It was at a meeting on the 9th July 1750 that the Royal Infirmary of Edinburgh first became aware of the substantial and unique bequest which had been left to it on the island of Jamaica. At the meeting George Drummond informed the managers that he had received a letter stating that Archibald Ker, a Scottish surgeon from St Thomas-in-the-East, near Kingston, had died leaving his Redhill pen to the infirmary.
The Edinburgh Infirmary for Sick Poor or ‘Little House’ opened in 1729 on Robertson’s Close and received its Royal Charter in 1736. The infirmary was the teaching hospital for the University of Edinburgh Medical School and was instrumental in establishing Edinburgh’s reputation as a centre of medical excellence and Enlightenment. However, the medical school and infirmary also produced generations of medical practitioners who supported and propagated slavery and imperialism in the British empire, while growing wealthy from the fees of students who came from the colonies. Throughout the eighteenth and nineteenth centuries the hospital benefited substantially from the charitable donations, subscriptions, and legacies of individuals who derived their wealth from enslavement, the trade in enslaved people, and the goods they produced.
In his will, Ker bequeathed ‘the annual profits of his estate (real and personal) towards and for the use of the Royal Infirmary at Edinburgh’. Ker went on to further specify that it was his ‘resolute intention and desire that the said estate be kept and not sold or otherwise disposed of’. Legally this meant that the infirmary had been gifted an estate it could never sell, together with an enslaved workforce that it could presumably neither sell nor emancipate.
Redhill consisted of 420 acres in the sugar parish of St Thomas-in-the-East, around 27 miles from Kingston. The property was a pen, as opposed to a plantation. While the best land was used for the more profitable business of growing sugar cane, coffee, and tobacco, pens were devoted to rearing livestock for the larger estates. Ker’s estate held 39 enslaved people (21 males, 18 females) valued at £2,115 Jamaican currency. Of the 39 enslaved, two were listed as children.
However, Archibald Ker’s legacy was not an indiscriminate act of philanthropy from Jamaica but rather part of a much larger appeal for funding on behalf of the hospital.
In July 1745 the managers received bills of exchange from Mr Alexander McFarlane for the sum of £500. MacFarlane (1702-55) was very wealthy and owned 5,605 acres on the island and was listed as the owner of 791 enslaved people at probate. A further substantial donation was made by James Barclay who left the infirmary a £200 legacy in 1762. Barclay came from a landed Scottish family in Cairness and had worked his way up from bookkeeper (who supervised enslaved labourers in the sugar cane fields) to the post of auditor general of the revenues. At the time of his death, he owned a large estate of some 3,149 acres in Westmoreland. Smaller donations were received by the likes of Dr John Cochrane of Kingston, Jamaica. Donations which could be traced to slave-related wealth were also received from other Caribbean islands including Antigua, Tobago, Montserrat, Barbados, and St Kitts.
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The infirmary’s financial ties to slavery did not end with the eighteenth century. By the mid-nineteenth century, it was evident that the hospital had become unfit for purpose and it was decided that the construction of a new hospital would begin on Lauriston Place.
As was the case from the infirmary’s foundation funding was a fundamental and continued concern for the managers. Public subscriptions were sought and the published subscription list of 1868 shows that £51,168 was raised. Among the subscribers were individuals who had significantly profited either directly or indirectly from the practice of slavery.
The largest donation came from one Mrs Buchanan who donated a staggering £5,000. Jane Buchanan (d.1883) was the widow of James Buchanan (1785-1857), a Scottish West India Merchant who profited from commerce related to chattel slavery and made his fortune in Grenada, Jamaica, and Brazil before returning to Scotland to live handsomely off the profits.
Other benefactors included William Frederick Burnley (1810-1903), the son of William Hardin Burnley (1780-1850), the largest owner of enslaved people in Trinidad, the well-known Dundee linen manufacturer David Baxter (1793-1872), and The Carron Company who made gigantic iron sugar pans which were used to boil sugar cane syrup and exported to the Caribbean and America. In a subsequent subscription list of 1879, among the names of those who profited from slavery were Julia Caroline Hoyes (1818-91) and her husband John Hoyes (1806-1885) who owned the Prospect estate in St John, Francis Brown Douglas (1814-85) who was awarded compensation as owner of Bellaire in St Vincent, and the Edinburgh Tobacco Boys School.
The hospital at Lauriston Place (which is now known as the Old Royal Infirmary) was built and furnished with the help of slave-related wealth. The hospital was complicit in and benefitted substantially from charitable donations and legacies derived from the practice of slavey from the time of its foundation until at least the end of the nineteenth century. The Old Royal Infirmary building on Lauriston Place was recently renovated and is now home to the Edinburgh Futures Institute at the University of Edinburgh. The institute is focused on tackling today’s increasingly complex issues by bringing people and disciplines together to make better futures possible and it will be interesting to see what plans the EFI have to decolonize what is a material legacy of slavery and to fulfil its pledge set in stone above the main entrance: ‘patet omnibus’ – open to all.
The list of donors mentioned above is far from exhaustive, and an official report investigating the infirmary’s benefactors with financial links to slavery during this period (post-1840) has yet to be written or commissioned by either the EFI or the Lothian Health Service. However, recently, in February 2024, the Lothian Health Service published its official report titled ‘Slavery, the Royal Infirmary of Edinburgh and the Legacies that Remain Today’, which included a series of recommendations and proposed actions. This report was based on the findings of an initial research project titled ‘Uncovering Origins of Hospital Philanthropy’, which investigated the Ker bequest and identified the hospital’s donors with ties to slavery pre-1840.
In light of the report NHS Lothian stated that it would make amends for its historical links with slavery. While it ruled out providing any form of direct financial reparation, it did agree to seven recommendations. In addition to providing a public apology measures included establishing a steering group to ensure the delivery of the proposals, tackling racial inequalities in employment by ensuring diversity and inclusivity in its workforce, commissioning a commemorative plaque and new artwork to represent people who fought against Atlantic slavery, educating staff and local groups about the hospital’s connections with slavery, and exploring how to work in partnership with hospitals in Jamaica and West Africa. The board also committed to undertaking further research to examine the connections between other NHS Lothian hospitals and slavery.
But as more and more institutions such as universities, banks, museums, the National Trust, and the Church of England attempt to decolonize, such projects along with their academic researchers and recommendations are facing a steadily growing backlash. For example, in response to NHS Lothian’s recommendations the Scottish Conservative MSP Stephen Kerr, declared it was ‘absurd’ to see health bosses ‘holding conferences to promote woke ideology’. However, given the fact the Scottish contribution to the British Empire was undeniably disproportionate it is certainly fitting that Scotland is, once again, at the forefront of current debates concerning legacies of slavery and empire.
This recent debate begs the question of how many other hospitals across the UK profited in substantial ways from the practice of slavery. A quick search of UCL’s Legacies of Slave-ownership Database, for example, shows that the Commissioners of Greenwich Hospital owned Golden Vale Estate in Jamaica between 1788 and c.1811 and that a plethora of other hospitals covering the length and breadth of the country benefitted from slave-related related wealth.
As NHS Lothian Chairman, Professor John Connaghan CBE, recently stated, the NHS is an institution ‘with core values of compassion, honesty and integrity’ and as such it needs to acknowledge the uncomfortable fact that its hospitals have benefitted from wealth drawn from the practice of slavery. Yet, do NHS Lothian’s recommendations actually go far enough and what should a decolonized health system actually look like?
Within healthcare this would means confronting and challenging the colonizing practices that have influenced healthcare in the past, and which are still present today. Many argue that if an institution such as the Edinburgh Royal Infirmary is serious about reparation, then apologies and commemorative plaques are just not enough. What is needed, they argue, is a ‘radical institutional change’ – a thorough investigation into how the baked in inequalities and stagnation which currently plagues the healthcare system are the direct result of a colonial past and the inability to confront this legacy.