“Holding open the door of healing,” An Administrative, Architectural, and Social History of Civic Hospitals: Toronto, Winnipeg, Calgary, and Vancouver,1880-1980

Abstract

The following dissertation examines the history of general hospitals in modern, central and western Canada. It follows extensive case studies of the Toronto, Winnipeg, Calgary, and Vancouver general hospitals. The last few decades have seen an expanded interest in hospitals by Canadian medical historians, but the overall literature is thin. Further, many of the extant histories focus on a particular constituent: the medical profession, administrators, or architects. In this dissertation I argue that these general hospitals were contested spaces, and that their organization and layout reflected negotiation between several parties. A further important vector is the role hospitals played in the social life of their communities. As these general hospitals grew, and began treating middle-class patients, they also required large sums of money from the public purse. Administrators had to account for the shape and use of medical space to the general public that helped finance it, as they did to the doctors who worked there. During the period 1880-1945 general hospitals moved from the periphery of medical care to the centre, but not without substantial growing pains. These institutions routinely lacked funds and space, and remained in operation as much through the efforts of medical professionals as by concerned citizens. After the Second World War the Federal Government shifted from a standoffish institution to one ready to release funds and administrative energies towards new ideals of social welfare. Funding increased dramatically for the building of new hospitals, and legislative developments such as Medicare transformed the social and political relationship between hospitals and patients.