinical training under the supervision of medical staff.[6]

 

976-6-71a
Figure 2 Cataract needle used by Dr. Weston L. Herriman, class of 1855 at Queen’s School of Medicine – Museum of Health Care

However, at the beginning of 1867, the governors of the hospital already noted some difficulty with managing its finances due to the growing number of people using its services. They began discussing the possibility of limiting the admission of patients and finding ways to increase the hospital’s annual income to ensure the hospital did not go into debt. In June of that year, the governors attempted to solicit aid from the Kingston City Council and the region’s Country Council—an appeal that was made repeatedly over the course of a few months to no avail. Although members of the City Council recognized the importance of KGH to the local community, Council also saw the institution as a private endeavor for paying customers, and thereby insisted that the hospital seek public aid in order to fund the hospital. By August, the situation was dire: The loss of the hospital’s annual grant from the newly formed government, as well as the hospital’s loss of substantial credit as a result of the collapse of the Commercial Bank of Canada, dealt a heavy blow to the already-struggling hospital.[7]  With all sources of funding exhausted, the governors of the hospital announced the possibility that KGH would need to close its doors if sufficient funds were not forthcoming.[8] 

Members of the community sought other sources of funding to keep the hospital open. Of note, Horatio Yates, the chairman of the hospital board and a founding member of Queen’s Medical College, led a vigorous search for funds to keep KGH open, through which effort he managed to secure funds from several wealthy locals including John Watkins, a merchant who was a longtime supporter of the hospital.[9] The most notable effort by members of the hospital and community, however, was the initiative to raise funds from the general public through various fundraising events. The response from Kingston’s wealthy elite as well as from other members of the public was overwhelming. Galas, benefit concerts, and other events were held to support the hospital, including a benefit event held by the celebrated Meagher Brothers, who volunteered to give a skating exhibition to music performed by the R.C. Rifles’ regimental band.[10] For those who lacked the financial means to donate funds directly to the hospital or the means to attend the special events, valuable supplies and other provisions, such as onions, bread, meat, beer, and cordwood, were collected to help keep the hospital afloat.[11]

horatio_yates
Figure 3 Dr. Horatio Yates. Chair of the board of KGH in 1867 – McCord Museum

Ultimately, thanks to the efforts of KGH’s Board of Governors and the broader public, the hospital successfully averted the threat of closure in 1867. As an article printed in the Daily News on 19 January 1869 noted, by the end of 1868 KGH “succeeded in closing the accounts of the year without being in debt.”[12] However, the impact of the 1867 crisis on KGH and on other hospitals also highlighted a growing shift in public attitudes towards public health care at the time. Not only did government officials and members of the public recognize the importance of publically funded hospitals, but they also came to recognize the public hospital as a necessary service that needed to be upheld. “The absolute necessity of public hospitals is acknowledged by all,” the Daily News reported. “There are always numbers of sick poor, with whom the hospital or death is the alternative. The means by which a public hospital should be supported has been a question. But we are pleased to observe that in the Parliament of Ontario, in a discussion on the question of public hospitals, the very sentiment prevailed of their chief support being derived from the general revenues of the Province.”[13]

*Funding for this position was made possible through Queen’s University’s Work Study Program.

 

Endnotes

[1] H.E. MacDermot, One Hundred Years of Medicine in Canada, 1867-1967 (Toronto: McClelland and Stewart, 1967), 80; J.T.H. Connor, Doing Good: The Life of Toronto’s General Hospital (Toronto & Buffalo: University of Toronto Press, 2000), 90.

[2] J.T.H. Connor, Doing Good: The Life of Toronto’s General Hospital, 90, 91; Margaret Angus, Kingston General Hospital: A Social and Institutional History. Montreal and London: McGill-Queen’s University Press, 1973, 47; Daily News (Kingston), “The Hospital,” 18 September 1867.

[3] Daily News (Kingston), “The Hospital,” 18 September 1867.

[4] James A. Low,  “Kingston General Hospital: A National Treasure.” Historic Kingston 46 (1998): 32, 33; Margaret Angus, Kingston General Hospital, 47.

[5] It is difficult to imagine that cataract surgeries were performed in 1867, but by this time it was a fairly routine procedure carried out using specialised instruments.

[6] The medical school’s faculty formed the majority of the hospital’s medical staff at this time. For the history of Queen’s University’s Medical School see A.A. Travill, Queen’s University at Kingston, Faculty of Medicine 1854-1979: One Hundred and Twenty-Five Years Dedicated to Education and Service (Kingston: Queen’s University, 1979), and A.A. Travill, Medicine at Queen’s 1854-1920: A Peculiarly Happy Relationship (Kingston: Faculty of Medicine, Queen’s University, 1988.

[7] It was not until much later—in 1872—when City Council became increasingly involved in financially supporting the hospital and its new endeavor of building a smallpox building to isolate and treat patients. See Edwin E. Horsey, Care of Sick and Hospitalization at Kingston, Ontario, 1783-1938 (Kingston: Self-published, 1939), 51. See also Hugh C. Nickle, “Nickle Notebooks,” (Self-published, 1936), 70-80; Angus, Kingston General Hospital, 47.

[8] Daily News, “The Hospital,” 12 December 1867.

[9] In 1862, John Watkins made a substantial donation of $4000.00 towards the construction of a two-storey addition to the hospital. Named after Watkins, the Watkins Wing opened in January 1863 to treat 36 patients with infectious diseases. During the threat of KGH’s closure in 1867, Watkins continued to make regular donations to the hospital, a practice he continued until his death in 1876.

[10] Hugh C. Nickle, “Nickle Notebooks,” 66, 68, 71, 82-83, 87-89; Daily News, 2 January 1868.

[11] Ibid; Angus, Kingston General Hospital, 47, 48.

[12] Daily News. “The Kingston Hospital.” 19 January 1869.

[13] Ibid.

Bibliography

Angus, Margaret. Kingston General Hospital: A Social and Institutional History. Montreal and London: McGill-Queen’s University Press, 1973.

Connor, J.T.H. Doing Good: The Life of Toronto’s General Hospital. Toronto & Buffalo: University of Toronto Press, 2000.

Daily News (Kingston). “The Hospital.” 18 September 1867.

Daily News. “The Hospital.” 12 December 1867.

Daily News. 2 January 1868.

Daily News. “The Kingston Hospital.” 19 January 1869.

Horsey, Edwin E. Care of Sick and Hospitalization at Kingston, Ontario, 1783-1938. Kingston: Self-published, 1939.

Low, James A. “Kingston General Hospital: A National Treasure.” Historic Kingston 46 (1998): 31-42.

MacDermot, H.E. One Hundred Years of Medicine in Canada, 1867-1967. Toronto: McClelland and Stewart, 1967.

Nickle, Hugh C. “Nickle Notebooks.” Self-published, 1936. Three notebooks presented as a gift to Ann Baillie, Head of KGH School of Nursing. Contains newspaper articles regarding Kingston General Hospital published by The British Whig and The Kingston Daily News.

Travill, A.A. Queen’s University at Kingston, Faculty of Medicine 1854-1979: One Hundred and Twenty-Five Years Dedicated to Education and Service. Kingston: Queen’s University, 1979.

Travill, A.A. Medicine at Queen’s 1854-1920: A Peculiarly Happy Relationship.  Kingston: Faculty of Medicine, Queen’s University, 1988.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s