During 2005 two opposing currents battled for supremacy in the world of medical archives. On the one hand the drive to preserve, conserve and open up to access medical collections up and down the land, characterized by the successful projects funded by the Wellcome Trust's Research Resources in Medical History (RRMH) scheme, continued its progress. On the other, there seemed to be no slackening in the tendency of institutions holding medical collections to seek ways to shuffle off their curatorial responsibilities. Keeping archives is expensive, particularly if those archives are in central London and so disorganized or inaccessible that they cannot earn their keep. The temptation to dispose of them in such circumstances can be overwhelming. The RRMH scheme quite properly insists that the collections it helps are cared for in the future in optimum storage conditions and are accessible to the public. This can make managing a collection seem even more expensive than merely keeping it in mothballs. But in the long run there is no more cost-efficient way of managing the archives of sizeable institutions than employing a professionally-trained archivist in a permanent role, and providing a minimum standard of secure storage and controlled access to the records.
The year 2004 was a fairly typical one for accessions to repositories, to judge from the annual digest compiled by the National Archives (http://www.nationalarchives.gov.uk/accessions/2004/04digests/medic.htm). Among the myriad hospital and community health council records received by local repositories, a few items stand out. The account book of the Chequerbent Sick and Burial Society, 1839–1894 (Bolton Archive Service) sounds like a useful source for study of the way medical services for the poor were provided by local voluntary insurance schemes in the Victorian period. Interesting early records of mental health care in Scotland are suggested by the minutes of the Magdalene Asylum, Edinburgh, 1798–1938 (Edinburgh City Archives) and material relating to a proposed lunatic asylum in Inverness in the nineteenth century (Highland Council Archive). A tantalizing item—a “whisky issue book”—is found among the records of Upton Mental Hospital, the former county asylum (Cheshire and Chester Archives). Another county asylum, Stafford, is represented by case books, 1855–1917 (Staffordshire County Record Office). Two accessions of wartime material are sufficiently unusual to merit comment: Leicestershire Record Office has acquired the autograph book of a nurse at Wicklow Lodge Military Hospital, 1916–18, which includes poems by patients; Norfolk Record Office meanwhile announces the accession of records of the 231st station hospital, Wymondham, of the USAAF 2nd Air Division, 1943–45, a reminder off how deeply embedded into the life of East Anglia the American air force became during the second half of the last century.
Acquisitions in the special and university repository area were dominated as ever by the collecting activities of the Wellcome Library. Noteworthy accessions included papers of the twentieth-century mental health specialists, Michael Fordham, Sigmund Foulkes and Roger Money-Kyrle, and records of the herbal medicine manufacturer William Ransom & Son Ltd, of Hitchin, 1850–1960. The Wellcome also acquired two case books from Holloway Sanatorium for the Insane, Virginia Water, 1885–1902, to add to the seven volumes already held. This incidentally was the first significant accession to the Wellcome's collections to be made via eBay—perhaps an augury for the future. Holloway Sanatorium was an interesting institution: founded in 1885 as an asylum for the middle and upper classes by Thomas Holloway, the pill manufacturer, it seems to have been at the forefront of some of the new developments in the mental health field, such as the use of occupational therapy for recovering patients. It was also one of the first hospitals to include photographs of patients with their case notes. The Sanatorium's patient records were dispersed when it closed in 1981, leaving William Crossland's magnificent late Victorian interior (see http://www.archimage.co.uk/holloway.htm) to the vagaries of fate.
By the time of its closure, Holloway Sanatorium was part of the NHS, but patient records, as physical artefacts, have never enjoyed long-term legal protection in Britain. On the other hand, for many years the Lord Chancellor's instrument (LCI 92), recently reinforced by the provisions of the 1998 Data Protection Act, have closed most patient records held in public repositories to researchers for 100 years (deemed to be a maximum life span) from the latest date in the record. This means that it would be quite possible for the same case book from, for example, the middle of the twentieth century to be traded perfectly legally on eBay one day and then immediately closed to view for several decades by a record repository that bought it. The restrictive practices of archivists have sometimes caused understandable frustration in academic, genealogical and other circles, and in the field of medical records as much as any other. But what the legislature takes with one hand it gives with another, and vice versa. From the beginning of 2005 the provisions of the Freedom of Information Act came into force, dispensing with the 100-year closure rule and theoretically opening all records held by public authorities to general public access. There remain exemptions to this general right of access, particularly in relation to the continuing protection of data subjects under the terms of the 1998 Act; and it is still not clear how “public authorities” are defined. But there is no doubt that access to medical records will become somewhat less restrictive from now on.
The provision of on-line research resources of interest to medical historians continues apace. Some of the most useful of these are not specifically medical in subject-focus but encompass vast bodies of documentation that can now be searched productively. Such databases are, it must be said, also usually only available by subscription or via a subscribing institution. The Times Digital Archive (a commercial product of Thomson Gale) permits flexible searching of the entire content of the newspaper from 1785 to 1985. Documents on-line, by contrast, is a charge-based service by the National Archives; it provides among other things access to the text of the registered copies of the wills proved in the Prerogative Court of Canterbury, the principal court of probate in England up to 1858. The text cannot be word-searched as no optical technology has yet been developed that can handle manuscript with sufficient precision, but the resource certainly enables much easier access to a large and important body of documentation that could formerly only be exploited on site via manual indexes and microfilm.