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The Italian Patient - Santa Maria Nuova

The poor received free treatment at hospitals, six senior doctors were employed and food and wine were served to patients - 14th Century Florence could challenge our own NHS

01 Sep
2005
Used with permission Picture of Bienvieni

Used with permission Re-enactment of patient in bed

King Henry VII had been so impressed by positive reports of the Hospital of Santa Maria Nuova that he had requested the statutes.

He then used them to create the structure and administration of London's Savoy Hospital, work that was continued by Henry VIII. The Savoy Hotel and Chapel now stand on the site of the old hospital.

The statutes also say that Santa Maria Nuova had an outpatients' clinic; a private wing, a pharmacy that was also open to outpatients, a district nurse service, a fracture ward and a separate ward for the violently insane, where patients were kept in chains. Patients were issued with slippers, a nightshirt, a cap and a leather robe. Monks, nuns and lay people did the nursing with almost one nurse per patient. Consultants performed daily ward rounds with junior doctors. One hundred live-in members of staff - including skilful surgeons, worked in the female outpatients ward.

Three times a day inpatients were offered pine nuts, walnuts and sugared almonds. Before meals attendants brought water for the patients to wash their hands. The nurses helped those who couldn't feed themselves. A huge cauldron of chicken soup was kept near the hospital entrance for the poor.

John Henderson has calculated that the mortality rate was 10%.

Evidence
Used with permission The Statutes of Santa Maria Nuova The hospital account books list Benivieni's salary. For a part-time position he was paid a yearly salary which was almost enough to support a family of five. What we cannot tell is what proportion of his overall income this amounted to.

Considerable money was also spent on apothecaries, medicines and good quality food. In fact, an entry made on 25th January 1374 revealed that the hospital bought 489 pairs of chickens, no doubt to make the famous chicken soup it promised all its seriously ill patients. A hospital slaughterhouse kept patients supplied with meat and poultry. The accounts also list orders of fresh fruit and vegetables.

A version of the statutes of the Hospital of Santa Maria Nuova is held at the Bodleian Library in Oxford. This is possibly a presentation copy to King Henry VII.

Thinking History
Statutes of Santa Maria Nuova

Official records look comfortingly authoritative, but they need to be tested as rigorously as anything else. We need to know when these statutes were drawn up; are they a blueprint for action, or a crystallization of existing practice? Who drew them up, and were these the people who then oversaw the running of the institution? Were the statutes actually put into operation?

Q. How can we test whether the statutes were put into practice?

Q. How unusual was Florence's health care provision?

Q. How was all of this paid for?

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Article Information

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Copyright information
• Body text - Copyrighted: The Open University
• Image 'Picture of Bienvieni' - Copyrighted: Used with permission
• Image 'Re-enactment of patient in bed' - Copyrighted: Used with permission
• Image 'The Statutes of Santa Maria Nuova' - Copyrighted: Used with permission

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