Making room at Meanwood Park:

a planned approach
BY D. A. SPENCER
Physician Superintendent, Meanwood Park Hospital, Leeds

In August, 1969, Meanwood Park Hospital, Leeds, Areci Lee& C.R. FIirddersf ield Dewsbury Parts Of
had 848 in-patients accommodated in 18 villas. Like C.B. C.B. W e s t Riding
many other similar hospitals it was grossly over- County
crowded by modern standards. Originally built in the Approx. Council
1920’s and 1930’s as a “model” mental deficiency Populntioii 500,000 132,000 50,000 80,000
colony by Leeds Corporation, it never reached the
Discharges in w tl m w tl m w tl m w tl
size of 900 residents which had been the pre-war plan.
In 1948 Meanwood Park became a hospital under the 1970 8 19 27 2 4 6 0 1 1 0 0 0
control of the Leeds Regional Hospital Board and for 1971 6 11 17 1 1 2 0 0 0 1 0 1
twenty years the number of beds remained at about
840. For a period one villa contained over 70 severely 1972 4 15 19 3 1 4 0 0 0 0 0 0
mentally handicapped residents and others had up to
60. Totals: 18 45 63 6 612 0 1 1 1 0 1

This was still the situation four years after the

memorandum in 1965 on Impuovinq the Eoectiveness Grand Total: 77 (52 women, 25 men)
of the Hospital Service for the Mentally Subnormal
HM(65)104, had advised in paragraph 18 that a ward
should not normally accommodate more than 30 adult Less than six of the patients discharged have failed
patients or 20 children. It was obvious that a drastic and have had to return to hospital. A few other
reduction in the numbers of patients was essential at patients were discharged direct to their homes and a
this hospital. Even if the nursing staff was expanded very small number of others have been placed in
and the living accommodation upgraded reasonable epileptic colonies and in other hospitals for menta!
conditions could not be achieved until the number of illness or geriatrics.
patients in each villa was limited to about 30 in the
villas for adults and 20 for children.
Meanwood Park Hospital was the main hospital
The objective was a decrease from 840 to 600 be+. serving a population of nearly 800,000. In 1969 one
Three ways of reaching this target were open. Firstly, villa had been converted into a short stay admission
there was the possibility of discharging a number of and assessment unit. An active programme of
patients; secondly, admissions could be restricted; and investigation, assessment and appraisal at case con-
thirdly, there was the hope of transferring some ferences kept new long stay admissions to a minimum.
patients from Meanwood Park Hospital to a new Nevertheless some long-term patients had to be
hospital for the mentally handicapped being built near received and they tended to block beds in the assess-
Wakefield. The in-patients at Meanwood Park ment unit. In other cases, day-patient care was used
Hospital had been classified according to the section to forestall long stay care. Day assessment for review
on mental retardation in the international classification of patients was introduced.
of disease, injuries and causes of death produced by
the World Health Organisation. The hospital possessed During the period 1969 to 1973, 67 patients died in
an active psychology department which was able to the hospital and the beds of these patients were
assist in the assessment of many patients in the mild to removed from the villas.
borderline ranges of intelligence who were the more
obvious candidates for discharge.
Discharges Number of Deaths at Meanwood Park Hospital
The local authorities - especially in Leeds, from Year. Male Female To!al
which most of the patients originated - have been
helpful and 77 patients, 52 women and 25 men, have 1970 6 14 20
been dicharged to local authority hostel accommo- 1971 16 24
dation and, in the case of 10 Leeds women, to 8
supervised flatlets. 1972 10 13 23
The following table shows the number of men and ~ ~ __
women discharged to the care of the different local Totals: 24 43 67
authorities the hospital served. - - ~

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Transfers to other hospital Reactions

Work on the building of the new Fieldhead Hospital
for the mentally handicapped in Wakefield, Yorkshire,
began in 1969. This hospital, costing over f2,000 COO.
was opened by Princess Alexandra on July 11, 1972.
With 480 beds this new hospital had been deliberately
planned to accommodate some patients from Mean-
wood Park Hospital in addition to replacing about 300
beds in 3 smaller hospitals for the mentally handi-
capped in the Wakefield area. Originally it had been
hoped to move 100 patients from Meanwood Park
Hospital to Fieldhead, but this figure had been
reduced to 80 by the time the new hospital was
commissioned and had received patients from the
Wakefield hospitals which were closed. In the autumn
of 1972 the transfer of patients from Meanwood Park
was initiated.
The eligibility of patients for transfer to the new
hospital was determined on a basis of their homes
being in the service area of the new Fieldhead
Hospital. From 1970 onwards the relatives of these
patients were approached by letter and through inter-
views about transfers to the new hospital. From
August, 1972, to June, 1973, 68 patients were trans-
ferred from Meanwood Park to the new hospital as
the following table shows:-
Transfers from Meanwood Park to Fieldhead Hospital,
Wakefield
Date Male Feinale Total
August 1972 1 0
October 1972 8 13
January 1973 4 20
February 1973 9 12
June 1973 0 1
The reduction in the size of a hospital population
by over a quarter cannot occur without causing some
unrest amongst patients, relatives and staff. The
position was aggravated at Meanwood Park by an
extensive programme of upgrading villas which began
in 1970 and resulted in two villas at a time being out
of use for periods of from 6 months to 18 months.
Two new prefabricated villas were erected in the
grounds for the accommodation of 30 patients each,
and these have helped to relieve overcrowding during
the run-down of numbers and renovation of villas.
Among the in-patients some who were not immedi-
ately eligible or suitable for discharge thought that
they should join those who were. A few patients were
reluctant to leave the hospital, but the greater fear of
discharge was expressed by relatives. Some have
stated that they do not want their patient to go out
of the hospital. A few patients took their own
discharge precipitately which led to innuendoes in the
community that patients were being indiscriminately
discharged. The policy of restricting admissions
prompted the jibe that it was easier to obtain a place
in the more selective and expensive public schools
than in Meanwood Park Hospital.
Staff attitudes varied from the cautious, con-
servative, pessimistic cynicism of some of the older
members to an over-enthusiastic expectation on the
part of some younger staff who thought discharges
were not quick enough. A real fear was that with
the reduction in patient numbers the nursing staff
establishment, which had been increased to 267, would
be cut back, but it is hoped that this threat has been
1 averted.
21
The hospital managers, imbued for many years with
24 a custodial outlook, were initially apprehensive about
policies which were the reverse of those to which
21 they were accustomed, but with the encouragement
1 of visiting teams from the Hospital Advisory Service
and the Regional Hospital Board they have come to
accept the changing scene in mental handicap and
have found a new pride in the progress which has
been made.

By April, 1973, the objective of 600 in-patients at The Future

Meanwood Park had been reached. If the recommendations of Command 4683 Better
Services for the Mentally Handicapped are to be
implemented, Meanwood Park Hospital will have in
Table showing run-down of in-patient numbers at the future only 400 beds - 300 for adults, 100 for
Meanwood Park Hospital, Leeds children - with 130 day places - 80 for adults and
50 for children. Of its 600 residents at present nearly
Yearly 550 are severely subnormal and the question of how
Year Jan. April July Oct. Reductiori Total many more patients can be discharged is the new
challenge which is going to face Meanwood Park
1969 840 840 848 834 10 ) Hospital in the future.
1970 830 801 790 779 65 ) 190
1971 765 752 733 728 48 ) Ref erences:
1972 717 710 704 690 67 ) Improuirig the Effectiuetiess of the Hospital Service for the
Meritall:/ Subriormnl: HM Memorandum (65) 104, Paragraph
1973 650 600 - - half yearly 18.
reduction of 50 A Glossary of Metitnl Disorders: Studies on medical and
population subjects No. 22. HMSO 1968, Page 22-24.
Better Services for the A4etitally Handicapped: HMSO 1971,
Total Reduction: 240 Commnd. 4683.

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