Divorcing faith and charity

Henry VIII swept away half of England's hospitals almost by accident. When his hands were outstretched towards the wealth of the monasteries, hospitals too came into his grasp. Since so many were run by monasteries, or along monastic lines, how were they to be distinguished? Henry's survey of ecclesiastical income in 1535 included hospitals with clergy. Hard on its heels came the Act authorising the suppression of monasteries with an income of less than 200 a year. Few hospitals were wealthier than that. Yet only a handful were actually dissolved under the statute. The Dissolution was mainly a piecemeal process of pressure on institutions to surrender to the Crown. By 1540 the monasteries of England and Wales had all gone and with them many hospitals, including the greatest of them all, St Leonard at York.

Others survived only to succumb to the Crown's mopping up operation against the remaining religious houses, such as collegiate churches and chantries. Between 1544 and 1546 some notable hospitals fell to the Crown, including that of St Bartholomew in London. During the earlier Dissolution, the lord mayor of London pleaded for the city's great hospitals to little effect. Four were lost. But by this time the king had relented sufficiently to keep St Bartholomew open, and it was soon handed over to the Corporation of London. Edward VI was more generous. He gave to the Corporation St Mary of Bethlehem, which was to become notorious as Bedlam, and St Thomas Southwark. He even founded two new London hospitals.

The result of Henry's purge was to hasten the separation of faith and charity. Some hospitals escaped the cull and continued to function as almshouses under a cleric as master, such as Cross at Winchester. But almshouses founded after Henry's reign were more likely to be placed in lay hands. Meanwhile the medical profession, dominated by clerics throughout the medieval period, had begun to admit laymen. Gently, almost imperceptibly at the time perhaps, a groundswell was building which would eventually produce the modern hospital under the direction of physicians and surgeons.

Tomb of Rahere, St Bartholomew the Great, LondonFew medieval hospitals made that transition. Two that did are St Bartholomew and St Thomas in London. Through their metamorphoses we can trace the shifting shape of care. For St Thomas's the price was a transformation so thorough that it no longer even stands on its ancient site in Southwark. It moved to Lambeth in Victorian times. Nor did it leave behind any venerable hospital buildings. The old St Thomas had already been rebuilt. However the Church of St Thomas in Southwark now houses The Old Operating Theatre Museum, which sheds light on the evolution from medieval to modern medicine.

The museum of St Bartholomew has already been mentioned. Rahere, the founder of this great hospital in 1123, lies nearby in what is now the parish church of St Bartholomew the Great. His resting place has survived centuries of upheaval and disaster. Rahere built a priory to oversee his hospital. Naturally the priory was dismantled by Henry VIII, but the choir of its church was left to serve the parish. Then the Great Fire that destroyed so much of medieval London stopped short of Smithfield. Once again Rahere's tomb was safe. Amid the hubbub of London's streets this silent testimony endures of the charity that sprang from faith.