The construction of a general hospital was first proposed in Birmingham in the 1760s by a local physician, Dr John Ash. Born in Coventry and educated at Oxford, Ash was one of three physicians resident in Birmingham at the time.

Although the town already supported a workhouse, which offered medical treatment to many sick local paupers, Ash suggested that an institution was required to provide healthcare for labourers who were not legally settled in Birmingham (namely those not born in the parish or employed there for longer than a year).

As a result, meetings were held at a local inn, one of the few public buildings available at the time. Subscriptions were promised and, soon after, a piece of land on Summer Lane was purchased by a building committee.

Progress was delayed for several years, due largely to the fact that many other projects took precedence, including the construction of a canal to the Black Country, roads and bridges, not to mention the outbreak of war in North America. As a result, a hospital with 40 beds was finally opened in October 1779, several decades after similar institutions had opened in London, Bristol and even Northampton.

The General Hospital in Birmingham, in contrast to the local workhouse, which was funded out of rates paid by property owners, was a voluntary hospital. Funds were obtained from subscribers who voluntarily paid a guinea a year, sometimes more, towards the expenses of the institution.

In exchange, subscribers were permitted to provide potential patients with letters of recommendation which gave many local working people access to a new form of institutional health care.

While much doubt has been laid on the efficacy of drugs and treatments available during this period, a little bed rest and a sufficient diet were certainly benefits many poor labourers were not always guaranteed at home.

At least 225 patients received the benefits of such treatment in the hospital’s first year; another 304 were treated as outpatients. Numbers climbed steadily to 1,000 inpatients in 1813, by which time outpatients totalled 1,500 and beds surpassed 100.

Three years later, the hospital was included on a tour of England undertaken by Grand Duke Nicholas of Russia, who contributed £100 towards the charity’s £5,000 annual income.

By the 1840s, the hospital still treated approximately 2,000 inpatients a year, but significantly more work was being undertaken by the Outpatient Department which treated between 10,000 and 20,000 cases annually, many of which were industrial accidents.