The Royal London Hospital for Integrated Medicine was founded as the London Homoeopathic Hospital by Dr Frederick Foster Hervey Quin in 1849.
He was among the first doctors to practice homeopathy in Britain, and had studied with its founder, Hahnemann. The original London Homoeopathic Hospital was in Golden Square, Soho, and was established on 10 October 1849, although it did not receive its first patient until March the following year.
Quin was a prominent figure in London society and very well connected, having been physician to Queen Victoria’s father-in-law Prince Leopold, father of Prince Albert. He was a personal friend of Charles Dickens and godfather to one of his children. Among his other patients were the painter Landseer and the novelist Thackeray. But, despite his connections, Quin was always committed to bringing homeopathy to the people.
The hospital’s first great success came in 1854, when a cholera epidemic broke out in Soho, originating from the water of the Broad Street pump (this was the infamous epidemic which came to an abrupt end when Dr John Snow removed the handle of the pump). At that time, the London Homoeopathic Hospital was the closest hospital to the pumps and achieved remarkable success in treating the victims of the epidemic. The Hospital’s mortality rate was 16 per cent, compared to 53 per cent at the nearby Middlesex Hospital.
Even then there was scepticism towards homeopathy. A report on the epidemic for Parliament the following year omitted the figures from the hospital. These were only published after a thunderous speech in the House of Lords by Lord Grosvenor, Chairman of the Hospital Board.
The Hospital's reputation continued to grow, and homeopathy gained increasing support. Just ten years after its establishment, in 1859 a new and larger Homoeopathic Hospital was built in 1893-5 on its present site in Great Ormond Street and a new wing, facing Queen Square, was added in 1911.
Many well-known homeopathic physicians were associated with the RLHH in the 19th and 20th centuries, including Robert Ellis Dudgeon, John Henry Clarke, James Compton Burnett, Edward Bach, Charles E Wheeler, James Kenyon, Margaret Tyler, Douglas Borland, Sir John Weir, Donald Foubister, Margery Blackie and Ralph Twentyman among others. The famous names are not only doctors: Miss Marion Brew, ‘Lady Superintendent’ or Matron from 1875 to 1906, was a prominent figure in the nursing profession.
A cache of 300 volumes containing the case notes of 1,426 patients treated from 1889 to 1923 was discovered in the vaults in 1992. This rare material offers a fascinating insight into the Hospital's work during that period.
Most patients were manual workers, including lacquerers, fancy box makers, ostrich feather workers, fancy stationers, and other long-vanished occupations. Phthisis and consumption (both forms of tuberculosis), bronchitis, rheumatism, gastric ulcer and female health problems were among the most common diagnoses. Treatment successes varied from speciality to speciality. For diseases of women, for example 74 per cent were reported cured and 62 per cent of respiratory problems were cured.
Other aspects of the hospital's work are much more familiar. Patients came from all over the country, typically because other treatments had failed or because of personal preference. Clinicians took a keen interest in individual patients, their constitutions and general well-being. But most important of all, there were many reports of remarkable improvements in difficult medical problems. For instance a doctor treating a girl with the dreaded, and at that time incurable, tuberculosis wrote: "Her hair became thick, colour came to her cheeks and replaced the earthy and waxy hue. She is a healthy and even fat girl of nine, sharp at her lessons and often top of her school. Her gait is elastic and she romps and plays. A more satisfactory result it would be impossible to desire."
The Hospital continued to thrive and, in 1920, the Hospital first received Royal Patronage from His Royal Highness the Duke of York (later King George VI) who became president of the Hospital in 1924. Following his accession to the throne in 1936, the Hospital was honoured by the Patronage of His Majesty The King gaining its ‘Royal’ prefix in 1947. Subsequently, on her accession to the throne, Her Majesty Queen Elizabeth II became the Hospital's Patron.
At the outbreak of the Second World War, the Hospital became an independent unit in the Emergency Medical Service for the treatment of air-raid casualties. But the RLHH itself did not escape from the relentless bombing and severe damage was sustained. The gallantry of the staff during the raids and particularly during the actual bombing of the hospital was recognised by the award of four George Medals and one MBE. During this period too, we welcomed refugees from Nazi persecution onto our staff notably Drs Otto Leeser and Eric Ledermann.
In 1948 the Hospital became part of the newly created National Health Service (along with the Glasgow, Liverpool, Bristol and Tunbridge Wells homeopathic hospitals). The Minister of Health Aneurin Bevan, the driving force behind the NHS, gave a personal assurance on the future of homeopathy in the NHS..
During the 1950's and 60's the RLHH's influence spread internationally, through young overseas doctors who attended the Hospital for clinical attachments. These included Dr Diwan Harish Chand, homeopathic physician to the President of India and the influential Argentine homoeopath Dr Francisco Eizyaga.
But on 18 June 1972 the RLHH suffered a devastating blow when a Trident airliner crashed at Staines, close to Heathrow airport. Sixteen of the Hospital's doctors and colleagues, including one of the most senior doctors, Dr John Raeside, were killed. They had been on their way to the International Homoeopathic League Congress in Brussels.
Until the NHS reorganisation of 1974, the RLHH was an independent hospital within the NHS, with its own management board. In 1974 it was incorporated into the South Camden health district.
The air crash, followed by loss of independence marked the beginning of the most difficult period in the hospital’s history. In 1981, in a major blow to the Hospital, the operating theatres and surgical beds were closed; the total number of beds was reduced from its maximum of 170 to 45. Yet another NHS reorganisation took place in 1982, resulting in the RLHH becoming part of Bloomsbury (later Bloomsbury and Islington) Health Authority.
The hospital responded actively to these changes, by developing and diversifying its complementary medicine services. It became the largest centre for homeopathic medicine in any industrialised country and began to develop other types of complementary medicine. Starting from the late 1950’s Dr Ralph Twentyman introduced Iscador and other complementary therapies for cancer, in what was to become the NHS’s first complementary cancer service. Dr Anthony Campbell established the NHS’ first acupuncture clinic in 1977 and Dr Michael Jenkins developed allergy and environmental medicine.
The hospital also pioneered NHS services offering manual medicine, establishing the first such service with the appointment as consultant of Dr Adam Ward in 1995. Other NHS innovations included the first NHS department of homeopathic podiatry in 1984 and the first NHS autogenic training service in 1985.
Meanwhile, in 1990 the hospital a further reduction in size when the male medical ward closed, and John Weir Ward, which specialised in the holistic care of patients with cancer, became a five-day ward. By 1991, this had closed completely, leaving only one remaining ward. The Nurses' Home, which stood opposite the Hospital in Great Ormond Street, was vacated around the same time.
In 1991 the RLHH took the opportunity to become autonomous again, and, more importantly, offer greater choice to patients and their GPs by applying for NHS Trust status. On 1 April 1993 the Royal London Homoeopathic Hospital NHS Trust took control of the hospital. The success of this owes much to the Trust’s first Chairman, Dr J Dickson Mabon who, apart from being a homeopathic doctor, had been an MP and Government Minister for many years and put his formidable political skills to good use.
Through the turbulence and uncertainty, our greatest advocates were our patients. Through the League of Friends, Community Health Councils, and as individuals, they lobbied in every way possible to support the Hospital to keep the service flowing. In April 1992 the Hospital gained independent trust status and Full Trust status was achieved the following year.
The first Annual Report of the RLHH NHS Trust tells of a challenging but rewarding year. The hospital started to focus explicitly on integrated medicine as was evident from several developments. A consultant in musculo-skeletal Medicine was appointed to develop the specialty. A new programme of integrated care for patients living with chronic rheumatic and bone conditions was introduced. Both combined a wide range of orthodox and complementary therapies. The Complementary Cancer Care Package to help patients to improve their quality of life was further developed, and a Macmillan Nurse was appointed, funded by Macmillan Cancer Relief. The Children's, Homoeopathic Podiatry and Women's Clinics all saw increasing number of referrals.
A major development was the opening of the Academic Unit, comprising seminar rooms, tutorial areas and a resource centre. Directors of Education (Dr Russell Malcolm) and Research (Dr Peter Fisher) were appointed.
Education was multidisciplinary, aimed at doctors, nurses and therapists. Research concentrated on demonstrating that the treatments used were effective, in line with the demand for evidence-based medicine.
Healthcare professionals also started showing more interesting integrated medicine with an increase in the number attending courses. Nurses and therapists continued to look at ways of developing their role, and completed further training to extend the range of complementary therapies offered, including breathing and relaxation courses, therapeutic massage and reflexology. The Hospital held a series of international conferences between 1997 and 2006, entitled Improving the Effectiveness of Homoeopathy, each attracting about 200 delegates from 26 countries.
In 1998, there was a reduction in service income from health authorities; the Trust's major concern was to ensure that the future clinical services of the RLHH would be secure into the new millennium and beyond. The growing patient demand for high-quality integrated medicine in a changing and increasingly primary-care led NHS, led to the need for a merger with a compatible NHS Trust. The RLHH Trust Board identified Parkside Health; a Trust providing extensive community and specialist services in the west of London, as having a culture and values well matched with its own. The Board considered a merger would present an excellent opportunity to combine RLHH's national expertise in complementary medicine with Parkside's success in providing integrated services through its centres for health and care.
Parkside, apart from its centres for health and care, had many specialist services that complemented those provided by RLHH, including older people's rehabilitation, palliative care and services for people with disabilities, women and children. After a period of consultation the merger took effect on 1 April 1999. The partnership with Parkside only lasted for a few years, ending when the government abolished community trusts.
On 10 October 1999, the RLHH celebrated its 150th anniversary. To mark the occasion the Hospital’s Patron, Her Majesty The Queen visited on 23 November 1999. During her visit she viewed the clinical facilities and was presented with a bouquet of plants used in homeopathy, prepared by the Chelsea Physic Garden.
On 1 April 2002, the RLHH joined the University College London Hospitals NHS Trust, as part of its Specialist Hospitals Board, enabling closer collaboration and integration between complementary therapies and conventional medicine to provide better care for NHS patients. The merger coincided with the government's commitment to integrate complementary and conventional care within the NHS, where there is evidence of the effectiveness of complementary therapies.
From 2002 to 2005 the RLHH underwent a comprehensive £20m redevelopment, transforming it into a state-of-the-art treatment and research facility in homeopathic and complementary therapies, as well as providing additional access to a wider range of conventional expertise through the six other UCL Hospitals. While the refurbishment was in progress the hospital’s clinical services moved to Greenwell Street, adjacent to the Royal National Orthopaedic Hospital.
The renovation was planned with careful consultation with patients and clinicians to provide a peaceful healing environment, as well as facilities for group clinics, education and an information centre. The ‘old boardroom’ which had been unseen, divided into a series of offices since the redevelopment of 1911 was restored as the pharmacy with its anteroom forming a retail and waiting area. The ‘new boardroom’ was transformed into a library, the Complementary and Alternative Medicine Library and Information Service, which opened its doors to the public in July 2008. The renovated building also houses lecture theatres, together with seminar and smaller meeting rooms.
Clinical services resumed in the renovated building in June 2005, and it was formally reopened by HRH The Prince of Wales on 12 October 2005. In his speech the Prince said: ‘To read the newspapers, one would think that complementary and conventional medicine are virtually at war, with complementary and alternative medicine in retreat. How refreshing, then, to come to this corner of Bloomsbury, with its unique concentration of world-famous specialist hospitals and medical institutes, to find that the reality on the ground in the NHS is quite different.
Instead of hostility, there is collaboration and integration: health professionals with expertise in complementary and conventional medicine are working together freely and enthusiastically, in this splendidly redeveloped building with a single, shared objective: to improve the outcome of treatment for patients.’
In 2006-2008 there was a sustained media attack on complementary medicine in the NHS; this included a letter calling on PCTs to no longer commission complementary medicine, which was the front page lead in The Times, coinciding with the Prince of Wales’ speech to the World Health Assembly in May 2006. This met with strong public and political support for NHS homeopathic hospitals, including local campaigns and an Early Day Motion in the House of Commons, signed by 206 MPs.
Again the RLHH responded with innovations meeting patient need. These included:
- the NHS’s first herbal medicine service, led by Dr Saul Berkovitz and launched in 2008
- group acupuncture clinics allowing acupuncture for common painful conditions to be delivered cost-effectively
- an integrated antenatal service in collaboration with UCLH midwives.
Meanwhile integration is burgeoning between the RLHH’s services and those of other UCLH specialist hospitals in areas such as pain, allergy, complementary cancer care, stress and mood disorder, and irritable bowel syndrome.
New information and education services have also been introduced, including:
- the UK’s first course in integrated complementary medicine for primary health care workers: ‘Integrating Complementary Medicine in daily practice’, launched in 2005 (RLHIMs Education Department)
- NHS Evidence - complementary and alternative medicine, the National Institute for Health and Clinical Excellence’s (NICE) evidence website, in collaboration with the Research Council for Complementary Medicine and University of Westminster. This service was absorbed into NICE’s core functions in 2011
- The Complementary and Alternative Library and Information Service (CAMLIS)
In November 2007 the senior clinical and management staff unanimously decided that the time was right to change the name of the hospital to the Royal London Hospital for Integrated Medicine (RLHIM) in order more accurately to reflect the nature of its work. Permission was granted by the Ministry of Justice and the Board of Directors of University College London Hospital NHS Foundation Trust. The renaming became official on 16 September 2010.
The RLHIM has continued to innovate and integrate: it has introduced a successful non-drug insomnia clinic, a facial pain service in collaboration with the Eastman Dental Hospital and offered its complementary cancer care service in the new Macmillan UCLH Cancer Centre since it opened in April 2012.
The thread running through the highs and lows of the last 160 years is not great names, nor even the contribution to the art and science of homeopathy or integrated medicine. The ideal that has sustained the Royal London Hospital for Integrated Medicine is a commitment to making available the best that an integrated approach to medicine can offer to help those who need it, when they need it, regardless of ability to pay.
