Atlantic Slavery and the Royal Infirmary of Edinburgh

This project, funded by NHS Lothian Charity, will make recommendations to the NHS Lothian Board about how we learn from the Royal Infirmary of Edinburgh’s historical connections with slavery and take action to help root out modern day racism, inequality, and discrimination.

NHS Lothian, as a healthcare provider and an employer, have a duty to improve health and work outcomes for the diverse communities we serve and employ. We are committed to being an anti-racist organisation and recognise that this means we must do more to help eliminate discrimination, advance equality and foster good relations between the different groups of people who use our services, who work for and with us.

British slavery and colonialism have left damaging social consequences in the UK and in former colonies. As part of our long history, we know that hospitals across Lothian benefited from funds that came from Atlantic slavery. We are taking responsibility for understanding and acknowledging our past so that we can learn from it and act.

Phase 1: Research: Uncovering Origins of Hospital Philanthropy: Report on Slavery and the Royal Infirmary of Edinburgh

In August 2021, NHS Lothian Charity funded a joint piece of work with NHS Lothian, contracting an independent researcher to review evidence in Lothian Health Services Archive and other archives to bring together the documented history of the Royal Infirmary of Edinburgh (est. 1729) and the enslavement of people of African descent.

The report outlines the extent to which profits from slavery impacted our early history. It confirms that some benefactors of the original Royal Infirmary of Edinburgh were enslavers or benefitted financially from enslavement. It provides more information about an estate in Jamaica directly owned by the Royal Infirmary from 1750 to 1892, including the lives of the enslaved and, later, indentured labourers, who worked on it. The property was called Red Hill pen.

The recorded names of the enslaved people of African descent on Red Hill pen.

The chart below shows that:

  • Between 1744 and 1795, around 11 per cent of RIE’s entire income and 42 per cent of RIE’s charitable donations came from slavery-associated sources.
  • Red Hill’s annual rent in 1810 was £350, approximately equivalent to £317,400 today (using the Measuring Worth website’s Relative Wage or Income Worth calculator).
Pie Chart of the Royal Infirmary of Edinburgh’s Total Income, 1744-1795

The graph below shows that the money from Red Hill made up 8 per cent of RIE’s total income between 1744 and 1795. It made up 31 per cent of income from all charitable gifts and 73.8 per cent of gifts (by value) from individual people with ties to slavery.

Graph of the income the Royal Infirmary of Edinburgh received from enslaved labour, 1744-1795

The chart below shows that between 1808 and 1817, 18,785 patients were admitted to RIE, meaning slavery- associated income was used to provide healthcare for 1,390 patients during this period.

Number of patients received by the Royal Infirmary of Edinburgh, 1808-1817

For more than a century after the Royal Infirmary of Edinburgh was founded, holding people of African heritage in slavery was legal in the British Empire. This was encouraged and supported at many levels of British society. At the same time, people in Britain and throughout its colonies morally opposed, campaigned for the abolition of, and rebelled against British slavery. As the research report shows, examples of resistance to enslavement could also be found within the walls of the Royal Infirmary.

Rather than simply concluding that the managers of the Royal Infirmary of Edinburgh were ‘men of their time’, the research uncovers more information about their involvement, and so their complicity, in enslavement. What did they know? Answers to this question, as the historical report makes clear, are not always forthcoming or clear-cut; but it is important that the available sources are interrogated, and that these questions are asked.

The full research report and findings are available to download by clicking the link below. Please note that this is an academic research paper. Readers are advised that some of the language used and referenced in the report comes directly from sources in Lothian Health Services Archives and may be unfamiliar or uncomfortable to read. FAQs and a Glossary are available below.

Uncovering Origins of Hospital Philanthropy: Report on Slavery and the Royal Infirmary of Edinburgh. Findings from the research that was funded by NHS Lothian Charity and conducted by an independent researcher to look at the Royal Infirmary’s historical connections with Atlantic slavery

If you need a copy of the report in a different format, please contact our switchboard on 0131 242 1000 or send us an email.

Phase 2: Public Engagement

A second phase of work began in October 2022, organising a series of events with NHS Lothian staff and members of the public that will take place throughout January 2023.

The aim of these events is to start a conversation about what we have learned, its lasting impact and what changes can NHS Lothian make today.

We want to hear from those groups who are most adversely affected by this history of slavery, including NHS Lothian BME staff and the wider ethnically diverse communities across Lothian.

The following events are taking place.

  • 9 January 12.30 – 13.30 – Royal Infirmary of Edinburgh – For NHS Lothian staff
  • 14 January 11.00 – 13.00 – Old College, Edinburgh University – For the public
  • 16 January 12.30 – 13.30 – Western General Hospital – For NHS Lothian staff
  • 21 January 11.00- 13.00 – Old College, Edinburgh University – For the public
  • 23 January 16.00-17.30 – Online – For all
  • 24 January 19.00-20.30 – Online – For all

Two events for the public and NHS staff will also take place at the Centre for Research Collections, University of Edinburgh where the relevant eighteenth and nineteenth century records used in the historical report will be available to view, with the guidance of staff at Lothian Health Services Archive.

  • 31 January 16.00 – 17.30
  • 7 February 18.00 – 19.30

You can join our conversation by booking at a place at these events using this link – How we used to care for people in Edinburgh by enslaving other people | Tickets, Edinburgh | Eventbrite

Phase 3: Recommendations and Actions

Following the public engagement, recommendations will be made to the NHS Lothian Board by an Independent Advisory Group [see the Led by Experts section below]

The Advisory Group will consider the conversations during the public engagement and use this information to help develop final recommendations. These recommendations will suggest how NHS Lothian might correctly and appropriately understand and acknowledge this part of its past and take action that contributes meaningfully to tackling the racism and racial inequalities experienced by people working for NHS Lothian and using our services.

Phase 4: Implementation of Recommendations

The final stage of this project will be the implementation the Advisory Group’s recommendations. This will ensure that the project has long-lasting positive outcomes, contributes to our anti-racism work, helps us root out modern day racism and discrimination and contributes towards improvements in health and work outcomes for the people we serve and employ.

Led by Experts

An independent advisory group was appointed in October 2021 to hear and amplify the voices of Black people living and working in Lothian. The Group is diverse in its membership and co-chaired by Christine Maitland-Francis, Pedetin Femi-Olekanma and Laura Hutchison.

The advisory group members are:

Andres Honeywell, Jim Crombie, Chris Bruce (Oct 2021 – May 2022), Ken Stewart, Celeste Gibson, Laura Hutchison, Christine Maitland-Francis, Pedetin Femi-Olekanma, Colleen Macaulay, Rakiya Suleiman, Cynthia Gentle, Ruth Honeybone, Derick Amoako Yeboah, Seun Elias, Diana Dodd, Shelly-Ann Brown (Oct 2021 – July 2022), Diana Paton, Shola Akinosho, Edwin Jesudason, Simon Buck, George Appiah, Tina Makedenge, Jane Ferguson, Titilolayo Oke

This is the link to read the Advisory Group Terms of Reference


In 2020, the NHS Lothian Equality and Human Rights Team became aware of information about the potential historical links between NHS Lothian and Atlantic slavery. This was at the same time as evidence was emerging showing that people from Black and Minority Ethnic (BME) backgrounds were being disproportionately affected by COVID-19 and the global profile of the Black Lives Matter movement was bringing broader race equality issues into sharper focus in the UK, along with the shocking murder of George Floyd.

This information was taken to, and discussed with, the NHS Lothian BME Staff Network. They asked NHS Lothian Corporate Management Team (CMT) to explore this further and to consider what could be learnt by the organisation.

NHS Lothian CMT was keen to understand the historical links to slavery and any legacies arising from it. This prompted a recruitment process for a researcher, employed by the University of Edinburgh and funded by the NHS Lothian Charity, to review NHS Lothian archival evidence and produce a documented history of any connections with slavery, with a focus on the Royal Infirmary of Edinburgh.

Tackling racial inequality and racism is a core part of what NHS Lothian does. This helps us contribute to a health and care system where everyone in Lothian lives longer, healthier lives, with better outcomes from the care and treatment we provide and where everyone who works with and for us has better experiences. This project is helping us to deliver this ambition.

This project in no way detracts from the work that NHS Lothian continues to do to provide care and support for patients and the wider community. It was fully funded by NHS Lothian’s official charity, NHS Lothian Charity. An independent researcher was contracted by NHS Lothian Charity to undertake the research and will help to facilitate the subsequent public engagement activity.

  • Read the report: The full historical report is available for you to read, with an overview of the findings provided in the Executive Summary. This is the link to the research report.
  • Register to come along to one of our events being held in January 2023, in Edinburgh and online, by emailing us using this email address [email protected] or calling our switchboard 0131 242 1000. Be part of our conversation about what we have learned, the lasting impact and what changes NHS Lothian can make now.
  • If you can’t attend any of the events, you can take in our conversation through our survey. Ask us for a copy of the survey by emailing us using this email address [email protected] or calling our switchboard 0131 242 1000
  • Attend an open ‘Our Archive’ event, where you can look at some of the relevant eighteenth and nineteenth century records used in the historical report, with the guidance of staff at Lothian Health Services Archive (Centre for Research Collections, University of Edinburgh).
  • Tell others about this history and encourage them to take part in this important conversation.

We want to have a conversation with the public and people who work for NHS Lothian about the research findings, their implications today and what NHS Lothian can do now. This conversation will help the Independent Advisory Group make recommendations to the NHS Lothian Board.

These recommendations will reflect the feelings and considerations gathered from the various events, in particular from those groups who are most affected by the legacies of British colonialism and slavery.

The feedback we are seeking will inform recommendations and we do not intend to update or change the research findings that are being presented. However, we do welcome any relevant additional sources of information that will help us to understand and recognise NHS Lothian’s historical ties to slavery and its legacies today.

The findings from our public engagement will be published on this website alongside the recommendations and outcomes of this work.

Everyone’s voice is important. NHS Lothian wants to hear responses to this research, and opinions about what should happen next from NHS staff, patients, and people living in Edinburgh and Lothians. We want to hear from people from our ethnically diverse communities, who are most affected by the legacies of British colonialism and slavery. Your contributions, along with those of others who respond, will form the basis of a report about the findings of our public engagement that will also guide the Independent Advisory Group’s recommendations to the NHS Lothian Board.

An Independent Advisory Group for this project was appointed in October 2021.

The Advisory Group was established to hear and amplify the voices of Black people living and working in Lothian as we began to discover more about the historical links of health services in Lothian with Atlantic slavery. Members from a wide range of cultural backgrounds, and in particular, Africa, the Caribbean, and Scotland have been invited to join, as well as those with professional expertise and relevant roles within NHS Lothian.

The role of the Group is to consider the meaning of this history, and to agree what might be an appropriate response to the findings.

You can find out more about the group, including membership, by reading the Advisory Group Terms of Reference.

Yes. Like elsewhere in Britain, across Scotland, slavery-associated wealth was embedded into the country’s economy and landscape. University College London’s Legacies of British Slavery Database, and the Slave Voyages Consortium’s Trans-Atlantic Slave Trade Database, amongst other sources, help us to understand the scale of Britain’s connections to slavery.

Many other organisations are investigating their connections to slavery. Some examples include:

City of Edinburgh Council Link to Edinburgh Slavery and Colonialism Legacy Review

George Watson College Link to The Legacy of George Watson

Glasgow City Council Link to Glasgow’s Slavery Legacy

University of Glasgow Link to Historical Slavery Initiative

Guy’s and St Thomas’ NHS Foundation Trust Link to Thomas Guy, Sir Robert Clayton and Our Shared Colonial Past: Sources, Context, Connections

At the moment, we know very little about the enslaved people on Red Hill. Documents which on other estates might be referred to as ‘plantation records’ have not yet been found for Red Hill. Beyond reasonable speculation gained by using other sources concerning similar sized estates, we do not know the working hours and conditions of the enslaved people on Red Hill, or detail about their lives beyond their work. It is difficult at times to even know what the estate was producing (timber and livestock, mostly, but seemingly sugar-related goods too during some periods of its history). The researcher, Dr Simon Buck, has found no information in Lothian Health Services Archives about the deaths of enslaved people, and only a few examples of the numbers of enslaved people living and working on the estate for some years. In particular, there were 39 people in 1749 and 46 people in 1817. The details become less clear after this when the estate was merged with two other nearby estates. It is possible that this kind of information was not documented at the time. If it was, we know that it is rare for such documents to survive. Equally, we may not have found the right sources yet. We hope this report encourages others to carry out further research on these important questions.

It is worth highlighting some examples in the report where we get some small insight into the lives of the people on Red Hill. Although a short and inconclusive account, the case of Juliet, and enslaved woman on Red Hill, and her children, highlights the impact of enslavement on the estate’s women and children.

Documents about the estate’s running in the 1830s also highlight both small and more significant acts of resistance among Red Hill’s apprenticed labourers – an important conclusion can be drawn from these sources that many of the formerly enslaved people on Red Hill truly resented or despised their ‘apprenticeship’ and sought to resist their coercion by various means.

It is very difficult to get a sense of how much money was ‘worth’ in different periods of time. The research report includes sample modern-day values using three different types of ‘calculators’ provided by Measuring Worth, a website designed by academics and used by economic historians and historians of slavery. Still, these modern-day values should be interpreted as guides rather than s precise equivalents.

The report does not include the equivalent ‘worth’ in today’s money for the Royal Infirmary of Edinburgh’s total accumulated income from slavery-associated sources. To assess accumulated wealth over a period of time requires complex, year-by-year study. As this report covers a vast period–from the Royal Infirmary of Edinburgh’s foundation in 1729 to the abolition of slavery in 1833 and beyond, a year-by-year study was not possible in the timeframes of the project.

The report instead focuses on the proportional impact of the Royal Infirmary of Edinburgh’s slavery associated income, which amounted to between 7 per cent and 11 per cent of the Royal Infirmary of Edinburgh’s entire income in the mid-to-late eighteenth and early nineteenth centuries.

Ever since the period of chattel slavery (a system which allowed people to be considered legal property, to be bought, sold, and owned forever), the idea of ‘reparations’, or ‘making amends,’ has been energetically and emotionally debated.

Reparations have often been interpreted simplistically as claims for single, one-off payments. However, reparations may also cover other forms of social justice such as, forms of financial reparation, programmes of positive action, cultural projects, and public apologies.

Phase 1 of this project (the research) was designed to be the beginning of this process. Phase 2 (the public engagement) aims to better understand what ‘reparations’ or, a preferred term, reparatory justice, might look like for NHS Lothian, our staff and for our ethnically diverse communities.

The desire is to better understand how NHS Lothian and Scotland might correctly and appropriately learn from its past and act to help remove racial inequality and shape a positive future for everyone.

The slavery period and the early history of the Royal Infirmary of Edinburgh may seem like a long time ago, but they are closer than we think. The Royal Infirmary, for example, only sold its Jamaican property in 1893 – possibly around the time your grandparents or great-grandparents were born.

The ‘legacy’ of slavery can mean many things. The actions taken in Britain by enslavers or those with financial ties to slavery created vast material legacies (e.g. corporations, roads, schools, universities and hospitals). Many developments that we think of as key features of modern British history were connected to slavery-associated money. This has continued to impact British society long after the abolition of slavery.

The most immediate legacies of British slavery, though, were for enslaved people and their descendants.

Academic consensus is now that Atlantic slavery was central to the underdevelopment of both Africa and the Caribbean. Slavery and colonialism also established and sustained racist ideas about Black people which still influence the world we live in today, manifested in Britain by the racial discrimination and inequalities we see in all aspects of life, including health.


Slavery and the colonial period that followed it has established and sustained racist ideas about Black people which still influence the world we live in today. The timeline below charts the history of the Royal Infirmary of Edinburgh alongside some key dates relating to the racial inequalities we see today, in all aspects of life, including health.

June 2020
September 2020
September 2020
December 2022

Jamaica becomes an English colony.

Barbados passes an influential ‘slave code’. It defines enslaved people as chattel property, describes Africans as ‘heathenish and brutish’, and sanctions extreme violence against enslaved people by enslavers.

University of Edinburgh Medical School is established.

The Royal Infirmary of Edinburgh is founded, as the Hospital for the Sick Poor.

King George II grants the Hospital a Royal Charter, naming it as the Royal Infirmary of Edinburgh.

The Royal Infirmary takes ownership of Red Hill plantation in Jamaica and the 39 people enslaved there.

Passage of the Act for the Abolition of the Slave Trade, making trafficking in enslaved Africans illegal in British ships.

Passage of the Abolition of Slavery Act. The Act comes into effect in 1834, although many colonised people continue to be exploited as apprenticed labourers until 1838.

Joseph Lister (known as the ‘father of modern surgery’ and invented antiseptic surgery) appointed as Head of Surgery at the Royal Infirmary.

The Royal Infirmary moves to a new location in Lauriston Place.

The Royal Infirmary sells Red Hill pen.

The Royal Infirmary becomes part of our National Health Service.

Jamaica achieves independence from the United Kingdom.

Lothian Black Forum leads the campaign to recognise the murder of Axmed Abuukar Sheekh as racially motivated. Axmed Abuukar Sheekh was a Somalian student who was killed by white Scottish fascists on Edinburgh’s cowgate in January 1989.

Sir William Macpherson labels the Metropolitan Police as ‘institutionally racist’ in his report setting out the findings of the public inquiry into the investigation of the murder of Stephen Lawrence.

The Race Equality Duty comes into force, introducing a positive duty on public bodies to eliminate unlawful race discrimination, promote race equality and good relations between people of different racial groups.

The new Royal Infirmary opens at Little France.

The Equality Act 2010 comes into force, harmonising and strengthening equality law in Britain. It includes the public sector equality duty, which requires public bodies, and those carrying out public functions, to have due regard to the need to eliminate unlawful discrimination, promote equality of opportunity and foster good relations when they are carrying out their work.

Sheku Bayoh, a 31-year-old Black man born in Sierra Leone, dies after being restrained by police officers in Kirkcaldy, Scotland. A public inquiry into his death was announced in 2019, with terms of reference published in 2020 and evidential hearings beginning in May 2022. The inquiry includes establishing the extent to which the events leading up to and following Mr Bayoh’s death were affected by his actual or perceived race.

NHS Lothian BME Staff Network is established to provide BME staff with a safe and confidential and supportive space, peer support, and to raise awareness of BME issues and increase the visibility of BME staff.

Public demonstrations in support of the Black Lives Matter movement occur across the world, including in Edinburgh, after the murder of George Floyd.

Growing evidence emerges of the disproportionate impact of COVID-19 on ethnically diverse communities. The Scottish Government responds by establishing an Expert Reference Group to make recommendations on data, evidence and systemic health and socio-economic inequalities facing minority ethnic communities.

NHS Lothian establishes an Independent Advisory Group to inform its work examining the history, legacy and impact of historical ties Atlantic slavery.

8.3 per cent of Edinburgh’s population identifies as a non-white ethnic group. Around 5.9 per cent of the NHS Lothian workforce identifies as being from a BME background.

NHS Lothian publishes the research report, Uncovering Origins of Hospital Philanthropy: Report on Slavery and the Royal Infirmary of Edinburgh.


Abolition: In this context, the legal prohibition of slave-trade and -ownership. An abolitionist was someone who campaigned for abolition.
Anti-racist: Taking action to oppose racism and promote racial equality
BME: BME stands for Black and Minority Ethnic Communities and is the designation agreed and used by the Independent Advisory Group for this project
Chattel Slavery: A specific type of servitude that legally defined and treated African people as sub-human and moveable property who could be purchased, sold, loaned, mortgaged, used as collateral, and inherited.
Colonialism: A practice where a powerful country directly controls a less powerful country or territory (the “colony”) and uses the colony’s resources to increase their own power and wealth. Colonisers impose elements of their culture, including religion, language, economics, and other cultural practices, on those they rule. Colonialism is an expression of power that relies on oppression, extraction of resources and silencing other ways of being and knowing.
Enslaver: Someone who enslaved another human being: this term is preferred rather than slave owner, slave holder, slave master/mistress, as it affirms that slavery was forced upon people.
Enslaved person: A more humane way of describing someone who was legally owned by another person. What in the past has historically been called ‘a slave’.
Indentured labourer: A person who is contracted to work for a specific number of years without the option of terminating the contract. This system of bonded labour was revived in the British Empire in the period of the abolition of slavery. Indentured labourers were recruited to work on sugar, cotton and tea plantations, and rail construction projects in British and other European colonies in the Caribbean, Africa and South East Asia.
West Indies: A term used during the era of European colonisation that referred to colonies in the Caribbean.