The Mediaeval Hospital
At the start of the fifteenth century, Barcelona had a total of six small hospitals: the Hospital Desvilar (also known as Hospital de l’Almoina), the Hospital de Marcús, the Hospital d’en Colom, the Hospital Vilar (also known as Hospital de Sant Macià), the Hospital de Santa Eulàlia and the Hospital de Santa Margarida. All of these institutions were founded by religious orders or individuals, and although under the aegis of the Chapter of the Cathedral and the Consell de Cent, Barcelona's governing council, almost all of their funds came from the citizens' charitable donations.
Early in 1401, the financial difficulties besetting many of these small hospitals led the Consell de Cent and the Cathedral Chapter to agree to merge these six health centres and construct a single new hospital, thereby improving administrative procedures and the management of resources. This decision was ratified on September 5 of that year by a papal bull of Pope Benedict XIII, approving the establishment of the Hospital de la Santa Creu — the Hospital of the Holy Cross.
The new centre, one of the oldest in Europe (and anywhere in the world), was conceived as a large building with four rectangular two-storey wings set around a central courtyard, following the model of an ecclesiastical cloister. King Martin the Humane presided over the laying of the first stone, on 13 February 1401. The work was finally completed in 1450. In due course the building was extended, in the eighteenth century, and minor modifications were made in the nineteenth and early twentieth centuries.
The Hospital de la Santa Creu was run from its foundation by the Molt Il·lustre Administració (MIA), a body on which two canons and two lay citizens respectively represented the Cathedral Chapter and the Consell de Cent. The income of the institution remained dependent on charitable donations, gifts and bequests from private individuals. This being so, two people, an ecclesiastic and a layman, directly controlled the hospital's finances.
Over the years, the hospital's funding was supplemented by various privileges bestowed by kings and popes, of note among which, by way of example, were the privilege of inheriting the assets of people who die without leaving a will or any legitimate descendant (1418) and the 'privilege of the comedies' (1587), with which Philip II granted the Hospital the exclusive right to stage theatrical performances in Barcelona.
The Hospital de la Santa Creu was for more than five centuries the great hospital of the city of Barcelona and its province. The charitable activities of the hospital went beyond the care of the sick, and until the late nineteenth century it also had an important role in taking in and training orphaned children.
The Hospital de la Santa Creu made a crucial contribution to the evolution of medicine. Its medical work led to the founding of the Royal College of Surgery, the origin of the future School of Medicine. In fact, from the nineteenth century the hospital was engaged in the intense scientific and educational activity that established its reputation as a medical centre of the first order, on a par with the great European hospitals being built in those years in major cities all across the continent.
By this time, however, the Gothic building in the Raval was starting to show signs of fatigue. After five centuries of uninterrupted activity, the Hospital de la Santa Creu could no longer keep pace with the growth of the city of Barcelona and the constant advances in medicine. The construction of a new hospital had become an absolute necessity.