Introduction
Today the Royal Infirmary of Edinburgh is one of Scotland’s most famous and prestigious hospitals. This reputation has been achieved after a long and proud history of medical excellence, underpinned by overwhelming support from generations of Edinburgh people.
The infirmary has occupied four sites in the city, ‘moving house’ three times in three centuries. At its new base at Little France in the south-east of Edinburgh, it remains at the forefront of delivering the highest quality healthcare to patients.
The early years
The very first Edinburgh Infirmary – the Royal Charter came a little later – opened in August 1729. It was paid for by public funds, after an appeal was launched by the Royal College of Physicians of Edinburgh.
The hospital was certainly welcome, but its facilities were far from adequate to meet the needs of the sick. When it first opened, the infirmary was based in the ‘Little House’ at the head of Robertson’s Close in the Old Town and had only four beds.
Recognition of this problem was swift, however. In 1736, a Royal Charter was granted by King George II, which gave the hospital not only royal patronage but also important legal rights. A new building was quickly commissioned, designed by the architect William Adam.
The hospital moved a short distance, to what would become Infirmary Street, in 1741, and here conditions were in marked contrast to the cramped facilities at Robertson’s Close – the new Royal Infirmary of Edinburgh had 228 beds.
Edinburgh’s growing population, combined with advances in what medical science could actually do for patients, saw demand for its services increase still further, however. The infirmary gradually expanded to occupy most of the land between present-day Infirmary Street and Drummond Street, including the old Surgical Hospital, which opened in 1832, and the new Surgical Hospital in 1853.
But still this was not enough to meet the needs of the sick. By the 1860s, concerns were being expressed about the conditions at Infirmary Street, and once again, plans were drawn up for a new hospital for Edinburgh.
Lauriston Place
In 1872, the architect David Bryce was asked to design a new Royal Infirmary, and his plans were heavily influenced by the “pavilion” model advanced by the nursing pioneer, Florence Nightingale. The Infirmary moved to Lauriston Place in 1879, and at the time, it was described as “probably the best planned hospital” in the whole of Britain. Beneath an imposing clock tower, the walls of the impressive marble entrance hall were lined with wood panels, listing the benefactors who had given donations to the new hospital.
The main hospital building was also complemented by the Edinburgh Royal Maternity Hospital – the city’s first purpose-built maternity facility – which dramatically improved the care of expectant mothers and their newborn babies. But by 1910, the maternity hospital was struggling to cope with demand, and after the First World War, it expanded into several flats in nearby Lauriston Park and Graham Street.
In 1939, the new Simpson Memorial Maternity Pavilion opened at Lauriston Place, next to the main hospital. Generations of Edinburgh ‘babies’ still fondly refer to coming into the world at ‘Simpson’s’, which was named in memory of the pioneer of anaesthesia, Sir James Young Simpson.
Despite these advances, as early as 1946, there were concerns that the Royal Infirmary site had already outlived its usefulness, and could not cope with the demands of the new National Health Service, founded in 1948. It would take half a century before a replacement hospital was finally agreed.
During the 1950s and 60s a number of options were discussed to replace the Royal Infirmary, including rebuilding on the same site, or building a new hospital on a green field site.
Finally, a decision was made to gradually rebuild and add facilities at Lauriston Place. One of the most significant developments came in 1969, when the Princess Alexandra Eye Pavilion – Scotland’s only dedicated hospital for eye conditions – opened at Chalmers Street.
Further modernisation and expansion at Lauriston proved extremely difficult, however. Largely due to financial problems, and issues surrounding alteration or demolition of listed buildings on the site, the first phase was not completed until 1981.
By the late 1990s, it was widely recognised that the old-fashioned Victorian hospital was in urgent need of replacement. It was agreed that work should begin on a new hospital to replace not only the Royal Infirmary and the Simpson Memorial Maternity Pavilion, but also the Princess Margaret Rose Orthopaedic Hospital and the City Hospital, bring all their services onto one purpose-built site.
Little France
In 1998, then Scottish Secretary Donald Dewar signed the agreement that would build a brand new Royal Infirmary at Little France, on the south-east outskirts of the city. The first patients were treated in January 2002, when the PMR closed, and the phased move from Lauriston was finally completed in 2003.
The main hospital building is now being redeveloped, as the Quartermile project, but Chalmers Hospital, the Princess Alexandra Eye Pavilion, and the Lauriston Building remain to care for patients.
