St. Bartholomew's Hospital

St Bartholomew's, the oldest and greatest hospital in London, is doomed to die an inglorious death, after nearly 1000 years at the forefront of medicine. Unless a miraculous scheme is devised - and there are battles raging for Bart's - two 20th-century politicians will be responsible for crushing the very cradle of medicine in the British isles. If successful they will have triumphed were more tremendous forces have failed: the Plague, the Dissolution of the Monasteries (Bart's was started as a religous institution), the Great Fire, and two World Wars.

Bart's was founded in 1123 as a sanctuary for the ill, the aged and the passing stranger. From the start, it was a famed monument to modern medicine; it remains at the cutting edge - millions of pounds have been invested in new technology. Less well known are the hospital's fine archives, architecture, and collection of art and objects.

The building's foundations were laid 'both in spirit and stone' by the monk Rahere, who lies buried beneath a great canopied tomb in the church of St Bartholomew the Great. A sinful and worldly wit, he led the creeping life of a courtier, indulging in 'carnal delights' and pouring pleasantries into princes' ears. Then, struck down with malaria on a pilgrimage to Rome to purge his 'frivolities and triflings', Rahere vowed to build a hospital for the poor if he recovered. St Bartholomew appeared to him in a 'vision full of awe and sweetness' saying that the hospital, as well as a church in his name, should be build at Smithfield in London. 'Under the shadow of my wings', said the saint, 'I shall always defend and protect this place'. He is there today, carved over the church porch, forever protecting the 12th-century stones, but with wings too meagre to defend the hospital from the onslaught of 20th-century politics.

You enter Bart's through an ornate arch, built in 1702 by Edward Strong. A carved, richly clad Henry VIII stands proud beneath the pediment. He re-founded St Bartholomew's in 1546 after the Dissolution of the Monasteries had failed to close its doors - due to the City's pleas for help with all the 'myserable people lyeing in the streets, offendyng every clene person passing by the way with theyre fylthie and nastye savors'.

The Great Hall

The building was planned as a palace for the poor, and the grand staircase alone is worthy of princes, with two enormous works by Hogarth covering the entire stairwell. The figures clustered around Christ in The Pool of Bethesda were all painted from patients at Bart's in the 1770s; there is an alarming, grey-faced sufferer of chlorosis, and a baby with congenital syphilis. The Good Samaritan on the other wall was painted in situ. Both Hogarth and James Gibbs, who designed the main buildings in the 1730s, worked for the hospital for free. Gibbs' monumental masterstroke is the Great Hall, a room that roars out the glory of St Bartholomew's and all those who have nurtured it over the centuries.

Still clothed in its original sumptuous yet subtle tones, the hall is emblazoned with the names of the hospital's benefactors, all shining forth in gold from the walls. There are portraits of teachers - at what was one of the first and greatest teaching hospitals in the world - set in ornate movable frames which can be wheeled around the room. Bart's is the proud possessor of works by Millias, Lawrence and Reynolds, not to mention a cast of the explorer David Livingstone's lion-bitten left humerus.

One of the most precious objects is the Royal Charter granting the Hospital to the City of London, shakily signed by Henry VIII only a few months before he died. The unrivalled archives contain innumerable medical records, such as those of James Chard, admitted with 'chimney-sweeper's cancer' in 1848, who hadn't washed for 'five or six years at a time'.

Most ancient is the hospital's original grant, written on a small piece of parchment in 1137 and still hanging heavy with seals. There are also Gibbs' plans for the courtyard, described as 'the finest open-air room in all England'. This grand scheme to a large extend survives. Disgracefully the South Wing was demolished in 1935 though later rebuild with many of the original stones.

The sons and daughters of St Bartholomew's are legion. William Harvey, who discovered the circulation of blood, was physician between 1609 and 1645. Elizabeth Blackwell, the first woman doctor in the British Isles, studied here. Mozart had his tonsils out in the 1770s and the poet Robert Bridges was the casualty physician in the 1870s.

How can such an institution be abandoned? It has been a general hospital serving London for eight centuries, building up not only its archives but also treasured traditions of service, and a unique relationship with the City and its patients. Irreplaceable, all this is at risk of being lost forever. There are schemes afoot for the salvation of Bart's: the most beguiling is that it reopens as a charitable institution, free to the public and supported by private and City funds, thereby once again becoming 'a spiritual Sanctuary in stone' for the sick, the poor and 'the homeless wanderer', just as it was in 1123.