HOSPITALS & SANATORIUMS
Hospital is a
institution with an organized medical and nursing staff, and with permanent
facilities, that provides a range of medical services, including surgery, for
people requiring intensive treatment or observation. It may also include
facilities for childbirth and infant management, as well as various outpatient
clinics.
The Gate of an asclepion in
Some authorities state that as long
ago as 4000 BC temples of the ancient gods were used as houses of refuge for
the sick and infirm and as training schools for doctors. Later Asclepion the temples of Asclepius the
Greek god of medicine served the same purpose. Historical records also show
that hospitals existed in
The number of hospitals grew in the
first centuries. In the 4th century AD hospitals were founded in
During the Crusades religious orders
were created that had as their chief duty the care of the sick and these orders
built a number of hospitals particularly in the Mediterranean area. The most
famous was the Knights of St John of
Jerusalem. Throughout the Middle Ages, the
Renaissance and even later hospitals were almost entirely run by religious
groups.
During the 18th century
municipal hospitals operated by the civil authorities began to appear. Various small
private hospitals were operated by churches and by individual doctors. In 1751 the
first public hospital in
From the middle of the 19th
century on, the number of hospitals greatly increased, principally because of
the discovery of anesthesia and aseptic surgical techniques. During the 20th
century the demand for hospital services expanded further with the spread of
economic prosperity.
General hospitals
General Hospitals treat patients
with all kinds of medical and surgical needs and are concerned primarily with
conditions likely to require treatment lasting for days or, at most, a few
weeks. There is a considerable trend towards day-care surgery in which patients
are not detained overnight after their operations.
Nearly all medium-size and large
hospitals also have out-patient departments covering a wide range of
specialities, to which patients are referred by general practitioners (GPs).
Most of the patients admitted to the hospital wards for surgical treatment are
brought in after being seen at an out-patient clinic. Clinical staff work in out-patient departments as well as in wards,
operating theatres, intensive care units, and other departments. Most
medium-size general hospitals also have an accident and emergency (A&E) or
casualty department and often a maternity department.
Staffing and Facilities
General hospitals are staffed by
consultants in the various medical, surgical, gynaecological, paediatric, and
psychiatric disciplines and by their junior medical and nursing staff. In
addition, there is a parallel hierarchy on the administrative side concerned
with general staff administration, catering, housekeeping, laundry,
engineering, accounting, medical records, cleaning, finance, purchasing,
stocktaking, and salaries. Clinical departments include a range of special
diagnostic facilities such as X-ray, computerized axial tomography, and
ultrasound scanning, electrodiagnostic facilities and pathology laboratories;
pharmaceutical services; physiotherapy; social services; and suites of
operating rooms (theatres) with their ancillary services for instrument
sterilization, changing rooms, and stock rooms.
The largest general hospitals cover a
wider range of specialities and usually have, in addition to those mentioned, a
premature-baby unit; a psychiatric wing; full facilities for dental and facial
surgery, plastic surgery, and reconstructive surgery; a radiotherapy unit; MRI
(magnetic resonance imaging) scanning; a renal dialysis unit; organ transplant
facilities; an occupational therapy department; a physical medicine unit with
physiotherapy gymnasium and therapeutic pool; a burns unit; a department of
medical physics; and a lithotriptor unit for the non-invasive treatment of
kidney stones and gallstones. Some very large general hospitals have a
cyclotron for the production of artificial isotopes for PET scanning (positron
emission tomography).
Hospital Organization
The clinical staff
of hospitals are organized into the major divisions of surgery,
medicine, obstetrics and gynaecology, paediatrics, and psychiatry. Smaller
specialities, such as dermatology, endocrinology, ophthalmology, ear, nose and
throat (ENT) and genitourinary medicine (GUM), fall under the appropriate major
heading. Each speciality is staffed by one or more consultants and by various
doctors in training, including senior registrars, registrars, senior hospital
medical officers, senior house officers, and pre-registration medical officers.
Heads of the main divisions and the chiefs of pathology and radiology form a
medical advisory board. This meets at regular intervals, usually monthly, to
deal with medical administrative matters in conjunction with the full-time
administrators. Medical staff committees also exist to review the professional
work of the individual clinicians. These committees may report, as required, to
the medical advisory board. In addition, hospital ethical committees meet
regularly to consider, and approve or reject, proposals for medical research
that would involve patients.
Many of the largest general
hospitals are designated as teaching hospitals and are associated with
universities, degree-awarding royal colleges, or the Society of Apothecaries.
These hospitals are generally regarded as being in the forefront of medical
research and in their ability to provide the most up-to-date forms of
treatment. A considerable amount of medical education and training, formal and
otherwise, however, is also conducted in non-teaching general hospitals.
Most hospitals are owned by
government but a smaller number are privately owned and are run as
profit-making business enterprises. Most of the professional consultant staff
working in private hospitals also hold appointments
under the NHS, usually on a “maximum part-time” basis. The amount of time they
can devote to private work is regulated by the terms of their appointments.
A third class includes voluntary
hospitals financed by private subscription or bequest. Military hospitals for
personnel of the armed services and their families were, until recent financial
constraints
Specialist Hospitals
These are hospitals that specialize
in one category of patient or one type of illness. The function of specialist
hospitals has changed considerably with medical advances. A hundred years ago,
for instance, there were many hospitals or sanatoriums, devoted to the
treatment (so far as there was any treatment) 
of tuberculosis. With the advent of
effective antibiotics most of these hospitals have been closed. Similarly,
infectious disease and “fever” hospitals, also once commonplace, have, for the
same reason, almost all been closed, as have many
psychiatric hospitals. More effective drug treatment has made out-patient
management of psychiatric illness more feasible.
Proof of
Registered FCD letter was sent from
Censored letter from
Detail of the censored letter;
German cross with eagle “GEOFFNET”
it means opened
