St. Bartholomew's Hospital, Rochester was founded in 1078 for the care of the poor and lepers. It survived as a charity until taken over with the founding of the National Health Service. The hospital closed permanently in September 2016.
History
Medieval
St. Bartholomew's Hospital, Rochester was, until it closed, the oldest existing hospital in England, predating its more famous namesake in London by fifty years. Six hospitals were founded before the Norman Conquest in 1066, but none of them are still functioning. Shortly before St. Bartholomew's was founded, Archbishop Lanfranc (consecrated 1070) erected a hospital at Harbledown outside Canterbury, but it is no longer in existence.
The original hospital was on the main road between Chatham and Rochester which is now known as Rochester High Street. Being for the relief of the poor and leprous, it was built outside the city itself in an area of Chatham which lay within the jurisdiction of Rochester called "Chatham Intra" ("Chatham Within"). The hospital was run by a "Custos" (Warden) or Prior with a number of canons.
Finance was obtained from grants and from the revenues of lands settled upon the hospital, the normal pattern of support for institutions during the Middle Ages. Even with this income the hospital might well have failed but for donations from the Priory of St. Andrew. The priory contributed daily and weekly provisions to the hospital along with the offerings from at altar of St. James and at that of St. Giles, both within the cathedral. On the installation of a new bishop they had the right to collect alms from those present at his table, and even had the cloth covering the table. Henry III gave "forty shillings yearly arising from land within the Hundred of Andeltune".
Following a representation by the Prior and brethren of the hospital to Edward III in 1342, the king ordered an inquiry into the revenues of the hospital. The inquest before Sir Richard of Cobham revealed holdings worth £9 yielding an income of 21s 6d. The enumeration notes that there were nine brethren and sisters ("fratres et sorores") and the prior who was himself a leper. Consequently, in 1348 he granted that "poor lepers ... should be quit from all manner of Taxes, Tollages contributions and other quotas and charges for ever". Additional funding was obtained from Henry IV. In 1449 Henry VI confirmed the previous charters.
Early modern
As a result of the Dissolution of the Monasteries (which, for Rochester, occurred in 1540), Henry VIII granted the patronage to the Dean and chapter of Rochester. The hospital therefore continued as an independent charity, but without the grants and offerings from the cathedral. The only income was from the estates settled on it. William Lambarde writing in about 1570 described the hospital as "a poor show of a decayed hospital". Most of the monastic hospitals were given to the Crown; Greenwood suggests that it was only the poverty of the hospital that preserved its independence.
The development of a Royal Dockyard at Chatham brought people and prosperity to the area. The meagre estates which had formerly only supported a decayed hospital became more valuable. The value increased to the point that two attempts were made to seize the land for the benefit of the Crown, one under Elizabeth I and the other under James VI and I. Ultimately the matter was settled in 1627 with the lands vested in the hospital under the ultimate control of the Dean of Rochester as Governor and Patron.
Income from the estates was of two sorts: fines and rents. The former refers not to judicial punishment but to one-off payments made on the taking up or renewing of a lease. The latter was a periodic payment made by a tenant, just as in modern usage. In 1716, the Chapter of Rochester Cathedral tried to obtain a voice in the management of the estates, in particular claiming that all fines and rents should be passed directly to the Brethren of St. Bartholomew's Hospital. An appeal to the Bishop of Rochester led to a settlement whereby the number of Brethren was increased, but the Dean still managed the leases and received the income.