Description:Fame can be a fickle, unpredictable thing. Joseph Sampson Gamgee (pictured), sometime surgeon of Birmingham, would be puzzled to know that his name has been preserved and broadcast to the world as a character in a fantasy novel. It’s doubtful whether in his wildest imaginings Dr Gamgee could ever have seen himself battling for supremacy with Orcs and Dark Riders. All the same, Sampson Gamgee knew all about the battles of life and death. He tended the injured in the Crimean War, and created a kind of dry dressing for their wounds - known as Gamgee tissue - to counter the risk of infection. After that he became Principal Medical Officer of the Anglo-Italian Legion. In 1857 Gamgee came to Birmingham to serve as a surgeon at the Queen’s Hospital at Five Ways. The struggle between life and death in the Victorian Midlands was not as dramatic as at the front, but it was no less urgent for that. Gamgee had only to observe the outpatients’ department at Queen’s to see that the hospital ward was a very dangerous place indeed, and not at all the kind of place to entrust with sick people. Isolation was practically impossible, space and cash were at a premium and infection could spread like wildfire. In simple terms the charity hospitals, the mainstay of healthcare in the country, were struggling to stay alive (as were their patients). In 1869 Gamgee came up with a scheme to address this problem. Dr Gamgee’s idea could be called revolutionary in a number of ways. You could argue that it led to the very notion of health insurance; you could even argue that it led to the creation of the NHS. You could certainly say that it created one of the city’s most successful and respected institutions: the Birmingham Hospital Saturday Fund. Birmingham already had an annual Hospital Sunday, when all the money collected at church services was earmarked for the town’s hospitals. Gamgee pressed for a Hospital Saturday, a day of street collections organised by the working men of the town to extend and improve the Queen’s Hospital. Simply put, his idea was to involve the working classes of Birmingham directly in the funding of the medical services they so relied upon. The response to Gamgee’s call was staggering. Such was the enthusiasm and generosity of the people that Queen Victoria herself felt moved to contribute £100 herself to the institution named after her. In all the “Working Men’s Fund for the Extension of the Queen’s Hospital” found £4,000 of the £10,000 needed for the new facilities. But it was clear from those early efforts that the difficulties faced by the medical charities did not end with the building of a new ward; they were on-going an annual. What had originally been conceived as a one-off collection became an annual event, and the monies distributed to Birmingham’s six hospitals and dispensary. On the first official Hospital Saturday (March 15 1873) over £4,000 was raised, partly through street collections and partly from workers who donated earnings from working overtime. Sampson’s Gamgee personal involvement with the movement ended that same year, but the acorn he planted continued to grow and adapt. From 1878, instead of a single day of collection, workers were invited to contribute a penny a week from their wages, leading to annual donations of £10,000 or more. As a result, few hospital services in the country were as well-supported as Birmingham’s were. But for many, it was not the care they received in hospital, but outside it, that made the Birmingham Hospital Saturday Fund unique and irreplaceable. In 1891 BHSF reconstituted itself as a “not for profit” company in order to buy land and property for convalescent homes. The notion of convalescence, preferably up in the mountains or down by the sea, was a peculiarly Victorian invention, but a luxury beyond the means of most working people. BHSF’s embracing of the idea was an early indication that it was moving beyond basic health care and into something more “value-added”. The first home opened at Tyn-Y-Coed near Llandudno in 1892, and its facilities were available to all men living within five miles of Birmingham Town Hall. Here the men could spend a couple of weeks in gentle exercise and relaxation before the return trip to the big, unhealthy city. It was two years before a similar establishment, also in Llandudno, was opened for women, followed by a third for children. The success of Tyn-Y-Coed led to spate of BHSF convalescent homes and sanatoria all over the place, from Great Barr and the Lickey Hills to Malvern and Weston-super-Mare, though only the one at Kewstoke in Weston (opened in 1933) still survives today. But convalescence was only one area in which BHSF was expanding beyond what was seen as the central core of medical treatment. Soon after the unveiling of Tyn-Y-Coed the Fund was providing home nursing, as well as surgical appliances and artificial limbs, for contributors. In 1895 the city’s horse-drawn ambulance service was supplemented by four specially commissioned “quadricycles” from the firm of Allday & Onions. The four-wheeled ambulance was designed to deliver an injured person more swiftly and comfortably from the scene of an accident to hospital. By the early 20th Century the rest of Britain was beginning to catch up. Lloyd George’s National Insurance Act of 1912 was the first national attempt to link benefits to contributions, but it would not be until the 1940s that the nation’s health was truly taken into state ownership. On the other side of the fence, the private sector has hoovered up many organisations founded on the model of the BHSF. The Birmingham Hospital Saturday Fund has survived and prospered nevertheless. Its members may not need pedalling to hospital anymore, but they still have reason to thank Dr Joseph Sampson Gamgee.