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History When the Liverpool Royal Infirmary closed its doors on the 17th December 1978 a special period in the history of hospital care in Liverpool ended. For 89 years it had served the community and witnessed many important changes in medical and nursing techniques. The building of the Royal Infirmary opened in November 1889 as part of the 'enlightened' Liverpudlian response to pressing problems of urbanisation and disease. There had been two preceding infirmaries in Liverpool. The first was built in 1748 on Shaw's Brow, almost on the site now occupied by St. Georges Hall, for 'those in distress from all parts of the nation and Ireland'. This was replaced in 1824 by a second Infirmary on the higher and healthier ground of Brownlow Hill, designed by John Foster. He considered his designs to have produced a classical monument, with light, spacious and airy interiors, suitable for a hospital. This became the Royal Infirmary following the visit of Queen Victoria to Liverpool in 1851. In 1859, Rathbone instituted the first district nursing service in the country, and in 1862 established a School of Nursing to service the Infirmary and the district nursing. By the 1860's there was a realisation that the hospital was ill-equipped to cope with the mounting pressures of population, medical services and medical educational provision. The idea to build a new Infirmary of 'inspiration and progress' may have been seeded as early as October 1858 when Florence Nightingale came to Liverpool and presented two papers to a meeting of the National Association for the Promotion of Social Science. She drew widely on her experience of hospitals, and detailed the defects of hospital design and construction, management and practice, perceiving these elements as interdependent upon one another in order to develop a 'healthy hospital' that would at least do the sick 'no harm'. Nightingale was aware of the connection between poor hospital design and the prevalence of hospital diseases such as sepsis and fever, and of the advanced design and managerial remedies that were to become the principal guidelines for the new Infirmaries. Alfred Waterhouse (1830-1905), the Liverpool born architect and champion of high Victorian Gothic, was a natural choice for the new Infirmary.
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