Centre of the County's mental care

When opened in 1899 it was known as Hill End Asylum. In the 1920s it was renamed Hill End Mental Hospital. In 1933 it encountered a further change of name to Hill End Hospital for Mental and Nervous Disorders. Finally it became simply Hill End Hospital.

  • The Hill End complex is in the centre, Cell Barnes and London Road estate are in the background; Camp and Ashley Road industry to the right.
  • Ward inspections in the open air during World War Two.
  • Barts Drama Group during its professional downtime. Members entertained fellow staff and patients in the hospital's own theatre.
  • A ward scene during the Barts occupation of Hill End.
  • Anesthetist Gordon Ostlere plays himself in the film version of his book Doctor in the House, based on his experiences at Hill End.
  • Grave markers which were discovered in the hospital's cemetery, now the Garden of Rest.
  • One of the former ward blocks has been retained in the modern development.
  • Postcard view of the main entrances to Hill End at the end of Camp Road east.
  • A scene from the mid 1940s when Barts occupied the hospital.
  • The surviving chapel is now the base for Trestle Arts.
  • The Garden of Rest with interpretation panels.
  • A postcard view showing the chapel to the right and main administration block on the left.
  • The surviving front lodge at the junction of Camp Road east and Hill End Lane.
  • Former staff houses in Hill End Lane, formerly known as Station Road.
  • Early mental care

    The story of Hill End as an institution began in 1815 when Hertfordshire and Bedfordshire shared asylum space at Bedford. In the 1850s a new and very large asylum was built at Arlesey.

    The Three Counties Asylum (Huntingdonshire was the third county in the consortium) was designed by George Fowler Jones, who included in his specification, what became known as the longest corridor in the country at around half a mile. This alone gives some idea of the size of the collection of connected buildings, largely in white brick.

    As part of the modernisation of local government, the Local Government Act 1888 included a requirement on the new county councils that each should take responsibilities for its lunatics.

    Now Hertfordshire was to develop its own plans and the result was Hill End Asylum.

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  • The name was Hill End

    The asylum was located at Hill End, which was close to the population centre of the county and next to a branch railway line with connections to Hatfield, St Albans and Watford.

    The name Hill End came from the name of a farm of the same name on which the asylum was built, and was located at the lower end of a ridge or hill extending from Camp Hill eastwards. The railway company created a siding and track from the main line (now Alban Way) to bring in the millions of bricks required for its construction, and the eventual 7,000 tons of coal needed for annual heating.

    The architect was G T Hine. A London architect, and originally from Nottinghamshire, Mr Hine specialised in asylum architecture and won many of the competitions for these buildings. The enormous task of building the asylum was awarded to Howe & Co, Hartlepool, and operations began in 1897.

    A decision was made in 1899 to reserve a plot of 1.5 acres on the boundary as a cemetery. Today it is known as the Garden of Rest. The cemetery was laid out just beyond the asylum boundary, and during the lifetime of the institution was the burial place of over a thousand patients, and a few staff too.

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  • Abnoxious story

    The public's most-viewed building, as seen from Camp Road east, is the lodge at the main entrance, at the corner of Camp Road and Hill End Lane. This housed the site engineer. Following the drive to the left after having passed through the main gates, were two further gates. The first, Hillside, was for the hospital clerk or steward. The medical superintendent lived in the second, named Keeling House. Eight cottages, which would be outside the boundary, but on the new perimeter road, were constructed by Mr Redhouse. They were for married members of staff. Completed in the Spring of 1899 was a station platform and building to enable staff and visitors to reach the asylum easily.

    Now, here is an intriguing account. Mr John T Patience of Popefield Farm, near the Smallford crossroads, also farmed fields to the east of Hill End and owned butchery shops in St Albans. He complained that a blocked drain somewhere was throwing water onto his land. The "blocked drain" which Mr Patience thought must be the cause of an obnoxious smell was, in fact, part of the asylum's method of dealing with sewerage from the building, something which does not seem to have been thought through properly at the design stage.

    The effluent from the various downpipes was allowed to flow out onto the fields of the estate, someone being employed to move, what must have been a flexible pipe, to avoid a build-up of solid matter. This ad-hoc arrangement remained in use for some years and an ongoing correspondence about the smelly topic appeared in the Herts Advertiser.

    Later, tanks and filter beds were constructed between the recreation ground of the estate and the Hixbury Road boundary. Today Earthworks and the allotments occupy the former sewage works.

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  • Twentieth century growth

    New farm buildings were set up in Tyttenhanger Green Lane (now renamed Highfield Lane). The unit came to be called Home Farm and was only demolished in 2009 for the Tillage Close housing development.

    The collection of farm buildings included a patients' block as an alternative to the general wards. Members of staff, mainly a cowman and a carter, lived in Beastneys Farm homestead.

    The Home Farm buildings were provided with thatched roofs, and it is recorded that they were re-thatched in 1923.

    Ever since 1899 wen it opened, it had been known officially as Hill End Asylum. In the 1920s it was renamed Hill End Mental Hospital, given that asylum was no longer an appropriate label for the work the institution carried out. This was followed by a further name change in 1933 to Hill End Hospital for Mental and Nervous Disorders. During the post-war period there was a contraction to Hill End Hospital.

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  • Barts at Hill End

    By far the greatest upheaval in the hospital's history occurred in 1939. Under government emergency regulations the four main London teaching hospitals were to be relocated to Home Counties' sites in the Emergency Medical Services scheme (EMS). In preparation for the transfer of St Bartholomew's Hospital from the City of London to St Albans, the existing patients were moved out. 302 were moved to Wallingford; 306 moved more locally to Napsbury; the Three Counties Hospital at Arlesey accepted 346; and 198 were moved to Leicestershire & Rutland Mental Hospital, Narborough. A number of nursing staff accompanied these movements.

    The last of Barts' departments returned to the City of London in 1961, leaving Hill End to return to its former role of mental care.

    A change in national policy towards mental care, from large institutions to smaller facilities within the wider community, enabled Hill End Hospital to finally close in 1995.

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Barts at Hill End

Smallford toll house

Ward duties at Hill End during the 1950s.


Fresh air for patients in the late 1940s.

Highfield Park Trust

Tree tour at Highfield

A tour around the park.

The Trust was formed to manage the grounds which surrounded Hill End and Cell Barnes hospitals once those sites had been redeveloped.

It is a mixed estate of fields, woodland, orchards and garden landscapes, all open to the public as a Park. Regular tours take place, and fund-raising events are organised throughout the year.

The headquarters of the Trust until recently has been West Lodge, but it has recently moved into a new building nearby.

The Highfield Park Trust website is here.

Apple orchard at Highfield

Apple orchard at Hill End.

Between the old rural communities and the new young Highfield, there is a story missing. Here was a flourishing community which survived for almost a century, and then was gone.
Hill End – What Lies Beneath, by Mike Neighbour