In November 1924, Barcelona City Council agreed that, while there was no specific building, two hospital blocks with capacity for 80 patients would be used as the Municipal Hospital for Infectious Diseases, separated from the rest of the buildings. Built in 1914, these were made of wood and lacked even the most basic hygiene and sanitary conditions. This is how the Hospital for Incurables was built, which would soon have its name changed.

It was in June 1928, when Barcelona City Council, responding to a press article by the thinker and writer Eugeni d'Ors, made the following agreement: “The welfare establishment supported by the Council, the Hospital for Incurables, where patients suffering from illnesses considered to be incurable were cared for, would from then on be called the Hospital-Residence Mare de Déu de l'Esperança".

The problem of the incurable patients with irreversible processes and social patients became too large for the Council's resources to cope with. The Council had been taking beds from the Hospital for Infectious Diseases in order to give them to the Hospital de la Mare de Déu de l'Esperança. After it had definitively accepted the inviability of the new hospital project, two new buildings were built in 1933, and work was undertaken to enlarge the capacity to 244 beds. In order to guarantee attention to emergencies and cases where operations were needed, in 1935 the surgical block was created.

During the war, the Hospital de l'Esperança also suffered the danger of enemy bombings, as the nearby gasworks were a key target. The patients had to be transferred to Vallvidrera, to the former mental asylum of Betlem, a building which was highly unsuitable, and the care capacity was reduced to 170 patients. Shortly after the war, the project began which would be the definitive location of the Hospital de la Mare de Déu de l'Esperança, near to the sanctuary of Sant Josep de la Muntanya, in the La Salut neighbourhood. This four-storey building, inaugurated on 22nd June 1945, at that time only occupied one wing of the current building.

The new hospital was intended to be an example of the application of the principles of modern healthcare construction. Rooms were provided for one or two patients, or in larger wards there were separations with low walls. When it was inaugurated, even though it was envisaged for a capacity of 250 people, this was limited to 196 (74 men and 122 women), as rooms had to be provided for auxiliary staff and for the nuns who took care of the patients' treatment. In 1948, the municipal Emergency Surgery Service was based in the Hospital, which occupied 30 beds.

In 1951, work began on the central part of the Hospital. This is the part that joins the two blocks of the building, and gives it its H-shape. After this work, the centre had a capacity of 216 beds. In 1955, construction of the wing in the second block of the building began in order to increase it to 520 beds. Also during the 1950s, the concept of the hospital as a place for long-stay patients with irreversible diseases began to change. Instead, it began to be seen as a hospital focussing on illnesses related to the elderly. Despite earlier discussions on what should be its future, in 1975 the Hospital de la Mare de Déu de l'Esperança was converted into an old people's home. The operating theatres and medical teams had to relocate to the Hospital de Nostra Senyora del Mar. But in 1977, the situation changed radically and it was decided to convert it into a general hospital. An agreement with the Social Security guaranteed the continuity of service and, from then on, it began to be provided with different services. In 1978, the Nephrology Service was installed, which would carry out the first kidney transplant the following year. In 1981, the Emergency Service began and in 1982, the Intensive Care Unit and Blood Bank were established. Up to 1990, surgical work increased and much was done to improve the care given to patients.

The last step that the Hospital de l'Esperança has taken was the remodelling of healthcare that was carried out by the MAR Health Park in 1992. The Hospital moved towards specialisation in two well defined areas: On the one hand, surgery, in particular in ophthalmology; and on the other, the care of disorders of the musculoskeletal system. Following the directives of the project of functional integration of the MAR Health Park centres in 1993, work began on the creation of a therapeutic area for Rehabilitation.

The Physical Medicine and Rehabilitation Service was transferred from the Peracamps Centre in October 1993, to become incorporated into the Musculoskeletal System Unit. This Unit functionally integrated the Services of Orthopaedic Surgery and Traumatology, Rheumatology and Physical Medicine and Rehabilitation.

The demand for care for patients with osteo-articular chronic-degenerative pathologies is expected to increase significantly as the population ages. An attempt has also been made to link primary healthcare professionals as far as possible with the Hospital and convert it into a centre of reference for these pathologies.

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