The National Health Service was born half a century ago next weekend. Let's mark its jubilee with a look-back at its effect on medical care in general, and Kingston Hospital in particular.

In 1948, when the NHS was born, Kingston Hospital was a picturesque anachronism.

Outside it was a historian's dream, its elegant period buildings harmonising one with the other in mellow brick and Portland stone; inside was less idyllic.

Most of the buildings were Victorian workhouse structures, built between 1838-98, and had become sadly outmoded.

Since the birth of the NHS, that situation has been turned inside out. Externally, Kingston Hospital is now a brutally jarring mismatch of designs and materials. Inside it is one of the most up-to-date hospitals in Europe, if not the world.

However, part of the old workhouse complex remains as an echo of how the hospital looked when the NHS arrived on July 5, 1948. This lone Victorian survivor was built in 1868 as a medical showpiece of its kind. It cost the then vast sum of £7,000, and had beds for 80 workhouse patients in eight wards.

Now it is known as Regent Wing, and is mainly used as offices.

Kingston Hospital evolved from Kingston Union Workhouse, which opened in 1839 in a neo-Tudor brick building for 320 paupers, and was so handsome it was dubbed "The Grand Palace" by local ratepayers. Other buildings followed, including three workhouse infirmaries, built in 1843, 1868 and 1897, and two nurses' homes, opened in 1898 and 1928.

The whole complex, built on what had been a large field off Coombe Road, was transferred to the Regional Hospital Board after the inception of the NHS.

In 1948 the hospital had 403 beds. In-patients during the year totalled 6,547, with an average stay of 20.5 days, and 3,899 operations were performed. The maternity department recorded 1,421 births.

Contrast that with now. The latest annual figures record 440 in-patients' beds, with 22,961 operations and the average stay down to 4.6 days - thanks to day surgery and advanced new techniques. The out-patients department had 190,474 attendances, and there were 3,501 births.

Fifty years ago, only 21 doctors were employed full-time, with 13 visiting consultants who spent one sixth of their time at the hospital. There were also 160 live-in nurses, plus some 40 non-resident and part-time ones. Today there are 235 doctors and dentists and 856 nurses.

Back in 1948 all the wards were on "Nightingale" lines: long and narrow, with beds in neatly aligned rows so nurses could see all patients from one observation point. Now they are divided into separate bays with six to eight beds in each.

Gradually the impressive but outdated period buildings have been replaced. The first project was a new out-patients department, started in 1959, followed by a medical centre, the Kenley psychiatric unit, new kitchens and works departments, surgical and dental wings and a new mortuary and dental wing.

Developments in the 90s have included the Bernard Meade wing, officially opened in 1992, and new day surgery and maternity units.

The 1897 nurses' home was demolished a few weeks ago to be replaced by a car park, and a new £3.6 million ward block is currently under construction to cope with the extra workload when Kingston Hospital takes over most of the surgical and medical work currently carried out at Queen Mary's, Roehampton.

Still more development is planned during the next five years.

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