St Bartholomew's Hospital including St Bartholomew-the-Less Church

St Bartholomew's Hospital is the oldest hospital in London and the overall site boundaries have remained much the same since it was established in 1123 by Rahere, who also established the priory centred on St Bartholomew-the-Great (q.v.). Rahere, a jester and courtier of Henry I who became a monk, had a vision of St Bartholomew when he was making a pilgrimage to Rome as a sick man, and made a vow to found a priory and hospital for the poor and sick in Smithfield on his return. The Hospital and Priory gradually became separate and were independent institutions by 1420, the Priory later dissolved by Henry VIII in 1539 although the Hospital was permitted to continue its work albeit without an income. Henry was eventually persuaded to grant St Bartholomew's to the City of London in 1546 and Letters Patent of January 1547 endowed it with properties and income. It became one of four royal hospitals administered by the City, the others being Bethlem, Bridewell and St Thomas's.

The medieval parish church of St Bartholomew-the-Less, so-called to distinguish it from the priory church, is within the Hospital walls and had a churchyard, remains of which are paved areas to the north and east of the church. This was one of 4 burial grounds within the hospital site, the remainder since built over. Originally one of 4 priory chapels recorded in 1184, it became a parish church in 1546/7 when the hospital was re-established by royal charter under Henry VIII. It has a C15th tower and west vestry, and was altered in 1789-91 by George Dance the Younger, but the present building is largely that of Thomas Hardwick dating from 1823-5; it was damaged in World War II and reopened in 1951. Until 1929 it had 3 medieval bells. Inigo Jones was baptised here in 1573.

In the Roman period the area was outside the City walls and was the site of a cemetery between 1st and 4th centuries, following which it was used for agricultural purposes. A Roman coffin discovered nearby is in the Hospital Library and Museum. Wat Tyler was executed outside the hospital in the 1381 Peasants' Revolt.

From the C18th the hospital developed as it became wealthier and the new Henry VIII Gate by Edward Strong was constructed in 1702, later refaced in 1833-4 by Philip Hardwick who carried out a number of works at that time. In 1723 the Governors decided to commission a new hospital and the medieval buildings were demolished apart from the parish church. The new hospital was designed by James Gibbs in 1728/9, who had become a Governor of the Hospital in 1723 and gave his services free, his design consisting of a formal arrangement of four blocks around a central square. The first to be built was the North Block in 1730-32 with its Great Hall, which was completed by 1738 with a ceiling by Gibbs made by Jean Baptiste St Michele, and a staircase with two paintings on canvas of 'The Pool of Bethesda' and 'The Good Samaritan' of 1735-7 by William Hogarth, who had been appointed a Governor in 1734, again providing these paintings without exacting a fee. The design of four separate blocks was as a precaution against fire and three of the four remain, while much additional building has been carried out throughout the hospital site by various architects. Philip Hardwick was responsible for re-facing the blocks in Portland stone in 1850-52 and in 1859 he designed the central fountain, which was restored in 1988-90. The lamp posts and shelters in the square date from the 1890s. During WWI the East Wing was used for sick and wounded soldiers, and in 1948 it became part of the National Health Service.

In 1993 St Bartholomew's was threatened with closure following Sir Bernard Tomlinson's Report of the Inquiry into the London Health Service, but the strength of public opposition saved the hospital, which in 1994 became part of the Royal Hospitals NHS Trust, amalgamating it with The Royal London and The London Chest Hospital, and later Queen Elizabeth Hospital for Children. In 1998, The Government announced that Barts was to remain open on its Smithfield site as a specialist cancer and cardiac hospital, a recognition of its continuing innovation in these fields, whilst general hospital services would be concentrated at the Royal London in Whitechapel. The Trust was renamed Barts and The London NHS Trust in 1998.

Within the hospital precinct is an area south of the churchyard of St Bartholomew-the-Great now a private garden for use by the hospital. The internal quadrangle around which the four blocks range is an important space with a central fountain and formal layout of trees and four shelters. The churchyard north of St Bartholomew-the-Less and adjacent to the hospital boundary wall was laid out as The Princess Alice Garden in 2001 in celebration of HRH Princess Alice, Duchess of Gloucester, who since 1937 had been President and later Patron of the Guild of the Royal Hospital of St Bartholomew. The garden commemorated her 100th birthday on 25 December 2001 and her long association with the Guild.