Until 1948 there was no national health service: only those who could afford to pay for a doctor, and for the treatment, had access to healthcare.
As early as 1920 the government was examining the possibilities of a system of health provision for all. The two world wars were instrumental in this process, showing what could be achieved with the national Emergency Medical Services network. A review of health provision in the 1920s and 1930s showed just how the quality of care varied across the country, and how there were an almost total absence of specialist services.
Britain was in a desperate state after the Second World War with economic disaster looming, so it took a lot of persuasion by politicians to convince the nation that they could afford to launch a national health service. However, despite reservations from professionals, politicians and the public, the NHS started on 5th July 1948 based on the founding principles which are still in place today: that it should meet the needs of everyone, be free at the point of delivery, and that it be based on the patients’ needs and not their ability to pay. Hospitals, whether they be municipal or voluntary, were brought together under regional hospital boards. Family doctors, dentists, opticians and pharmacists were no longer self-employed but were paid by a central Executive Council, and local health authorities took over the running of immunisation and maternity clinics and community nursing.
By 1947 the hospital was split from Botleys Park Colony and became St. Peter’s Hospital, its name derived from Chertsey’s Church. Botleys continued to function as a hospital for the mentally ill and not only had nursing staff but occupational therapists, social workers, psychologists, physiotherapists and speech therapists on hand to work with the patients. New patients were first taken to the Hospital Block for a full physical and mental assessment. The block was the hub of the hospital which contained an operating theatre, dental room, laboratory, x-ray department and pharmacy.
Patients at Botleys Park were classified into four groups determined by their age and levels of intellectual and physical disability. The first group of patients were young adults who were physically able but had some learning difficulties. These had generally been referred to the hospital for rehabilitation after “failing in the community”. Nursing for these patients concentrated on learning skills needed to care for themselves back in the community, such as “regular habits, good manners and satisfactory personal hygiene”. To enable this, patients worked in the laundry and needlework rooms, or worked in the farm or tended to the hospital grounds. The second group of patients were adults who had some learning difficulties but also suffered from physical conditions such as epilepsy. These patients required longterm care in sheltered accommodation. Their routine was more regimented. The third group were those, adults or children, who required continuous care and nursing due to either physical or mental conditions which prevented them from doing much for themselves. The final group were children who “cannot satisfy the educational requirements of normal school” due to physical conditions which affect their learning abilities.
Whilst at Botleys Park adult patients, where possible, were given simple jobs such as taking in laundry from the town, packing compost and folding polythene sheeting. The money earned from this went towards their care and any treats or personal items they wished to buy. Over time, and with changes to medical treatment and the perception of how to treat patients with special needs, there was a move away from institutionalising those with learning difficulties and so by the 1980s Botleys Park was used solely for psychiatric patients.