Wartime Health

Posted 14th May 2017 by Maggie Clowes

Appleby was immensely proud of its Red House Hospital run by VADs for convalescent service men but who looked after the civilian population?

In 1914 Appleby had two doctors - Dr Andrew Sprott and Dr Harvey de Montmorency both of whom were based in Boroughgate. in addition there was the Sick Nursing Association which had been set up by Lady Hothfield at the end of the nineteenth century to provide a trained nurse to minister to poorer members of the community. There was no hospital; the nearest place to offer any sort of nursing care was the workhouse in Kirby Stephen. There is a reference in 1873 to a fever hospital on Fair Hill but it was not a permanent structure as in 1893 a member of the council and the Medical Officer walked up to Fair Hill and commandeered a house to isolate smallpox sufferers .Eventually an isolation hospital was set up in Ormside. Until half way through the war there was still no hospital in the town and the one set up then was solely for convalescent soldiers.


Each year the Medical Officer of Health reported to the town council on the health of the town. In 1916 the report was given by Dr Henderson, the Deputy Medical Officer. Normally the report was tucked away in the council minutes. On this occasion it warranted headlines.

More Dangerous to be a Baby than a Soldier
A small birth rate

“As months passed these children became increasingly precious. It had been calculated that it was safer to be an infantry man in France than to be an infant under one year at home. When they considered that the birth rate was falling in many places and the deaths in many places outnumbered the births and that babies were still dying at that alarming rate they would see how vital a matter it was that they should do all in their power to conserve infant mortality.” The Appleby council in a progressive spirit had appointed a district nurse* to look after child welfare and the County Council, because rural areas weren’t taking action, was to set up a scheme for the whole county."
“At Appleby there had been a tremendous drop in the birthrate. Only 14 babies were born in 1916, against 43 in 1915 (this had been he highest in the whole country) 14 births and 22 deaths. How could they escape extinction?”

He did not give figures for infant mortality but said ,

“In view of the war they must save the lives of as many children as they possibly could. This could be done by careful treatment of the children while they were young and it was also advisable to have lectures for women in regard to the upbringing of babies."

The Mayor's response to this worrying report was laid-back; they would not consider the report unsatisfactory. Certainly the death rate among infants had increased and the birth rate had decreased very much, but taken all round he thought the report satisfactory. (!)


We do have a brief report given at the end of the war. Things had not improved. In 1917 there were 22 births, in 1918 only 20 (the death rate in that year was 46) Was Dr Henderson to be proved correct? (Could the lack of possible fathers have had any impact?)

Thanks to the initiative of the indefatigable Lady Hothfield Appleby had a qualified nurse to tend to the poor. In 1893 she set up the Sick Nursing Association with the object of collecting enough subscriptions to pay a nurse. The money rolled in and the fund was boosted by a splendid concert in the Public Hall . Well attended by local notables, the hall was packed and the programme was reckoned to be one of the best held in Appleby for a long time. It raised £20 (over £1,000)

Within a year a nurse had been appointed - Miss Annie Barber - and accommodation provided in the Castle Lodge. She was kept busy - in seven months she had paid 640 visits to the sick poor. Patients were referred by a doctor or by a member of the Committee. A special service was held in St Lawrence Church where the Reverend Canon Matthews appealed eloquently for funds to maintain the nursing service in Appleby. He hoped that there might be at some time a cottage hospital “In his experience there had been much sickness in this place. Not many years ago that little town was visited by a terrible disease, and many very valuable lives were lost simply because they were unable to deal properly with the sickness.” Ultimately the nurse was provided with a house and the role gradually turned into that of Health Visitor in response to concerns about infant mortality.

Dr Henderson was actually expressing what was a huge national concern about infant mortality which had reached appalling heights by the end of the nineteenth century. In 1907 efforts to deal with this included the passing of the Notification of Births Act which recommended that the local Medical Officer of Health should be informed within 36 hours of any birth. Unfortunately its implementation depended on the local M.O. who thought it

should only be applied in Kendal. Appleby Town Council disagreed but we do not know the outcome of the disagreement. As you will see from the chart below matters improved dramatically throughout the twentieth century.

Chart from Vision of Britain