THE 1830s have been described as an usually quiet period for hospital construction, as the moneyed classes throughout England sought alternative ways to manage the requirements of the sick poor. In general, a reformed Poor Law was seen to meet the needs of the destitute in large industrial communities more effectively than hospitals and dispensaries which often appeared to allocate their services indiscriminately. The decades following the New Poor Law of 1834, however, were characterised by an intensified period of hospital foundation, especially specialist institutions. Though opponents to specialisation remained vocal throughout the 1860s, members of the medical profession had begun to recognise specialties as proper and legitimate fields of practice. A decade later and specialisation was already regarded as inevitable. As a result, during this second wave of voluntary hospital foundation many of the country's largest cities and towns gained specialist hospitals, such as those for women and children, while other towns, which had long survived without institutions for those with specific diseases or disabilities began to develop their specialist services. For example, between 1834 and 1861, fifteen more eye institutions are known to have been established throughout England, and eighteen more were founded in the next two decades. In London, twenty-two specialist institutions were founded in the 1860s alone. By 1861, more than a hundred specialist hospitals existed nationally. Between 1843 and 1871, Birmingham gained several, including hospitals for the deaf, children and women. Not all thrived, but like those located in the capital and other industrial towns, these institutions rapidly attracted patients, many more coming from great distances given improvements in transport. Unlike earlier institutions, most opened with beds for inpatients and grew more quickly than did a first generation of English specialist hospitals.

A SMALL, BUT SOUND MEDICAL CHARITY: THE EAR HOSPITAL

By the second half of the nineteenth century, charitable initiatives in Birmingham were supporting a greater number of local medical charities. For example, only three years after the completion of the Queen's Hospital, another very different, specialised institution was inaugurated. The Ear and Throat Infirmary in Birmingham was founded in 1844 largely through the efforts of Mr William Dufton, almost three decades after the first English institution devoted exclusively to the treatment of diseases of the ear opened in London's Soho district in 1816.