NOTTINGHAM GENERAL HOSPITAL: Personal Reflections

John Bittiner and David Lowe

Nottingham General Hospital: Personal Reflections – Twenty-two years on!

Nottingham General Hospital: Personal Reflections, was a book written by Nottingham Evening Post reporter David Lowe and retired Consultant Physician Dr John Bittiner. A book still very much in demand, it was first published in 1990, its aim being to tell the story of the Nottingham General Hospital through personal reflections and written historical documents

Although it is now over twenty years since the General Hospital closed its doors, and little remains of what was once a thriving hospital, for those who remember the place, especially its former members of staff, the memory of the place still has a warm feeling of nostalgia. Come across any former members of staff and pretty soon you will hear them all swopping stories and anecdotes about the time they worked there, and if they were there at the time, the closure, which was announced in 1989. Although closure was inevitable, as its acute services had all but transferred to the Queen’s Medical Centre, with just the Radiotherapy and Oncology Department awaiting transfer to the City Hospital, and the services that were left, which was healthcare of the elderly, were also waiting transfer to newer premises, it still came as a bitter blow, as it was felt management at the time didn’t take into consideration the many years of dedicated service staff had given to the place, and that some members of staff were about to face an uncertain future. As you will see as you read through the book, in later chapters, the concerns of staff are expressed, as they begin to wonder what is to happen to them, as they leave their familiar surroundings of the General Hospital, as their department is about to be transferred to the Queen’s Medical Centre! As an example, you will come across remarks made by many consultant surgeons and physicians of the time, that the General Hospital was too small, and there was not enough bed space for the increasing demands placed on their services, and that transferring to the Queen’s Medical Centre will allow them to expand. However, the one remark that is in common with those who were facing transfer was the hope that everything will be just the same as it was at the General in the new premises of the Queen’s Medical Centre!

As patients and in particular staff were about to step into the brave new world that was the Queen’s Medical Centre, in a sense, what this book captured was the ‘mood of the of the moment,’ the mood of the moment being, ‘the fear of the future’. The General Hospital with a history that spanned over two centuries and had seen many changes, including two world wars and the inception of the National Health Service, and was therefore considered part of Nottingham’s heritage. So the thought of there being no General Hospital was, for the citizens of Nottingham, anathema. As was said at the time, ‘Alright the hospital buildings maybe crumbling a bit, they can still be done up, besides but we love the old place. Anyway, things won’t be the same in the new place!’ Also, what gave the General it’s ‘uniqueness,’ was its location at the top of Park Row and at the corner of the Ropewalk, adjacent to the centre of Nottingham, which was convenient for staff and patients alike. Unlike the QMC which is further out on the western fringes of the city, sandwiched between Lenton, Dunkirk and Wollaton.

With the Queen’s Medical Centre soon to be celebrating its 40th anniversary and the General Hospital’s closure over twenty years ago, other views expressed at the time like the ‘QMC is too big,’ or: ‘It won’t have the same friendly atmosphere as the General,’ are, becoming like the General Hospital, a distant memory. In a way, we have become used to the Queen’s Medical Centre, and we take it, like all hospital services, very much for granted. For example, the sprawling 42 acres that is the Queen’s Medical Centre campus has, since it was opened by Her Majesty the Queen on Thursday 28th July, 1977, seen many extensions and additions to the care it provides. So much so, that the old adage of: ‘The QMC is too big,’ has been superseded with: ‘The QMC isn’t big enough!’ When the General Hospital was at the height of its powers, it occupied a site of just three acres. The same could be said for the Nottingham Children’s Hospital, Forest House, which transferred to the QMC in early 1979 and the Women’s Hospital on Peel Street, which transferred to the QMC in 1982, they were all built on small plots of land, making expansion, by today’s standards, almost impossible. Like the General, they too had a similar history, in as much as they were, before the inception of the National Health Service in 1948, voluntary hospitals. In other words, for their upkeep they relied entirely on public donations. Like the staff from the General Hospital, staff from both the Children’s and Women’s Hospitals also voiced similar concerns when they too faced transfer to the QMC. Also, like the General, with the length of time since both hospitals transferred to the QMC, between the late 1970s and early 1980s, they too are becoming a distant memory.

As a footnote to the General Hospitals uniqueness, it was a hospital that never knew the political changes that have altered the course of history that is the National Health Service. With just a foot note in the bibliography section and additional photographs that were unavailable at the time, I have made no attempt to alter the original text. Therefore, with a time span of twenty-five years to date, you will see just how much the National Health Service has changed since this book was published in 1990. With 21st century commercialisation of many of the NHS’s services, hospitals like the General represented an age of deference, when those in charge gave orders that were never challenged, and an era when the world moved at a much slower pace, before time management became the order of the day.

2012: Former Nottingham General Hospital, since renamed Royal Standard Court

As owning a book of this nature is becoming increasingly harder to come by, and transcribing and reproducing from an original copy is no substitute for actually owning a copy, I would like to thank David Lowe, whom I’ve worked with on numerous occasions, for allowing me to transcribe Nottingham General Hospital: Personal Reflections and publish an online version of the book through the Nottingham Hospitals History website.

Paul R. Swift BA Honorary Archivist, Nottingham University Hospitals NHS Trust

27 June, 2015

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Originally published in 1990 by Special Trustees for Nottingham University Hospitals

FORWARD

Nottingham General Hospital has served the community with great distinction for more than two centuries. It has earned great admiration and intense loyal support from patients, citizens and staff. It has always had an important educational and training role. For a decade it played a vital part in launching the new medical school. Already nearly bursting at the seams on its central but very restricted site it built new office and laboratory accommodation to enable the University's professors of medicine and surgery to take up their appointments, despite the delays in building University Hospital. In 1973 it agreed to accept for clinical teaching one half of the medical students. Although the numbers were perforce small, new doctors graduated as planned in 1975. In due course the General made a contribution to the initial staffing of University Hospital. The Special Trustees for Nottingham University Hospitals wished the story of the Hospital to be brought up to date before its final closure, and this book is the result. Dr John Bittiner is a former senior and long serving member of the consultant staff of the hospital, with an intimate knowledge of it. From 1983-84 he was President of the Nottingham Medico-Chirurgical Society, founded in 1828. Mr David Lowe is an experienced professional journalist and author and health correspondent of the Nottingham Evening Post. Rather than writing measured sequential history, they have, with the generous help of many members and former members of staff and others, depicted the General Hospital by a vivid patchwork quilt of personal recollections. In doing so they have brilliantly captured its spirit.

The spirit and work of a hospital is more important than the bricks and mortar. Fortunately the tradition of dedication and service of the General Hospital live on with greatly enhanced facilities and opportunities in other Nottingham Hospitals.

David Greenfield Chairman, Special Trustees

PREFACE

Nearly everyone in Nottingham above the age of adolescence will have a personal recollection of the General Hospital. My first encounter was as an anxious eight-year-old waiting in the long queue of children to see the man with a light on his head. I now realise he must have been an ear, nose and throat consultant. Much to my mother's displeasure, the specialist said I didn't need my tonsils or adenoids removed. A few years later I was back again – this time as an in-patient to have those troublesome tonsils whipped out. Memories of my only stay in hospital is somewhat hazy. White tiles on the corridor walls, fish for Saturday night supper and wondering why the lavish helpings of ice cream I'd been promised to ease the post-operative sore throat failed to arrive. In 1976, some 30 years later, I went back to the hospital, not as a patient but as an Evening Post reporter to observe a Friday night shift in the Accident and Emergency Department. It wasn't a bit like the TV drama Casualty but I certainly saw life in the raw. In a tiny treatment room, an elderly patient lay on a trolley, moaning and groaning. The poor lady was lousy – literally – and it was hard to stomach the smell from her ulcerated legs. It was my first insight to the General's caring role. Since then the Accident and Emergency Department and many other services have been transferred to the University and City Hospitals. The General's main role now is centred on health care of the elderly and radiotherapy. While helping to produce a special publication marking the bicentenary of the General Hospital, I remember a comment made by a former administrator Lionel Joyce. "I was absolutely not backwards," he said, "by the strength of feeling about the General Hospital, it was really quite overwhelming." As a Nottinghamiam I am well aware of the depth of feeling, for it has always been regarded as the People's Hospital. So I was particularly proud when the Special Trustees invited me to write this book with Dr John Bittiner. The General Hospital and the surrounding area have always had a unique character. Walk up Park Row and there is an immediate sense of history as you turn into the courtyard. Equally impressive is the approach from the Castle, passing Memorial House, once the nurses home, and the plaque marking the spot where Charles I raised his standard in 1642. Look at the network of buildings and you begin to appreciate the scale of services the General once encompassed. At the same time you are aware, by comparison with modern hospitals, how compact a site it occupies. Space, or rather the lack of it, was a problem from its inception and eventually contributed to its death knell. Today the distinctive Jubilee Wing and many other famous wards stand silent and empty, awaiting the final closure of the General Hospital in 1992. The buildings, where thousands of patients have been nursed and treated with such loving care, have outlived their usefulness. They are costing millions to run and maintain. Nottingham Health Authority believes the only sensible solution is to dispose of the site and reinvest the money and providing more appropriate accommodation around the district. So, in this sense, the spirit of the General will live on in the new settings. Buildings are not important – people are. This book salutes the generations of staff, patients and supporting organisations and individuals who made the General such a great hospital. John Bittiner and I are very conscious that the story we present is neither complete nor perfectly balanced. It has been considerably influenced by the responses to our requests for information. The responses received were invariably valuable, but inevitably they varied in style and

4 cover. Contributions of disciplines and persons to the life of the General are not measured by the lengths of the accounts in our book. Many who work devotedly and invariably receive insufficient mention or no mention at all. We hope that readers will forgive us for omissions under representations and errors, and that they will welcome the positive side of what we offer.

David Lowe

CONTENTS

Nottingham General Hospital: Personal Reflections – Twenty-two years on! Page 1 Forward by Professor David Greenfield Page 3 Preface by David Lowe Page 4 Chapter One: Early Years Page 7 Chapter Two: Early Medicine and Surgery Page 11 Chapter Three: Expansion and Development Page 15 Chapter Four: The Twentieth Century up to 1948 Page 23 Chapter Five: How other Nottingham Hospitals Developed Page 33 Chapter Six: The Great Benefactors Page 38 Chapter Seven: The Momentous Years, 1948 – 1982 Page 41 Chapter Eight: The Growth of Specialist Services – Doctors’ Memories Page 48 Chapter Nine: Spirit of Nursing Page 86 Chapter Ten: Support Staff Page 107 Chapter Eleven: A Day in the Life of Castle Ward Page 126 Chapter Twelve: Patients’ Memoirs Page 128 Chapter Thirteen: Voluntary Spirit Page 131 Chapter Fourteen: Stroke – The Great Challenge Page 137 Chapter Fifteen: Social Activities Page 139 Chapter Sixteen: Fight to save the General and Bi-centenary Celebrations Page 143 Chapter Seventeen: Future Services – by Philip Hogarth, Unit General Manager Page 148 Chapter Eighteen: Future use of the site Page 149 Appendix One: What was so special about the Nottingham General Hospital? Page 152 Appendix Two: Matrons of the General Hospital Page 154 Appendix Three: Management of the Nottingham General Hospital Page 155 Appendix Four: List of Senior Medical Staff 1782 – 1948 Page 156 Appendix Five: List of Senior Medical Staff 1948 – 1988 Page 157 Appendix Six: Bibliography and picture credits Page 159

CHAPTER 1

EARLY YEARS

Nottingham General Hospital has always looked the part from the day it admitted its first patients on 28 September 1782. The original two-story structure was a graceful building and early drawings show cattle grazing peacefully on the front prospect with open fields all-round. The site, chosen because it was a "very healthful place", is steeped in history. A plaque on the wall of St James's Terrace, near the entrance to the Parkside Day Hospital, denotes the spot with Charles l raised his standard in 1642. The land – originally known as Derry Mount – formed part of the Northern Bailey of the Royal Castle. It passed into the possession of the Duke of Newcastle when the Castle was raised to the ground and the Dukes town house was built on the site. The foundation stone for the hospital was laid on 12 February 1781 when St Mary's Church bells rang for four hours. Under the stone they place silver coins and an inscribed plate proclaiming the hospital was "open to the sick and lame poor of any county." The stone came to light 100 years later when the Jubilee Wing, the magnificent five-storey building, was added in 1898 to mark Queen Victoria's Diamond Jubilee. The grand opening of the General Hospital began with a Mayoral procession from the hospital to St Mary's Church. As part of the bicentenary celebrations in 1982, the opening ceremony was re- enacted and the original route was followed as far as possible. How did the General, one of the oldest surviving hospitals in the country, come to be built in the first place? Today we take hospitals for granted. Yet until the eighteenth century the only institutions caring for the sick in England were those that had developed from religious orders, such as St Thomas’ and St Bartholomew's in London. They were places for general and spiritual care rather than skilled management cure. Nottingham too had its hospitals. One was the Hospital of St John, which stood at the corner of Parliament Street and Glasshouse Street. From 1600 until 1720 it was used by the Corporation as a workhouse or "house of correction." By the late eighteenth century, an awakening of social conscience led philanthropic individuals and groups to found hospitals with a special concern for the sick. The founding of the Nottingham General Hospital came from a legacy left by a Nottingham banker John Key, who died in 1778. His bequest of £500 for the building of a County Hospital or Infirmary was dependent on another £1,000 being raised by public subscription within five years of his death.

John Key founder of the hospital

A series of meetings were held in 1782 to plan the hospital. The Duke of Newcastle and the Nottingham Corporation each gave an acre of land and the cost of the proposed hospital was £3,300. (The eventual cost of the building was £4,879, plus £617 for furnishing, including the purchase of 44 iron beds). Prominent among the early subscribers were cotton magnet Sir Richard Arkwright, inventor of the spinning frame; distinguished scientist Sir Henry Cavendish and Peter Nightingale, great-uncle of Florence. John Simpson was appointed architect and he had a beautiful hilltop site to develop. The only building near Derry Mount was the Duke of Newcastle's townhouse. The Castle Park (now the Park Estate) and open fields lay below the hills to the West and the North and the Trent Valley to the south. The foundations were laid close to the Bug Holes, where plague victims were reputed to have been left in isolation. The stone laying was followed in the afternoon by a great public dinner at Thurland Hall. There was feasting on venison and "every other dainty the season produced." The fundraising ball, was to become an annual event, went onto the early hours of the next morning. Construction proceeded and by September, 1782, the two-story building was ready to receive patients. But first there had to be a grand opening. The Mayoral procession walked from the hospital to St Mary's Church. Tickets had been sold at 2s 6d a head for the church service "to prevent the common people from coming in from the country and the common people of the town from leaving their work and crowding the church doors to get in." The day ended with a gargantuan dinner at Thurland Hall and a concert and ball at the assembly rooms.

An engraving by James Newton showing the South-East prospect of the hospital, 1782

The hospital opened its doors in 1782 with 44 iron beds and a small staff, including an apothecary and secretary, a matron, a porter, cook, housemaid, three nurses and an apothecary’s assistant. The matron was paid £15 a year, plus three guineas for tea and sugar. Qualifications for the post were that she should be "of good moral character, in good health, able to read and write, keep accounts and to have a good working knowledge of household economy." Nurses received no training and were little more than glorified drudges. They were paid five guineas a year, plus one guinea for tea and sugar. They were expected to have cleaned their wards by 7am in the summer and by 8am in the winter and to have served breakfast within an hour of finishing

8 cleaning. They were also expected to carry coal and do other manual work. Patients were forbidden to give any gratuities to nurses and other staff. This regulation was apparently very unpopular with the nurses – posters, reminding patients and staff of the rule, were regularly torn down. The apothecary was the key man. He was paid £40 a year, plus three guineas for tea and sugar, and was responsible for putting into practice the instructions of the three honorary physicians and for volunteer surgeons, who all gave their services free. In addition to the resident staff, a barber was employed to shave the patients. The hospital was also served by a chaplain, who attended the patient’s spiritual needs and supervised the library. One of the early visitors to the hospital was John Wesley, founder of the Methodist Church. On one of the three preaching engagements, he said of the hospital; "neatness and decency shines through the whole, I have seen nothing like it in the three kingdoms."

The brass plaque from the foundation stone, discovered during the building of Jubilee Wing in 1899.

Watching over everything with an eagle eye was the Weekly Board, two of whom made daily visits and exercised stringent control over would-be occupants. Patients had to endure the scrutiny of the Board before admission to ensure they were ‘objects of charity.’ No one with ‘smallpox, the itch or other infectious distempers’ and none who were ‘disordered in the senses’ were to be admitted. Pregnant women and children under six were also refused admission. Apprentices and domestic servants could only be admitted if their employers paid 6s a week to be admitted.

All patients (except in the case of accidents) were required to obtain a letter of recommendation, signed by a subscriber to the hospital. The number of recommendations was in proportion to the size of subscription. A subscriber who donated £100 or five guineas annually could recommend six in-patients and 20 outpatients. If a patient died, the subscriber was responsible for removing the corpse or defraying the expenses. Patients were expected to bring with them clean linen, change of clothing, towel and soap, knife and fork, plate, mug, spoon and a pair of slippers. These conditions satisfied, patients had to present themselves on Tuesday between the hours of 11am and 1pm when they were taken to a whitewashed ward and the hospital rules read to them. These forbade receiving any drink, food or medicine from outside the hospital. Games, cursing, abusive language or indecent behaviour were banned. Smoking was allowed by permission of the physicians and surgeons. The drinking of spirituous liquors was frowned upon, although patients had an allowance of 2½ pints of beer day (beer being the normal drink in those days) and the hospital had its own brewery. Patients had to be up at 7am and in bed by 8pm in winter and 9pm in the summer. They were then locked in by the Matron. Breaking the rules could lead to instant discharge and patients being debarred from future admission. There was not always room for all the patients. Priority was given to those in the worst pain: those coming from the greatest distance and how much their patron subscribed. The others were put on a waiting list until room could be found for them. Patients who were well enough were expected to assist in nursing other patients, washing, ironing and cleaning. Before a steam engine was installed in 1813, they are also expected to pump water from the hospital well. The idea that nurses needed skill and training did not gain acceptance until the mid-nineteenth century. So when the hospital opened, the nursing staff were seen as housekeepers. Patients were locked in at night by Matron and for the rest of the night were attended by ‘watchers,’ recruited from townswomen at 6d a night. Supervision of the staff was delegated to house visitors, appointed by the Board. Carrying white wands to be easily identifiable, they visited the wards once-a-day. The nurses withdrew and patients were asked ‘if the servants had done their job.’ The visitors then viewed ‘meat, provisions and malt liquor ‘to ensure that the patients were receiving their allowance of 14 ounces and bread and 2½ pints of beer a day and 4lbs of meat a week. They also received some cheese, milk and butter. The diet was particularly generous considering there was so much hardship and starvation in Nottingham during the first 50 years of the hospital's existence. Some patients were prescribed a low diet of two pounds of meat a week or a milk diet, which included no meat at all. On the day of their admission, all patients who had come from the country were provided with a bowl of broth. The food allowance for hospital staff was slightly better than that provided for patients. Each servant, for example, was entitled to a pound of meat a day. Every annual report up to 1830 contains the statement: ‘Here instead of cold, nakedness and hunger, patients have warm and comfortable lodgings with plentiful diet.’ Certainly they were much better off than the thousands of local framework knitters. Wage cuts kept these men and their families in the state of poverty and during bad harvests they were reduced to starvation. In the year after the hospital opened, horse guards were called in to quell hunger riots. So although the hospital was rather dark, stuffy, smelly and ill-ventilated, it provided an enlightened shelter for the sick. There was a garden on the south side of the hospital for the recreation of patients with elm trees and an open field between it and the Castle. When the hospital began, it was run rather like a country estate. An important member of the staff was the Porter, who was paid £10 a year and provided with a livery coat and hat. One of his duties was to prevent inpatients leaving the hospital without permission and inform the matron of every stranger who entered the hospital. As well as ‘pounding the herbs in the great mortar’, he also looked after the hospital livestock. Near the herb garden was the stable for the horse and the sty for the hospital pigs. The latter posed problems – one ward was ‘very offensive arising from the midden and the piggeries placed below the window.’ What could not be grown or raised was obtained from benefactors and in 1782 an appeal was made for linen. The hospital was described as being in ‘great want of linen and rags, large quantities of which are constantly used by the surgeons.’

CHAPTER 2

EARLY MEDICINE AND SURGERY

Two centuries ago, John Attenburrow, the General Hospital’s first and longest serving surgeon, went to work in his shirt sleeves. It was a bloody job, carrying none of the prestige or social status of today's consultant surgeons. Mr Attenburrow’s instruments – fearsome braces, saws, amputation forks and trepanners (for removing bone from the skull) – would terrify modern patients. Only 40 years or so before the General Hospital opened, surgeons had shaken off their origins as barbers. But in 1782, there was still no obligation for doctors or apothecaries to be qualified. This did not happen until 1815 when Parliament passed the Apothecaries Act. As a result the General Hospital became recognised for teaching and six pupils were admitted as indentured apprentices – the forerunner of present-day medical students. When the hospital opened, the medical staff comprised three honorary physicians, Dr John Davison, Dr Snowdon White and Dr John Storer and four honorary surgeons, Mr Joseph Hollis, Mr Joseph Rigsby, Mr Attenburrow, who was the most senior, and Mr Thomas Wright. Incidentally no fewer than four members of the Wright family became surgeons at the hospital – Thomas (1782 to 1819); his brother John (1795 to 1819); William (1819 to 1866) and his son Thomas (1851 to 1891). The honorary physicians and surgeons gave their services to the hospital when they could spare the time from serving more prosperous fee-paying patients.

John Attenburrow, the hospital’s first surgeon

The day-to-day responsibility for patients lay with the resident apothecary, who was also the pharmacist and dispenser and hospital secretary. He spent the long, dark winters nights doing his accounts by candlelight or his whale oil lamp. Mr Charles Pennington, the first house apothecary (he became an honorary physician in 1799) was responsible for the surgeons’ instruments, and was expected to administer the vigorous physical forms of treatment such as bleeding, purging and leeching. He distilled herbs from the hospitals herb garden but with the exception of a few powerful

11 remedies, such as digitalis, the rest of the potions he stored in his dispensary were ineffective. He was also expected to show male patients how to give other male patients enemas and to act as storekeeper. The apparatus, for which the apothecary was responsible, was amongst the most modern in the country. For example, baths which were almost unknown except among the wealthy were available from the opening of the hospital. The hospital and its staff at this time were referred to as ‘the house’ and ‘the family’ and the nurses and other ‘servants’ when directed to ‘obey the house apothecary has the master and the matron as the mistress’ Surgery was a gruesome business. Although this historical record makes no reference to any operating theatre in the early days of the General, conditions cannot have been a far different from those described at St Thomas’ Hospital, London in 1780. A wall cabinet held the unwashed instruments. Some pegs held the blood stained coats which the surgeons and his assistant wore to save the good ones. Beneath the table – a rough slab with a channel down the middle – was a box of sawdust to be kicked into place whenever the blood was dripping most freely. By all accounts, Attenburrow, who became a member of the Royal College of Surgeons, was an enlightened man, held in high regard by the profession and the poor people of the town. But imagine the terror of the patient, who, primed only with a modicum of laudanum and a piece of leather to bite on, entered the theatre to be strapped onto the table. Surgeons had no anaesthetics and only urgent cases were operated on. Indeed Mr Attenburrow and his surgical colleagues performed few operations, mostly amputations and cutting for stone in the bladder. They worked swiftly under the flickering light of whale oil lanterns and candles. It was 1839 before gas was installed at the General Hospital. During the first 50 years of the hospital there were only 404 major operations. They were performed in a room which served not only as an operating theatre but also as a day room and chapel. After most operations the wound would inflame and become septic, pouring out pus. Septicaemia and gangrene were common. Many patients died and others only recovered after a long and exhausting illness. No wonder patients dreaded hospital and operations. As Frank Jacob observes in A History of the General Hospital: ‘These operations were performed with supreme skill and incredible speed and, in the hands of the expert, with wonderful success. In the hands of the fumbler, half an hour of agony might end in failure.’ Before attempting amputation or any other operation, Mr Attenburrow had to consult the Hospital senior physician Dr John Storer, who relied entirely on his five senses for a diagnosis. He had no thermometer or stethoscope. His watch had no second-hand and he did not take a patient's pulse. Influenza, smallpox and fever were the feared diseases. Bleeding by a liberal use of leeches and opening the veins was a favoured form of treatment. Blood drawn off was carefully examined. But the physician had no way of testing it because the microscope had yet to be used in hospitals. Indeed, knowledge of chemistry, physiology and pathology was elementary and he tested urine for diabetes by tasting it! Emetics and purges were much used, and also blisters, which were kept open and running by special irritating ointments. Another device was a seton, a string put through the skin and left in so as to reduce a running sore. Treatment of consumption (tuberculosis) involved putting the patient on a swing and then spinning him around in circles until vomiting was induced. In 1783 the General Hospital paid £42 for an ‘electrical machine’ which was used in the treatment of various ailments and also to improve a person's general state of health. Anyone could attend a hospital to be electrified but those who could afford it were expected to pay 6d for each electric shock. A more pleasant treatment was bathing in the hospitals own hot and cold medical baths. To the poor they were free, but to others a charge of 6d was made. Vapour baths were also available to charge of 5s and new sets of sulphur baths were added in 1824 and 1828.

Dr John Storer, the hospitals first physician

The surgeon was subordinate to the physician. This harked back to the early days when the physician was usually an ecclesiastic while the surgeon was a layman, though by the end of the 18th century most surgeons occupied as good a position socially as the physicians. The General Hospital’s senior physician was a remarkable man. Dr John Storer was born in Perthshire and received his medical education at Glasgow University. He joined the Army Medical Service and fought in the War of Spanish Succession. By the time he came to Nottingham in 1781, he was a respected figure in his profession. He played a leading part in the founding both the General Hospital and Sneinton Asylum, forerunner of Mapperley and Saxondale Hospitals. He lived and practiced at Thurland Hall until 1828 when he moved to Lenton Firs. Dr Storer, the first President of the Bromley House Lending Library, died in 1837 at the age of 90. His memory lives on through the John Storer clinic for people with drug/psychiatric problems. Another distinguished physician at the General Hospital was Alexander Manson, who pioneered the use of iodine in the treatment of goitre, frequently known in those times as ‘Derbyshire neck’ and other diseases. Dr Marshall Hall, honorary physician to the General Hospital for a year until 1827 made an important contribution to our knowledge of reflex action. Surgeons and physicians saw some extraordinary cases and none stranger than the hospitals ninth patient – an 18-year-old woman named Kitty Hudson who was admitted in 1783. As a young girl, Kitty, a cleaner at St Mary's Church was promised by another servant a stick of toffee for every mouthful of pins she collected. The habit stuck – until in a series of operations over a period of two years, surgeons removed ‘great numbers’ of pins and needles she had swallowed. They were extracted from her feet, legs and arms, both breasts and other parts of her body.

Kitty lived to tell the tale and duly born 19 children. For some years she walked twice a day to Nottingham and back to Arnold where she was the post lady. Meanwhile John Attenburrow was trying his best to fight smallpox – then a major killer. In 1798 Edward Jenner published his findings about the protection offered by cowpox inoculation. Two years later Attenburrow introduced vaccination in Nottingham in the face of intense criticism and hostility.

Using a carbolic spray during an operation.

He inoculated his son with complete success – and as soon as townspeople saw the practice was safe, mothers began to flock with their children to Mr Attenburrow's surgery on Beastmarket Hill. He treated them without charge. John Attenburrow, a man of merciful heart, remained honorary Surgeon to the hospital for a remarkable 61 years until he died in 1843, aged 87. One problem faced by early surgeons and physicians with how to obtain human skeletons and bodies for dissection in order to study anatomy. Groups of body snatchers or ‘resurrectionists’ undertook to provide a supply bodies for such a purpose. In 1827 St Mary's Churchyard was raided and nearly 30 bodies were removed and taken to London. A legal way of obtaining bodies, however, was from the scaffold. In 1815 a 19-year-old called John Hemstock was convicted of murder and hanged at the Shire Hall. At the time the death sentence applied to trivial offences such as stealing a purse. Following execution everyone convicted of murder would have their body dissected and exposed to public view. John Hemstock had appealed to the judge to remit his part of the sentence but to no avail and his body was delivered to the General Hospital for dissection. The Weekly Board saw the opportunity of acquiring a perfect skeleton ‘at about two thirds of the price now estimated’. They purchased John's body and sent it to London to be prepared and jointed. The skeleton of John Hemstock was still hanging in the hospital in 1900 but was later dismembered and used to instruct nurses in anatomy.

It was almost a century after the hospital began that a proper surgical wing was opened in 1879. This coincided with the great increase in surgical work as a result of Lister’s discovery of antiseptic treatment. The practice of bloodletting and the use of leeches had almost been forgotten when the hospital celebrated its first centenary. But Dr Jacob recalled that when he was house physician in 1900, one of his colleagues, Mr Crackle, always kept a small supply ready for use in a glass bowl – ‘just as one keeps goldfish!’

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CHAPTER 3

EXPANSION AND DEVELOPMENT

When the General Hospital opened, in addition to serving the 25,000 citizens of Nottingham, it served a further 75,000 in the county and also has some patients in Derbyshire. Within two years, 10 more beds had to be opened to meet growing demand. The original building still forms part of the present-day hospital and a little plaque on the wall in the courtyard near the main entrance marks the site. But it is now surrounded by two other buildings and, with two stories added, has lost its immediate identity. The recurring problem for years to come will be how to expand on a compact site. As early as 1787, The Derbyshire Wing was added to create 20 more beds. It was provided largely by donation of over £6,000 – an enormous sum in those times – given by the Honourable Henry Cavendish, of Chatsworth House. The Derbyshire gentry were generous because they had no hospital of their own until 1810. It was the first of many extensions. A further development in 1812 provided four more wards, two spacious day rooms and a bigger shop (dispensary) and storeroom.

The hospital in 1787 after the Derbyshire Wing with added.

The turn of the eighteenth century had brought great deprivation with a huge increase in corn and bread prices, causing terrible suffering. Typhoid, smallpox, tuberculosis and cholera were also rife in the town, which was growing rapidly. It is hard to imagine the inequalities of life in Nottingham at this time. The gentry had mansions with elegant, spacious gardens but even they washed so rarely that a bath was taken only under doctor's orders and strong perfumes were used to hide personal smells. The Trent was then an open sewer while the confines of enclosure meant that the town's poor lived in such filthy, overcrowded conditions that wounds were invariably infected. In 1847 a Nottingham doctor reported that local living conditions were among the worst of any town in

Victorian Britain. ‘In many instances the inhabitants of a number of houses have to resort to privies few in number and common to all, some of them are without doors, so noisome as scarcely to be approachable and so exposed to offend all sense of decency. Some are so ill constructed that the drainage from them runs into adjoining houses; others are so broken up and filthy as to be wholly useless.’ The largest group of workers were stockingers, toiling at their knitting frames for long hours with their wives and children to earn about 7s a week. Up in the garrets of their cottages – long windowed to catch every minute of daylight – children as young as three or four had to make themselves useful. Boys and girls of six and seven were carried to the coal mines in darkness and after 14 hours filling or hauling tubs, with chains chaffing their little bodies, were carried home asleep, still in darkness.

A typical street scene in Victorian Nottingham.

As the pace of industrialisation quickened, Nottingham turned from a garden city to an ugly sprawl of densely packed back-to-back houses. When enough sewerage had accumulated in the alleys it was sold to ‘muck majors’ who dumped it in the street until they had the barge full to sell to farmers. The great fear was fever and the end of the war with France in 1802 was celebrated by launching a fund to establish a fever house at the General Hospital. But the plans had to be postponed when hostilities broke out again the following year. In fact, it was 1828 before the Fever House was opened for the admission of contagious diseases such as smallpox and scarlet fever. No attempt was

16 made to separate patient’s suffering from different diseases because it was thought that a patient suffering from one virulent disease could not contact another. The rules for the Fever house was slightly different from the rest of the hospital in that anyone who suffered from scarlet fever or smallpox could be admitted on any day of the week without recommendation. The building also contained two ‘lock’ wards for treating male and female patients suffering from venereal disease. These wards were kept locked at all times; they also derive their name from ‘les locques’, the rags from which sufferers cocooned themselves. From 1832 paying patients were also admitted at a fee of 3s a week but in 1842 the wards for syphilitic patients were closed and added to the Fever establishment. In 1812 a lunatic asylum was opened in Sneinton. The commissioning committee for the asylum was formed; the foundation stone was laid in 1810 and the hospital opened for 60 patients in 1812. It is still possible to see part of the original wall, near Sneinton Market. The asylum cost less than £20,000, funded by the county and the town. It was the first institution to come under the Asylum Act of 1808 and the first to be created from the rates. Previously asylums were private and pauper lunatics were to be found ‘chained in cellars, gardens and workhouses, fastened to the leg of the table, tied to a post in outhouses or perhaps shut up in an uninhabited ruin.’ Meanwhile Dr Alexander Manson was making strides in clinical medicine. He treated 72 cases of cholera over 12 years and believed many derived benefit by giving them iodine. At this time Nottingham people also believed that bathing in St Ann's Well had a great curative properties. Nottingham was still in the midst of the reform riots and Dr Manson was stoned as he drove his gig through Pelham Street. Later in the evening his house was attacked and stones hurled through the windows. He resigned soon after this incident. By 1832 when the hospital celebrated its golden jubilee, it was noted that 17,269 in patients were treated in the first 50 years. Of these 10,165 were ‘cured’ and 901 died. There had been 302 amputations, 14 patients trepanned and 93 ‘cut for stone’ in the bladder. By 1971 the General Hospital was seeing over 70,000 ‘casualty’ patients and treating almost 16,000 in-patients a year in its 546 beds. Meanwhile medicine was slowly making advances with Jenner’s discovery of vaccination in 1796 by far the most important in the fight against smallpox, then a rampant killer. The stethoscope was invented in 1819; enabling doctors better to diagnose conditions of the heart and lungs. Joseph Jackson Lister, the father of Lord Lister, was elected to the Royal Society during the General Hospital’s jubilee year (1832) for his work on optics and the microscope, which was later to prove of value to Pasteur and others. It was 1852 before Dr Gill made application to the General Hospital for its first microscope. The clinical thermometer had not yet arrived – that had to wait until 1868 and pulse containing by the watch until 1848. By 1835 the General Hospital was overflowing. Cholera epidemics (330 died from the disease in 1832) and more industrial accidents were taking their toll. The town's population had risen to 40,000 and to increase the capacity of the hospital, Bromley Ward was created. The surgeon's rooms, library and day rooms were requisitioned to form the Bazaar Wards, financed from the proceeds of ladies bazaars. At this time, too, the role of outpatient and after-care was beginning to be recognised. In 1831 a dispensary was opened in a house in Hockley and in 1843 it moved to its present premises in Broad Street. The General Hospital was still running on a tight budget. In 1834, for example, important additions were made to its cutlery supplies – two tablespoons, four dessert spoons and one teaspoon. Until then the hospital possessed only seven spoons and the matron held herself responsible for their safety. It seems odd that a hospital should be without spoons but at this time cups had no handles. So patients took a ‘dish of tea’ and ate broth or soup by holding the dish in both hands. In 1831 the Matron Mrs Bell was warned for neglecting her duties – hospital visitors discovered some patients had not been washed once a fortnight as directed by the committee. She resigned soon afterwards. Nursing at this time was in a deplorable state. The idea that nurses needed skill and training had not yet gained acceptance. In 1835 a male nurse was given a month's notice to quit (but eventually was allowed to stay) for throwing an apple up to the window of the patient in the female wing.

At this time the hospitals two male nurses earned 15 guineas and the seven female nurses’ wages varied from 10 guineas to 12 guineas. Accommodation was scanty. There were so few rooms for female nurses and servants in 1844 that night nurses were occupying the beds in the daytime. The mangling room and lumber room were converted to create extra bedrooms. In the same year Matron was instructed to make frequent inspection of the patients’ bedding, which was to be changed every three weeks in the summer and every four weeks in winter. She also employed a new assistant scourer, who was also considered capable of acting as a night nurse.

The hospital in 1832.

But improvements were on their way. A report by Resident Apothecary Francis Sibson to the Weekly Board in 1845 was the first attempt to recognise the evils of the existing nursing system and the proposed reforms. All nurses were to reside in the hospital and day nurses were to be exclusively engaged in nursing. Nurses were also freed from domestic duties such as sweeping and carrying coal. Most important of all, a superintendent nurse was to be appointed from the Institution of Nursing Sisters in London at a salary of £30 a year. In his report Sibson, who made a major contribution to the hospital, explained why such reforms were necessary. Matron, apparently a difficult woman, had overruled the house surgeon in ordering the cook – when she was having treatment as a patient – to resume her work in the kitchen. The Board informed the Matron that ‘interference with patients or with servants that are patients, without the sanction of the medical officers could not in any account whatever be allowed in future.’ Matron clearly resented the interference of Francis Sibson in her nursing domain and domestic arrangements. There are no more minutes of the Weekly Board which relate to nursing affairs until 1869 when a trained Matron was appointed. In 1853 Florence Nightingale was invited to institute a training school at St Thomas's Hospital in London. Before she had time to do so, the Crimean War broke out and her energies were diverted in another direction. The opening of the Nightingale Training School for Nurses at St Thomas's in 1860 brought vast improvements in the quality and status of nursing. The first trained matron at the General Hospital was Mrs Pedgrift and the year after her appointment the Weekly Board was told that her arrival was ‘already telling considerably to the advantage and comfort of the patients.’ The annual report of 1872 states: ‘There is a great improvement in the cleanliness of the infirmary and an absence of that peculiar hospital smell there used to be in times past.’ During the same year preparations were underway to create a Nursing School. Meanwhile the hospital was getting up-to-date in different directions. Gas lighting was installed in 1839 to replace the use of whale oil lanterns and candles. Trouble was experience with patients from time to time, mainly due to their insistent smuggling into the hospital of liquor and other articles which were expressly forbidden by the rules.

The complaint heard by the Board in March 1847 stated: ‘Patients communicate with friends and get in provisions over the garden wall.’ Another report in November 1848 said: ‘Joseph Robinson, painter, had permission from Mr White on Wednesday morning to go out for an hour to buy flannel and did not return until the evening, and having been detected bringing in meat and other things he became so abusive as to render it necessary to send for the police.’ At his subsequent court appearance, Joseph’s crime was considered sufficiently serious to a one month spell on the treadmill at the House of Correction. But patients were not deterred by threat or prison sentence and the smuggling continued unabated. By 1854, the position was so bad as to warrant the matron appointing a nurse to search all female visitors before they were admitted to the premises. In 1844 the general hospital handled its first disaster. Twelve people were crushed to death and more than a hundred injured while watching a public hanging at Garner’s Hill, near the Shire Hall on 8 August. Thirty-three of the most severely injured were treated at the hospital. In the same year the whitewashed wards disappeared – they were all given the coat of tea-coloured paint.

Postern Street entrance to the General Hospital.

Further expansion of the hospital went ahead when Thomas Hine, the well-known Nottingham architect was commissioned in 1854 to prepare plans to add a third story to the original building. This was completed in 1855, increasing the number of beds to 136, and at the same time a Gothic Chapel was erected between the main building and the Fever House. But perhaps the biggest breakthrough of all was the introduction of anaesthesia. Chloroform was developed in 1848; Lister's antiseptic techniques in 1876 paved the way for modern surgery. Until then, wound infection was almost universal. Four years previously the Board considered re- siting the entire General Hospital, believing it had become so impregnated with a disease-causing miasma that the only remedy was to build anew on a different site. The Norwich and Norfolk Hospital did this but in Nottingham the influence of Pasteur and Lister prevailed before the plans for a new building were ready. It was now recognised that the bacteria which caused sepsis could be killed by chemicals. But initially only the walls, floor and air were treated with antiseptic and the surgeon still ‘operated while attired in their old frockcoats which were used for many months and even longer without being cleaned... The more marked and stained the coat the greater the lustre which accrued to the wearer’. It was not until the beginning of the 20th century that surgical instruments were sterilised.

A recurring theme in all voluntary hospitals, and the reason for their eventual absorption into this state health service in 1948, was financial anxiety. The tasks expected of them were limitless, whereas their income depended entirely on the philanthropy of the rich and the energy and persuasiveness of the not so rich in extracting smaller amounts of money from their colleagues. Finance was a problem 200 years ago, just as it is today.

1895: Shipstone operating theatre.

A warning note sounded in the first annual report in 1783. For although the hospital had been established with due economy, expenses still exceeded expectations. The 1948 concept that hospitals should be run by a compulsory levy, rather than by voluntary subscriptions, was not, of course, a new one. In 1813 an institution whose functions differed little from the General Hospital was in operation on a site bounded by Mansfield Road and York Street. St Mary's workhouse provided care for ‘poor parishioners’ and did so from the parish rate. The development was the forerunner to the municipal system of hospitals like the City Hospital, which was built and run by the local authority, in contrast to the ‘voluntary hospitals’ maintained by gifts and subscriptions. By 1875 there was great concern about the number of industrial accidents and how to get the money to look after the victims. Accident cases rose from 504 in 1871 to 651 in 1875. They occupied so many beds that 138 ordinary surgical and medical cases had to be refused admission in 1875 and the campaign was launched for a new, 50 bed surgical wing. The new wing, located on the Park Row frontage, which opened in 1879. It added two wards with 45 beds, connected to the main building by covered corridor and included a new wonder – a hydraulic lift to convey patients between floors. By 1881 the financial anxieties had turned to reality – there was a deficit of £305, plus the building fund debt of £853. But benefactors were generous. Coal mine owner Sir Charles Seely donated a large house off Mansfield Road which was converted into The Cedars, providing 20 beds for convalescing patients. In 1897 he purchased a large house adjacent to the Cedars and equipped it with a further 20 beds. He maintained both houses entirely at his own expense until he died in 1915. A Nursing Committee was established in 1893 to consider most aspects of nursing life, as well as complaints from the public and the staff themselves. It was made up of seven members – five laymen and two medical representatives. The Committee also concerned itself with training because

20 by this time the hospital was admitting in training nurses from other institutions. The training lasted two years (later this was increased to four years) and cost £10, after which nurses could be awarded certificates if they passed all their exams. But the matron was not allowed to receive more than eight training nurses – two for the Workhouse Association and six for the nursing Association. The training in the hospital had improved greatly since it first opened. Nurses attended lectures on medicine, surgery, nursing, anatomy, physiology and bandages. By 1900 there were seven sisters, four nurses and a housekeeper.

1895: James Foreman Ward.

A national event can often be harnessed to local objectives and Nottingham chose to mark Queen Victoria's jubilee in 1897 by building a substantial extension to the hospital. Alfred Waterhouse, the architect of the Prudential building in King/Queen Street, was asked to present a design for the Jubilee Wing. Impressed with the circular wards he had seen in various new hospitals, the foundations were dug for a five-storey circular building with the top three floors containing circular wards of 58ft diameter and each with 16 beds. On the north-east side, a sanitary block was connected to the wards by iron bridges. To the south there was a service block with two small three-bed wards, an enlarged laundry, mortuary and mortuary chapel. The foundations for the Jubilee Wing were dug in 1899, revealing the plaque placed there in 1781, as well as several caves and tunnels. The Wing was occupied in 1900 and increased the bed complement to 210. In addition, a new kitchen, two entrance lodges and new main entrance and entrance hall were built. This extra work was paid for by one of the hospital governors who wished to remain anonymous. It was revealed later that this was Sir Charles Seely. The whole project was completed in 1902. A new-age was dawning. Electric lighting was installed in the Jubilee Wing and the Board began to replace the gas lighting in all the other wards. The opening of the Wing also coincided with the ability of medical staff to go beyond their unaided senses in searching for disease. For in 1898 the hospital had been given an x-ray apparatus. By the end of the year, the technique had been used to examine 127 patients, locating 20 needles, three foreign bodies and two bullets. It was also used for the examination of 36 fractures, 14 cases of diseased bone and 16 sprains and rheumatic conditions. In

1900 it produced another triumph – the diagnosis of a kidney stone by using a 20 minute exposure. By the end of the century, the hospital, despite its perpetual financial difficulties, had continued to develop substantially. It was also keeping up with new techniques in the service of the city population which now stood at 275,000.

The hospital in 1895

1895: Nursing and medical staff group.

The old entrance provided by Sir Charles Seely about 1880.

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CHAPTER 4

THE TWENTIETH CENTURY UP TO 1948

The 50 years from 1897 to 1947 was a period of rapid growth, interrupted by the two World Wars. Not only was the hospital substantially enlarged from 144 to 477 beds, including the Cedars, but the oldest parts of the hospital were renovated and remodelled. This era also saw the creation of a wide range of specialist departments at a cost of £350,000. The hospital was fortunate in having two major benefactors, Sir Charles Seely and Mr W.G. Player, who, in addition to giving large sums of money, were dedicated to the welfare of patients. The 20th century dawned with Nottingham taking full advantage of the industrial age. At this time a third of the city's workers were employed in the lace and hosiery trades. Nottingham was quickly making its name in other world markets – for Raleigh cycles, Player’s cigarettes and Boots pharmaceuticals. Mining, too, had expanded and the Royal family were supplied with Gedling coal. The early years of the century saw the pattern of disease begin to change. The gradual abolition of pail closets and earth privies began in Nottingham in about 1912 and was completed by 1923. As a result enteric infections such as typhoid and cholera were almost wiped out. But tuberculosis was rampant and Sir Charles Seely gave the hospital two houses to care for TB patients. The houses were used in conjunction with Sherwood Forest Sanatorium, near Rainworth, created by Dr William Bramwell Ransom. The success of the attack on enteric disease was such that deaths dropped from 73 in 1900 to only a single death in 1928. Meanwhile the fever wards were re-housed in 1902 in the Old Children's Hospital on the side of Postern Street.

Sir Charles Seely provided a bridge to connect the fever wards to the main hospital. The bridge, resembling the Bridge of Sighs, was admired by everyone except its donor, who had it pulled down and replaced by the present structure.

The hospital in 1900.

In 1906 the hospital suffered a serious outbreak of diphtheria. Twenty-eight cases, including some nurses, were successfully treated with anti-toxin. The general improvements in the health of the population followed the demolition of the city's worst slum areas by 1914. In that year Sir Charles Seely resigned due to failing health and Mr Frederick Acton, a shrewd lawyer became Chairman of the Monthly Board

Outbreak of First World War

Upon the outbreak of war, 102 beds were immediately placed at the disposal of the military authorities. The Jubilee Wing was soon full of sick and wounded soldiers and further hospital expansion became necessary. In 1915 temporary wards to accommodate 150 casualties were built on the front lawn. The complement of beds at the Cedars was increased to 54 for less serious cases. Broxtowe House, which still serves the hospital as a home for resident medical staff, was bought for £547. The Thornton family house in the Ropewalk was given to the hospital and the Red Cross provided additional equipment and nurses. Another temporary building for a further 53 beds was erected in 1917 – with the War Office and Mr W.G. Player sharing the cost. The huts were soon in use, heated by six large stoves provided by Mr W.G. Player who afterwards added a balcony to accommodate 20 more patients. Despite the great influx of war casualties, the number of civilian patients remained at the pre-war level of 219. The various ambulance corps did fine work in transporting patients to and from the hospital. As well as terrible wounds, the sick and injured soldiers were suffering from trench fever, nephritis, neuritis and shellshock. Before the war began, the General Hospital had three physicians, two assistant physicians, four surgeons and two assistant surgeons. Of these, one physician, one surgeon and one assistant physician were members of the Territorial Force, were called up at the outbreak of war. The other assistant physician joined up soon and afterwards. Six nurses were called up immediately and others followed. Many of the doctors in the city joined up and those remaining did their work. The normal

24 residence staff was then just three house surgeons and two house physicians. As Dr Frank Jacob recalls in A History of the General Hospital: soon these were reduced to three: ‘Next we had one man as senior house surgeon and three women doctors. They all did excellent work.’

Wounded soldiers in Jubilee Wing, 1916.

Wounded soldiers in terrace huts on the front lawn.

In April 1918, the medical committee was able to report: ‘The civilian work of the hospital has not suffered in quantity or quality in spite of the large amount of attention required by the soldiers in our own and other hospitals in Nottingham.’ In the same year Miss G. Knight, matron for 25 years, retired on a pension of £80 a year.

Dr Frank Jacob, well-known physician and author of A History of the General Hospital

Eventually the war came to an end. The influenza epidemic of October, November and December, hit Nottingham with great severity and many of the young soldiers, who had survived the horrors of war, succumbed to this new enemy. Dr Jacob recalls: ‘At the hospital we were very fortunate. Although most of the nurses and maids suffered from the influenza and 50 were incapacitated at one time, we had no deaths.’ The hospital developed one new method of treatment during wartime – physiotherapy – but refused to provide outpatient facilities for venereal disease. So these were developed by the local authority at Glasshouse Street in 1942. This conflict between trying to integrate all specialities on one site, making it a truly General Hospital and allowing separate institutions to develop, such as the Children's Hospital, opened in 1900 and the new Women's Hospital, opened in 1919, was to prove a recurring theme.

Post-war developments

After the war, two public meetings were held to erect a war memorial for the city and county of Nottingham. It was decided to build a new nurses’ home, designed by Evans, the hospital architect, on a site fronting on to Lenton Road. Considerable difficulties were encountered in laying the foundations because of different site levels and several old wells and caves in the rock. During excavations the remains of the Outer Bailey Wall of the Old Castle, built in 1252, were uncovered in several places. The wall was about 6 feet thick, of waterstone blocks bedded in clay, with the outer face dressed and pointed with hard white lime mortar.

The new nurses’ home was opened by the Prince of Wales in 1923 and provided 130 rooms. In 1927 the fifth story was built, adding another 40 rooms. The ability of doctors to diagnose disease had been extended by x-rays and in the 1920s further progress was made with the advent of laboratory tests. Funds collected in memory of Dr W.B. Ransom were used in 1925 to establish pathology laboratories in the fever wards, formerly the old Children's Hospital.

Ransom Memorial Laboratory.

As the demand for beds grew, the Ropewalk Wing, another important extension was built in 1927 and open by Princess Mary. The new wing was built on a large disused reservoir which had been given to the hospital by the Corporation. It was connected to the main hospital by a tunnel under Park Row and provided facilities for outpatients, x-rays; ear, nose and throat inpatients and a new dispensary. This enabled the Old Outpatients Department in the main building to be converted into a Casualty Department in 1929. At the same time another ward was added to the top of the Jubilee Wing and 1931 saw the creation of the purpose-built Pearson operating suite – a far cry from the days when one room served as a day room, chapel and operating theatre.

Ropewalk Wing as it appeared in 1927.

Louis Pearson Operating Theatre.

Children's Ward in the Aural Department.

William Player had contributed £50,000 towards the cost of the Ropewalk Wing and also financed the additional story for the Jubilee Wing. It contained a circular children's ward, named after his wife Mabel Player, and was opened by Lord Moynihan the same day as the Ropewalk Wing was opened. By 1932 the hospital had 174 nursing staff, including the Matron, two assistant matron's, two tutor sisters, one home sister, two housekeeping sisters, one theatre sister, one sister in the orthopaedic department, two sisters in the x-ray department, one sister in the massage department, two night sisters, 14 ward sisters, 48 fully trained staff nurses and 97 probationer nurses. Frank Jacob commented:

There is an excellent teaching school under the supervision of the tutor sister. A certain number of the nurses, having passed their final state examination and become fully trained state registered nurses, remain at the hospital, and if found suitable are promoted to sisters’ posts when these fall vacant while others leave to take up higher posts in other hospitals. In addition to the teaching given by the tutor sister, members of the honorary

28 staff deliver lectures to the probationer nurses at frequent intervals, and a high standard of efficiency is thus secured. In 1932 Mr W. G. Player donated £25,000 for a new Medical Block, containing two wards, built on the steep west face of the site overlooking the Park. The Player Wing, as it was called, increased the number of beds to 344.

W.G. Player Ward, 1934.

The Outpatients Department, Ropewalk Wing, 1934.

The following year his brother John gave £25,000 to launch fund for a private pay block. The principle of catering for ‘paying’ patients was nothing new; in 1785 the Board resolved that such patients could be admitted at a cost of 6s a week. The Freemasons added £4,600 to the Player donation and in 1938 the Pay Bed wing was open on the corner of Park Row and the Ropewalk. It contained 43 beds as well as its own operating theatre and nurses’ home. Meanwhile the Cedars, which had been developed at the turn of the century to ease pressure on beds, was extended in 1933 at a cost of £11,000 to accommodate another 40 beds. The following year an outpatient psychiatric clinic was opened at the General Hospital and two honorary consultant psychiatrists were appointed.

Outbreak of World War Two

With the outbreak of the Second World War the General Hospital became part of the Emergency Medical Service and 75 extra beds were squeezed into the existing wards to deal with the expected flood of casualties. The hospital was well-prepared. Nottingham was the first city in the country to have a fire station training depot and the first to develop an Air Raid Precaution (ARP) network. The precautions included 288 public shelters, huge refuges cut into solid rock, 24,000 Anderson shelters, 2,880 domestic surface shelters, and 1,817 communal surface shelters. Caves, some extending from Mansfield Road into Sherwood Street, were also utilised. Retired staff were retained or recalled and senior medical students were recruited to help the 12 resident medical staff. Nursing staff were on call at all times for air raids and arrival of convoys of injured troops. Frank Jacob commented:

In this war the convoys arriving in the hospital were unlike those in the first war. Improved transport by air; hospitals with operating surgeons almost in the firing line; the use of new remedies against sepsis; drugs like sulphanilamide and penicillin and blood transfusions, completely altered the outlook for the wounded soldier. Most winners were quickly healed and the weary months of suppuration avoided.

The General Hospital formed four mobile surgical teams, each comprising a surgeon, an assistant, an anaesthetist and two nurses. These were on standby to go out to stricken areas where heavy casualties occurred. The team was called out to Newark in March 1941 when 40 were killed in an air raid. Although Nottingham was bombed on only 11 occasions, 179 people were killed and 350 injured. The worst blitz occurred on the night of 8 and 9 May 1941 when 159 people including 31 children were killed and 274 injured. The heaviest casualties were at the Co-op bakery on Meadow Lane, where 49 employees and members of the Home Guard were killed and another 20 injured. Six rest centres were in operation and they dealt with 1,286 people who had been ‘bombed out.’ Recalling the events of that fateful night, Frank Jacob wrote:

In the major attack a number of bombs fell near the hospital – none of these exploded. This was the sort of special mercy for it is not likely that the old part of the hospital would withstand a severe shaking. On the night of the major raid, 73 patients were admitted suffering severely from injuries, burns and shock.

The Chairman of the House Committee later praised the arrangements for the evacuation of certain wards and the reception of casualties. A copy of the minute, displayed on hospital noticeboards, conveyed the appreciation of the committee to the honorary staff, resident medical officers, and the matron, nursing staff, domestic staff, engineering staff, voluntary stretcher bearers, voluntary fire watchers and secretarial staff for their untiring services so willingly given during the emergency. Of the steadfastness and willing service of the hospital nursing staff Matron Miss Plucknett reported:

During the first few years of the war no administrators or ward sisters were allowed to sleep away from the hospital except for annual leave. This ban was raised later. The senior administrative staff were on call for all sirens and convoys, sisters and staff nurses were an alternating call although some sisters preferred to be on-call always. The remaining staff were on rota, but all members of the staff gave the extra time as their war effort.

During the war years the domestic shortage was appalling and the hospital could not have continued its work had it not been the goodwill of the nurses who turned their hands to any job that wanted doing. (This is a fact always overlooked and taken for granted, possibly because it is difficult for anybody other than nurses to realise what was done and, of course, because of its non-spectacular nature.)

Frank Jacob said ARP methods and voluntary aid work especially that performed by nurses and ambulance staff earned the highest commendation and appreciation. He described how the convoys came first from the Middle East.

Invariably the patients had been extraordinarily well attended, well plastered and wounds healing or healthy. Plasters were pencilled with the date of the wound, of plaster and suggested date of renewal. The medical cases from the Middle East were mainly malaria, infective jaundice, rheumatism and several cases of desert sores, very difficult to heal. The condition, which we knew in 1914-18 as shell shock was, during this war, labelled anxiety neurosis. There were a fair number of those cases mostly among the younger soldiers; they were discharged as soon as possible to a special hospital near Birmingham. Cases of dysentery were few from the Middle East but many from the Far East: not in an acute state but much debilitated. The Normandy cases were similar in regard to wounds – always the main impression was the good condition in which they arrived. Their wounds were much more recent – some arrived and were operated on in Nottingham within 18 hours of being wounded. Many were brought by air from Brussels or Antwerp to a reception hospital near Swindon and distributed by train from there to various hospitals. The prevalent type of cases was that of injury by shell and mine. Many compound fractures and flesh wounds of the lower limb, mainly in plaster and nearly all having had penicillin injections during the journey. Convoys always arrived at the dead of night, somewhere between 9pm and 3am. They were nearly always late, and thank goodness the Defence Forces always had a mobile canteen and provided most welcome cups of coffee and cocoa and also biscuits for those waiting for the trains. All the drivers of the ambulances were women; they were always cheery, good drivers and no grousing. Convoys were received in the main hall. Mr Alan was in overall control of the hospital and Mr Neil was very regular in turning up to see that operations went well. The number of admissions in an average convoy was 100 – 150 but sometimes more. An auxiliary hospital with 110 beds was set up in a newly completed school at Selston. This enabled the hospital to equip 620 beds, and of these, 300 were requisitioned by the Ministry during the invasion of France in 1944.

Aural surgeon Mr E. J. Gilroy Glass was the first member of staff to be called up during the Second World War. Serving with distinction at hospitals in France and India, he attained the rank of colonel. Mr John Sheehan, senior resident surgical officer at the General Hospital and later an honorary surgeon, served about three years of the war in the Royal Army Medical Corps as a surgical specialist he attained the rank of Lieutenant-Colonel. Dr Crawford, the senior resident anaesthetist at the General Hospital, served in the RAMC during the last three years of the war as a specialist in anaesthesia and numerous junior medical staff served in the RAMC. Major J. U. Hogarth, the only son of surgeon Mr R. G. Hogarth was killed in Italy while serving with the Grenadier Guards and Pilot Officer Herley Pearson and Lt John Basil Pearson, two of the four sons of Lieutenant-Colonel Noel Gervis Pearson – later to become hospital chairman – were killed on active service. There is a memorial window to them in Wollaton Church. The large number of troops training in the area provided much work for the Casualty Department, medical officers in charge taking full advantage of the facilities provided for diagnosis and treatment. Services of all physicians and surgeons and assistant physicians and assistant surgeons, and the heads of all departments, such as X-ray, fracture clinic, pathology and physiotherapy, were available for these consultations. Individual reports were sent on each case to each MO. In addition to air raid casualties and cases from the services fighting at home and overseas, the hospital was responsible for accidents among all civilians engaged in essential work of any kind such as miners, transport workers and merchant seamen. Between 1939 and 1948 the General Hospital treated 6,692 in-patient service cases, 34,000 outpatient service cases and 287 air raid casualties. Several nurses and medical staff were en route for their war service, including Miss Vera Anderson, an industrial nurse at Boots Station Road factory, who was awarded the George Medal for outstanding bravery during the air raid on Nottingham in May 1941 when the factory was burned out. She trained at the General Hospital from November 1934 to January 1939. Miss F. E. Robinson, second assistant matron at the hospital before being called up in 1939, was awarded the Royal Red

Cross and Miss Edith M. Toon, who was trained from May 1936 to November 1940 – was mentioned in dispatches for outstanding work in India. During the early years of the war, it was still possible to continue the expansion of the hospital. The hospital's original nurses’ home, overlooking the Castle Grounds, which was built as a memorial to those who fell in the 1914 – 18 war. But the addition of many new departments for the hospital and the reduced hours of duty for nurses meant that accommodation had become inadequate. Pearson House, a five-storey building, was opened in 1941 on the Standard Hill frontage, near the site of the demolished St James’ Church. It provided accommodation for 84 nurses and 12 maids and included a large recreation room with a stage and dressing rooms for dramatic entertainment. In 1943 Castle Ward was created by adding to the Player Medical Block with William Player again providing the finance. The old Fever House, which had now become a substantial surgical wing, underwent major alterations to provide an additional 20 beds. It was renamed University Ward in recognition of the money endowed by Nottingham University College Student Rags.

New age dawns

The end of the war ushered in a new age and the end of some long-standing traditions. For 165 years the Mayor and Sheriff of Nottingham and members of the Executive Committee, Governors and friends of the hospital had walked in procession to St Mary's Church. The last anniversary festival was held on 22 October 1947. The Bishop of Sheffield, Dr I. G. Hunter, preached the sermon on the welfare state and the desirability that the health service should be efficient and evenly spread, without respect to persons or places, after the service, the hospital president, Lt Col N. G. Pearson, who was to be chairman under the new order, declared: ‘We are determined, insofar as we are allowed, to maintain and manage this hospital, in exactly the same spirit of the interests of the patients as before.’ And the Medical Committee reported:

On 5 July, 1948 this hospital will be taken over by the Sheffield Regional Board. Local patriotism will deplore its attachment to the University of another town, but we hope that with the coming of University status to Nottingham, amoure propre will no longer be offended. With the change of ownership of the hospital from this July, they will occur no change in the medical, nursing or ancillary staff, and the citizens of this city and county who have demonstrated in the past their pride in, and affection for, this hospital can be completely reassured that the tender care of the hospital patient will continue.

The hospital had seen extraordinary progress from a humble institution with 44 beds to a major development which by 1948 comprised 423 beds within the hospital and 114 at the Cedars. As Frank Jacob wrote:

This extraordinary progress in the care and cure of sick people is due to the complete revolution in the theory and practice of medicine brought about by the application of the method of science. The revolution which did not begin until our hospital had half run its course and which we owe to Pasteur, Lister and Claude Bernard. Parallel with this was a spirit of humanity which inspired Florence Nightingale in her work, and all those noble people who have built and maintained our hospital.

The population of the town and county of Nottingham had increased from 100,000 in 1782 to about 800,000 in 1948. Now the hospital – which had grown by means of more than a million pounds of voluntary investment, was preparing to join all the other hospitals under state ownership. Frank Jacob wrote:

One cannot avoid the feeling of regret that our old voluntary system with its many happy virtues has passed away. Neither can one avoid looking forward to the future. Shall we look forward with hope or fear? Certainly with hope. Hope that the co-ordination of all the hospitals in the area may eventually bring benefit to all of them. Hope that the spirit of voluntary, unselfish help will survive and animate all the hospitals.

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CHAPTER 5

HOW OTHER NOTTINGHAM HOSPITALS DEVELOPED

When the National Health Service was formed in 1948, a wide range of hospitals had developed in the Nottingham area. As readers will recall, the rules of Nottingham General Hospital, stated that no cases of mental illness should be admitted. Mr John Storer the hospital’s first physician was instrumental in the establishment of Sneinton Asylum, which opened for 60 patients in 1810. The asylum became the forerunner of Mapperley Hospital, opened in 1880 and Saxondale Hospital, near Radcliffe-on-Trent, closed in 1988 after 86 years’ service as an important psychiatric hospital.

The Children's Hospital

The Children's Hospital had evolved from Victorian times. In 1869 a group met to found a hospital for sick and poor children. The daughter of architect T.C. Hine bought a house at 3 Poston Street, which she presented to the committee. The original nursing staff were recruited from the sisters of St Lucy. So the building became known as Lucy's Home or Telford Place but its official title was the Free Hospital for Sick Children. The entrance gateway to the hospital, parts of which are still in use in other capacities, was bought by T.C. Hine from Alfreton Church when it was undergoing Victorian restoration in the 1870s. In 1876 and new wing was added, followed by 1878 by an isolation block, the gift of the Jacoby family in memory of their daughter.

The old Children’s Hospital, Postern Street.

Overcrowding was soon a problem, prompting eminent lace manufacturer Thomas Birkin to endow a mansion house off Mansfield Road to become the new Children's Hospital. It was opened by the Duchess of Portland in 1900 with 40 beds, which increased to 80 when Princess Mary opened the Player extension in 1927.

Mrs W Saunders, a young patient having a tubercular gland removed in 1903, recalls salt and sand bags being used to keep her head in place. Bad teeth were extracted without anaesthetic and she remembers nurses holding her mouth open and making her swallow rice pudding. Parents had to stand outside the ward during visiting times. And when my mother arrived at 8am with my clothes to take me home, a sister bluntly told her: ‘We don't discharge until 10am – come back then.’ Another lady, E.M. Cox, went into the Children's in 1929 to have her tonsils removed. The day after the operation she was wrapped in a red blanket to wait for parents before setting out on a 12 mile journey home... by bus. But the experience cannot have been too daunting. Later she returned there is a nurse and vividly remembers that fateful night in 1939, bed bathing patients on Margaret Jenny Player Ward when the siren sounded to announce the declaration of war. Later, hurried arrangements were made to remove as many patients as possible to safety. For some that meant clothes baskets in the basement! Youngsters were also transferred from the General Hospitals children's ward, which W.G. Player had built on the top of the Jubilee Wing. It was thought its position was too dangerous and they were transferred to the Children's Hospital. The ward became a women's surgical ward. Taking the Children's Hospital away from the General Hospital posed no problems since staff who specialised in the care of children did not interchange with the staff of the adult illness General Hospital. The twentieth century development of expensive techniques such as X-rays, pathological tests, isotope scans and computerised tomography made it necessary to decide whether it was more economical to duplicate such facilities, or to take children to larger general hospitals, where these resources would be centralised. This dilemma, unforeseen in 1900, was resolved in 1978 when the Children's Hospital closed and its occupants became the first in-patients of University Hospital. The buildings vacated by the Children's Hospital were renamed Forest House and became the headquarters of Nottingham Health Authority.

Nottingham Children's Hospital, Forest House.

Women's Hospital

The General Hospital set 12 beds aside for women's diseases in 1875 but in 1893 a separate Women's Hospital was created in two splendid Georgian houses near St Nicholas Church, 29-31 Castle Gate, now occupied by Radio Trent. In 1919 the Women's Hospital move to purpose-built premises on Peel Street, and Mr Alexander Moxon Webber was appointed honorary surgeon. It combined in 1929 with another small hospital, the Samaritan Hospital in Raleigh Street, to create a 60 bed unit. Mr John Player provided £25,000 towards another 38 beds opened in 1939. The building, closed in the early 1980s when services transferred to the University Hospital, was later converted into luxury flats.

29-31 Castle Gate.

Women’s Hospital, Peel Street, now luxury flats.

Eye Hospital

The Nottingham Eye Dispensary was founded in 1859 in Park Row. It then moved to a house at 56 St James’ Street (now the site of the Albany Hotel), where its title was changed to the Nottingham and Midland Eye Infirmary. Supported by voluntary contributions, the volume of work increased and once again new premises became essential. A purpose-built Eye Hospital in the Ropewalk was opened by the Duchess of Portland in 1912. It was subsequently enlarged to 63 beds with supporting accident and outpatient facilities. In 1959, on the celebration of its centenary, the infirmary's title was changed to the Nottingham Eye Hospital. The most modern equipment for eye treatment was installed and it became a centre for corneal grafting. By 1970 about 24,000 patients a year were attending the Eye Casualty Department and the Eye Hospital. Casualty in outpatient clinic services transferred to University Hospital in 1977 and all eye services transferred there in 1983. The Ropewalk building became the headquarters of the Nottinghamshire Family Practitioner Committee.

The Nottingham and Midland Eye Infirmary, opened 1912.

Highbury Hospital

Highbury Hospital opened in 1815, as the Basford County Institution, remained a workhouse until 1925-30. Many of the original buildings have now been demolished. By 1970, the hospital had 312 beds – 188 of them for acute medical, surgical, maternity and gynaecological patients, and 124 beds for mentally handicapped patients. The hospital now provides 100 beds for the elderly and about that number for people with a mental handicap.

City Hospital

The City Isolation Hospital and Sanatorium at Bagthorpe was built between 1889 and 1891. About 1885, the Board of Guardians purchased from the Corporation some 60 acres of land off the Hucknall Road and the Bagthorpe Workhouse and Infirmary opened in March 1903. The older workhouse buildings were renamed Valebrook Lodge in 1937 and the City Infirmary became the City Hospital. Military patients were treated there during both World Wars. Soon after the municipal hospital was established, the foundations were laid for three specialised units which were to develop greatly over the next 40 years. Up to this time, the hospital had been largely dependent for specialist medical and surgical advice on doctors visiting from elsewhere – mostly Nottingham General Hospital. The City and County Local Authorities saw the increasing need for skilled surgery in cases of pulmonary tuberculosis and other chest disorders and in 1936 they appointed Mr Lawrence O'Shaughnessy to conduct a thoracic surgical operating session one long weekend in each month.

Over the years the number of hospital deliveries has been steadily rising, and all the medical officers took a share in this work. The first full-time resident obstetrician and gynaecological officer (Dr J.B. Cochrane) was appointed in 1938.

1903: South view of the Bagthorpe Workhouse and Infirmary.

It had been the custom for medical officers to carry out the simpler laboratory tests on their own wards but in 1938 Dr A.H. Johns opened a clinical pathology laboratory with one technician to help him. The scope and efficiency of the tests improved greatly although some specimens were still sent to the General Hospital Laboratory. The City Hospital expanded tremendously as a major teaching hospital in the 1970s and further developments are planned in the 1990s.

Harlow Wood

Harlow Wood Hospital, one of the most up-to-date and best equipped orthopaedic centres in the country, was opened by the Duke and Duchess of York in 1929. The land on the site near Mansfield – originally part of the old Sherwood Forest – was given by the Duke and Duchess of Portland. The hospital serves a wide area, including many patients from Nottingham.

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CHAPTER 6

THE GREAT BENEFACTORS

As a voluntary hospital, Nottingham General depended on the generosity of its benefactors. It was fortunate to be given great support by the local gentry and the business people of Nottingham. The work begun by John Key and the Duke of Newcastle and other original subscribers continued in various forms, even beyond the day when the hospital became part of the National Health Service.

Sir Charles Seely, Bart (1833-1915)

Born in Lincoln, he was Lieutenant-Colonel of the Robin Hood Rifle Volunteers from 1869 to 1895 and MP for Nottingham from 1869 to 1874; 1880-85 and 1892-95. After retiring from Parliament he was made a Knight of Grace of the Order of St John of Jerusalem, becoming a baronet in 1896. He was High Sheriff of Nottinghamshire in 1890. His association with Nottingham General Hospital covered nearly half a century. During that period he made immense gifts, both of money and personal commitment. His principal donations included The Cedars and an adjoining house in 1887, which became a pre-convalescent unit and is now a rehabilitation centre. He gave the bridge to link Postern Street with the main hospital and bought two houses for the use of TB patients. He was also chairman of the committee which raised funds for the Jubilee Wing, a handsome addition to the hospital and he personally provided a new entrance hall. First elected president in 1873, he held the office nine times and he was chairman of the Monthly Board from 1897 until 1914. He was made a Freeman of the Borough in 1895 and died in 1915.

William Goodacre Player (1866-1959)

The Player family has provided the hospital with numerous facilities and Mr W. G. Player must rank with Sir Charles Seely in his generosity to the hospital. He gave £10,000 towards the cost of the Memorial Nurses Homes, contributed £50,000 towards the Ropewalk and £28,000 for a new Medical Wing. He also created a children's ward named Mabel Player, after his wife. He was president of the Monthly Board from 1915-18 and chairman from 1926 to 1932.

John Dane Player (1865-1950)

Mr J. D. Player donated £25,000 in 1933 to launch the fund for a Pay Bed Wing. He also gave £40,000 to assist a major project for the Children's Hospital and gave great help to the Women's Hospital. The Freedom of the City of Nottingham was conferred on him in 1934 in recognition of his services to the city.

Sir Louis Pearson (1863-1943)

The General Hospital owes a great deal to the Pearson family. Sir Louis Pearson succeeded Mr W. G. Player as chairman of the Monthly Board. He gave £1,000 towards extending the Cedars; £5,000 towards the cost of the Ropewalk Wing, £7,000 for an operating theatre (which was named after him) and he also endowed two beds. He was responsible for raising £12,000 towards the cost of the Pearson Nurses Home and built a covered walkway, leading from the side of the Board Room to the Nurses Home, in memory of his daughter Gladys, who was a VAD nurse during the 1914-18 war. He was President of the Hospital in 1924-5 and chairman of the Monthly Board until 1942.

Lieutenant-Colonel Noel Gervis Pearson (1884-1958)

Nephew of Sir Louis Pearson, he was chairman of the Monthly Board when the Hospital became part of the National Health Service. He was the first Chairman of the Nottingham No 1 Hospital Management Committee which was established in 1948. Gervis Pearson Ward was named after Lieutenant-Colonel Gervis Pearson in recognition of his important contribution to the hospital. At the outbreak of the First World War, he enlisted in the Ninth Sherwood Foresters and served with

40 distinction – he was awarded the MC in 1916, the DSO in 1918 and was twice mentioned in dispatches. He was president of the Hospital in 1930-1 and 1947-48. Miss Molly Denman recalls:

He was a great big man and sometimes he would go round the hospital at 5:30 in the morning. When I was Night Superintendent he used to just come in the office and say ‘Good morning’ and go to some of the wards. He was the sort of person who would go and see for himself that something was required and see that the wards had it.

Finding the nurses had to clean up bedding when patients were incontinent; he had washing machines installed in every ward. This caused a lot of contention when the General Nursing Council, which said that nurses’ must not do washing. But in the end the hospital won the day. Every nurse had a pair of scissors as part of their equipment and Lieutenant-Colonel Pearson would himself stamp each nurses’ named on a brass nametag in the workshop of his home in Bramcote. A Church of England lay reader, he conducted morning service from the hospital chapel once a week and in 1951 compiled a book of prayers, which has been used by many hospitals around the world. He paid for the book to be published and arranged for copies to be sent free to any nurse anywhere in the world who wanted one.

Frederick Attenborough

A Nottingham pensioner, who died in 1869, left his life savings – £4,200 – to the General Hospital. The man of humble origins, he received a head injury early in his life and he always maintained that the treatment he received the General saved him. He later enlisted in the Third Dragoon Guards and was in the service until 1851. Private Attenborough was discharged with a medal for good conduct, a pension of 1s 6d a day and a valuable tea service from Col Arthur and officers of the regiment. He never married and left all his property to the General Hospital. He was buried in the General Cemetery and memorial stone records the hospital committee’s thanks for his ‘generous and grateful deed.’

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CHAPTER 7

THE MOMENTOUS YEARS 1948-1982

Two systems of hospital care had evolved in Britain. ‘Municipal Hospitals,’ like the Nottingham City Hospital, were maintained by local authorities from the rates while ‘Voluntary Hospitals’ like the General relied on subscriptions and gifts. The war had shown that the two types of hospital could work closely together to provide a national hospital service. Many of the voluntary hospitals were in a parlous financial state. So when the political desire to create a health service free at the point of use but supported by compulsory taxation came to fruition in 1948, all hospitals, voluntary and municipal were absorbed into the newly created National Health Service. The cost of treatment had increased enormously. Between 1783 and 1947 the number of hospital beds increased tenfold and annual expenditure had risen from £900 to over £230,000. In the early days of the General Hospital, it was funded mainly by the wealthy. By the end of the nineteenth century, a large part of the hospital's revenue came from less prosperous sections of the community – collections in churches, the mines, factories and other places of work. In 1939 the Hospital Saturday Contributory Fund was introduced. For a payment of 4d a week, deducted from wages, a man was entitled to treatment, together with his wife and dependents, in any general or municipal hospital in the country. Each patient was given a voucher and when this was returned by the hospital to the appropriate contributory fund, the latter would pay a proportion of the cost of the treatment. Anybody who did not belong to a contributory scheme and who could not afford to pay still required a letter of recommendation from the subscriber to receive treatment at the General Hospital. In addition to financial contributions, the hospital received gifts in kind. Egg, potato and vegetable weeks were organised to provide patients with more appetising and healthy diets and, even

41 when such foodstuffs were rationed during the Second World War, the people of Nottingham proved exceedingly generous. The 165th annual report for 1947 – the last year before nationalisation – notes that the officers included Lieutenant-Colonel Noel Gervis Pearson (President), William Goodacre Player (Vice President) and Lord Trent (Trustee). It reports:

Like his great predecessors, Sir Charles Seely and Mr Player, Lieutenant-Colonel Gervis Pearson has a love of beauty and has made the hospital garden a very lovely thing. The magnificent stretch of emerald green grass, with its restful paths and herbaceous border, which flanks the main building, is at once a delight and a joy to patients and nurses alike. At one time there was a goldfish pond outside what is now the matron’s office. There are tables and rustic seats, and lifelike models of animals on the roof of the small power house. The covered way leads from the side of the Board Room down to the Nurses’ Homes. Here beds of daffodils delight the eye in season and a double tennis court provides pleasant recreation.

Lieutenant-General Pearson also renovated the old clock which had marked the passing hours from the early days of the hospital. The first bells were not heavy enough to be heard all over the building and the maker provided new bells, weighing three tons. The hospital was taken over by the Sheffield Regional Hospital Board on 5 July 1948. Lieutenant-Colonel Pearson became Chairman of the Nottingham No. 1 Hospital Management Committee, which governed the General Hospital and a group of other hospitals including Ruddington Hall, the Cedars, Basford Hospital, Newark Hospital, Hawtonville Hospital and Nottingham Eye Hospital (then known as the Nottingham and Midland Eye Infirmary). One of the first achievements was the amalgamation of the 60-year-old Ear, Nose and Throat Hospital with the General Hospital and the addition of 13 more beds in that department. The General Hospital’s long tradition of care for the people of Nottingham provided a firm basis when the National Health Service was established in 1948. A member of the consultant staff arriving during this period, and himself a general physician or general surgeon, was struck by the standard of excellence and devoted service he found. In his opinion, the standards were set primarily by the general physicians and general surgeons. The hospital continued to grow and the solid foundations laid by the early benefactors was strengthened by a number of new departments. These included the establishment of a new Dental Department, on the Ropewalk, the building of twin theatres on the roof of the hospital's original building and the extensions to the Casualty Department in the Ropewalk Wing. Virtually all the development took place when the hospital was under the guidance of the Nottingham No. 1 Hospital Management Committee, which was established in 1948.

Frank Jacob Ward, 1950s.

The 1950s saw the Department of Pathology greatly extend its work and adopt many new techniques, particularly in the field of biochemistry. The Radiotherapy Department also continued to expand and acquire new equipment. An additional story was built on the Ropewalk Wing, providing a 32 bed ward for radiotherapy cases. In 1963, an intensive care unit was opened at the General Hospital, in which the most seriously ill patients could be kept under close observation, using newly developed monitoring equipment and life-support machines.

The Medical School

In 1965 it was decided that Nottingham would be the location for Britain's first new medical school since 1893. The school was to be associated with a very large new hospital, which was to be built near Nottingham University. This momentous move, first announced in Parliament in July 1964, significantly shaped the future pattern of hospital provision and health care in Nottingham. Its profound impact on the General Hospital is examined in greater detail later in this chapter. After considerable delay in the acquisition of the site, construction of the 1,400 bed University Hospital and the medical school began in 1971. The first medical students arrived in Nottingham in 1970. Since the construction of the medical school had not yet started, they were housed in newly built accommodation intended to be occupied later by the Department of Pharmacy. The first students were ready for clinical training in 1973 and because of the delay in building the new hospital, their training was carried out in the existing Nottingham hospitals.

Department of Medicine 1973.

The Medical Education Centre, Postern Street.

To enable the General Hospital to accept medical students in 1973, a further expansion of facilities was necessary. In 1968, an additional floor was built on the Player Medical Wing to provide accommodation for the University Departments of Medicine and Surgery. In 1969 a residential block for doctors and nurses were built on the corner of Park Valley and Lenton Road in The Park, on Park Terrace and The Ropewalk, were required for residences and for new departments. Thornton House

43 was converted in 1971 to enable the hospital to expand its outpatient facilities and a new Medical Library, teaching centre and car park were built on Postern Street in 1972. A Breast Screening Unit was opened in 1979 and a two-storey extension to the Dental Centre was completed in 1978. In 1981 a Hearing Services Centre was established and a second linear accelerator costing £250,000 was installed in 1982. A further £250,000 was spent converting a room in the Radiotherapy Department.

Trent Wing

The most important development was the building of the Trent Wing on the hospital's former front lawn and tennis courts at a cost of £1.4 million. Construction began in 1967 and the wing was opened by Sir Keith Joseph, Secretary of State for Health and Social Security, on 3 May 1972. The towering block, completely concealing the original eighteenth century building, was hardly in keeping with the rest of the hospital's architecture. But with no land available to expand outwards, they literally had to soar upwards. Although the wing was created as an expedient solution to the problem of providing much-needed beds and facilities for teaching medical students, it offered some of the finest ward and operating theatre accommodation ever commissioned in Nottingham.

Operating Theatre, Trent Wing.

In all, the Trent Wing provided nine floors of additional accommodation including three surgical wards, Daybrook, Carlton and Beeston, on the third, fourth and fifth floors. This created an extra 84 beds in six bed and single bed bays. There was a suite of operating theatres, an endoscopy unit, a mortuary, stores and sterile supplies unit. The wing also contained centralised and much improved kitchens and dining facilities for staff and patients. A spacious new dining room next to the kitchen had fitted carpeting and attractive lighting. A comfortable coffee lounge, adjoining the dining room, and there was a separate sandwich room for staff who brought their own lunch. Two floors of laboratories replaced the old Ransom Building pathology department in Amberley Street, which had become extremely cramped. The wards represented a new style for the General Hospital. Each has four rooms containing six beds and four single bed rooms. Patients have bright, well-furnished day rooms and an overnight room for the use of a relative visiting a patient who is very ill. The theatre suite included one theatre for general surgery and another for orthopaedics. This brought the General Hospitals complement to main theatres to five. At this time the General Hospital had 1,400 staff and plans were provided to recruit another 200 to cope with the extra work generated when the Trent Wing became fully operational. The end of the 1960s has also seen the upgrading of the Shipstone and Pearson Theatres and the addition of an eight-bed intensive care unit. These theatres, plus a temporary one above Portland Ward, were used until the Trent Wing was commissioned. The Trent Wing, which took several years to build, had actually been conceived in 1955 – long before the Medical School and the University Hospital were approved.

Other Developments

An extension to the War Memorial Nurses’ Home at 2 Park Valley, provided extra accommodation for 63 nursing staff and 1 Park Valley was converted into flats for married medical staff. Nottingham's new joint School of Nursing opened at the General Hospital to link in with University Teaching Hospital. The Pharmacy Department, growing in importance with the advent of new, powerful drugs, was upgraded in 1968. The extensions included additional storage, mechanical ventilation system and a new automatic high-speed autoclave. Work, costing £60,000 went ahead in 1974 to upgrade Fleet Ward – one of the oldest parts of the hospital. But the General were still bulging at the seams, struggling to cope with a 40 per cent increase in patients admitted without a corresponding increase in beds. At that time 45 patients passed through each of its beds in a year compared with the figure for London hospitals in the lower 20s. By 1978 situation had reached crisis point. Seriously ill patients were being refused admission because of an acute shortage of beds. One of the main problems was elderly fracture patients occupy up to 60 beds needed for surgical and medical waiting-list cases. A consultants said: ‘The hospital

45 situation in Nottingham will get better as the new teaching hospital brings in extra resources.’ Fortunately – that relief was now coming. The Queen visited Nottingham as part of her Jubilee celebrations on 28 July 1977 and performed the opening ceremony of the new University Hospital and Medical School. It was described in 1979 is the largest group of hospital buildings in the world. It was built at a cost of about £70 million, equivalent to two Concords. The architects Building Design Partnership, produced a structure comprising four blocks, three for the hospital and one for the Medical School, linked around a central service area. The giant complex was progressively opened as money allowed. But it was the mid-1980s before 1,300 beds were commissioned. By then many services had transferred from the General Hospital, which was now fighting for survival. We have described how separate developments for mental illness, children's services and a number of specialities were established away from the main General Hospital site. Some elements were reunited in University Hospital, enabling it to be a truly general hospital. The hospital has fulfilled its destiny to combine the best in teaching and patient care. As Professor William Waugh commented:

Some like Queen's Medical Centre; others find it large and impersonal. But it does work and all those (and there were many) who brought this massive endeavour to a successful conclusion are often forgotten, but they deserve very much more credit than they are usually given.

When the need arose the General Hospital rose magnificently to the challenge of providing desperately needed facilities for the new medical students. At first it was envisaged that it would continue in full use as a support hospital when the University Hospital became fully operational. By 1980, however, it was evident that there was not enough money to open up University hospitals second phase and keep the General in full swing. As the General prepared for its bi-centenary anniversary, it faced its gravest hour.

The General Hospital’s Contribution to Medical Education

Of course the project which ultimately sealed the Generals destiny was the decision announced in Parliament in July 1964 that Nottingham was to have a new University Hospital and Medical School. Setting up the first new medical school to be established in Britain this century (Cardiff had been the last in 1893) was a daunting task. In October, 1965 a Medical School Advisory Committee under the chairmanship of Sir George Pickering, then Regius Professor of Medicine of Oxford was formed to advise the University on various aspects relating to the establishment of a medical school. The Committee took evidence from the number of local consultants, and also visited the City and General Hospitals. The enquiry report declared:

It was clearly important to enquire whether the existing hospitals in Nottingham might satisfy the University's need without there being a teaching hospital built for this purpose. We visited the City and General Hospitals and we found that we agreed with the opinion of the officers of the Regional Board and while they have an important part to play in the whole arrangements for medical education they would not be suitable as teaching hospitals. They are too far off from the proposed medical school at the University to allow integration. To set up a Medical School in such circumstances would be to perpetuate a defect which has made the proper organisation of medical education impossible. The hospitals are designed as service hospitals. They do not have, and cannot have, except at enormous expense, the facilities needed in a University Hospital in the second half of the twentieth century.

Alternative sites were considered before they settled for the one off the Derby Road, near the University. The alternatives included Ruddington, Clifton, Bramcote and University Park (Highfields). Sue Ablett, who has researched the history of the Medical School says: ‘Wollaton Park was also mentioned but I don't think that was ever really a serious suggestion.’ The Pickering report wisely recommended that academic staff needed to be in post long before the students arrived to prepare Nottingham physically and emotionally to absorb the impact of

46 the huge teaching hospital. As a result David Greenfield, Foundation Dean of the Medical School and Tony Mitchell, Foundation Professor of Medicine, arrived on the scene and was soon followed by five other foundation professors. A joint University and Regional Hospital Board Planning Team was appointed to design the new teaching centre with people such as Robert Graham and Jim Scott playing a key role. But an unexpected major stumbling block soon emerged. There were legal problems over the acquisition of the site for University Hospital and the Medical School. This led to a seven-year delay before building started in 1971 – and the first students were to arrive in 1970. So it became clear that the existing Nottingham hospitals and their staff would have to be used for all of the teaching in the early years. Thus the General Hospital played a crucial role in giving birth to the Medical School.

1969: The site of what is now the campus for Nottingham's Queens Medical Centre.

The Pickering Committee had planned on the basis of Nottingham Medical School having about 132 students a year. Because of the delay in building University Hospital the Medical School started with an entry of 48 students a year, of whom 24 were received at the General Hospital and 24 at the city hospital. As an insurance against further delay in the building of University Hospital and to help with the influx of students at the General Hospital, the Trent Wing was opened in 1973. Sue Ablett takes up the story:

The appointment of Tony Mitchell as Foundation Professor of Medicine was important for the General. When he arrived in Nottingham he was adamant that, as the representative of the new Medical School, he needed beds at both hospitals. Both were very welcome and he took over the beds of the vacant post at the General. A sad series of deaths among some greatly respected members of the medical staff meant that, within a relatively short time, he was the longest serving senior physician at the General.

The appointment of Jack Hardcastle as Professor of Surgery in 1970 gave further impetus to developments at the General. Although, when he was first appointed, he had very few facilities – only about six beds, he found the other consultants most helpful and, in fact, the small amount of clinical work allowed much-needed time for planning the clinical curriculum. Latest surgery was provided

47 with academic accommodation at the General Hospital identical to that provided for the Department of Medicine. Considerable readjustment was called for on the part of all members of staff and they responded enthusiastically to the challenge of playing a part in the new teaching arrangements. Dr (now Professor) Stephen Jones was appointed as the first Clinical Sub-Dean to co-ordinate clinical teaching across the whole area. In an article written in 1976, Professor David Greenfield, the first Dean of the Medical School reflected:

People living along way from Queen’s Medical Centre may question this concentration of resources. I understand their fears and views. Certainly the economic climate has changed since the centre was first proposed. But I believe its establishment has brought to Nottinghamshire health resources which otherwise we would not have so quickly if at all. This is because it is meeting a national need for medical education as well as local need for service. Ten years ago, [in 1966] the pressures on the medical services in and around the city had reached unacceptable levels. Health facilities were only about 70 per cent of the average level in the rest of the country. Now things are very much better, though there is still room for improvement. The Queens Medical Centre is principally about people. A great many of those working in it have had long experience in Nottingham, particularly in the General, the Children's and the Eye Hospitals, and patients will find the same spirit of service has been developed over the years in our other hospitals. And they will find facilities of which Nottinghamshire can be proud.

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CHAPTER 8

THE GROWTH OF SPECIALIST SERVICES – DOCTORS’ MEMORIES

Introduction

Medical science had developed during the nineteenth century to such an extent by 1900 it was no longer possible for one man to be familiar with all the theoretical information and practical skills available to the practising clinician. A growing number of practitioners, instead of taking exclusive responsibility for their own group of patients, began to rely on the referral system, whereby a GP or doctor with a wide range of patients to look after would call in a specialist for advice. This produced changes in the way doctors organised their practices. Consultant specialists began to take rooms in a central position where they would be convenient for both patients and general physicians visiting for advice. In 1873 there were 36 qualified medical men in Harley Street and by the end of the century 157 specialists were practising their. One of the first to put a plate on Wimpole Street was Dr Conan Doyle (creator of Sherlock Holmes), who had intended to become an eye specialist but soon abandoned medical practice to become a full-time author. Anaesthetics was one of the first branches of medical practice to acquire its own group of specialists. After Dr John Snow successfully administered chloroform to Queen Victoria at the birth of Prince Leopold, many other physicians chose to specialise in the administration of anaesthetics. Other specialists developed as technical skills and knowledge became too complex for the general practitioner to master, and before the end of the nineteenth century there were specialists dealing with the skin, the throat, the bladder, the nervous system, infectious diseases, rheumatism, gout, cancer, the heart, the lungs, the mouth, the eye, the liver and just about every other part of the body. When the principle of asepsis was accepted by surgeons and the number of operations which could possibly be performed successfully expanded, surgical specialists began to develop too. From the earliest days the General Hospital was fortunate in the quality and vision of its physicians and surgeons. Attenburrow was vaccinating his own and other children in 1800 – just two years after Jenner had made public his life-saving discovery. Anaesthesia was in use by Sibson at the General Hospital as early as anywhere in Britain and the antiseptic techniques of Lister were promptly adopted.

At the turn-of-the-century the General Hospital had only five resident medical staff – a house physician, assistant house physician, a house surgeon and two assistant house surgeons. So, apart from surgery, which began to develop in the 1870s and 1800, the growth of specialist hospital departments was a twentieth century phenomenon. The X-ray department began when a simple X-ray machine was presented to the hospital in 1898. Two rooms in the basement were equipped to accommodate it and Mr Blandy, the Honorary Dentist, took charge of the new department. A year later 91 photographs were taken successfully, proving of immense value to the physicians and surgeons in their diagnostic work. In a well-endowed hospital like the General, doctors discovered they needed to be assisted by specialist support staff. Roentgen’s X-ray equipment, for example, may be employment of specialist technicians necessary. It also led to the introduction of a new speciality, radiology, and by opening whole new areas of the body which had hitherto remained mysterious and impregnable, led directly to even more specialities developing. New X-ray equipment, enabling instant X-rays was installed in October 1915 and an extension and reorganisation of the radiology department was begun.

X-ray equipment, installed in the Gen Hospital in 1898

A physiotherapy department was established a month later. Treatment by electrical devices and massage had been carried out for many years but it had not been put on a sound and progressive footing. By the end of the war no new convoys were arriving but a large number of disabled soldiers were needing treatment. At the request of the Ministry of Pensions an orthopaedic centre was started in the temporary hut cited on the front lawn of the General Hospital. At first, services for 40 patients were directed by Mr W.F. Neil. Later services for 75 patients were developed with Mr C.H. Allen in charge of in-patients and Mr Neil responsible for outpatients. They were assisted by Mr A. R. Tweedie for ear, nose and throat cases and three physicians, Dr W.T. Rowe, Dr J.W. Scott and Dr H. S. Smith Wallace for medical cases. In 1920 the hospital increased its honorary staff with a medical officer in sole charge of the X- ray and Electro-Therapeutic Department, an honorary physician in charge of the Skin Department and two honorary anaesthetists. The Ear, Nose and Throat Department was established in the same year with Mr A. R. Tweedie and Mr H. Bell-Tawes appointed honorary surgeons. They had, at first, only a few beds and very poor accommodation for both in-patients and outpatients. But their skills were rewarded with the opening of the Ropewalk Wing in 1927, which gave them excellent facilities – 40

49 beds, a children's ward, a well-equipped operating theatre and outpatients department, all on one floor. The Wing also contained a Physiotherapy Department and a large gymnasium. In aural surgery, Mr Tweedie, Mr E.J. Gilroy Glass and Mr Bell-Tawes were outstanding surgeons. Mr Bell-Tawse was for many years secretary of Nottingham Medico-Chirurgical Society, one of the oldest medical societies in England, founded in 1828. Mr Tweedie devoted his spare time to the welfare of the deaf and was instrumental in acquiring a fine building in Forest Road for the Nottingham and Notts Institute for the Deaf. Further progress in a scientific approach towards medicine at the General Hospital came in 1925 with the opening of the Ransom Pathology Laboratories. They were named after two imminent General Hospital physicians, Dr W.B. Ransom and his father Dr W.H. Ransom. But it was the opening of the Ropewalk Wing in 1927 which really heralded the arrival of specialist facilities at the General Hospital. The Wing provided an Outpatient Department, and inpatient ward for ear, nose and throat patients, an X-Ray Department fitted with the latest equipment and a Physiotherapy Department. A new dispensary was also opened and the new wing enabled the old Outpatients’ Department in the main building to be converted to a Casualty Department in 1929. The old Fever House, dating from the 1930s, was completely reconstructed to make a new surgical wing.

Early 1920s Outpatients Department, Nottingham General Hospital.

Casualty Department, 1929. Note the ambulances.

Interior of the Casualty Department, 1929.

In 1923, Mr A.R. Anderson, honorary surgeon for 34 years, retired. His only son Kenneth had been killed in France during the first few weeks of the war and Mr Anderson devoted most of his time to wounded soldiers. A ward was named after him. During a doctors ‘dinner in his honour, a speaker reflected:

He has lived through wondrous times and witnessed a revolution in the art of surgery. He has seen the black night of sepsis, seen dawn and the eastern sky flecked with light, seen the sun rise and sepsis disappear before the glorious light of Lister's discoveries. Mr Anderson has been a pioneer in our city. He has worked by the strong light and given life to multitudes who otherwise would have died and has trained a band of faithful followers to carry on the work.

Mr Anderson, a former president of the Medico-Chirurgical Society, was awarded the CBE in 1919.

Surgery made tremendous advances in the first 40 years of the century. In 1899 the General Hospital had just two operating theatres – and one was woefully inadequate. By 1939 five more theatres had been added – a specially designed ear, nose and throat theatre, a small theatre in the casualty department, a fine theatre built by Sir Louis Pearson in 1931, the Shipstone Theatre and the new Theatre exclusively for the Pay Bed Wing. This was the age of exciting discoveries. In 1929 Alexander Fleming noticed that a mould called penicillium produced a substance which he called penicillin. This substance had valuable ‘antiseptic’ properties and seemed entirely harmless to man. However, it was not until the 1940s, under the stress of war, that Chain, Florey and other associates in England were able to produce penicillin in usable quantities. Since then, penicillin has remained one of the most important antibiotics in the treatment of many infectious diseases. Meanwhile the General Hospital’s turnover of beds began to increase and there was a need for convalescent facilities. The Cedars on Mansfield Road, originally the home of Mrs Gertrude Seely, was given to the General Hospital for use as a small convalescent unit during the First World War. In the early 1920s, Lord Trent, gave £50,000 for the upkeep of the hospital. A further 60 beds became available in 1932. In 1932 – the hospitals 150th anniversary – Frank Jacob reflected:

The new doctor has a scientific outlook – but he has not lost his humanity. The progress of the science of medicine has been incredible. In surgery, formidable operations to the brain, chest and abdomen are carried out without pain and with little more risk than crossing the street.

At that time, he ranked the three greatest discoveries in the previous 25 years as blood transfusions, insulin for diabetics and liver for pernicious anaemia. The first blood transfusions were carried out

51 soon after the First World War. At first the donor was always a relative or friend of the patient. Nottingham Boy Scouts, aged over 17, organised the city's first blood donor service in 1929. Frank Jacob recalled the remarkable recovery achieved by the use of insulin.

In 1923 there were in my wards two men and one woman in the last stage of diabetes, feeble, wasted to skin and bone, ever parched with thirst, all doomed to certain death within a few months. Thanks to insulin all three soon became well-nourished and strong, the farmer doing his ordinary heavy farm work, the clerk at his desk, the woman that a household duties and enjoying her tennis. All three were still in good health and enjoying life when I retired in 1937.

He also recounted the cases of a doctor friend who in 1925 was in a diabetic coma.

Instead of dying in 48 hours as he would have done before the discovery of insulin, he recovered and in a few days was seeing his patients again. There is something dramatic about this action of insulin which is only equalled by the effect of blood transfusion to the man who is dying from loss of blood.

As more and more specialist departments opened the General Hospital needed more convalescent beds. In 1946 arrangements were made with the British Red Cross Society to use Ruddington Hall as a pre-convalescent annex with beds for 60 patients. It was acquired by the Ministry of Health in 1952 and extended a year later when Orchard House was given to the hospital by an anonymous donor. The extension to the Memorial Nurses’ Home, which opened in 1955, contained a new guest lounge called the Bramcote Rooms for nursing staff to entertain friends and relatives.

The Bramcote Rooms.

With the opening of the Trent Wing in 1973 – the hospitals most significant development of the century – the General had a total of 545 beds with another 48 in the Pay Bed Wing. The hospital was that the height of its powers. The main specialities were general medicine, surgery, accident and emergencies, orthopaedics, radiotherapy, dental surgery and ear, nose and throat surgery. We now consider how these departments develop it in greater detail and doctors and consultants past and present reflect on those momentous years.

Advances in Medicine

Dr John Bittiner writes: The advancement of medicine has taken a great leap forward since the end of the Second World War. Great successes have occurred in all branches of medicine and surgery.

While clinical medicine has, to some extent, decreased in importance, technological advancements have more than made up for this. They have been great improvements in diagnostic medicine, following the discoveries of the previous 100 years (X-rays, cardiograph and various scopes) for inspecting the inside of the patient. The auriscope, ophthalmoscope and cystoscope have all been improved upon. Advancements in anaesthesia and muscle relaxing drugs have made possible new and sophisticated surgical techniques. The equipment of the General Hospital immediately after the war was scanty indeed compared to that of its final days as a great district general hospital in the late 1970s. In all disciplines plastics and disposables were used. Cutting down to a vain to give intravenous fluids was replaced by ‘giving sets’ of great reliability and sterility. In specialities such as cardiology, high-tech equipment like defibrillators and pacemakers were used. Kidney machines and other forms of dialysis were used in renal medicine. Numerous aids were developed for health care of the elderly, especially in the home, to help in cooking, washing and walking. Prosthesis in cancer, for example, following the removal of a breast – became much more sophisticated. The use of a grummet in the distressing condition of ‘glue ears’ in children was another innovation. Better hearing aids and new methods for testing hearing were developed. The linear accelerator became an invaluable piece of equipment in the Radiotherapy Department. In ophthalmology, powerful magnets and operating microscopes to remove foreign bodies from the eye were devised. Laser beams (now widely used in medicine) advanced the treatment for the detached retina. Fibreoptic's allow exploration of various parts of the bowel and bile ducts. The Department of Radiology has been advanced by body imaging ultrasound, radioactive isotopes, scanners and magnetic resonance (partly developed in Nottingham). Intensive care is now a household phrase. The recurring theme over the years of ‘not enough money to buy’ (as pointed out by Dr Neville Chambers) is well illustrated in intensive care in the General Hospital, where much of the monitoring equipment was made in the Medical Physics Department from ‘home-made sources.’ Microsurgery, in the repair of nerves, replacement of fingers and so on, benefited from special microscopes. Because of the difficulty in treating some diseases in the more advanced state, screening for them, to allow early diagnosis is now extensively and sometimes controversially used. The most common cancers sought are those of the cervix, breast and bowel. It is worth remembering that extensive screening was done for tuberculosis 50 years ago, mainly with the use of small X-ray films. The technique, known as mass miniature radiography, was often carried out in mobile vans. The improvement in anaesthesia and life support techniques has allowed the replacement and transplantation of various parts of the body. The most successful have been hip replacements, giving greater mobility and loss of pain to the recipients. Renal transplantation may allow a normal lifestyle. Knee joints and urinary bladders have also been successfully replaced or transplanted. This step before screening for disease is prevention. This usually requires widespread social change to be effective. Some preventative measures are now accepted; others are more uncertain. Few do not believe that smoking is harmful. The same may be said about excessive drinking. Most believe in some exercise. Gross obesity is obviously harmful. The value of diet in the prevention of disease is not proven. How much salt and sugar should be taken? How bad are certain fats for good health? Is stress bad? Virtually all British Prime Ministers have reached three score years and 10 in the past 100 years. Do prime ministers suffer stress? The prevention of certain genetic diseases by prenatal diagnosis is an ethical minefield. Some techniques such as scanning are safe and simple; others carry risks of abortion. The problem arises when the results of the tests are known – to terminate the pregnancy or not. Casting its influence over all aspects of medicine with its pervasive presence is the computer. Examination of the City of Nottingham Health Department National Insurance Formulary for 1937 shows scarcely a drug that is in use today. A few still in use include Aspirin, Phenobarbitone, morphine, atropine and digitalis. Most of the others had no or little therapeutic effect. But, the great many successes have occurred in the past 50 years in the treatment of both ineffective and non- infective diseases. The advent of sulphonamides in the late 1930s and penicillin in 1942 helped to eliminate many killing diseases often associated with the young. Few medical students or doctors in this country have seen puerperal fever with its high mortality or rheumatic fever with its ensuing

53 mitral stenosis and young death. Many other antibiotics and chemotherapeutic drugs have been developed since. One of the most important was streptomycin, in 1943, which helped control and almost eliminate tuberculosis. In 1938 there were about 28,000 deaths in this country from TB. Older people will remember the sanatoria overflowing with people with TB well into the 1950s. Whole families were decimated. A wide range of other bacterial diseases were also controlled. But not the viral diseases, that has yet to come. Another equally important attack on ineffective diseases was made by immunisation. There are now no cases of smallpox in the world. Diphtheria has fallen from tens of thousands of cases in the war years to only a few cases in recent years. The control of rubella, especially in young women, has been a big factor in reducing defects in the new-born. Acute poliomyelitis (infantile paralysis) with its devastating effect on the patient and family is now a rare disease. Other diseases preventable by immunisation include whooping cough, measles, mumps and tetanus. Most of these diseases when they do occur are in the non-immunised. In non-infective diseases there have also been many successes. In heart disorders, the beta- blockers and anti-hypertensives how much improved the outlook. Diuretics which were barbaric in their early years are now highly effective. Steroids are used in many life-threatening diseases, especially asthma. They have also helped to control many diseases and improve the quality-of-life in others. In blood diseases such as leukaemia and, also in cancer, chemotherapy has made big advances. Symptomatic control of Parkinson's Disease with drugs has overtaken surgery. Drugs for the management of psychiatric disease have to a large extent eliminated the very long stay hospitals and asylums. In-Vitro fertilisation (test-tube babies) are now commonplace. It could be argued that the contraceptive pill has changed women's lives more than any other single drug in history. And, of course, there are many more examples. But all drugs have their side effects. Sometimes they are calamitous. For example, Thalidomide, causing deformities in babies, and untreated Factor VIII infecting haemophiliacs with acquired immune deficiency syndrome (AIDS). There still remain many intractable problems such as arthritis and back pain, many cancers, coronary artery disease, stroke, Alzheimer’s disease and other dementias. The long-term future for continued advances in medicine remains with sound and rational basic research.

The City's First Woman Doctor

Dr Sarah Gray

General practitioners have a long tradition of serving the General Hospital. Dr Sarah Gray – the first woman doctor in the city – came to practice in Nottingham from Edinburgh, where she trained in 1890. A former Lady Mayoress, Mrs Hilda Hobson, recalled in 1955:

Dr Gray was a familiar sight, driving down Park Row from the General Hospital in her open Victoria. She was a little woman with very bright eyes and wore steel rimmed spectacles. She always wore a grey costume, perhaps she was deliberately unobtrusive. In those days there was a tremendous prejudice against women as doctors, and for years she had an uphill climb against it.

The First World War did much to break down not prejudice – six women doctors did excellent work at the General Hospital. General practitioners also made a significant contribution to the development of a specialist department of general medicine at the General Hospital. Men such as Dr W. Whimster, a visiting physician before the Second World War, became an honorary assistant physician in 1946 and then for consultant status after the formation of the health service.

Specialists emerge

When Tony Mitchell, Foundation Professor of medicine at Nottingham Medical School, arrived in Nottingham in 1967 there were six physicians – and some of them were shared between the General and the City Hospitals. A degree of specialisation had already begun. For example, a Department of Neurology was created, carrying out electrical recordings of the brain and other procedures. This service, started with just one visiting neurologist from Derby, developed with Nottingham eventually having three full-time neurology consultants. Nottingham is now a sub-regional centre for neurosciences, services having transferred from Derby Royal infirmary to University Hospital during the 1980s. But a lot of neurological disease, such as stroke, is still dealt with by general surgeons and physicians while staff from the Department of Health Care of the Elderly tend to be responsible for patients suffering from dementia. A specialist interest in heart disease was initiated by Dr P.H. O'Donovan, who became a consultant physician at the General Hospital in 1937. This interest in cardiology was continued by Dr Reginald Twort and an embryo cardiac department was established. It was equipped to carry out basic ECG recordings and had its own X-ray machine. Later a Department of Cardiology was developed by Professor John Hampton. The key feature of the planning a specialist services in Nottingham during recent decades has been to prevent duplication on the City and General Hospital sites. While the City was beginning to specialise in thoracic surgery, burns, plastic surgery, lung cancer and respiratory diseases, the General built-up specialist eye, ENT and radiotherapy services. Nottingham's health services in the 1960s were woefully under resourced with an acute shortage of doctors in hospital and general practitioner services. The opening of the Medical School attracted an influx of medical expertise. Many more specialists arrived such as Dr Peter Toghill, a physician with a special interest in liver disease and haematology, and Dr Michael Langman a specialist in therapeutics.

Dr John Proctor Remembered

Many local GPs were housemen at the General. Two consultants Dr Peter Toghill and Dr Robert Tattersall cut their teeth at the General as registrars. One of the most popular consultant physicians was Dr John Proctor. He collapsed and died while playing golf at Hollinwell with Dr H.M. Rice, senior pathologist at the General Hospital. Was past president of the Medico-Chirurgical Society, and specialised in diabetes.

Dr John Proctor

Hundreds of people from all walks of life crowded into the Nottingham Albert Hall Methodist Mission for his funeral service in 1966. An elderly woman sobbed as she entered the hall and said: ‘He saved my life.’ The Rev Kenneth L Waights, a former superintendent Minister of the Mission and a friend of the doctors said: ‘He was the beloved physician, an extension of the spirit of the Man of Galilee who went about doing good.’ Dr W.S. Whimster and Dr Proctor had a tremendous love of people. Even when exhausted and in need of rest, he would work incredibly long hours in the service of his patients. ‘He was often found on the wards in the small hours because he was worried about a patient.’ Dr Michael Wells, who had been a senior medical registrar, took his place.

Dr Peter Toghill, Consultant Physician

I came to the General Hospital as a house physician in 1955 for two years. First of all I was working with John Sheehan, who was always known to his juniors as Big Joe. I also worked with Matt Gray. Then I went away and did my National Service and returned in 1959 as a senior house officer to Dr John Proctor. He was a great doctor with a tremendous capacity for work. He was also a most cultured man and a fine musician. In my view he was the finest physician there has ever been at the General Hospital. You could not keep him out of the wards and he worked tremendously long outpatients sessions. During my presidential address to the Nottingham Medico-Chirurgical Society I told the story about Dr Proctor leaving a patient to sleep in the cubicle in out-patients. He was found at 8:30pm by one of the cleaners. Dr Proctor immediately took the patient home to Ilkeston in his car. He once

56 woke me up at 3am to ask about a post-mortem result he was interested in. Another outstanding physician was Dr Reggie Twort. I originally intended to be a GP in the East Midlands. But John Proctor fired me with enthusiasm and I went back to my own teaching Hospital in London and came back to the General Hospital as a consultant in 1968. At that time there was an influx of new physicians – Professor Tony Mitchell, Professor Michael Langman and others. We all came together as a phalanx of younger people determined to try and get the Medical School and University Hospital under way.

Dr Peter Toghill

I was still based that the General Hospital when the General still performed an important teaching role. We moved to the University Hospital when it opened and we straddled the two hospitals for a while. Paediatrics came first and medicine and surgery followed. The General Hospital was always at the centre of things and was always regarded as an excellent hospital. The trouble was that it was not big enough for the population it served. But it was extraordinarily busy. The consultants, nursing staff and everyone had to work very hard. There was tremendous morale and loyalty among staff at General. It was a hospital with a lot of character. The General Hospital was the springboard from which the Medical School took off. We have been tremendously fortunate in the appointments which have been made. In my view Tony Mitchell has been a superb foundation Professor of Medicine.

Health Care of the Elderly: an interview with Professor Tom Arie

Tom Arie was appointed in 1977 as Professor of Health Care of the Elderly at Nottingham University Medical School. The Department, the first in the country to adopt this title, has pioneered a combined approach towards care of the aged by physicians and psychiatrists. He recalls:

When I arrived, Nottingham was incredibly short of geriatric beds. It had less than half it should have, less than half the local authority places and a quarter of the day hospital places. It was also hugely understaffed medically and the service needed a complete reconstruction. At that point I was told that Portland Ward and possibly one or two other wards at the General might become available in the course of the transfer of beds to the newly commissioned University Hospital.

The health authority was advised that the wards were totally unsuitable for elderly patients. I took the view that the situation was so catastrophic that we had nothing to lose. At this time there was a standing waiting list of 100 patients waiting for transfers to the geriatric service, let alone the patients waiting at home. So geriatric moved into the General and it caused quite a controversy. There was then talk of closing the General. But ultimately a decision was taken to use it chiefly for ill old people.

Consultant staff, 1960s

At that time Professor Arie’s long stay beds were at the Coppice Hospital, an annex of Mapperley Hospital.

It was totally unsatisfactory from our point of view. No sooner had it been decided to use it for this purpose than the icy economic winds of the late 70s started to blow and it was quite clear the Coppice would close. Nurses started to leave and it was a very unhappy period. But in 1984 we transferred out to long stay wards at the Coppice into the Trent Wing at the General Hospital and we never looked back. The Trent Wing had been designed for surgery and it was totally inconceivable as a long-stay unit. Yet with a bit of money on conversions, with really good work by nurses in making it domestic and bringing in some antique furniture from the Coppice it became a really good long-stay dementia unit. It wasn't planned that way of course. But it showed that a successful unit of this kind could be run from a tower block in the centre of town. Relatives were delighted with it because it was so accessible. We also had a minibus to take patients on outings. Care of physically ill elderly people has been transformed too. In winter surgeons used to come and see me. They were having to cancel operations because beds were occupied with infirm sick old people. We tackled the problem by examining each other's waiting lists and decided which patients should have priority for admission. The lists began to tumble and opening beds at University Hospital provided another boost. New hospital waiting lists for admission have virtually gone.

Strengthening services for mentally and physically ill old people as one department also meant that patients were seen by the correct ‘team.’ Special units for old people with fractures and a unit for strokes opened. Joint planning and financing between the health service and local authorities gathered pace. Now Nottingham is famous as a training centre, attracting people from all over the world. Resources for the care of the elderly – statutory and private – have increased and are of better quality. As Professor Arie says: ‘Nottingham is now one of the better cities in the land in which to be old and frail.’ He pays tribute to the work of Dr Rory Boyd, Dr John Bendall and many other colleagues in fostering a collaborative spirit between services and specialities that produced such a progressive movement.

Great efforts have been made over the years to try and brighten the hospital environment by listing the help of artists in embellishing corridors and wards. The subjects of the murals are a collective effort involving patients, staff and visitors, many of whom have made their daubs with the brush, often revealing unexpected talents. These pictures symbolise the partnership on which the care of the aged depends.

One of the wall murals at the hospital (Portland Ward).

Surgery

Joan Attenburrow began the tradition of eminent surgeons at the General Hospital – a tradition that continued until the last operating theatre closed in the 1980s. For 70 years, until these Trent Wing opened in 1973, the Jubilee Wing held the four surgical wards – Anderson, Seeley, Hogarth and Mabel Player. The Trent Wing provided three surgical wards of the highest quality – Beeston, Carlton and Daybrook – and increased the number of operating theatres to seven. Anderson Ward was named after Mr A.R. Anderson, honorary surgeon from 1889-1923. Colleagues described him as a surgeon of merit, quick without haste in his operations, neat, accurate and clean. He had been house surgeon in the pre-Listerian days and became an acknowledged expert in abdominal surgery. Dr Ernest Kingdon, who later became an eye specialist in Nottingham, described the introduction of the antiseptic system in 1880.

All the wooden floors of the wards and passages were rubbed once a week with carbolic oil and surgeons worked in a cloud of carbolic acid spray, overlooking the fact that they operated while attired in their old overcoats. It was some years before the surgeons abandoned the belief that septic infection originated in the air, and the carbolic spray continued in use for a long period.

Hogarth Ward was named after Mr R.G. Hogarth, honorary surgeon from 1907-33.

In 1951 Frank Jacob recorded the remarkable progress of surgery. ‘It is now possible to remove along and to me, most wonderful of all, the specialist surgeon can operate on the heart, and even on the aorta, the main artery which carries the blood from the heart, around the body.’

Mr R.G. Hogarth, senior surgeon.

Mr John Sheehan

Mr John (Jo) Sheehan, long serving honorary consultant surgeon, lived and worked under the influence of the General Hospital for nearly 50 years – apart from four years’ war service in India. He recalls:

I heard of the General Hospital when I met a ward sister who had trained here. She advised me very strongly to try for a job here. Luck came my way and I was appointed in 1933. I found it a busy hospital bursting with energy and opportunities galore for training and experience. At my interview with the consultant I was taken aback when he asked me if I was an early riser. He should have asked if I was late to bed too as we were expected to do a ward round late at night before going to bed. That had its compensations as a sympathetic night nurse would provide a hungry resident with a poached egg on toast and one can say that many a pact for life started with a poached egg. Nurses worked long and hard in those days. The net result was a practical nurse without equal and they were justifiably proud to wear their GHN badge. In the pre-war days we have many outstanding local personalities – William and John Player, Sir Louis Pearson and Sir Thomas Shipstone, responsible for the theatres named after them; the latter also for the bottle of beer provided at mealtimes in the residents quarters. Another character was a well-known Notts cricketer, noted for his sardonic wit. Some days after having an extensive operation, he was visited by the late Lord Belper, President of the Cricket Club, asked how he was getting on, he replied: ‘My Lord, they shoved tubes in my arms, down my throat mouth, and choose into every other opening they could find until I felt like a bleeding sewer.’ Another memory concerns a resident colleague of mine who later became a leading Lincoln surgeon. A very anxious night sister sent a message by a porter late at night to his bedroom to tell him that one of his patients had not passed water since early morning. Awakened from a much-needed sleep, he replied: ‘Tell sister, neither have I.’ Need I had, he did get up to relieve the patient as well as himself. On my return after the war one of the most striking changes I noticed was that the residents no longer had to be single men as we had to be at Broxtowe House. The General Hospital had one of the best records in the country for bed occupancy and bed turnover. Dare I add that David Evans was a member of the House Committee that had put pressure on us to maintain this high standard. We were desperate for operating theatres

60 and other facilities and eventually we managed to persuade the powers that be to builders and new block. Regrettably the only space we could find for a site was the nurses’ two tennis courts.

Sir Keith Joseph's visit in 1973. L/R: (Back Row) Professor James Scott, David Evans, Maurice Naylor, Bill Judd. Front row: Sir Keith and Alderman Sidney King.

My patients were the first to move into the new Trent Wing. At the official opening I showed Sir Keith Joseph around. After praising it he turned to my young house surgeon said: ‘Aren't you lucky to be working such as new, modern ward?’ ‘No sir’ he replied, I much prefer my old round ward in the Jubilee Wing.’ I had much sympathy for him this opinion for as a resident I had worked in all these round wards. Their main advantage to doctors and nurses was that you could see at a glance how you're seriously ill patients were. They were also friendly wards because everybody could see and get to know each other. I suggest they should have a big re- think before anyone gets rid of the Jubilee Wing – this useful and unusual shaped block of wards is a city landmark. With sensible upgrading of all facilities, this block of wards could be converted into comfortable accommodation for the care of the old. Spare us the concrete monstrosities designed by trendy architects. The General Hospital readily gave a temporary home to the new medical school and the first batch of students received their clinical training here before I retired. Finally I would like to pay tribute to Frank Jacob, a physician of high repute. His book A History of the General Hospital has become a standard reference and the basis for many articles.

Mr D.W. Daly, retired consultant surgeon

In February 1968, I was appointed Consultant Surgeon to the General and Children's Hospitals in Nottingham. I was the first surgeon to be appointed for 13 years and so was very much the young man, for three of the other four surgeons were over 60 years of age. This resulted in a heavy work load, particularly in the emergency sphere. In 1974, when two paediatric surgeons were appointed, The Chairman of the Hospital Management Committee, Mr David Evans, asked me to start a clinic for breast diseases, where women could be seen promptly, that is to say without a waiting list for appointments. The Committee had been urged to create such a clinic by the various women's associations in Nottingham, for surgical outpatient appointments were about ten weeks ahead.

I was most fortunate to start the breast clinic jointly with Dr W.D. Fraser Consultant Radiotherapist, who was succeeded by Dr M Sokal. This clinic was one of the early ones in the country where surgeon and a radiotherapist worked jointly to provide the best service to the patient. I was elected twice as consultant representative on the Hospital Management Committee, serving two periods of three years, first on the Nottingham No 1 Committee, then on the newly formed University Hospital Management Committee. Therefore I had the privilege of seeing the changing hospital service in Nottingham that came about with the development of the School of Medicine. This enabled me to be the ‘last of the old first of the new’ surgeons, a point that was made in the delightful parties and speeches that were given on my retirement. It is interesting to note that in 1968 when I was appointed I was the youngest of eight surgeons; when I retired I was the oldest of 19! This illustrates the growth that occurred with the coming of the School of Medicine but also clearly demonstrates how poorly staffed Nottingham was in the early years of the National Health Service.

Mr Geoffrey Makin, Consultant Surgeon

Until the Trent Wing opened in 1972, all the operating at the General Hospital was done in the Pay Bed Wing, ENT Theatres, Eye Hospital, Pearson and Shipstone Theatres and Mabel Player Theatres. The latter were temporary but were in use for 12 years. Fleet Ward had Sisters Sitting Room and Bedroom attached, so she was always available to deal with problems on the Ward at any time! With the onset of Medical Student teaching in the early 1970s, the Bedroom was sacrificed to be converted into a Student Teaching Room, although Sister (now non-resident and even married!) retained her Sitting Room. At this time, Pearson Theatre was also converted into a Seminar Room. The first Intensive Care Unit opened in the Recovery Room of Shipstone Theatre in 1970. Subsequently purpose-built accommodation opened a few years later and was euphemistically named Waterton Ward after the first man to insert a brass tube in the carotid artery of a horse! Until air conditioning was installed in Shipstone Theatre in 1973, reduction in humility was achieved by opening the windows! Other developments at this time where the conversion of the magnificent Boardroom to a Resuscitation Room and the building of the multi-storey car park. Until this time, there was sufficient parking space in the courtyard for all the consultant's cars. With the building of the Trent Wing in the 1970s, the Consultants Dining Room was destroyed to create the access corridor. The writer still uses the dining chairs which he was allowed to purchase for 60p each.

Mr Jim Bourke, Consultant Surgeon and Senior Lecturer in Surgery

I arrived in Nottingham on 1 January 1972, and immediately discovered that the hub of medical life and activity was the main corridor of the General Hospital. At one end was Waterton Ward (the new intensive therapy unit) where the lights never went out. At its side was Anderson Ward, a floor of the magnificent Victorian round ward building. The centre of the ward was still occupied by the redundant fireplaces. On the other side was ‘in-patient X-ray’ where the days X-rays could be easily traced. Off the corridor was the link to the then new Trent Wing – two main operating theatres, Beeston, Carlton and Daybook Wards, some laboratories, the dining room and other ancillary facilities. Matron had her office on this thoroughfare which also contained the general office. Halfway down the corridor was the original lift shaft with a more recent lift to transport people to Fleet Ward, Shipstone operating theatre and the Chapel – the place of dark brown solemnity. At the far end of the corridor was the Accident and Emergency Department nestling in the shadow of Tower House. The ambulance entrance acquired a canopy to intrude over the courtyard of the hospital. Beside the Accident and Emergency Department was the boardroom. This contained a portrait of Surgeon Arbuthnott who was part of the first attempt at a medical school in Nottingham in the 1830s. Soon it was removed and re- sited to allow the boardroom to become the emergency receiving room for the people of Nottingham where the students of the new medical school who arrived in the autumn of 1970 could be instructed. The main character contains the history of over 200 years of the development of medical care in Nottingham within its walls and floor.

Orthopaedics

At the beginning of the twentieth century, increasing awareness of the plight of crippled children, coupled with prospects for their effective treatment, led public spirited individuals in many parts of the country to set up special guilds. Social Services did not exist in the way we know them today and the philanthropy of the well-to-do was often the only means of help available. The crippling diseases prevalent at this time were tuberculosis, rickets and poliomyelitis, which all flourished in the conditions of bad hygiene produced by poverty. The unfortunate sufferers had little hope of being anything other than a burden to their families, if they survived the illness. It was in this setting that the Nottingham Cripples' Guild was formed in 1907. Emeritus Professor William Waugh explains in his excellent book The Development of Orthopaedics in the Nottingham Area that Orthopaedics was practised at the General Hospital before the Cripples Guild was founded. But the hospital had always found it difficult to provide beds for orthopaedic cases and offer the special after-care which was considered essential. General surgeons treated orthopaedics cases at this time and the Guild recognised that they did so ‘most skilfully but the patients came too late and there was particular difficulty with personal supervision and special after-care treatment during convalescence.’ By 1911 and convalescent home was founded in Mablethorpe but the Guild recognised the great need for specialist hospital accommodation. Plans were halted during the Great War and it was not until the post-war years that Orthopaedics came to be recognised as a speciality. This was largely due to the perseverance of Sir Robert Jones, who, with Mr G.R. Girdleston, drew up a national plan for helping cripples based on prevention, treatment and training. Sir Robert recommended establishing a number of central orthopaedic hospitals, each surrounded by a group of clinics. Because two of the crippling diseases – tuberculosis and poliomyelitis – were ineffective, the Heathfield and ransom pattern of open hospital sites in country, pinewoods or lakeside's prevailed. Nottingham's Orthopaedic Hospital at Harlow Would Hospital, near Mansfield, was officially opened by the Duke and Duchess of York in August, 1929. In a Centenary Lecture delivered in 1981, Prof Tony Mitchell, Foundation Professor of Medicine at Nottingham University reflected:

Not only did this remove patients from their friends and relatives in the city but it also led to an unfortunate schism in orthopaedic surgery because hot orthopaedics in the shape of fractures still had to be dealt with at the General Hospital, where the Casualty Department received them, whereas the cold orthopaedics of longer term and elective procedures took place at Harlow Wood. Separation by geography thus gave rise to a further separation of one type of orthopaedic surgeon from another.

The formation of the Cripples Guild owed much to the interest of the Duchess of Portland. In 1922 the Guild moved from St James Street to a larger building at 45 Park Row. The Park Row Clinic was described by the Daily Journal on 11 February 1926 in somewhat extravagant terms.

The strong ultraviolet rays from the magnificent mercury vapour lamp give a weird effect to the treatment rooms. They have given the opposite result too many little folk, who, suffering from rickets tubercular spine and other dreaded diseases, have gradually become sunburned and sturdy in the room of miracles.

In the early days of the Park Row clinic, since there were no hospital beds available in Nottingham for the specialised treatment of orthopaedic patients, arrangements were made to transfer patients in need of such care to St Gerrard's Hospital in Warwickshire and to Biddulph Grange Orthopaedic Hospital in Staffordshire. But the Guild was determined to see a specialised hospital established in Nottinghamshire. It declared: ‘Our hope is that in the very near future we shall be able to say that no crippled child in the whole of England has a better chance of adequate care and treatment than one born in Nottingham.’ Between the wars the General Hospital continued to treat fractures. When Alan Malkin came to Nottingham in 1924, he was the specialist orthopaedic surgeon who did no general surgery. Before, and after he arrived, the Cripples Guild have the advice of an honorary consulting surgeon, Mr R.G.

Hogarth and five honorary consulting surgeons. One of them was Mr Frederick Crooks who practice orthopaedic surgery in Nottingham while continuing to perform general surgery. He was honorary consulting surgeon to the Cripples Guild from 1923 onwards. He was recognised in the local press as an ‘orthopaedic surgeon’ in 1923 but there was no such appointment until Noel Birkett was appointed in 1947. Meanwhile the General Hospital became one of the first hospitals in the country to introduce a specialist fracture clinic, which started in 1935 in James Foreman Ward. Patients treatment include re- education of the injured joint or limb by massage, exercise in the Monty Hind gymnasium and by use of electrical appliances. There was now growing recognition of the need to setup specialist casualty and fracture services but it was not until the early 1950s that anyone injured anywhere in the country would be seen by an orthopaedic surgeon within 24 hours – one of the great achievements of the NHS. Large numbers of troops were trained in the Nottingham area during the Second World War and these provided much additional orthopaedic and accident work. The hospital also organised mobile surgical teams. But they were called out just once – to Newark in March, 1941 when 41 people were killed in an air raid. During the latter years of the war, convoys of wounded from the European fronts were received in Nottingham. Those coming from Normandy might arrive and be operated on within 18 hours of wounding. The convoys often arrived in the middle of the night and there were usually 100 to 150 admissions. Mr Frederick Crooks died in 1950. A clinical room, adjoining Anderson Ward was named after him in 1960. After Mr Crooks’ death, Mr Noel Birkett became responsible for organising orthopaedic and accident surgery in Nottingham. He drove himself hard and did a regular ward round on Sunday mornings. No additional staff were appointed until he retired as he always felt there was no operating time, clinic space or beds for an extra consultant. This meant that he remained committed to a gradually increasing workload and he undertook this with apparent enthusiasm. Plans for a new accident service on the Postern Street site of the General had been drawn up before the war. The scheme was shelved in 1939 and the money earmarked for it was claimed by the Government in 1948. Thereafter, no development without ever took place which must've been frustrating for Mr Noel Birkett, who had to work the whole of his professional life with inadequate facilities. He had a great influence in the development of orthopaedics and Nottingham and it was his own interest in neurosurgery that probably determine the policy that orthopaedic surgeons in Nottingham would look after head injuries at the General. He died in 1985, having retired in 1970, and he is remembered as a capable and dextrous surgeon, the master of his craft. ‘Even under heavy pressure he showed at all times patience and tolerance to his staff, both medical and nursing, who held him in high esteem. He gave freely of his time, and the care of his patients dominated all else.’ A personal idiosyncrasy was that he never won a watch because he paid little regard to time in his work and always refused to stick to a rigid schedule. When Mr Noel Birkett retired in 1970 various changes were made in the long established pattern of the organisation of orthopaedic and accident work at the General. Mr Hugh McKim Thomas was appointed and Mr Peter Jackson and Mr William Waugh took on the share of the accident work. This meant five orthopaedic surgeons were now involved and more were to come…. Mr Nicholas Barton in 1971, followed by Mr Robert Mulholland in 1972. Mr Chris Colton had come back to Nottingham – his home-town – in 1973 after working at the Royal National Orthopaedic Hospital. It became possible to have one consultant on call on the same day each week for the accident service and there was also a daily fracture clinic. The beds which Mr Noel Birkett used for elective orthopaedics were now added to the total number available four trauma. But 70 beds was nothing like enough and more often than not 30 or more patients would have to ‘sleep out’ in wards all over the hospital. This made ward rounds difficult and it also made orthopaedic surgeons unpopular with their surgical colleagues, whose beds they field with unwanted trauma (and the ward sisters did not like it either). The discrepancy between the beds allocated and the increasing load of trauma was eventually acknowledged by the hospital but a more realistic provision was not made until the move to Queens’ Medical Centre. Additional appointments continued to be made – Mr Chris Howell replaced Mr Alex Morrison in early 1977 and Mr George Milligan became senior lecturer in the same year. Mr John Webb filled a new post in 1979.

Since the Second World War, orthopaedics has made tremendous strides. Soon after the formation of the National Health Service, TB, polio and rickets slowly disappeared – partly as a result of improved social conditions. For example, free milk and orange juice provided to schoolchildren during the war was a major factor in the elimination of nutritional rickets. Pasteurisation of milk, together with improved housing and hygiene reduced to spread of TB. Finally polio (infantile paralysis) gradually disappeared after the introduction of the Salk vaccine. With beds available, it was now possible for more patients with osteoarthritis to be admitted for rest and physiotherapy. The old Cripples Guild Clinic had been taken over by the NHS in 1948 and did sterling work for another 20 years. At least two outpatient sessions a week were held at Park Row, and surgeons saw 50 to 60 patients at each clinic. There was also a plaster room, physiotherapy department and a small workshop. Anyone needing to be x-rayed was sent to a private radiographer across the road in Oxford Street. School clinics were also established by the local authorities, the largest one being held at Chaucer Street. Orthopaedic surgeons needed good physiotherapy and rehabilitation for their patients. Indeed before the war (and for some years after) they were responsible for the services themselves. However, when consultants in physical medicine were appointed, they took responsibility for this work. Nottingham was fortunate when Dr Sam James was appointed because with great skill and tact he managed to organise the physiotherapists into providing a really excellent departments at the City and the General Hospitals. A brand-new department was built at the City Hospital, with a pool for hydrotherapy (something which had not existed previously in Nottingham). This was opened in the late 1960s and Miss Trussell went there as Superintendent when the Park Row Clinic closed in 1968 and was transferred to the outpatients department at the General. An equally important step forward was the creation of a first-class rehabilitation unit for outpatients at the Cedars Hospital. This also had a pool, and was able to undertake all aspects of remedial treatment so that it was no longer necessary for Nottingham patients to be sent to Harlow Wood for inter-patient rehabilitation.

Group Capt. Douglas Bader officially opening the Nottingham School of Physiotherapy with Alan Scowcroft, and Alderman and Mrs Derbyshire in attendance

Although Sam James deserves great credit for organising these departments, he would not have been successful without a dedicated group of physiotherapists, occupational therapists and remedial gymnast to cooperate with him. Group Capt Douglas Bader open the Nottingham School of physiotherapy in 1965 and Alan Scowcroft was Principle for many years. The speciality of physical medicine was renamed ‘rheumatology and rehabilitation’ and son James was joined by Dr Tony Swannell in the 1970s and together they set up a very good department at the City Hospital. Mr David

Bossingham replaced Sam James in 1980 and more recently the department has appointed a senior lecturer. Meanwhile orthopaedics has seen the dawn of a new age. Sir John Charnley's contribution to total hip replacement has been described as the most important advance in surgery since the war. By 1977 the operation had become standard procedure and the survival of Harlow Wood as an Orthopaedic Hospital in the 1980s rested on the success of hip replacement. The knee, being a more complicated joint, was more difficult to replace. Progress was slow at first but gradually this became more common operation at Harlow Wood. Arthroscopy, leading to precise diagnosis of injuries of the knee, was also introduced. Meanwhile the accident and emergency workload had been growing all the time. As Professor William Waugh reflects in his book: ‘It was fortunate in the way that the attempt to resurrect the Postern Street scheme for a new accident service was not successful in the 1950s. If it had been, there might now be two accident services in Nottingham and the future of the General Hospital would have been different.’ The debate whether there should be one or two accident services in the town had gone on for a long time. Most consultants favouring the concept of a single unit for Nottingham, basing their arguments on the assumption that it was better to have one first-class unit rather than risking having two second-class units. Eventually, of course Accident and Emergency Medicine became the speciality in its own right and Nottingham was fortunate when Mr Peter Weston was appointed in 1972 as the first A and E consultants. He was an experienced general surgeon who had a long-standing interest in the management of trauma. He was able to make considerable improvements in the casualty department at the General Hospital, which included a new admissions room in the old Boardroom. The standard of resuscitation and the care of the injured greatly improved. He also undertook the management of head injuries, much to the relief of the orthopaedic surgeons. This important group of patients benefited from being managed in one ward by one consultant. This whole development was very important for orthopaedic surgeons. They no longer had responsibility for the immediate diagnosis and management of the injured but they continued to treat fractures which make up a high proportion of all injuries. Meanwhile as the General Hospital prepared to celebrate its bi-centenary in 1982, life on James Foreman Ward was hectic. This 28-bed all-male orthopaedic ward, dated patients who were mostly young motorcyclists or elderly fracture cases. It was often dubbed Traction Row and a pretty nurse needed a quick line in repartee while tending her duties among the array of broken legs, thighs, hips and ankles. ‘They give as good as they get,’ recalled Barbara Brown, who was sister in charge. Boredom was the main problem four patients, especially the young ones, and this led to occasional hijinks such as the day young patients pelted each other with grapes.

James Foreman Ward 1982.

Co-author David Lowe recalls interviewing Sister Brown about some of the difficulties on the ward at this time. James Foreman Ward had just one bathroom and toilet for 28 patients. One patient, aged 89, had been on the ward for two years, occupying a badly needed bed because there was nowhere for him to go. The sleeping out problem persisted. It meant doctors and patients scattered around the hospital because there were not enough beds, particularly for the elderly, in hard-pressed specialities such as orthopaedics. Nottingham and Harlow Wood are now linked together to form an Orthopaedic organisation with a national and international reputation. This is largely the result of the appointment of more consultants of outstanding ability, including Professor Angus Wallace, who succeeded William Waugh as Professor of Orthopaedic and Accident Surgery. The future of orthopaedic hospitals will continue to be debated but while facilities cannot be provided entirely in Nottingham, Harlow Wood will still be needed. The hospital has been reprieved for ten or fifteen years and in view of recent developments there including a third operating theatre, this seems realistic.

The General Hospital in Wartime by Dr Atholl McLaren

I was sent to the General Hospital in 1943 by the War Emergency Medical Service, pending my leaving for the RAF Medical Branch. I was to be ‘Resident Orthopaedic and Fractured Officer’, the post-equivalent to RSO and too senior for my age or experience, but very well paid by the standards of the day and a marvellous opportunity to progress in the speciality. My chief was Mr Frederick Crooks, the tower of strength and integrity. His deputy was Mr Noel Birkett who was my mentor and guide, and who performed the useful function of making me do as I was told! Both were busy in the hospital and elsewhere. So I was quite often on my own, with Foreman Ward for male patients from the coal mines all the roads and University Ward for ladies, mostly elderly with fractured hips. My job (or my boss) was such that I could not be dragooned into a session of anaesthetics all donor sessions for the Blood Transfusion Service. Even so, these became part of the diversity of life.

Medical Staff, Christmas, 1945 Back Row: L/R, Dr E.A. Horne, Dr R.A. Marshall, Dr J.D. Proctor, Dr I.R. Spark, Dr H.B. Liebermann, Dr J.L. Davis, Mr H.M. Stanley. Second Row: Mr J. Swan, Mr A.N. Birkett, Dr W.J. Mowat, Dr P.H. O’Donovan, Mr F. Crooks, M. F.C. Hunt, Dr J. Kilian-Clarke, Dr G. Evans, Dr H.S. Wallace, Dr A. Gordon. Front Row: Dr J. Wilkie Scott, Dr W.T. Rowe, Mr C.H. Allan, Mr W.F. Neil, Col. N. Gervis Pearson, Mr A.M. Webber, Mr T.G. Battersby, Mr E.J. Glass.

Myself, and I think all those in my job, was urgently invited to go down a coal mine to help understand the circumstances there. I went down Pinxton No 2 in October 1943. The medical and surgical staff were either too old, or not otherwise available for military service – and several had come back from retirement to help out. Physicians and I met rarely, Drs Wilkie Scott, Rowe, O'Donovan, Wallace and Whimster come to mind. Dr Rowe treated me in his ward for a chest infection, using camphorated oil rub, Aspirin and Dover’s powder. I was very grateful for his understanding and for his not prescribing the new and painful penicillin. At this time penicillin was prepared by natural growth on the median contained in quarter milk bottles. These were racked almost horizontally on brackets in the shopfitting Department of Boots on Castle Boulevard (shops will rarely refitted in wartime). The product, more preciously allocated than gold, was inserted via a curved eight inch needle strapped to the front of the thigh, injected every four hours. It worked well but was not universally popular. Bill Neil was serious surgeon and chairman of the house committee, with John Swan and Freddie Hunt and A.M. Webber and C.W. Allen back from retirement. Mr Crooks, of course, did general surgery as well as orthopaedics. The hospital was governed by the house committee, and in particular the House Governor, Mr H.M. Stanley who lived in Tower House. His was a firm hand on the staff and establishment, but always felt that he was leaned on very firmly by powerful personalities such as Messrs Neil and Crooks and others. Supplies must have given great problems – a new and very necessary X-ray machine was lost in the Atlantic and every item had to be extracted from wartime ministries who grudged them, even if the hospital could find the cost. Of the nursing hierarchy I never learned much – matron was Miss Plucknett, a charming and courteous but isolated figure for us. She had two attitudes – one gentle and kind to junior doctors, and possibly two nurses. The other was strict, hard and intensely protective of her nursing staff. You could tell which was which by looking and/or listening. In Broxtowe House I shared my life with the most interesting and assorted set of colleagues one could ever meet. J.H. (George) Brownlee was Resident Medical Officer, big, amiable with a baffled bellow when things were awkward. He was a New Zealander, passionately devoted to the hospital and to his work – but mostly to his idol Bill Neil. His operating sessions often went on to 9 or 10pm, his recreational sessions much later. He had an old Austin two-seater called Peter with no silencer, so it was never difficult to hear him come in. Out of a typical mess, five would be Irish, to English, a Russian/American from Kiev via Bronx, a Czech or maybe two, a South German refugee, a South African and a couple of Scots. Bridge is very interesting if you share the table with the American, opposed by a Czech and German who cheerfully hate each other, but enjoyed bridge! Civilian accidents and fractures abounded in the blackout and in factories and coalmines working under pressure with substitute labour and worn equipment. To this we had to add the acceptance of war wounded who were beginning to arrive from the Middle East, then Europe. They arrived as convoys of perhaps 200 to the Midland Station, normally after midnight. Met there by a senior accident surgeon and a secretary they would be allocated to the General or City Hospitals or to Harlow Wood. Brought in at 1 or 2am, off an ambulance train from the port, with limbs in plaster over open wounds or Tobruk splints, attention had to be immediate. Every time Mr Crooks spent the night with us, attended by his secretary who has cycled in from Mapperley Park, and Mr Birkett did the same task at the City Hospital. All patients were examined and treatment decided, operating lists prepared for the next morning, either by the orthopaedic or surgical firms. Compared to field ambulance conditions, we worked in great luxury and tranquillity, but it was a period in life which must have made a lasting impression on us all – and certainly on those who depended on our care. Coming to Nottingham for a ‘posting of six months’ I spent over two years before the RAF had room for me, and enjoyed the work, the place, and the people. Even then the hospital building no longer fully suitable, and by now it is obsolete and calls for replacement – but with memories like these who could see come without a pang?

Pathology by Dr Hugh Rice

Pathology services really started at Nottingham General Hospital when Dr Kilian Clarke arrived from St Mary's in 1926. But towards the end of his career, he suffered ill health and Dr Eustace Horne was appointed second pathologist in 1945. Dr Hugh Rice arrived at the General Hospital in 1949. He recalled:

I was aware of the General Hospital has a big and busy general hospital with a long, proud tradition. Dr Horne was running haematology and histopathology very efficiently. My own speciality, microbiology and chemical pathology, were both in a pretty rundown state. Ransom Laboratory was very dark and painted in institutional colours. The walls of the bacteriology section were covered from bench to ceiling height with pictures and newspaper cuttings. There was obviously a great deal to do in reorganising the department. After a month I presented a report to the Management Committee. The chairman, Lieutenant-Colonel Pearson was very helpful and I received the full backing of the Medical Committee, chaired at that time by Dr O'Donovan. But apparatus was in short supply and I needed to recruit and train more technical staff. Two of the three existing staff were retrained. One was an extremely competent technician, Mr Frank Rowan, who became chief technician. Another was Mr Frank Hartley, who took over as chief technician when Mr Rowan sadly died of cancer. My right-hand man for many years until he recently retired was Mr Cliff Durrant, senior chief medical scientific officer in charge of microbiology. There are still people in the department at University Hospital whom I took long straight from school and they have worked their way up over the years. Sterilisation was a thorny problem at the General Hospital in the old days. All the hospital dressings were sterilised in one vast autoclave. I spent a lot of time trying to improve matters. We also had a number of incidents involving cross infection on the wards, including a major salmonella outbreak in the 1950s when we had to close the hospital for all admissions for three or four weeks. We had about 100 positive cases. Fortunately no one died. Some were very ill but ultimately recovered. When I arrived, the hospital was still very much a run on the lines of a voluntary hospital. The Act to form the NHS had been passed only a few months before and we did not know what staff salaries were going to be or who was to be appointed consultant. But the hospital was pretty efficient. We had an excellent matron, Miss Plucknett and the hospital secretary Mr Henry Stanley was a man of great ability and knowledge. He made a tremendous contribution to the hospital. The NHS brought many more regulations until it took a fortnight to get a washer changed. In the old days to job would have been sorted out in half an hour. Soon after I arrived detailed plans were drawn up for a new pathology block. But we had to wait 22 years before the new department was finally built as part of the Trent Wing. It incorporated the public mortuary which had previously been at Leenside police station. The mortuary attendant there was a great character called Bull. The coming of the medical school brought major changes, including extra medical and technical staff.

Dr Rice recalled:

‘I had been appointed pathologist in charge and the Hospital Management Committee has granted me the title of Director of Pathology. But that became the concept which was not acceptable to the consultants in the four disciplines of pathology.’

Pathologist in the various specialities were appointed and the services were run by a committee of consultants. Dr Rice was appointed by Sheffield Region as chairman of the committee for the first three years. The workload is increasing all the time as new path ology tests and techniques were developed. Before he retired in 1980 the Department the Department was handling 400,000 specimens a year compared with 10,000 specimens a year in 1949. Pathology services are no longer represented on the General Site, following the transfer to University Hospital.

Dr Rice recalled:

I did not think it was fair to take an active part in the running of the new department at University Hospital. I felt the people who would be running the new department should have a say in how it was arranged. At that stage there was still quite a lot of work going on at the General, and I used to give some lectures to students. We were very happy department and we all got on very well. Everyone was extremely friendly.

Anaesthetics – Dr John Buckley

When I returned to Nottingham after the war – I was born there – anaesthetics were given by honorary general practitioners and one resident anaesthetist. The most active was Dr Ian Spark, who later became a consultant in the NHS in 1948, and Dr Arthur Gordon, who continued an honorary appointment. I was appointed honorary anaesthetist in August, 1946, having worked in officially since November 1945, when I was discharged from the Army. Dr Ken Crawford was resident anaesthetist at the General until being called up for the Army. He returned to Nottingham in 1946/47 and was appointed honorary anaesthetist at the General. I became anaesthetist to the thoracic unit which was at its Newcastle once a month! The unit became independent in 1948 under Mr William Buckley (no relation). Dr Donald Munro was appointed whole time anaesthetist to the unit soon afterwards. I was not prepared to confine myself to thoracic surgery. Dr Munro also started the intensive care unit using thoracic surgical beds.

X-ray and Radiotherapy

Radiotherapy has been practised that Nottingham General Hospital since 1903. The first recorded purchase of radium was July, 1929 and half a gramme was brought by the British Empire Cancer Campaign to establish a radium centre. It later became known as the Hogarth Radiotherapeutic Centre as a tribute to one of the hospital's leading surgeons, Mr Robert George Hogarth. He served the hospital as a consultant from 1901-1933 and was closely concerned with cancer surgery and the potential use of radiotherapy. A fine footballer and athlete, he was medical officer to Nottingham Forest and Nott’s County football Clubs for many years. Numerous honours were conferred on him, including an honorary Doctor of Law degree from Edinburgh University. When the radium centre was named after him in 1948 on the eve of his eightieth birthday, the Duke of Portland described Mr Hogarth as the founder of cancer campaign in the county of Nottingham. Another key figure once Mr Frederick Hunt, who was appointed the Radium Commissioner. But the real founder of the radiotherapy service was Dr Glyn Evans, who was appointed the General Hospitals first radiotherapist in 1944. Like many other fine specialists who were to follow him, consultants such as Dr Finbarr Cross and Dr William Fraser, he came from the Christie Hospital, Manchester. The General Hospital had acquired its first deep X-ray therapy equipment in 1931. But before 1946 the Radiotherapy Department mainly treated superficial conditions – there was no systematic method for treating tumours. Dr Evans completely reorganised the Radiotherapy Department, putting it on a sound footing and replacing obsolete equipment with new machines, including deep X-ray therapy equipment. The Department also began using the Pattison and Parker rule for estimating dosages. A keen photographer, Dr Evans was instrumental in starting a small medical photography unit at the hospital in 1948. He died in 1970. Until the 1950s the radiotherapy consultants were allocated a share of beds in the surgical wards but it was felt that a separate ward was needed. The Ropewalk Wing had been built on the site of an old reservoir; a decision was made to add a further floor to create two radiotherapy wards. They were named Gervis Pearson after the chairman of the Hospital Board. Two radiotherapist's remember from the 1960s with affection are Dr Miles Benton and Dr George Jarrett. Dr Benton recalls:

I remember someone managing to let steriliser, which contained a selection of radium needles and tubes boil dry. Of course it overheated and the radium needles exploded, showering radium all over the place. This unique accident happened before my time. Freddie Hunt was the Radium Officer before and during the war. Walter Mowat was the diagnostic radiologist, who did the X-ray therapy work. When he moved to Cardiff, Finbarr Cross took over. When Cross went back to Ireland, Bill Fraser became Director of the Department and was appointed consultant in 1955.

Deep X-ray Therapy Equipment, Radiotherapy Department.

The diagnostic potential of X-rays led to the Ropewalk Wing being opened in 1927. As well as improved facilities for outpatients on the ground floor, it contained the beginnings of an X-ray Department on the lower ground floor. The therapeutic department was reconstructed in 1932 and new X-ray equipment and lead lined cubicles installed. For many years the X-ray Department and Radiotherapy was separate departments in the basement of the Ropewalk Wing until they were combined in 1945 when Dr Walter Mowat succeeded Dr R.A. Clayton Rigby as consultant radiologist. Later the department started to separate in the face of substantial expansion. By 1950 the X-ray Department was carrying out 35,000 examinations a year. A linear accelerator – the most advanced in the country – was installed at the General Hospital in 1964 as a result of a gift from the Olds Charitable Trust, which met half the capital cost. At that time the General was one of the largest provincial treatment centres in the country with more than 14,000 patients a year. Some patients had to travel rather long distances to attend radiotherapy clinics, coming from as far as Newark, Grantham, Ilkeston and Mansfield. The gift by Mr Hogarth of 48 The Ropewalk (his family home) to the Department meant that patients could be resident during this time of treatment.

48 The Ropewalk

A long serving member of the department recalls an 87-year-old patient telling her how, as a young boy, he delivered newspapers to 48 The Ropewalk when it was a family home. Each Christmas Eve a maid came to the door to hand him his Christmas box – a golden sovereign on the silver salver. It was more than the boy’s father earned in a week. In the early days, radiotherapy treatment was tried as a cure for many diseases but only five per cent of its use is for benign diseases – for example to relieve the pain of arthritis of the knee joint. Today came four and radiotherapy are the non-surgical treatments of cancer. The Department at the General Hospital employs 75 people including ward staff, physicists, radiographers, secretarial and record staff. A considerable amount of complex equipment is needed for treatment. A body scanner has been installed at the City Hospital and the Radiotherapy Department will transfer there in 1992. The Hogarth School of Radiotherapy is also due to move to new accommodation in the Centre for Clinical Oncology at the City. Oncology, originating from the Greek word Oncos, meaning a lump, is a science relating to the behaviour of malignant tumours in patients. Treatment is by surgery or chemotherapy or a combination of both. Radiography has two branches – diagnostic radiography and therapeutic radiography. Diagnostic radiographers use X-rays, radioactive substances, ultra sound and magnetism to produce high-quality images of the body which help doctors to diagnose disease and the extent of injury. Therapeutic radiographers are responsible for delivering the correct radiation treatment to patients, almost all of whom have a malignant disease. Modern radiotherapy departments have a range of treatment units from superficial X-ray machines (low-energy) to high energy linear accelerators, which are capable of treating tumours at any depth in the body. Therapeutic radiographers are responsible for the correct interpretation of clinicians’ treatment prescription and work as part of the team to plan the most effective course of treatment for each patient. This involves accurate planning of a patient's treatment using sophisticated imaging equipment and the latest computerised planning techniques. While patients are attending for radiotherapy treatment the radiographer is responsible for their welfare. So caring and communication skills are essential. Diagnostic radiographers train that the School of Radiography at the Queen's Medical Centre and therapeutic radiographers train at the Hogarth School of Radiotherapy at the General Hospital. Approval has been given for a £4 million capital development at the City Hospital, including a scheme greatly to improve radiotherapy services. The project includes 48 radiotherapy beds (with room for expansion to 54 should they be needed), plus facilities for a 30-place School of Radiotherapy.

Mrs Fraser opening Fraser Ward, February 1989

The latest radiotherapy beds developed at the General Hospital were opened in November 1987 when the first patients were admitted to Fraser Ward. It marked a new development in cancer care at the hospital and staff on the 10 bed ward quickly receiving glowing tributes from families

72 about the quality of care they provide. The ward, on the first floor of the Outpatients Building in the Ropewalk, was created by upgrading the old aural ward (known as Princess Mary Ward) at a cost of £89,000 – with equipment provided by trust funds. It had been evident for some time that Gervis Pearson's 32 beds were insufficient to cater for growing radiotherapy demands of a unit serving more than half 1 million people. The new ward was named after the late Dr William Fraser, consultant radiologist from 1955 to 1981 who sadly died a few days after retiring. His widow Mrs E.G. Fraser perform the opening ceremony with 60 members of the family, personal friends and colleagues of Dr Fraser present. Consultant radiotherapist Dr David Morgan commented on the high standard of care introduced and upheld by Dr Fraser. He felt the ward was a fitting memorial to Dr Fraser. The event was attended by unit general manager Philip Hogarth, general services manager David Peverelle, unit accountant Tom Diall, senior sister Lyn Hicks and consultant radiotherapist's Dr Eric Bessell and Dr Mike Sokal. Ward sister Sandra Hummerston thank the team of nurses and the people who contributed to the friendly, homely atmosphere. She said:

Cancer care is not just about nursing one patient – it involves a whole family. Like its mother ward, (Gervis Pearson) Fraser Ward is an active, acute medical treatment ward. This is a point I must stress since many people (nursing and medical staff included) are still of the opinion that anyone who develops cancer is destined to die within days, weeks or months. This, on the whole, is a fallacy and while Gervis Pearson Ward and hopefully our ward provides an excellent service for those patients who are terminally ill, the aim of the unit is towards ‘cure’ and ‘long-term’ quality-of-life.

With the reorganisation of the hospital services in Nottingham, the very complex treatments with radiotherapy and chemotherapy that are nowadays required for patients with cancers, can no longer be performed without the backup of surgical, medical, diagnostic X-ray and laboratory colleagues. For this reason the four consultants are currently in post Dr Michael Sokal, Dr David Morgan, Dr Eric Bessell, and Dr Stephen Chan, together with all the nursing, radiographer and medical physics colleagues, some 100 in total, will be moving to the City Hospital in 1992. In addition to all the facilities that will be provided there for the patient's management, a whole suite of laboratories, headed by a Professor of Clinical Oncology, will also be developed. This new unit will then be able to provide the sophisticated care and research required for the people of Nottinghamshire into the twenty-first century.

Radiology at the General Hospital by Dr Eric Roebuck

Never, in the history of the General Hospital (and rarely in the history of the whole of medicine) has a scientific discovery being developed into a clinical service with greater speed than in the case of X- rays. Roentgen discovered the existence of X-rays in 1895, and within six months the first clinical X-ray was taken that the Nottingham General Hospital. On 17 November 1898 a complete apparatus for taking X-ray photographs was fitted up in the hospital, and two rooms in the basement where thoroughly equipped with the necessary accessories. The present department was opened in 1927, and was considerably enlarged during the late 1960s and early 1970s. The medical staffing of the department was initially on a voluntary basis. First Mr Henry Blandy (1886-1906), the honorary dentist, took charge assisted by his friend Mr Simpson of University College. It was not until 1920 that a permanent medical officer in charge was appointed. This was Dr Clayton Rigby who, just before his retirement, was joined by Dr Walter Mowatt in 1935. Walter Mowatt ran the whole of the Nottingham Radiological Service throughout the war virtually single-handed. This involved not only looking after the Nottingham population but also many wounded servicemen. Dr Frank Gordon was appointed in 1946 and Dr Eric Roebuck in 1965. It was during the late sixties that the biggest developments occurred. The patient throughput doubled to 400 cases per day – an almost unbelievable workload given the size of the department. Possibly the most significant development was the recognition of the General Hospital as a training centre for radiologist, a role which further enhance the national reputation of Nottingham and which

73 was made possible by the recruitment of additional specialists including Dr Bryan Preston, Dr (later Professor) Worthington, Dr ‘Satch’ Amar and Dr Martin Wastie. The radiographic staff had been no less illustrious. Mr Williams was the chief radiographer, and also undertook training of student radiographers from the 40s to the 60s. His successor, Miss Marjorie Lee, had a remarkable career. Her first association with the General Hospital was at a paper girl. Subsequently she became a technician, then trained as a radiographer, spending the whole working life that the General until the opening of the University Hospital. It was in 1969 that Mr Alan Swallow was appointed as full-time tutor to supervise the training of radiographers and a School of Diagnostic Radiography was established at the General Hospital to cover the whole of Nottinghamshire. Many new and innovative X-ray techniques first developed at the General Hospital, have now become routine procedures throughout the country. With this background the General Hospital Radiology Service wasn't ideal springboard from which to launch the new University Hospital Department, now one of the busiest departments in the country, and one which is continuing the academic traditions first established that the General Hospital.

Mass Chest X-Ray Unit

A Mass chest X-ray unit was opened in Postern Street in 1944, though it was administered as part of the Nottingham No 2 Hospital Management Committee, the centre work closely with the General and City Hospitals. A number of cases of lung cancer diagnosed by chest X-ray were referred to either Mr Barclay or Mr Linton at the City Hospital Thoracic Department. Both these consultants work closely with the Hogarth Radiotherapy Unit. The Medical Director of the Centre was Dr Arthur Beynon. In 1971 more than £120,000 was spent converting the building in Postern Street into a postgraduate centre. The building contained a mass miniature radiography unit, outpatient’s clinics and three consulting suites. When the mass X-ray unit closed, it became the headquarters of the John Storer clinic – the hospitals’ only link with the psychiatric services. Consultant psychiatrist Peter Tyrer recalls:

My links with Nottingham General were always tenuous – never more than one outpatient clinical week at the John Storer Clinic, which had a very pleasant homely atmosphere. The Germans have a word for it – Genuchlichkeit, which is difficult to translate but embodies aspects of cosiness, security and contentment. This feeling is not shared in any of the other Nottingham hospitals.

Mr Harold Renyard

I came to Nottingham, from King's College Hospital, in January, 1955 and replace Mr Llewelyn Davies is a general surgeon at Nottingham General, Newark and Highbury Hospitals. There was already a promise of the teaching hospital in the future. I joined Messrs Hunt, Swan, Field, Brownlee and Sheehan that the General Hospital with Mr Hunt and Mr Field joining Mr Masterman and Mr Gray at the City Hospital. Between us we had beds at Newark, Highbury, Heanor and Ilkeston Hospitals. Nottingham General, Newark and Highbury Hospitals were part of the Nottingham No 1 Management Group, with Mr Stanley as Group Secretary and Mr Reddaway, his assistant. They have the problems of the whole group at their fingertips. Individual hospitals and house committees, responsible to the Management Committee. Woe betide the hospital secretary for failing to carry out the orders of the management. Mr Stanley wanted to know why. These committees would walk around hospitals, poke their noses into corners, talk to patients, kitchen staff and generally keep the running of each hospital up to scratch. In January 1955, my family and I invited to the Sisters Christmas Party, where we nursing and medical staff and no doubt we were ourselves vetted. I remember a ward sister coming up to this shy young surgeon and introducing herself as Mable Player. It wasn't until years later, when I had beds on her ward, that I realised the ward was named after her. The General Hospital seemed to me to be ideally situated, near the centre of the city, providing easy access for patients, staff and visitors. It was really a ‘quart in a pint pot’ with beds utilised up to

74 the hilt. As the ‘new boy’ I did my outpatient clinic on Saturday mornings for many years. Likewise my only operating slot was the Pay Bed Wing Theatre on Friday afternoons. Each surgical firm of two was on call for emergencies for one week in three. I usually overflowed my small number of beds with emergencies, and never had much leeway for cold surgery. The advent of the Trent Wing was a godsend. We had new theatres, 28 bedded cubicled wards, teaching rooms, pathology department and canteen in one block. The use of the whole of Carlton Ward opened up one of the happiest periods of my surgical life and I retained it until retirement in October 1981. As colleagues retired so new young surgeons appeared, Mr Makin and Mr Hopkinson as general surgeons with a large vascular interest. Mr Fawcett has an interest in endocrine surgery. Mr Bates and his colleagues were pure urological surgeons. No longer were the older generation of surgeons, like me, allowed to step into specialist arenas and a good thing too! The advent of the Teaching Hospital and the Medical School caused great excitement and enthusiasm. During the infancy stages, clinical teaching was done both at the General and City Hospitals. Not only were the ward facilities adequate but there were radiological and pathology meetings in the lunch hour at both hospitals. Later, when the University Hospital was opened, my firm and I, were bussed to the University for lunchtime conferences. I think we all, both clinical teachers and students, has a very enjoyable time, gaining valuable experience. The original plan was to have the University Hospital, the General and the City to share the surgical work and teaching across the city and county. If I can remember well the Medical Committee meeting when it was reported that money has run out and the alternatives were to run down the surgical unit at the General Hospital, or postpone Phase Two of the University Hospital. I was the only dissenting voice among my colleagues, who were in favour of abandoning the General Hospital. Being near retirement, and having a large commitment to Newark Hospital, I felt I couldn't enter another phase at University Hospital. It was a happy 25 years of very hard work, amongst marvellous, helpful colleagues, which I would do all over again if I had the chance.

Casualty

Accident cases have always had high priority at the General Hospital. In the earliest days of the hospital, this was one category of patient which did not require a letter of recommendation. The increase in the number of industrial accidents led to the building of a new extension in 1875. By 1913 the hospital was treating 423 accident inpatients and 4,134 outpatients. A decade later release figures had doubled, including a dramatic rise in the number of road accidents, resulting in the reconstruction of the Casualty Department in 1929 at a cost of £29,000. The upgraded facilities included in waiting room for up to 180 patients, reception rooms, dressing room and a small theatre for minor operations. Two entrances were created – one for walking cases and another, covered by a glass roof, for stretcher cases. The department was staffed by two doctors, plus a sister and a small team of nurses. Serious cases, after initial treatment, were transferred to one of the specialist accident wards. By 1934 the hospital was expressing concern about the financial burden incurred in treating 549 road accident casualties. By 1970, the General Hospital housed the main accident and emergency department for the city and county area, including a 21 mile section of the M1 from Lockington in the south to Normanton in the north. Over 70,000 patients were seen in the Department in 1971. During the same year, and SOS went out for local doctors to help because the department was seriously undermanned. For GPs and several doctors at hospitals in the Nottingham area volunteered their services to provide cover during the crises.

Stephen Morris

Medical journalist and author Stephen Morris recalls the General Hospital Casualty Department in 1961/62.

Life in Casualty was never dull. Each day the Department saw a wide variety of accidents and emergencies, as taking all in its stride. There was strong on occasions, yet it was far removed from that seen on our television screens on Friday night! All casualties who had been knocked unconscious were admitted to the surgical ward that was on take for the ‘Conc. rota’. Possible fractures were X-rayed and if proven the casualty was referred to Fracture Clinic. Wounds were cleaned and sutured, sometimes by medical students working in ‘Cas during their vacation ‘. There were only one or two of these chaps around then, but they learned a lot.

Main entrance and Accident and Emergency Department, 1960.

Patients were sent in by general practitioners either went straight to the ward on take (if the houseman let Casualty know in time), all were seen in Casualty, then admitted. Beds were usually found, but sometimes it was necessary to ‘sleep out’ patients on wards not actually on take. Before the place was redesigned, ambulances would come into the yard and reverse up to a single pair of glass doors. In slack moment a porter would often sit in the wheelchair just inside these doors so that he could see out through the main gates, right up the Ropewalk. If an ambulance approached it would give a burst on its bell – or later the two-tone – and the doors would be quickly opened and a trolley made ready to whisk the casualty into one or other of the examination rooms. When I think of Casualty today I recall many friends. You got to know a lot of the ambulance crews, in those days from both City and County services. The place was always busy with policeman, patients’ relatives, tramps, ‘regular visitors’ and the occasional stray dog that has come in out of the cold! I suppose the Accident and Emergency Department at the QMC has much the same atmosphere today, but some are feel there was a very special service at the General. Obviously I recall many members of the staff in those days, all with affection, especially the Casualty Sisters, Margaret Button and Jean Midgley. Many friends were made here and many memories remain.

John Bittiner writes:

When the Ropewalk Wing was opened in 1929 it became possible to extend the Casualty Department (now called Accident and Emergency). Only adult patients were treated, as a separate casualty department had been established at the Children's Hospital – now Forest House. Although the number of patients increased rapidly over the years, few further extensions were made until the 1970s when the handsome boardroom of the hospital was converted to provide additional accommodation for the Casualty Department. Such is progress.

On the medical side some important changes took place. One of the most significant was the appointment of consultants to work in the department, rather than being titular heads. The training of

76 casualty officers improved markedly, resulting in improved treatment for the patients of Nottingham. It was, however, very difficult to recruit medical staff to the new speciality and many part-time staff from general practice were employed. The improvements in the post-war years which helped in both the management of patients and the shortening of waiting times included the wide range of plastic equipment and disposables such as syringes and needles.

Accident and Emergency Department, 1960.

Ambulance crews were much more highly trained and many ambulances better equipped with facilities such as oxygen cylinders, defibrillators (for heart attacks), nebulisers (for asthma) and sets for giving intravenous fluids. Radio communication helped save time and lives.

The Ear, Nose and Throat Department by Mr Jimmy Neil

The Ear, Nose and Throat Department was founded in 1920 when Mr A.R. Tweedie and Mr H Bell- Tawse were appointed as honorary aural surgeons to the General Hospital. At first, they worked in the Postern Street Buildings in the old Outpatients Department but in 1927 a splendid custom-built Department was included in the new Ropewalk Wing with outpatients', wards and theatre altogether on the first floor. In those days, before the advent of antibiotics, the infections of the ear and mastoid were potentially lethal. So acute mastoidectomy was a common operation and after many outpatient sessions there would be one or two acute cases to be dealt with. Both surgeons were well known in speciality. Mr A.R. Tweedie. H. Bell-Tawes was President of the Section of Laryngology at the Royal Society of Medicine in 1928 and Mr Tweedie President of the Section of Otology in 1931. To assist them they had the house surgeon, usually an experienced doctor with a higher qualification, who might eventually join the consultant staff, as did Mr Gilroy Glass, who was appointed honorary assistant aural surgeon in 1935. As he was in the TA he was called up in 1939 and the Department was run throughout the war by Mr R.A. Marshall and Mr H.B. Lieberman. Mr Glass ended the war a full colonel and on his return was appointed an honorary aural surgeon and set about reorganising the Department in preparation for the advent of the National Health Service. The staff was then increased by the appointment of Mr I.A.M. McLeod and Mr Austen Young, who replaced Mr Lieberman. I was appointed in 1951 to replace Mr Young who went to Sheffield. From this time, there were rapid advances in all aspects of medicine – sulphonamides, antibiotics, antihistamines and later at chemotherapy and steroids all necessitated changes in clinical practice. We started a combined clinic with the radiotherapists and later plastic and dental surgeons to improve the treatment of malignant disease. Microsurgery the ear and the use of the children replace

77 the old hammer and gauge technique and conservation of hearing was the aim rather than dealing with dangerous infections (although these still occurred). Audiometry became even more complicated. The greatest change occurred when we started having medical students in the Department in 1973. Luckily we were able to use the last of the money received from the sale of the old Ears, Nose and Throat Hospital in Goldsmith Street to upgrade the Outpatient Department and provide teaching facilities. We were able to appoint a senior registrar in addition to the registrar and two senior house officers. Nottingham was fortunate in being chosen as the site for the Medical Research Council's Institute of Hearing Research. The main building was on the University campus and there are four outstations in Cardiff, Southampton, Glasgow and Nottingham. Ours was cited in the old Postern Street buildings and the Hearing Aid clinic was moved in alongside it in the old Ransom Laboratory building. This was a great improvement on the original sites – first in an ancient building on Park Row, then an equally decrepit building on Standard Hill. Neither were very satisfactory. Later, in 1981, the Children's Hearing Centre opened in the old Children's Hospital on Cumberland Place, connected both to the Hearing Aid centre and the outstations by a bridge. The MRC funded the appointment of the Director as a joint Health Service/Research post and the centre was funded from a number of sources. The building itself had long been empty and was in a terrible state but it was possible to turn it into a splendid diagnostic department. Much equipment was provided by various charities and so were able greatly to improve the diagnosis and treatment of hearing impaired children. Meanwhile in 1978, the outpatients department had moved to the University Hospital into a larger department with much improved facilities, leaving the ward and theatres at the General until 1983 when they moved to University Hospital and the Department closed after 55 years of activity. The smooth running of the Department depended greatly on the nursing and ancillary staff. Chief among these I would mention is Sister Muriel Hardy, who presided with great skill over the nursing for most of the post-war period and Bill Baldwin, the theatre porter who was tower of strength to nervous junior anaesthetists.

Hearing Services

The opening of the Hearing Services Centre in 1981 was a major development for the General Hospital. The centre, which includes a hearing aid clinic and a children's hearing assessment centre, dislocated on the Postern Street site of the first Children's Hospital in Nottingham. The official opening of the centre was performed by the former Government Minister and Olympic athlete Christopher Chataway. Earlier in the day the children's unit was opened by Mr Ezra Rachlin, husband of the founder of the Beethoven Fund for Deaf Children, which contributed £5,000 to the project. Other donors included the National Deaf Children's Society. The hearing services centre houses a School of Audiology, one of only a few centres in the country, offering a training course for student technicians. It also offers training and education for other people involved with the problems of hearing impairment. The work of the centre includes the taking of anatomical earmoulds for hearing aids and the fitting of the various different kinds of hearing aids. In addition the centre provides a hearing and repairs service. Since its opening the centre has developed very close contacts with the social services, adult centres and the Institute for the Deaf as part of a multidisciplinary approach to the problem of hearing impairment. The hearing services centre also acts as a clinical outstation for the Medical Research Council's Institute of Hearing Research at Nottingham University. The children's hearing assessment centre has established a national reputation for the early detection and treatment of hearing in babies. About one baby in 1,000 is born with a severe or profound hearing loss. And one of the centre’s important roles is running a screening system for such disorders and offering help and treatment to those affected. Treatment may take the form of hearing a provision, surgery or, in some cases, surveillance until the condition has resolved. Dr Barry McCormick has demonstrated that the average age of detection of hearing problems in babies has reduced from nearly 3 years to 6 to 12 months since the centre opened. The centre, in conjunction with the Medical Research Council's Institute of Hearing

Research, is researching new methods for detecting hearing problems in new-born babies. From this work, highly sophisticated new equipment will be developed during the next few years. The joint effort by the Children's Hearing Assessment Centre and the Ear, Nose and Throat Department at Queens Medical Centre has also established a new charity, the Ear Foundation. This provides children, who have a total acquired hearing loss and would not benefit from the world's most powerful hearing aids, to be considered for the latest technology – a cochlear implant. This sophisticated device bypasses damaged nerves and provides miniature electrical stimulation to the auditory nerves, enabling some sensation of sound to be experienced. Three-year-old Michael Batt of Mansfield Woodhouse, became the first boy in Britain in March 1989 to receive the multi-channel implant. He can now hear a wide range of sounds and his speeches starting to return. The implant offers new hope of rescuing a small group of totally deaf children from their silent world.

Eye Services

For more than 100 years, Nottingham Eye Hospital gave remarkable service to the people of the city and surrounding areas. The first premises, opened in 1859, were in Park Row and then the infirmary moved to 56 St James's Street before a purpose-built Eye Hospital opened in the Ropewalk in 1912 at a cost of £13,000. One of the infirmary's first ophthalmic surgeons was Charles Bell Taylor, who was appointed in 1859. He preferred to perform cataract operations without an anaesthetic in a dark room with a light lamp focused on the patient. Another distinguished surgeon was Ernest Cory Kingdon, who became president of the Nottingham Medico-Chirurgical Society in 1908. Dr Alexander Christie Reid came to Nottingham in the same year and practice in Sneinton and Broad Marsh before being appointed honorary assistant surgeon to the Nottingham and Midland Eye Infirmary in 1909. He served the hospital with great distinction for many years until he retired in 1947. The author of many articles and inventor of an instrument for glaucoma operations, he died in 1950. Another distinguished member of the medical staff for many years was Dr Gordon Napier. The Galloway family have had a long association with the Eye Hospital. Mr Norman Galloway was consultant there from the 1930s until the mid-1960s when he retired. His son Mr Nicholas Galloway was appointed a consultant in 1967, worked at the General Hospital for a number of years and is now an ophthalmic surgeon based at University Hospital. For many years the Infirmary was administered separately from the General Hospital with Mr Wilson the long serving secretary. In 1953 the hospital became one of the first in the country to be approved as a training school for a diploma in ophthalmic nursing. At that time matron was Miss A M Edwards. The workload for both in-patient and casualty services was growing all the time and the pressure was eased with the addition of a new nine bed ward in the 1960s. For a time from 1979 onwards, casualty services were split between University Hospital and The Ropewalk. The Eye Hospital was always at the forefront of new techniques and microsurgery had been performed therefore a number of years. One of the last operations performed at The Ropewalk was in November, 1983 before all eye services came under one roof at University Hospital.

Dental Department

The Dental Department on The Ropewalk was founded in 1961 by Mr Tom Battersby, consultant dental surgeon to the General Hospital for over 20 years. A plaque, paying tribute to his work, was presented in 1968, donated by the East Midland branch of the British Dental Association. Another consultant who made a significant contribution to the department during the 1960s was Mr Selwyn. A new £216,000 extension to the department was opened in 1978 by Mr David Evans, then chairman of the Nottinghamshire Area Health Authority.

Outpatients

For the past 60 years, Outpatients has been a key department at the General Hospital – and even after the main hospital closes in 1992 it is envisaged that the Ropewalk Wing will remain for outpatient services. The Department expanded rapidly after the formation of the NHS and in 1972 there were 174,000 attendances. Although the outpatient caseload during the 1980s decreased with the transfer of some services to University Hospital, it is still the base for many important clinics in specialities such as radiotherapy, oncology, pain relief and genito-urinary medicine.

Dermatology by Dr Ian McCallum

A dermatological service was provided in Nottingham from the late 1930s by Dr Herbert Smith Wallace who had one large weekly clinic at the General Hospital and another at the Children's Hospital. Dr A.D. Fraser provided an outpatient service in a converted Turkish Bath in Upper Parliament Street. In the early war years these were converted into a scabies treatment centre and then into a dermatological outpatient department.

Nursing and medical staff and patients during a Christmas party in the skin outpatients clinic. L/R: Dr Ian McCallum, Dr Neville Johnson, Matron Miss Rachel Ross, nursing staff and patients.

Dr Smith Wallace retired in 1951 and Dr Ian McCallum was appointed to cover the General Hospital commitment. In 1959 the Parliament Street clinic was transferred to the Postern Street wing of the General Hospital, where the radiotherapy wards had previously been. To illustrate the keenness of the staff to effect the transfer with minimal upset to patients, the Parliament Street clinic with closed at midday on Saturday; members works throughout the weekend and opened the Postern Street clinic at 9am on the Monday morning. The service continued here until about 1977 when outpatient and in- patient facilities were provided in the purpose-built department at the Queen’s Medical Centre. In 1959 Dr E.N.M. Johnston was appointed after the death of Dr Fraser and in about 1965 Dr P.E. Kilby was appointed to a new post between Nottingham and Derby. Several papers from the Nottingham Department have been read by Dr P.D.C. Kinmount and Dr Ian McCallum at the British Association of Dermatologists. A team of consultant dermatologists is based at University Hospital. These include Dr Roger Allen, who trained as a senior registrar at the General Hospital.

Genito-Urinary Medicine by Dr John Bittiner

Venereal diseases have been with us over the centuries. However it was not until the First World War that the need for proper facilities to diagnose and treat them was accepted. In 1916 an Act of Parliament provided for free and confidential consultations in special clinics. It also protected the public from quacks and charlatans. Under this Act the venereal diseases were defined as syphilis (hard sore), gonorrhoea (clap) and chancroid (soft sore). Clinics, originally known simply as VD clinics, have now assumed a grander title of departments of genito-urinary medicine. These clinics were not always cited in hospitals. They were administered by local authorities. In 1948 they became part of the National Health Service. The service in Nottingham started in 1918 in North Church Street, off Trinity Square. It was run by Dr Buckley until the mid-1930s when it was taken over by Dr Taylor who was also a police surgeon. The clinic moved in the late 1930s to Postern Street opposite the present clinic. In 1942, a purpose-built clinic was opened in Glasshouse Street and a full-time consultant was appointed – Dr Marinkovitch. When he retired in 1963, Dr John Bittiner succeeded him until his own retirement in 1986. Dr Bittiner recalls:

When I arrived in Nottingham in 1963 the clinic had almost no equipment. The concrete building was dark and dingy, without curtains or carpets. I should say that this was normal for clinics at that time. The cubicles were open to the corridors. Sterilising was done in a fish kettle. The syringes were made of glass and metal; syringes were sharpened on the pumice stone. Sister Chantrill and other nursing staff spent much time making paper spills to light up the Bunsen burners so that matches could be saved. And there was one parent rubber gloves… The patients tended to huddle in the darkest areas of the waiting rooms to avoid being recognised by other patients. There were more than twice as many male patients as female, but when I retired the numbers were equal – is this equality of the sexes? I asked the regional hospital board for money to upgrade the clinic. The Senior Administrative Medical Officer (SAMO) was Dr Shone later Professor Shone in Nottingham. The Board was very generous and I was allowed to buy a wide range of equipment, including sterilisers, machines for taking blood pressure, microscopes, ophthalmoscopes, books and so on. Curtains, carpets, lino, and light painted walls help to brighten the clinic. Postgraduate education for doctors, nurses and midwives was initiated. As a young doctor and I treated thousands of patients who as syphilis in all stages. With the introduction of penicillin, this disease has almost disappeared. Perhaps one of the most dramatic changes in my lifetime has been the elimination of the terrible scourge of congenital syphilis with its blindness, deafness and other deformities. (At one time there were so many youngsters affected that we had Christmas parties for them and their parents.) The elimination was achieved by routine testing for syphilis of pregnant women in the ante-natal clinic and treating those infected with penicillin. When I first used penicillin it was so scarce and valuable that the patient's urine was collected, the penicillin extracted and used again. In my early days in Nottingham, if I required a new staff nurse, I put an advert in the Evening Post. Sister and I then interviewed the candidates, appointed one, and then notified the Finance Officer. To say that it is more complicated now is a major understatement. At that time I appointed Annie Kirkham as staff nurse. She is now the sister in the Department. The diseases recognised in the 1916 Act are now fairly uncommon. Many patients with other diseases, sexually transmitted an otherwise are now seen in the clinics. Such conditions include urethritis, vaginal discharge, genital warts and herpes, and, of course, anxiety. Herpes, genital warts and Acquired Immune Deficiency (AIDS) have caused widespread alarm in recent years, herpes and genital warts because of a possible link with cancer of the cervix and AIDS because it kills. When the Trent Wing at the General Hospital was opened in 1972, space became available in the Postern Street part of the hospital for a new clinic. The Glasshouse Street clinic was closed. This was a time of much creative excitement because of the new Medical School. A seminar room was built and teaching equipment became available for student teaching. My office was built in the space where, 100 years previously, patients had been admitted to the main hospital. The area had a gutter running through where the horses which used to pull the ambulances urinated! The students were good attenders – partly out of curiosity. I think that they expected to see peculiar looking men and lots of girls in long black stockings. Instead they saw ordinary people. The main difference from much of the rest of the hospital was that the patients were usually young and fit, mostly aged between fifteen and forty years of age. For the very young it was often their first visit to a hospital and they were frightened. I remember talking to a group medical students and telling them about a patient I had just seen. She

81 was twenty-three, married with one young child, and had minor genital symptoms. I asked her about her husband. She said that she was okay and so was her boyfriend. The three of them (all professional people) lived happily together. I remarked to the students, ‘You see how the other half lives.’ A voice from the student said, ‘We are the other half.’ I have seldom had to make up either funny or sad stories as I could always use true ones. I shall always be grateful to the chairman of a lecture who said that he had much pleasure in introducing Dr Bittiner, the consultant responsible for VD in Nottingham. Most of my stories (all hospital staff have their favourites) came from patients. I treated many of the local prostitutes and used to keep a medical register their names, which I called my ‘Whores Who’… Of course many stories were tragic, sometimes leading to suicide or murder. The problem of dealing with married couples, where for instance only one person had been infected, caused many difficulties. Earlier I mentioned Dr Buckley, the first consultant venereologist in Nottingham. His son John, a consultant anaesthetist known retired from the General, told me how his father was shunned by staff and virtually banned from entering the hospital because he treated patients with VD. I believe that the speciality although perhaps not respectable is now an accepted part of the hospital and has much to offer.

The General Hospital by Dr Ian McCallum

In the early 1950s when I came to Nottingham, the consultant staffing structure was small compared with present-day establishments. There were no waiting lists for outpatient appointments but the waiting time could be a source of complaint, especially in specialities in which x-ray pathological and bacteriological services were required. Medical and surgical standards were of a very high order but the workload in many instances was excessive. Junior staffing was a mere fraction of today's levels, as consultant posts were, in general, only available when existing staff retired or left for any other reason. As a result, these young doctors were grossly overworked and had poor prospects of advancement. In spite of these limitations the morale throughout the hospital was high. Special mention should be made of the Group Secretaries, H.M. Stanley and Gordon Davies, both of whom were held in high esteem by medical, paramedical and nursing staffs. The nursing staff was excellent and in my time (1951-73) both Matron Plucknett and Matron Ross controlled their staff with understanding and dignity. Medical and group medical meetings were well conducted and attended by almost all those who were eligible to do so. With the development of the NHS many problems had to be tackled and great credit is due to a succession of chairman and honorary secretaries for their voluntary contributions to the welfare of the service and of the hospital. The reorganisation of the health service in the late 1960s was, I think, particularly successful in Nottingham. The three hospital groups concerned sought to improve the service to the community in the spirit of cooperation, with the avoidance of confrontation.

Dr Eileen Clark, Retired GP

My memories go back to the First World War and the terraced huts erected to treat wounded soldiers. In the old days the Matron was very much the key figure. In terms of Administration you had Matron, the housekeeping sister, the house sister and the ward sisters. Finance and other matters were handled by the Monthly Board. The senior physician Dr Frank Jacob was marvellous. We called him Uncle Frank. In later years I remember going with Dr O'Donovan and house visit in his new Rolls-Royce. The house was on a cul-de-sac and he could not reverse the car. I said: ‘Well you have no option. There is no other way out.’

She explained that she could not get onto the staff at the General Hospital, although she was a well- qualified woman doctor.

Dr Keith Bywater, Retired GP

In the period after the war until the NHS was formed in 1948, the service by the hospital was second to none. Consultants were honorary and their incomes were determined by the number of private patients they were sent. If I saw a patient at evening surgery and I wanted him or her seen the next day I just sent them and there were indeed seen. The following day I received a handwritten letter from the consultant about the case. Question and answer in two days (not two months as at present if you are lucky). The Children's Hospital and the General Hospital were largely supported by industry and the two Player brothers (one helped each hospital). There was an annual dance in the Outpatients Hall on the Ropewalk in the winter attended by all the hospital consultants and their families and a lot of GPs and also the nursing staff – it was a family affair. How many GPs know the consultants these days? Things have got worse in this respect since the consultants (or a large number of them) are full-time hospital staff. The personal touch has gone. Nearly all the consultants lived on the Ropewalk, Oxford Street, Wellington Circus and Regent Street areas and walked to work each day. Now some of them have rooms in the area only. Nottingham's Harley Street is now a business place. The hospital was managed by one man, Mr H.M. Stanley, the House Governor and Secretary. Yet the hospital was efficiently run. The number of senior consultants stayed on during the war, even though over age, and kept things going. People such as Mr Alan, Mr Neil and Dr Scott. It used to be said in the 1930s that no one should be allowed to die unless they have been seen by Mr Hogarth.

Dr Jack Francis, Retired GP

Before the health service started in 1948 many of the staff of the General Hospital were in general practice. Two leading physicians Dr Whimster and Dr Proctor were both GPs originally. Before they joined the General Hospital staff they had to be elected and given recommendations. After the NHS was formed they gave up general practice and worked full-time as consultant physicians. Previously they were honorary and voluntary, making their income from seeing patients privately. Dr Proctor was a most delightful person – in my view the ideal doctor. He was extremely kind to its patients and took a real interest in them. He was in general practice for some years in Carrington. When they went on house visits, he always put the end of this stethoscope inside his jacket so that it would be warm when he put it on a patient. I also remember Frank Jacob being called in by GP to do a lumbar puncture. Afterwards he held up a test tube containing cloudy spinal fluid. The GP said: Is never got that out of my patient. You brought it with you! In the old days, there was no appointment system to see a consultant. You simply sent a patient and they were seen. Of course, the number of people attending hospital was minute compared with today. Many were treated by their own GPs then. Dr Francis ‘wife is the daughter of Dr Rowe, senior physician at the General Hospital for many years. She recalls: ‘I remember a small boy being sent to see my father with a potty stuck to his head. He had travelled to the hospital by tram. These days suppose they would have sent for the Fire Brigade.’

The General Hospital in the 1960s by Stephen Morris

Medical journalist and author Stephen Morris has great affection for the General Hospital, having been associated with it from 1960. He writes that – memories over the years tend to become distorted, and I don't doubt that mine could be now even more horribly nostalgic, having written so much about the place in the factual articles and, dare I say it, in some of my stories, all suitably disguised of course! But the one thing that never clouds from the memory is a wonderful effect the place have them all staff, whatever their role.

At night the lights of the buildings formed a landmark up to the top of Park Row and along the Ropewalk, giving a warm feeling of comfort and security. The hospital was like a watchful mother, ever ready to welcome into her arms those in need of care and solace. Coming into Nottingham by train from the West one of the first sites was not only the castle on its rock, but the four circular wards comprising the Jubilee Wing, and of course latterly the large Trent Wing. To a local lad like myself this was a real welcome home to Nottingham. In 1960 the hospital had, I recall some 459 beds all told, spread over 17 wards. There were also five operating theatres, plus all the supporting facilities. On the medical side the main wards were Portland (male and female) Castle, Frank Jacob, W.G. Player 1 and W.G. Player 2 (this later being renamed John Proctor Ward, after that dear physician). Consultant physicians also visited the hospital in those days were Dr Patrick O'Donovan and Dr Reginald Twort (both specialising in cardiology and general medicine), Dr W.H. Whimster (who specialised in numerological disorders and general medicine) Dr John Proctor (known and loved by so many diabetics this being his great speciality, but to also practice general medicine) and Dr Gwyn Evans (a general physician, but also an internationally recognised as inexpert in allergy). He was one of the first British doctors to go into Belsen concentration camp. On the surgical side the hospital was fortunate to have the services of many notable men operating generally and in various specialities. The Senior Consultant Surgeon was Mr John Swan. Then there were memorable names like Mr Freddie Hunt and Mr Jo Sheehan, long associated with the General. Mr Masterman, Mr Gray, Mr H.H. Renyard and Mr Tommy Field – a familiar figure with his half eye spectacles and his bowtie – but of course the most unforgettable character on the surgical side was John Brownlee. It is said that Richard Gordon who is now famous for his ‘Doctor’ books, once spent some time as a Housman at the General. It is believed that he modelled his character ‘Sir Lancelot Spratt’ on the late Mr Brownlee. On the orthopaedic side there were consultant surgeons Mr Noel Birkett, Mr James Campbell, and Mr Morrison. Meanwhile, up in the ENT there ruled Mr Gilroy Glass, Mr Marshall (who died suddenly in May 1963), and Mr A.I.M. McLeod, Mr Jimmy Neil and later Mr Hogarth. We used to remember the wards by starting with the Jubilee Wing (going up!) On the ground floor was Anderson Ward, then came Seely Ward, Hogarth Ward and at the top Mabel Player Ward. Neil Ward was under the watchful light of Sister Sidey. Below it was the male accident ward, James Foreman with Sister Monks in charge. The female accident ward was University and two other female surgical wards at the time were Fleet, a lovely Ward near the chapel, and just beyond it is smaller Ward in those days called 2Top. This later became Gover Ford Ward. The Ear Nose and Throat Department had its own wards and theatres, and above this, was the Radiotherapy ward, Gervis Pearson. Here too one should not forget to mention the Radiotherapy hostel, 48 The Ropewalk, which provided beds for patients who came for radiotherapy treatment, and although reasonably mobile could not get home after each days treatment. There is mention of the Radiotherapy Department elsewhere, but I recall the Consultants in this field well, Dr W.D. Fraser, Dr F.M. Benton and Dr George Jarrett. Other surgical specialities saw Mr Wynn Williams as the notable plastic surgeon, who founded the present burns unit at the city hospital and oral maxillary surgeons Mr Tom Battersby and Mr Selwyn. With the passing of time, names if not faces, elude one, but other names that come to mind were the Radiologist Dr Mowat and the pathologists Dr Hugh Rice and Dr George Hall. Lastly in the days before the infernal bleep, house officers were summoned to the telephone by the flashing of coloured lights. This system was certainly less irritating than the continual racket of bleeping. The lights could be seen where ever you were in the hospital. Each firm had its code, with flashing lights for the junior house officers and stationary lights for the registrars. The lights were green, red, amber and white. Day and night the lights went up. House officers were pretty good at answering their lights promptly, to be told by switchboard what number to ring. The administrative staff in the early 60s did a fine job. Mr Stanley the group secretary and his Deputy Cyril Reddaway kept things ticking over. And other names that deserve a mention are Claude

Abbott and most kindly man, and in charge of Medical Records, Mr Bill Eades, related to have his Deputy Mr Ray Nutt. Incidentally, I have experience at the Children's Hospital – as a patient. At the age of about 10 I was thought that I had some abdominal disorder that might, or might not be a serious matter. So my very caring lady doctor referred me to Mr Swann for his expert opinion. On examination chance one could find nothing serious amiss, but being overcautious sent me for various tests. One of these was the dreaded barium enema. During the procedure – at the Children's Hospital – the kindly Radiologist asked me ‘if the little chap was all right’. The little chap replied "yes thank you, but my mother says I haven't been the same since I had my tonsils out in this place!" My poor mother cringed in the corner. I later saw John Swan at his private rooms where I created an awful row! He concluded that the trouble was no more than ‘gastric distension’. Back at school I proudly told all my friends this frightful diagnosis and gained their sympathy. In later life of course I realise that all John Swan meant was that the ‘little chap’ had a tummy full of wind! Mr Swann and a lovely way with children. When I got to know him really well at the General I appreciated he had a lovely way with everyone. On his retirement I was at the celebration in Pearson House and admitted to him that it was I who had kicked him on the shins some 20 years previously. He merely laughed, replying that I was one of the many – and gave me another drink!

Anecdotes from the Early Sixties

Members of staff recall:

Visiting was always time to be ‘avoided.’ One afternoon I was trying to get away from Mabel Player Ward before the crowds charged in. Coming down the stone steps of the Jubilee Wing I tripped and went ‘backside- over-tip’. The pile of case-notes I was carrying went everywhere as did the contents of my overall pockets! I lay helpless on the steps, slightly stunned, while the oncoming visited chunks over me clutching their grapes and daffodils. One was heard to say. ‘The daft young so-and-so should look where he is going.’ So much for the ‘reverence’ for the white coated staff!

We all took nurses out from time to time. Getting them back before the Nurses Home was locked up presented a problem. One night a friend and I bought two girls back after a party. We were out of time. As Home Sister would be on the prowl we found a way round by going through the main hospital. The girls took it in turns to borrow my white overall and dash (like house women working late) through the corridors, police got into the home via a door left unlocked by friends (on night duty), the overall risk dropped from the window for the next ‘miscreant’ to slip it on and make a dash for it!

The place to take nurses – to impress – was the White Post at Farnsfield, or the American Cocktail Bar in the Black Boy!

Dancers were held regularly in Pearson House (Junior Nurses Home) and annually at the Sherwood Rooms. This latter event was the occasion of the year, and held in January for junior medical and nursing staff, admin staff and general hangers on. The crowds were usually welcomed by the Chairman of the HMC and Matron.

Everything would start politely enough with a few sedate dancers. Then later on more hearty members of the medical staff would appear (well oiled!). One chap always used to go the whole hog and wear full evening dress, white tie and tails. I'll mention no names, though where he is now I know not. He was an anaesthetist. At the time the kick Sherwood Rooms used to arrange silly games during these kind of functions. Races on miniature bikes and the like. One year things got totally out of hand and four cyclists – big housemen on little bikes – got in a locked group and collided en masse with matrons table. It was most spectacular! One chap slid right under the table and had to be extracted, or rather extricated, slightly stunned! Another occasion at one of these dancers, the date coincided with one housemen's birthday. At the appropriate moment the band struck up Happy Birthday to You, and he was held aloft from the balcony, in fact he was upside down and all he could see through a drunken haze was a trestle table groaning with food. He was eventually hauled back promptly passed out!

Each year the Consultants and the Sisters had their own ‘bash’, a full-scale dinner, held in the Outpatients Hall. Never having been privy to what went on at any of these events I can only assume that they were as eventful as those enjoyed by younger members of staff.

One well-known surgeon damaged his knee, and went to the dispensary to get something to rub on it. He came back fuming that they had charged him a shilling for ‘a small tube of cream’. He eventually was even more furious when a colleague quietly pointed out to him that he was a free sample from one of the drug reps! Dr Proctor's Friday morning diabetic clinic to large crowds. Once a very little chap, a miner, complete with flat cap, appeared clutching his specimen in a quart Shipstone's brown ale bottle – full to the brim!

Casualty was always busy. One Saturday afternoon and old man came in, on foot, and as he didn't look particularly ill he waited patiently while more urgent problems were sorted out. Eventually the young casualty officer got to him and apologised for the wait, asking what his trouble was. The man said he felt fine, nor had he injured himself. Well, why are you here? Asked the doctor. ‘Well lad’, the man replied, ‘I've come for a new rubber "doings" for the end of my NHS walking stick!’

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CHAPTER 9

THE SPIRIT OF NURSING

In this chapter, nursing staff past present recount their experiences, anecdotes and observations sum up the spirit of nursing at the General Hospital since the 1920s. Our first contributor is Honor Fawsitt (nee’ Pitt), who joined the January, 1935 intake of new nursing students at the hospitals Preliminary Nursing Training School. Her extracts from the rule handbook for that period provide a fascinating insight into pre-war nursing.

1. All nurses must be quiet, punctual, and obedient, and avoid loud talking on the corridors and in other parts of the hospital. 2. No nurse may absent herself from any meal without permission from the Matron. 3. All nurses must be on duty from breakfast and may not return to their rooms without permission from the Night Sister. 4. Bedrooms in the home to be ready for inspection by 10:30 am each day. Windows open. No boxes under beds, which must be made thoroughly. 5. All nurses who are late for meals, or at the gate, must report themselves to the Matron in her office next a.m. 6. All nurses must keep their drawers and cupboards locked and must not leave money or valuables about. 7. Nurses are never to be found absent from the wards when on duty, and never at the wards when off duty. 8. Nurses are not allowed on the corridors or staircases with their sleeves turned up or without cuffs on. 9. Nurses must be at all times kind and considerate to the patients and courteous to all visitors to the hospital. 10. Nurses are asked to remember their professional position in the wards and to avoid any gossip or familiarity with subordinates or patients. 11. All male patients are to be called by their surnames. 12. Nurses are asked to exercise hospital economy in every detail. 13. Any nurse feeling ill must at once report to the Sister under whom she is serving, who will immediately report to the Home Sister 14. SMOKING IS ABSOLUTELY FORBIDDEN. 15. No parcels or boxes of any kind are allowed in the bedrooms. They must be kept in the box-room provided for the purpose and should be clearly labelled. 16. Only five articles are allowed on the dressing table. 17. Nurses are asked to take after the bedspreads at night and forward them neatly, and stripped their beds when they leave their bedrooms before breakfast, and open the windows.

18. New writing with ink is allowed in the bedrooms. No flowers allowed in the bedrooms. 19. Flowers given to Home Sister will be arranged in the sitting room. 20. Pictures must be hung on the Hawks provided for them. IT IS STRICTLY FORBIDDEN TO DRIVE NAILS, OR PINS INTO THE WALLS ANYWHERE IN THE HOME. 21. The position of furniture must not be changed. 22. Many and valuables to be carefully locked up. Articles unclaimed or found lying about should be taken at once to Home Sister, to whom immediate notice of any loss should be given. 23. Keys for chest of drawers and wardrobes may be obtained from Home Sister upon a deposit of 2s 6d, which will be refunded when the keys are returned. All keys must be returned to the Home Sister. They must not be exchanged or given to any other nurse at any time 24. IT IS ABSOLUTELY FORBIDDEN TO INTRODUCE CANDLES, OIL, SPIRIT, MATCHES, OR ANY OTHER INFLAMMABLE ARTICLES IN THE HOME. 25. NO ARTICLE OF FOOD OR DRINK IS ALLOWED IN THE BEDROOMS. 26. Nurses are not allowed to be in the Sisters Room, or any sitting-room other than the one allotted to their particular year of training. 27. Dave nurses must leave their Sitting Room by 10pm; they must all be in bed by 10.30pm except when late passes have been granted, and all lights must be out by that time. 28. Night nurses must leave their Sitting Rooms by 12 noon and to be in bed by 12.30, except when special late passes have been granted. 29. Nurses may receive visitors in the Home, but they may only see them in the room provided for the purpose. Should the friends of any nurse wish to see over the Home permission must be obtained from Home Sister. 30. No probationer should leave the nurses home after supper. Nurses and probationers letters must be addressed ‘nurses home’ with Christian as well as surname, to avoid mistakes. 31. Nurses on leave for ‘Day Off’ or ‘Night Off’ may have breakfast in bed at 8am, but at no other time except by special permission. 32. ‘The matron asks each Nurse to conform loyally to the above and assist in this way to ensure, as far as possible, the general welfare and happiness of their colleagues. She earnestly appeals to each one to do all in their power, both in her behaviour and conversation, within and without the hospital, and uphold the good name of the Training School, and to endeavour to realise that the maintenance of the high standard of the certificate and success of the hospital depends on the efforts of each individual.’

The rules were followed by a section on taking notes, tests and exam papers and a section on the ethical aspects of nursing. Extensive guidance was given on domestic ward work including sweeping, dusting, cleaning brasses, polishing furniture and scrubbing out lockers. Nurses were advised: ‘One does not look on these as menial duties because domestic work well done is not menial. ’Precise instructions but also given on cleaning walls, kitchen, bathroom, sluices, bedpans and urinals. All infected utensils were to be sterilised by carbolic washing and all bed linen was to be soaked before sending wet to the laundry. More detailed instructions followed on how to give a bed bath and to make of the tray for mouth care; how to fill a hot water bottle and clean the metal parts of the wards screens.

Help set up, and use, trays for parasites (Head lice and Bedbugs), Sassafras oil (how it stank) and a fine metal tooth comb. How to set up, and use, trays for treatment of backs, preventative measures, and care of any broken skin on the patient's body due to being in bed. Any bed sore was a disgrace, reported to Ward Sister, who reported it to Matron, who came and inspected the offending area. This very seldom happened, as back rounds were done after every bedpan round. Patients who had bowel actions were always washed down and made comfortable. How to setup and use trees for mouth care; all ill patients had full care of the mouth after any food, or milky drink. How to take temperature, pulse and respiration, and chart same, asking at each time, twice daily, whether the bowels had been opened. Results noted and aperients given, as appropriate, that the medicine round in the evening. Is how to give an enema, and the various varieties of the same? Plain soap and water, Turpentine, olive oil. Method of giving an enema stressed, never unduly exposing the patient, keeping the patient warm, reassuring the patient, and explaining why the action was necessary. How to give medicines, injections, (hypodermic), and care of the medicine cupboard and safekeeping of the key to same. The different kinds of bed make-up for various illnesses, both surgical and medical; how to make various external applications, poultices, fomentations, appointments.

Solutions and lotions in, Newsome the 1930s were carbolic, boracic, perchloride of mercury, biniodide of mercury, acriflavine, eusol, hydrogen peroxide, iodine, methylated spirit and lysol. The handbook explained their uses and dilutions and how to test urine. Honor Pitt recalls that nurses nicknamed the new W.G. Player Ward as the ‘chicken run’. It had a lift which was good for practical jokes. Careful planning by the night nurses enabled the ‘covered wagon’ (the trolley for the dead) to be sent up the lift on its way to the morgue to meet the callow new night nurses on their way from midnight lunch. Meals at night with the same as daytime – breakfast at 7:30pm, dinner at midnight and supper at 6am. Imagine eating bacon and eggs, very overdone and hard, when starting a night's work. ’The lift was useful for another purpose – it forewarned nurses when night sister was coming to do her round. The telephone Porter also gave nurses a special ring when they saw sister leave her office to start her round.

Then it was off the radiator shelves, unwrap the cloak and popular bonnet on the head, and try and look alert. There was never much time for rest. The ward jardinières, solid brass, had to be cleaned; cotton bandages had to be washed, high-end and rolled and sheet turned sides to middle and fine hemmed together. For our first year in the Nursing School, chapel was compulsory after duty at night. Josie and myself worked the bellows on the organ and had innocent merriment by stopping in the middle of a push and then there was a nasty growing from the wind part.

Mrs Josie Cole, former nurse

Josie Cole (nee’ Downing) joined the General Hospital Preliminary Nurse Training School in 1935. She had applied to start nurse training at her local hospital but was told by the matron to apply further away from home. She wonders whether this was to stop young lambs running home to ‘mummy’ when the going was tough. She recalls having to seek references from the vicar and family doctor and detail High School grades on the application form and being interviewed by Matron Miss Liddell.

The first side to this high personage was daunting. The tall slim woman, in French navy soft crepe, with hundreds of tiny covered buttons marching from neck to ankles. A wonderful organdie Army Square, which she had a knack of holding down by its back point, by insinuating her hand behind her back and pinching the endpoint which tended to take off in a breeze, I imagine Mother Superiors might have been like that for presence, but Miss Liddell's smile was distant and small. I passed for the four-year training, was told what was expected of me, given the Rule Book, and went next door to be measured for uniform. The uniform was very stiff material, drill, with a broken grey/blue stripe, lined with unbleached calico, the skirt had to be nine inches from the ground... The bodice had two deep tucks on the front, and this successfully hid any bosom, so that the starched apron bib flowed over one's chest and presented an unyielding effect to the world and to one's anatomy. The skirt was fully gathered into a waistband and had three one inch tucks above the hem which gave a rather crinoline affect when one hurried about one's duties. ‘Nurses’, we were warned; ‘only run for Fire or Haemorrhage.’ The apron was secured at the waist by a two inch starched belt, fastened with pearl studs which broke all the time and cost us a fortune to replace. Our necks were held in place by end up right starched collar and inch in depth and fastened by a Pearl Stud. Oh dear, the long sleeves buttoned from elbow to wrist were neatened by starched cuffs, three inches deep, fastened with two pearl studs. We all rather fancied ourselves in the first and second year cap's, which were contrived from a starched oblong of fine cotton muslin, and gathered at the back into a butterfly effect. This butterfly was our only touch of individuality; some wore them angular, some frilly, some flyaway. The outfit was completed by black woollen stockings, black flat heeled leather lace up shoes, and oh how darling, when someone wore black Isle stockings. It was three years’ service before silk black stockings were sanctioned, and not thin silk then. We looked forward to our third year of training, when we were elevated to bonnets, gathered into a fetching frill at the back and held in place by strings – white cotton tapes. In the middle of each length was tied a white starched bow; the tape was taken under the chin and pinned on top of the head and was anchored to it with white knob pins at each side. Individuality again had its day as we could put starched lace on the bow ends, lace of a modest width, but lace nevertheless. In our third year, if we passed our hospital exams, we also went into mid blue denim type uniforms, and when we passed our state exams we have the glory of two inch navy petersham ribbon belts. These were fastened in front with a two-piece silver buckle, with a centre clasp. It didn't seem to make it all worthwhile, and to be called Staff Nurse.

But it didn't make much difference to the rules. I remember, begging for a midnight pass after a day off. My friend Honor recalls being sent back to the Nurses Home, stopped in the drive as she left by the Home Sister and told to redo her hair, and put on stockings… ‘You are a disgrace to the hospital, Nurse.’ She was off duty, and late for her meeting with a friend. Here we were, nearly at the end of training and holding great responsibility for the lives of our patients.

Before any intake was allowed on to the wards, students spent three months in the Preliminary School. Josie thinks they started at 8am, didn't eight-hour day in the school room six days a week and had Sunday off.

We studied anatomy, physiology, medical and surgical practice, hygiene, invalid cookery, public health, and practical nursing. The Sister Tutor in 1935 was lovely Sister Greaves, who took over from a motherly Sister Tutor whose name I forget. The retiring Sister was a delightful figure, plump, cheerful and wore a mauve print uniform with an apron, and a mauve petersham belt. Her cap was voluminous, covering her dark hair, done up in a bun, and tied under her jolly chins with a very large starched bow. The Matron and the Assistant Matron where the only officials who were let off aprons. We lived in a world of all the things we thought summed up nursing, only to find when, after passing the entrance exam, that life became hectic, that going through the motions of making beds, feeding simulated helpless patients, became a race to beat the clock, keep out of Sisters hair, and suffer aching feet and raw hands.

One of the ordeals of prelim was a visit to the sewage farm. Josie suffered the misfortune of seeing her only hat, blow off into the sewage bed. She also recalls having to make a liver cocktail as part of the diet for an anaemic patient.

We had to scrape the Royal liver and remove all the fibre and put it in a green glass coupe dish. It was green because this took away the colour of the revolting raw liver. The resultant mess was salted and peppered and presented to the imaginary patient on a tray with a dainty tray cloth.

Josie describes her moment of glory as drawing the circulatory system on the blackboard in the correct but simplified manner and years after seeing the same design still in use on the board. But it all had to end. After three months and her passing the exam, she still returned from a short holiday to see a name on the noticeboard outside Matron's office telling her she had been assigned to W.G. Player – a men's surgical ward.

I remember standing in the sluice at the beginning of the bedpan ground and the second-year nurse, with all the assurance that a year gives saying ‘Go on, Downing, go into the ward as though you've done it all your life.’ So I did. Bedpans were stainless steel, or heavy white china. Two of those piled in one's arms covered with a fair green bedpan cloth, soon made the arms ache. Urinals, or bottles as they were called, each had to be taken covered to the bedside. They were glass. One young nurse, Honor Pitt fell and severed an artery in her hand and was off duty a year. This meant we were in the January and March schools and so became friends. It was considered infra dig to be friends with anyone except those in one's own school. The hierarchy was very stiff. We stretched it a bit but there were always been noted and disapproved of. We were supposed to move to different Wards every three months, but it was up to Matron and she had ways of disciplining her nurses if she thought fit. I hated surgery and endured six months on the theatre staff, never moving from the junior slavery of swabbing down the walls from top to bottom after a list. It also involves standing in the background with a bucket to collect the bloody swabs the Surgeon threw around the room, and mending the rubber gloves. Any that had punctures from scalpels, were mended with bicycle puncture outfits. These were then sterilised and used in the theatre again. Making plaster bandages, entailed rubbing the stiff bandages too long tray of plaster of paris, then rolling them up and putting them in boxes according to width. It was murder on one's hands.

What weather conditions like on the wards? They were spartan in their simplicity with iron framed beds and horsehair mattresses.

The linen bedcovers on the new W.G. Player Ward were patterned with damask design of tiny shells, and woe betide any nurse who made up a bed with the shells facing up the bed; the flat bit had to be away from the patient... The old wards had heavy white cotton covers with a quilted pattern, and they had a right and wrong

89 side. Round end rubber air cushions were used for ill patients whose backs were at risk. These always had to be blown up by mouth, no air pumps. The ward Sister was Queen Bee on her ward. She had a sitting room on the ward, with a washroom and lavatory attached. The ward maid looked after her, taking her morning coffee, afternoon tea and thin bread and butter if she were on duty. We were never allowed to disturb Sister at any time in her sanctum. The staff nurse was in charge, and this was a good training in responsibility. I never saw a Sisters sitting room the whole time I was at the Hospital. There were no married Sisters, not even a widow. Sisters trained the staff by example. They explain various illnesses encountered, the reasons for treatments and the actualities of pain and suffering, although no one ever lost control of their feelings even in the worst and most harrowing situation. They were all dedicated. The most telling remark, from a junior Night Sister was ‘Guard him with your life, nurses,’ and we did. The classic question in the Preliminary School from Sister Greaves: ‘Who is the most important person on the ward, nurses?’ Primed by various pupils we knew what to say ‘The Patient, Sister’(Not the haughty Housemen, the distant Consultants, not the fearsome Sisters, no. The patient.) Sister Greaves reminded us at an early date to do for each patience as though we did it for our mother or father. The day on the ward started by the nurses standing round Sisters chair while she read the Night Nurses report from large ledger on her desk. Each nursing grade did specify jobs. Bed making, bedpan round by the juniors, helped by more senior nurses if necessary. Medicine round, temperature taking by the next grade up. Special jobs for patients needing treatment of an ad hoc nature by Sister or a senior nurse.

Opening of the Memorial Nurses Home by the Prince of Wales 1923

Meals came into the Ward in a heated trolley and Sister served each portion, according to the need of that patient. Well patients were offered a choice, sometimes if the appetite needed a lift. Nurses were assigned to any patient that was to be fed. Most patients were in bed; bed rest was considered important, although care was taken to sit up the patient, with the ever present sort of pneumonia if the lungs were not exercised. Physiotherapy was available if Sister thought it helpful. Patients stayed much longer in Hospital then, until they were really recovered. After operations there was only limited sitting out of bed, and stitches often stayed in for 10 days, during which time the patient walked about carefully, unless there were complications. Bedside dressings for the first five days were the rule, and extreme care was taken to avoid sepsis. Sterile dressings came in large round tin drums, which were refilled on the ward, or sometimes in the theatre, and sterilised in a sterilising broom by the porters. The swabs, gauze or cotton wool, were cut and folded by the staff, the theatre staff being responsible for the theatre drums. The linen on the ward was Sister's pride and joy. All the sheets and pillow cases where heavy Irish linen, which took some time to launder down to any degree of softness. The linen cupboard on the ward corridor was a model of neatness, every sheet sat on its pile with the rounded edge to the front. Every garment was examined for tears or tapes off and sent to the sewing room for repair. Bedpan and bottle covers have their own

90 place. Mortuary gowns were of the disposable cotton type, but of good quality, and decently long and full. Special mortuary sheets, each with a red corner sewn in we used to carefully fold the corpse into, and would then sewn top, bottom and along the back, and a neat label sewn to the front stating full particulars. The sluice on the ward, known and Nottingham as the Block, was the area where bedpans lived, as well as urinals – tall wineglass shaped glasses as I remember, the urine specimens. This was where any specimens pertaining to patients were kept for Sisters inspection before being thrown away. Pity the poor night nurse who had several bedpans, full of faeces, blood, bits and pieces. There is an apocryphal tale of one rebel, fed up of saving things, who whipped off the bedpan cover, showing an empty bedpan, and in response to Sisters lifted eyebrows said ‘Mrs Gower’s wind, Sister’.

Mrs Joyce Mitton Gordon (née Butler), former Sister

Mrs J.M, Gordon arrived in March 1925 to begin her training at the General Hospital. "I always wanted to be a nurse from the age of six," she recalled.

My mother used to tell me stories about her father in the Crimean War – and he saw Florence Nightingale. I came from Lincolnshire and had an aunt living in Nottingham. My mother thought it would be nice if I could go and visit her in my off duty period. After three months in training we were allowed on the wards, closely supervised, of course. I was very proud my uniform. I don't think the modern uniforms look right – they are not much more than an overall. I was at the General Hospital eight years in all, including four years training. I left in 1937 to marry a doctor, who was in general practice in West Bridgford. I was then her sister and had spent most of the previous four years on night duty. There were tonight sisters then – they junior and a senior. I was the junior but there was still a lot of responsibility because the hospital had over 400 beds. While I was at the General I knew Muriel Robins. She was already fully trained when I arrive and she went on to become Nottingham's first airwoman.

Mrs Marjorie Milner (née Oscroft) former Sister

Looking back on her training days at the General, which began in September 1928, Mrs Milner said:

We went to lectures in now or off-duty periods. We all lived in and it was wonderful. Our uniforms had to be down over our ankles. We could take our final State exams at the end of the third year. They knew how the year without lectures and I think that was a very good idea because during that fourth year, you've learnt a lot practically and gained in confidence. As a staff nurse I well remember walking down under the road to the Aural Department with my eyes closed because I was so tired. The Matron at that time was Mrs Liddell; she was a great disciplinarian. I was the theatre sister there for four years and I was the highest-paid sister in the hospital. I got £96 a year while the ward sisters received £80. But after my interview for the sister’s appointment I well remember Mr Liddle saying to me: "You won't get that salary because you trained here." But one of the surgeons stick up for me and Matron was overruled. Wonderful work was done at the General and I remember many of the consultants – Mr Hogarth, Mr Crooks, Mr Webber, Mr Allen, Mr Neil, Dr Scott, Dr Jacob, Dr O'Donovan and Mr Birkett. Another great character was Miss Prince, the Chief Pharmacist. Woe betide any nurse or sister who over ordered drugs. She came and raided their cupboards. In her office there was never anywhere to sit down because it was so full of books. But she was a great fountain of knowledge. I left the General in 1938 to get married. In those days you could not remain in nursing at the hospital once you got married.

Miss Molly Denman, former Principle of the School of Nursing

Miss Molly Denman began her training at the General Hospital on New Year's Day, 1930 at a salary of £25 a year. Apart from the years between 1934 and 1938 when she won a scholarship to do midwifery training in Leeds and a period as a sister in London, she spent all her career at the General. "There was something about the General Hospital," she says. "It had a soul." During the war years she was Night Superintendent and after studying for her sister tutor's qualification at the University of London, she was dedicated to the Hospitals School of Nursing, where she was Principal until she retired in March, 1969. This is her story. When Molly Denman started her training at the General Hospital, all nurses had to ‘live in’ and they only had one day off a month.

You had to provide your own uniform; your father had to equip you with three changes of uniform, including black shoes and stockings and stiff collars and cuffs. When you arrived you were instructed how to put your uniform on and were received with courtesy by the Home Sister – in those days Sister Owen. She was a very gentle kind of person but very stern. She was very good to sick nurses and looked after them very well.

Molly had a room in the Memorial Nurses’ Home, overlooking the Castle Grounds. Rules in the nurses’ home was strict. For example, no food or drink was allowed in the bedrooms. At 8pm the nurses went to supper. Chapel, conducted by Matron, was compulsory unless you were a Roman Catholic. There was no chance of going out after supper. On one occasion, she recalls, two nurses on their day off had brought fish and chips back. They were sitting on the bed and join this forbidden pleasure when Home Sister’s brought her knocking on the door.

We knew that we would be for it so out of the window went the fish and chips – only to bring a complaint from a woman living in The Park because fish and chips had been thrown out just in front of her.

Miss Denman remembers Mr Robert Hogarth, the senior surgeon as:

A very formidable figure, who was very strict in the theatre. He was tall, white-haired, very fresh looking and he had a very stern glint in his eye. I was on his ward as a junior nurse. If there was a message we were not allowed to speak to him. We spoke to the staff nurse who passed the message to sister who passed it to the Housman who passed it to Mr Hogarth.

Nurses’ Dining Room 1929

If a well-known surgeon at the time was Mr William Neil. Molly recalls: I was his ward sister at one time and he was the sort of man who, when he had done a series of operations, would come round at night to see that they were all right before he turned in."

Many people rather feared Mr Hogarth but Mr Neil was less stern.

He was a very fatherly figure. Although he was particular and an eminent surgeon people felt that they could approach Mr Neil's and the teamwork that went on in his ward was marvellous. He was a well-built man with white hair and very blue eyes that were penetrating but kind. It was hoped that the General Hospital would train nurses – not only for its own needs but would also send out well trained women into other spheres of public and private nursing. Indeed, in the late 1930s and 1940s some of the trainees were working as far afield as Australia, India, and Hong Kong and pre-eminently in Uganda, Kenya and Nigeria. In that era, a liaison group with the Church Missionary Society whereby nationals of those countries came to train and return to their own countries. They

92 qualified with a Certificate of the General Nursing Council of England and Wales, enabling them to set up further training in their respective spheres. The nursing experience gained that the General Hospital was second to none. Many of the patients and their relatives, as well as doctors and other members of the nursing staff, can testify to this. As well as the formal occasions when we gave Glory to God there was also feasting and merrymaking. The Annual Procession of nurses from the hospital to St Mary's Church winding its way through the city centre and up the hill was indeed a spectacle and always will lead by Matron and the dignitaries. On her return we feasted in the Boardroom at the expense of our Chairman. Many parties and celebratory events were provided including a Garden Party at Lenton Grove, the home of Sir Louis Pearson. This later became the Rheumatism Centre and is now the Music Department of the University. Col Pearson was also very generous in providing entertainment for nurses. The Nurses League was formed in the early fifties and held annual reunions and held annual reunions. These were generally enjoyed by all who love to reminisce about former days as trainees, student nurses, sister and tutors. Our first President was Mrs Elsie Lewis who was a real "fairy godmother" to us all and helped us found the Nurses’ Sports Club. Her interest and encouragement prevailed on many occasions and U2 her magnificent gifts nurses had Pearson House Recreation Room (beautifully appointed). Her personal gift of a B luthner piano enabled them to put on a Christmas show and also a Nativity Play calling for much late-night rehearsal during pre-Christmas weeks. After Ruddington Hall became a recovery hospital, the cast was transported there by Mr Rainbow, often in the van, heralding Christmas celebrations that lasted for ten days. Every nurse knew that "off duty" periods would be postponed until after New Year when we reverted to a more sober routine. Through it all the patients were never in second place. The Christmas Ball (sisters and doctors) was a great occasion. "Who was getting who" was decided by drawing lots out of a hat. The evenings at Bramcote were statelier when the Matron, Assistant Matron and Principal Tutor were interned entertained to dinner with the Chairman. These unofficial events were enjoyable and were courteous gestures by Colonel and Mrs Pearson, followed by a friendly chat and on one occasion by hymns around the piano. Turning to hospital matters it is true that leeches were kept in the pharmacy by Miss Frances Prince. I never saw them used, but was instructed how to use them in a demonstration in the Nursing School. More dreaded, however, was Miss Prince herself who frequently went, and conducted, around the wards tearing strips off the nurses who are torn off strips of plaster strapping to stick up notices on ward walls. As a voluntary hospital we had to be economic or with no let up about wastage of any sort. Leftover rice pudding was eaten behind the ward kitchen door and as for cups of tea, Jack the joiner, or even Bill, the mortuary porter, could help us out. As to diet – we supplied helpings of cabbage and suet roly-poly swamped in dilutive plum jam and called ‘dead baby’ by the nurses. We also had ‘summer pudding’ which was yesterday's meeting bread-and- butter soaked in dilutive rhubarb jam and sprinkled lavishly with desiccated coconut, a good standby in the war years when there was rationing. There will always challenges as when a smallpox patient was admitted. Matron wisely called for a volunteer to nurse her. A nurse emerged from the group much to the relief of the others. I recalled the volunteer later went to Africa and became Matron of a Leprosy Centre. A newly built school at Selston was used as an emergency hospital and manned by nurses who were sent out daily by ‘taxicab’. We were not really prepared, for there was no effective blackout – nurses went around and worked by torches screened by purple plastic discs. Even blood transfusions were carried out peering through the half-darkness. One recalls the drone of enemy aircraft overhead and news was whispered to Casualty staff that ‘they are bombing Coventry tonight, half our fireman have gone there. ’The news passed around than those nurses whose homes were in that city felt sick but worked more intensely. Our children's ward, (named after its donor) was called Mabel Player and it was the nurses’ job each night to carry every child downstairs to the basement in case the enemy bond is at night. In the end of the children were sent permanently to the Children's Hospital. Our telephone switchboard was manned by a Mr Cook, blind and expertly trained at St Dunstan's of high repute. His job was to receive from the RAF notification when enemy aircraft had crossed the coast – this was called a purple warning. Night Sister was informed, the porters turned off all gas apparatus. No hot meals! But kindly VAD used to fry us an egg on an upturned iron when we were fed up with scones only at teatime (3am). These nights were recorded by a pencil mark against the engraved plate on the wall of our office. There was the drill for decontamination squad nurses who were taught the method of cleansing gas casualties – in a concrete hut in Postern Street. Thankfully we were never called upon to use our skills in this

93 duty. There was also the danger of a direct hit on the hospital and the risk of radium being scattered where patients were wearing radium implants. When Mr Cook gave me the purple warning, my duty was to take out the radium plaques from the women on Postern Ward and from the men on Neil Ward. The House Governor was alerted and together we took the radium in a lead lined container to the sub-basement where a Chubb safe built in the sandstone rock was opened and the precious metal deposited and locked away. When this became frequent, our Radium Registrar Mr Fred Hunt, used to come to the hospital at 5am to reinsert the radium so that the patients had the benefit of as many ‘Marie Curie Hours’ as possible before the warnings happened again. I was privileged to be at Mr Hunt's eightieth birthday in Derbyshire and he has more than survived these harrowing early mornings. Many of the newer techniques were learned from wartime casualties. Army nurses trained at the General Hospital were J B Chambers, F Toon and an Assistant Matron from Ireland, F E Robinson. Miss Vera Anderson, an industrial nurse at Boots in Station Street, was awarded the George Medal for her courageous action during the bombing of their premises. Although Nottingham General Hospital had a Nursing School dating back to 1872, it never really became a training centre until 1919. Before then, training was by experience and not by qualification. The General Nursing Council, formed in 1919, required a three-year training. But the General Hospital, demanded a 40 year and only after completing the fourth year could nurses be awarded the Certificate of the General Hospital and where the coveted badge. It depicted the town arms surrounded by laurel leaves and the words GHN on a blue background. Each badge had an individual number. The Nursing School based in a large house at 5 Newcastle Drive, The Park. This had been bought by the hospital to establish what was called the Preliminary Training School. Many women have entered its portals for three months preliminary training on the basics of nursing. These were severe but happy times of hard work, study and formation of friendships never to be relinquished for we have all lived together. These were good days of striving to do our best and finding the joy to serve and understand sick people. After terminal exams the candidates became full student nurses and fulfilled their ambition. After each term we met in the Hospital Chapel for the End of Term service conducted by the Chairman who challenged nurses to even more service in the ‘sight of God who called them to serve anywhere the deed arose.’ As the new student nurses filed out of the Chapel, the each received from the Matron, a small, pocket sized book specially inscribed – it was ‘Daily Light on the Daily Path,’ one short page for reading each morning. In our Chapel every day, except Saturday and Sunday, a short service of prayer, him and Bible reading, was broadcast from 7.50 to 8am to all wards. As the BBC was switched off and the Chapel tuned in, the patients heard over the radio: ‘This is the Hospital Chapel– the powerhouse of the hospital.’ So in the best traditions of nursing we looked after body, mind and spirit of those committed to our care. In true acknowledgement of our basic motive the annual procession wound its way to a public service at St Mary's Church until July, 1948, when the State took over. But without the pledge of our Governors: ‘We are determined, insofar as we are allowed, to maintain and manage this hospital, in exactly the same spirit of the interests of the patients as before.’ Now we have to say goodbye to that noble institution and be ever thankful for what we have received. I recall the inscription on the nurses’ window at Guildford Cathedral, which reads: ‘To cure sometimes – to comfort always.’ That will be how I remember the General Hospital.

One of Molly Denman's proudest possessions is a watercolour, painted by local artist the late Ronald Crampton, showing nurses walking from the School to the hospital in the uniform of the day – fawn cloaks with scarlet hoods. Since this section was compiled, Mr Denman has suddenly died at the age of 81.

Mrs Mary Hodgson, student nurse, 1930-34

Mrs Mary Hodgson started her training as a nurse at the General Hospital in May 1930. She recalls:

We were expected to attend a small service and prayers in the hospital chapel every night after duty and we were not allowed to go out at night except an hour once weekly half day off, which started at 4.30pm and we had to be back in the nurses home by 10pm. Well betide anyone who was late. We were before Matron next morning's. We had two week’s holiday a year and lived in the nurses home on Standard Hill. There were no married nurses in those days and sisters were God-fearing people you never spoke to unless spoken to. We worked in the surgical, medical, aural, outpatients, casualty and x-ray departments to complete out training. I well remember the old wooden terrace huts set in the nurses home grounds, housing the chronically ill and incurable male patients. Our Matron was Miss Liddle. We respected her but were scared to death of being

94 called to her office for any minor offence is. Still, I look back on my training with pride and them happy that I trained there. It was a wonderful grounding for discipline. Our consultants on the visiting wards were Mr F Neil, Mr J Llewellyn Davies, Mr Hogarth, Mr A R Tweedie, Dr W T Rowe, Dr F H Jacob, Mr C H Allen, Mr A M Webber and Mr F Crookes.

Mrs C J Meekosha, former Sister

Mrs C J Meekosha (formerly Sister C J Clarke) was on the staff of the General Hospital, except for years break to do midwifery, from 1935 to 1947. During this time she was night sister (1941-42) and then became ward sister on the newly built Castle Ward. For the first year home of her marriage, she was ward sister on the Outpatient Department, being the first member of the nursing staff to ‘live out.’

Nursing group, 1934

Miss Kate Wright, Former Assistant Matron in charge of the Pay Bed Wing

Miss Kate Wright started at the General Hospital in 1924, on a salary of £20 a year. She was 19 and had previously done two years nursing in the cottage hospital at Grantham. She finished her training in 1928 and after two years as a staff nurse, and eight years as a ward sister she became Assistant Matron in charge of the Pay Bed Wing. The 40-bed Wing was built after John Dane Player launched an appeal with an initial gift of £25,000. Appeal organiser Mr J W Harding said:

The pay bed block will be under the direct control of the Board but it will have its distinct administration, nursing and financial arrangements and will be self-supporting. For many years it has felt that the work and scope of the General Hospital must be extended. The hospital, like many others in the country, is strictly speaking a voluntary hospital, which means treatment is given without charge. Voluntary contributions by persons who have received treatment is entirely at their option when they leave. But there is a large and ever-growing section of the community who, by virtue of their financial positions, are not entitled, unless it is extreme emergency to go into this hospital. The first effect produced by the Pay Block, will be to place at the disposal of a large section of the community for the first time, facilities for obtaining treatment in hospital at a scale of charges, which, while they maintain the independence of the individual, or related so as to come within their means cluster responsibilities. The tragedy of the middle classes in the case of sudden or serious owners has existed long enough. This is Nottingham's first effort to counter it. With 40 beds available in the Pay Bed Wing it follows that there will be 40 beds relieved in the voluntary hospital to reduce the constantly increasing waiting list.

The foundation stone for the Pay Bed Wing was laid in 1938. The building cost £70,000 and charges for patients were four guineas a week (excluding operation costs and special medical treatment) with a maximum charge for three weeks of 30 guineas. Each bed was equipped with a radio and phone and all the wards faced south. Noise was kept to a minimum with silent closing doors and rubberised corridors. The operating theatre, provided by Kate Adeline Homburger, who gave 3000 guineas, was

95 one of the most advanced in the country. The Pay Bed Block was connected by an underground corridor to the nurses’ home. The Wing ceased to be used in 1984 after steadily declining bed occupancy because of the expansion of private medical facilities in the area. This is Kate Wright's story based on an interview she gave in 1983 for an oral history project.

During our training we weren't allowed out after 8pm. We all had to go to Chapel and say goodnight to Matron as we filed out. Once a week we had what we called long evening and we were allowed out until ten. But we were very, very happy. We came on at seven in the morning and our oft duties were either from 2 to 4 or 10 to 12 or 6 to 8 and one day off a month. I lived in for the whole of my career. You never went home for Christmas. The ward sisters made a lovely Christmas for all their staff. In fact, a ward was always emptied and made into a sitting room for the staff at Christmas because they didn't go home. I can remember the first time I ever saw anybody die. That impressed itself on me very much. It was during my first month on the ward after two months in the preliminary training school For a treat we used to go to the Elite Cinema for our favourite again chips, which was 8d. On nights, we used to go to Crowshaws for cream doughnuts. When I moved into the Pay Bed Wing, we got lots of free tickets to trade shows at the cinemas. There were so many cinemas then and of course the Nottingham Empire, which was a wonderful place with twice nightly variety shows. We also went to tea dances at the Palais. I was responsible for setting up the pay bed Wing. We opened 1 May, 1938 with just one floor in use. We had a very good team of sisters, nurses and other staff and it was a very happy place. I was there 30 years, and it became a sort of family thing with patients seen as parents, children and grandchildren. It belonged to the City of Nottingham and it was their hospital. Sir Julian Cahn provided all the furniture and bedding for the Pay Bed Wing. When we opened we had 11 single rooms. As the years went by we found we needed more single rooms. By the time I retired in 1967, we had 25 single rooms.

The Pay Bed Wing

Mrs Nora Jacques (née Chamberlain), former nurse

Mrs Nora Jacques remembers the Ropewalk Outpatients’ Wing being opened in April 1927. ‘I was starting two years training’ at the Eye Hospital on May 1 and I saw the opening when I went for last- minute instructions. The father's cousin had noticed that the General Hospital before the First World War when Mr Anderson was a senior surgeon. When Nora arrived to start nurse training in 1930, Miss Liddle was the Matron. ‘She was very strict but very fair. ‘

I particularly remember a redhead sister, Sister Robinson. She was a great martinet. You had to clean all the brass on the floor and the brass sterilisers during night shift. If there was a spoon missing, the night nurses had to look for it. I also recall the diphtheria epidemic on the ENT ward. I caught it myself and was off for three months. I worked on the old terraced huts erected during the war, near the original home. When the new W. G. Player Wing opened, the huts were removed. I also remember the children's ward, Mabel Player, being opened and the Division 7 operating theatres with their huge boiling water sterilisers being gutted to build the new theatres. Griffin and Spalding's apprentice house and gardens on the ropewalk were pulled down to build the Pay Bed Wing. I also remember the deep x-ray machines being installed and the third floor in the outpatients Wing being used as a cancer treatment ward when the Postern Street ward closed. The social life of the hospital's marvellous with the garden fetes, balls, dances and fund raising events. There was a lovely friendly belonging feeling in the hospital. The city was part of us. I still smile when I think of Mr Joe Sheehan and Mr John Swan – then both housemen – doing this skit as the two Irish cleaning ladies for the Christmas concert. The housemen at the General Hospital at that time seemed more senior then, almost registrar standard. They were capable of carrying out operations. I remember many of the consultants from those times. Dr Frank Jacob was a much loved physician. He was a charming man and kind to patients. I remember he always wore high winged collars. He lived in the Ropewalk and his sister, who looked after him, always wore purple. Then there was Mr Gilbert-Smith the anaesthetist. The general surgeon Mr Alan did early thyroidectomy operations and Mr Llewelyn Davies, the urologist, became Lord Mayor. Some of the housemen at that time became consultants in the post-war years. These included Mr N Birkett, Mr E J Gilroy-Glass and H B Lieberman, Mr J F Sheehan and Mr J Swan. Mr W E Neil lived in the Ropewalk and he was a general surgeon. He was very popular and his wards were Division 7 and 2a. I remember his son Jim coming to the nurses ‘dance when he was about 14. Then he did his medical training and eventually became much loved ENT surgeon until he recently retired. Mr Neil's daughter worked with Miss Prince in the pharmacy. When I finish my training in 1934 I went to work for Mr H Bell-Tawse is his private practice. When the war started I went back to the General Hospital as a VAD (Voluntary Aid Detachment). I remember Miss Plucknett arriving to take over from Mr Liddle as Matron. I worked on various wards but also serve with the American to British ambulances, sponsored by film stars. These ambulances were used to transfers servicemen and air raid casualties to hospitals near to their homes.

Mrs Elizabeth Swales, former nurse

Mrs Elizabeth Swales, who lives in Newark, was a nurse at the General Hospital from 1938 to 1943. She trained there and has many vivid wartime memories. She recalls the eerie silence when the hospital clock chimes was stopped during daytime because it was thought the loud chimes might draw enemy bombers. She remembers the practice blackouts, which were organised before the outbreak of war.

Light bulbs are very small wattage work painted black and a small circle in the base left clear. These we used that entrance doorways and in the nurses’ homes, wards and operating theatres were effectively blacked out by fixed blinds and shutters. Bedrooms had black curtain lining material and one was responsible for ensuring that no lights showed – fines were imposed on offenders. Bathrooms, lavatories and washrooms had windows painted black, so that all windows had to be closed after dark. I remember one practice blackout when I was a junior nurse on night duty. All the lights were turned out and a man started having a rigor. I went to get a hot water bottle, which I managed to fill alright in the dark. But returning across the ward I fell across a settee. I went down the corridor to find the staff nurse and she was in a similar predicament – another patient was having a rigor in the side ward.

Mrs Swales remembers the hospital being flooded with Red Cross voluntary nurses on the day war was declared. It was feared there would be a lot of casualties. Firefighting lectures, demonstrations and practice had to be attended by everyone in terms so that staff could deal with emergency fire or incendiary bombs. Mrs Swales recalls

They were 501 beds in the General Hospital before the war. An additional 100 beds were provided as a precaution for use by air raid casualties. Air raid warnings were received by the hospital prior to the air raid siren sounding when possible. Air raid shelters were organised in the basements of the hospitals and homes. All staff

97 on duty were expected to use these during air raids so that a roll call and checks could be made so that staff were easily available to be on duty. Nurses on duty that escorted patients to shelters – walking and wheelchair patients were quite straightforward but bed patients were a priority. Special training was given. After much research it was found that the best arrangement was to pass strong webbing straps under the mattress and tied on top of the bedclothes, making a protective package, under and around the patient. Then two nurses or one nurse and a porter turned the complete package 90 degrees and it was gently lowered to the floor. The patient would then be tried along the floor to the shelter. Sometimes the all clear sounded before reaching the shelters.

The war also changed visiting routines. Before the war patients were allowed two visitors’ cards and only two visitors were allowed in the ward for each patient but others could visit when the first two left. During the war this practice was forbidden because air raid shelters had to be provided for visitors. So only two visitors were allowed and the visiting days were Wednesday (1.30-3pm) and Saturday (2-4pm). Food rationing created great difficulties. Meat, butter, cheese, bacon and sugar were all very scarce and Mrs Swales recalls that ‘meatless’ days were introduced twice a week. A special vegetable pie with gravy was served. We called it Lord Woolton pie as Lord Woolton was the Minister of Food. Carrots were very plentiful in our diet. It was said that they contained a vitamin which helped us see in the dark. Puddings were often baked without sugar and dried fruit and grated carrot was used to help sweeten them. Fish was unrationed that it was so scarce that one had to queue when the ship came in. Food queues were a way of life.

We were fortunate at the General Hospital has several benefactors sent baskets of eggs in what were known as egg weeks. Many were preserved for later use. English soft fruit, apples and pears were also kindly donated by benefactors and friends of the hospital. The work was hard and the hours long and many were hungry. A proportion of our clothing coupons were surrendered for uniform. Soap and soap powder were also rationed and we were allowed two soap coupons from our ration for bathing and washing personal clothing. Uniform, sheets and towels were sent to the hospital laundry. Sweets were rationed and chocolate was very scarce.

The hospital had an auxiliary fire post inside the hospital grounds, which was manned 24 hours a day. Large surface water pipes were also installed along the edge of the pavement with valve's for the fire services. Mrs Swales recalls: ‘These pipes were also a hazard in the blackout and in icy conditions. Many broken legs and wrists were caused by people tripping over them and one of our nurses fell and broke two front teeth. Nearby there were very large tanks of water for use in air raids.’ During the war the hospital entrance gates and railings were removed to be recycled into guns. Private houses also had railings requisitioned for the war. Mrs Swales recalls the good liaison between the officers and men of the Sherwood Foresters stationed at Nottingham Castle.

There were social activities and next change of invitations to functions. But there was one disadvantage. Night nurses’ rooms were on the top floor of the nurses’ homes and the band used to practice for hours in the castle grounds, especially before special parades. Sleep was difficult or badly disturbed. The war years were hard, but they were happy times too and the work was interesting and fulfilling. There was a good family atmosphere at the General Hospital and lasting friendships were made. Some continue still.

One of her dearest friends in the nursing school was Norah Singh – the first Indian student. The ship taking Norah back to her homeland was torpedoed but she survived. Norah and Mrs Swales continued to correspond until Norah died in Canada in 1988. Recalling those early days at the General, Mrs Swales says modern nurses now work much closer with the medical profession. ‘I can go back to the times when doctors did not allow nurses to take temperatures.’ Mrs Swales left the General Hospital in 1943. She later did midwifery training at the City Hospital, became a district nurse and later an occupational nurse in industry. She retired in 1979. Since then she has visited the General Hospital to attend meetings and reunions.

There is always a warm and friendly welcome awaiting at what I'm happy to regard as my second home and shall always be proud to call myself a GHN nurse. It saddens me to know that the GHN will close soon after 200 years of service to the sick and injured of the Nottingham district. No other single unit will take its place.

Miss Margaret Plucknett, Matron 1941-58

Miss Margaret Plucknett, aged 85, is the only surviving Matron of the General Hospital. She trained at Bristol General Hospital and became a State Registered Nurse in 1929, when she was also gold medallist for the year. She later became a tutor sister in Bristol before joining the General Hospital in 1940. She held this post for 13 months until May, 1941, when she succeeded Miss Iris Liddell as Matron. She held the post until she retired in December, 1959 and now lives in South Devon. Her very first week as Matron brought Nottingham's worst air raid. This is her story.

Miss Margaret Plucknett

As I came up and covered walkway with Miss Graves, my deputy, I saw the first Molotov basket of bombs descending on our town and I wondered what the night had in store for me. The bombs missed the hospital – very narrowly – but brought us in some very severe burns cases from a wholesale bakery which had a direct hit. Everything was ready and we had a very good team. A ward now filled with casualties with terrible burns injuries and I remember in those days burns were not so easily treated. Extra beds were placed in all wards where possible to increase the total number available. The movement of patients from the top floors in case of raids had to be planned. The use of Cedars Hospital, Ruddington Hall, Selston Hospital (a new school taken over for the duration of the war) enabled us to keep the main hospital reasonably clear for emergencies. All sisters and nurses who put on a rota each night in case an emergency occurred. Special surgical units were planned – with a team of doctors and nurses on standby to deal with outside emergencies. A first aid post was set up in the outpatients’ hall, manned by independent staff, such as Red Cross and St John nurses, plus married trained nurses, to deal with minor injuries. They were tremendous help. Further extensive plans had to be made for a Shadow Hospital in case the General suffered a direct hit. Increase bed numbers, plus the quick turnover of patients, meant extra linen – an emergency stock was kept which the ward sisters could call on at any time. We also had an emergency stock of drugs and dressings. The Linen Guild and its members gave marvellous support and a first-class sewing party was held at the home of Mrs Kaplowitch in The Park. Convoys were not as numerous as we had anticipated but D-Day casualties came our way from units pressing towards Caen and at another time we had a convoy of German prisoners. Another convoy brought in the

99 son of Mr and Mrs Frank Wills of Bristol – known to me because of the wonderful Wills involvement with the Bristol Hospital I had served for several years. We in Nottingham and the generosity of the Player family – Mr W G Player was chairman of the Committee at the General and Mr John Dane Player was never great benefactor for the Pay Bed Wing and the Children's Hospital. And so to the birth of the National Health Service in 1948. We welcome the NHS with reluctance, much as a large private firm doesn't relish takeover bids today. Nevertheless we realised it was progress, meant for the benefit of hospitals in the whole country and for the eventual benefit of the general public. We were a well- endowed hospital financially with friends galore in all walks of life. We realised, however good the intention of the NHS, that life for us could never be quite the same again. We no longer had total independence. New administrative rulings and new administrative departments emerged. Mr H M Stanley, the hospital secretary and house governor, was a nice man who cared about people. We got on very well, and I had a great respect for his assistant Mr Cyril Reddaway. The Regional Board assumed responsibilities for a wide range of issues, even to the choice of purchasing and linen. Nursing officers visited the hospitals in their region from time to time to discuss staffing limits or problems. Our hospital became one among many. The Nottingham General Hospital was a splendid organisation and we had a natural pride in its constant development to keep up with the times. The builders were constantly on the premises the whole of the time I was there, extending or improving a very old foundation. The last major development before I retired with the opening of the new Radiotherapy Department in the Ropewalk Wing. There have been many advances since then, of course. In my day there was no central sterilising department. Each ward and department had to ensure through sterilisation of instruments and syringes and fill bags of linen for central sterilisation in the basement. There were no disposable syringes, dressings, operating downs and sheets as there are today. It was a very different story. We knew the hard way but it was great. As regards to the nursing staff, I keep in touch with many of my former colleagues and I get a lovely lot of letters at Christmas. In 1978 I returned to Nottingham to give a luncheon party to the sisters living in the area who had worked so splendidly with me. It was a great time.

Mr George Wass, former nurse

George Wass was among the first batch of 10 old 12 male nurses to train at the General Hospital when the National Health Service was formed. ‘It was 1948’, he recalls, ‘and we did a shortened two-year training. The Government had introduced a scheme, whereby anyone who were trained in nursing could go and do another batch of nursing.’ Mr Wass already had extensive frontline nursing experience having spent six years in the Medical Corps during the war, serving in Palestine, Egypt and Italy. During his training period at the General Hospital he was on secondment from Rampton Hospital. He recalled:

The Matron of the General Hospital at that time was a very nice lady and I can remember her saying quite frankly that they did not particularly want male nurses but the Government had forced them to train some. She later admitted that some of the men were very good – much better than she expected.

Mr Wass's return to Rampton and under the Salmon reorganisation he became the first principle nursing officer in charge of the male and female sides of the special hospital. He later became principal nurse tutor and retired in 1979. He enjoys attending the nursing reunions organised by Miss Pamela Hunt. He concludes:

I have very happy memories of the General Hospital. During the training period we attended the same lectures as the female nurses but we were not allowed to work on the women's wards of the hospital. There were also separate elements of training. For example, male nurses at that time did not attend lectures in obstetrics and gynaecology.

Miss Rachel Ross, Matron, 1958-70

Miss Rachel Ross was matron of the General Hospital during the vital years from 1958 to 1970. She took a great interest in modern nursing organisation and techniques and went on several study tours in Europe and North America. During her time as matron, the General Hospital was a pioneer in nurse training, becoming the first in the Sheffield Regional Hospital Boards’ area to implement the General Nursing Councils’ new

100 syllabus. Miss Ross had been one of the council's examiners since 1956, and she was appointed a Nottingham JP in 1963. She left the hospital in 1970 to become regional nursing officer to the Leeds Regional Hospital Board. During a farewell reception at Pearson House she was presented with a cheque by Dr H M Rice on behalf of hospital medical staff. Mr David Evans, chairman of the Nottingham University Hospital Management Committee said that if the Salmon scheme was implemented, Miss Ross would be the last in a long line of matrons dating from 1782. Under the new scheme, he explained, the strata of nursing would be known by numbers. We have now come full circle – matrons are now back with others at some hospitals, including the City.

Nurses Training School, Newcastle Drive.

Mr Albert Holgate, hospital treasurer from 1953 to 1974, says:

Miss Ross was a remarkable character. Like all matrons of that era, they ruled their domain and wanted to know everything that was going on in the hospital so they could remedy the problem. They demanded great discipline from nurses but also looked after their staff.

Miss Ross once remarked: 'The hospital is an enormous part of one's life, not just a job. It is a way of life almost. ’During her period as Matron to landmarks were reached – 1967 marked the century since the first matron training nursing was appointed to the General Hospital, and in 1969 the Nurse Training School celebrated its centenary. Dr John Bittiner recalls:

Miss Ross look to most imposing figure in plain navy blue uniform. Apart from being strict when necessary she was a human and welcoming person. Nurses respected her because she was always fair. Offer many kindnesses I can recall the Christmas parties for staff and in particular those she gave the children of the medical staff. My own children enjoying them and were very sorry when they were stopped. She was much missed when she left.

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Nurse Group from the 1960’s

Dr H M Rice vice-chairman of the Group Medical Executive Committee, presents a cheque to Matron Miss Rachel Ross at her farewell reception at Pearson House in 1970. In the centre is Mr David Evans, Chairman of the Nottingham University Hospital Management Committee.

Mrs Valerie Gilbert, Service Manager, Health Care of the Elderly

Mrs Valerie Gilbert took over the post as Service Manager for the Elderly at the General Hospital on 1 December, 1988. Previously she was the Senior Sister of the Health Care of the Elderly Unit at University Hospital. Born and bred in Nottingham, she returned to the General Hospital after working there in the sixties and seventies when it was a busy acute hospital. Her contribution to the book is based on the talk she gave to the Hospital League of Friends.

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Last year I returned to the General Hospital as Service Manager for the Elderly. Entering the hospital gates on my first morning, the years seemed to slip away and it seemed like yesterday that I first walked through those gates as a first-year student nurse. The biggest change is the length of time patients spend in hospital. Thirty years ago the patient could expect to spend 12 to 14 days with a hernia repair or varicose veins operation. Nowadays it can be only two days. Anyone who has suffered a coronary thrombosis could expect to spend a month in the ward – the first week not being allowed even to feed themselves for fear of causing too much physical exertion. Nowadays it need only be one or two weeks. No longer do we have convalescent homes for our patients. Instead they are mostly discharged home. In Nottingham we had two lovely homes – the Cedars and Ruddington Hall. The Cedars is still thriving and is now with physiotherapy rehabilitation unit. Ruddington Hall is now privately owned. While we were student nurses we lived in the nurses’ homes – either Pearson House or the Memorial Home. To be married while we were students was frowned on in those days and one would have to obtain special permission from the Matron. We also could not stay out later than 10.30pm and were only allowed two late passes a month from Matron. As we were a lively lot in those days, we found that if we climbed over the mortuary gates in the late evenings, helped by our boyfriends, and tiptoed round to a colleagues bedroom window on the ground floor which she had left open we could all scramble through onto this poor girl's bed and creep back into our own rooms. Most of all I remember the close friendships formed among the nurses – some of which lasted a lifetime. We comforted each other when patients died, we offered advice and knowledge when we didn't like to ask the ward sister for fear of being told off for not knowing and most importantly we laughed a lot together. We worked hard and lived had, and we cared about our patients deeply. But so do the young nurses of today. The addition of the Trent Wing in 1972 was of enormous benefit for the patients of Nottingham needing surgery, although the design was not architecturally in keeping with the rest of the hospital. In 1979 the wards transferred to the Queens Medical Centre. The wards at the General Hospital are now used for the rehabilitation of the elderly. It was well known that because of the inadequate provision for the elderly hospital beds required for acute patients were occupied by the ill and the old and admissions became longer. Day rooms became lounges with homely looking furniture and wall lights. Tables were covered in pretty tablecloths. Whole rooms were furnished. Patients have also been taken out on trips by the nurses. Day trips on the canal, week-long trips to Jersey. Some patients have been taken swimming. All this was made possible with the help of the League of Friends. There is nothing more satisfying to a nurse and finding that a trip out with the patient jogs that patient's memory and he is able to recount so many thoughts and memories of times past. The elderly have a wealth of knowledge and nothing gives me more pleasure than to see a young nurse listening attentively to what an elderly patient is telling her about events of his past life. And what of the future? Our elderly patients and devoted staff need more modern surroundings to work in. The Stafford manage exceedingly well these past few years within these wards but more updated facilities are required to enable them to do a good job well. And our patients deserve better!

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Sir Keith Joseph talks to Sister Carol Walker, Daybrook Ward, May 1972

Sisters Muriel and Jean Price

When twin sisters Muriel and Jean Price started the nurse training at the General Hospital in 1964, life in the nursing school and the nurses’ home was little different from the 1930s. Muriel recalls:

There were still a lot of petty rules that we laughed at nowadays. But I suppose nurses from the 30s would be aghast at things that happen now. As first-year probationers we had to be checked into bed at 10pm by a senior nurse. We had late passes but there were ways of getting round that. If you were caught without a pass you had to report to Matron the following morning. Sisters were held in awe. They have their own corridor and rooms, segregated from students. We gave them great respect because although they were strict they were very knowledgeable too. There's a different sort of respect for sisters now. You are still in charge of the ward areas and the staff. But I think we treat our staff on a more equal basis. As students I think we were very much used as manual labour. Now there's more consideration shown towards students.

Muriel and Jean are so much alike that even today patients sometimes confuse the devoted sisters. Muriel says:

It takes a bit of explaining but we always sort it out. Patients see the funny side of it. It has never caused a problem. We grew up with it – there were five or six sets of twins in our time at the School of Nursing in Newcastle Drive.

Then nursing careers have run remarkably in tandem. They worked on the wards as staff nurses and gain sisters post at the same time. Muriel worked on Mabel Player Ward until she transferred to University Hospital in 1979 and Jean was a sister on Daybrook Ward until she moved to University Hospital in 1985. Muriel says:

We both have very happy memories of the General. It was personalised and compact and you knew everybody. The matron Miss Ross was super. She had a marvellous memory and she always that knowledge to you when she saw you. After the Salmon Report, the changes came so fast and furious that we did not have time to accommodate them. The pace of change has really run away with itself.

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Muriel and Jean, both members of the Nurses’ League, look back on their training and nursing at the General Hospital with great affection. Nurses had to complete their fourth year to earn a GH end badge and certificate. Today they wear those coveted badges with great pride. They conclude: The General Hospital was certainly a lovely hospital – it had great personality. The convalescent home, Ruddington Hall, was also a super place. It was a shame when it closed.

Miss G W Hayre, Matron, 1971-2

The last matron of the General Hospital was Miss Greta W Hayre. After nine years as matron of Nottingham City Hospital, she came out of retirement in January 1971 to serve as acting matron for nearly two years, following the appointment of Miss Rachel Ross as Regional Nursing Officer to the Leeds Regional Hospital Board. In wartime Miss Hayre served in the Territorial Army nursing service at posts in France, Egypt and Italy, including casualty clearing stations and field theatres, nursing at Anzio and on the Normandy beaches. Miss Hayre, who was the Nottingham representative of the National Association of the League of Hospital Friends, died in 1985 at the age of 77.

Mr Alan Hayles, former Assistant Matron

In 1971 when the General Hospital was at the height of its powers, the man in charge of the seven operating theatres was Assistant Matron Mr Alan Hayles. At that time an average of 45 operations a day were carried out plus as many as 12 emergency operations. One operating theatre, devoted entirely to emergencies, was open 24 hours a day, seven days a week. Born in Kent, Mr Hayles started his nursing training in 1951 and worked in hospitals in various parts of the country before moving to the General. The operating theatres was staffed by nine sisters, eight staff nurses, two enrolled nurses, 15 students or pupils, 12 technicians and three porters. Was there any prejudiced against the male matron? ‘No more than there is against women doctors,’ explained Mr Hayles. ‘After all, the first nurses were monks working in infirmaries.’

Re-union for senior nursing staff

School of Nursing

When and Richardson was appointed the first Matron of Nottingham General at a salary of £15 a year plus three guineas for tea and sugar, nurses were not thought to need skill and training. The status of nursing was changed dramatically by the Crimean War and the part played by the volunteer nurses under Florence Nightingale. The General Hospital’s School of Nursing dates from 1871 when the first

105 probationers were accepted. The Hospitals first train matron was Mrs Pedgrift. Important though the Matron was, the most crucial person in the hospital nursing team was the ward sister. She was responsible for all aspects of her kingdom, which she often would very strictly, as readers of the Richard Gordon Doctor books will recognise. As one medical secretary recalled: ‘The sister in charge of casualty wielded great power. She kept her housemen in order and when she shouted everybody jumped. There was far more discipline – but the atmosphere at the General was always good.’ At this time, the loss of a generation of men in the 1914-18 war meant that there were many unmarried women in the community so ward sisters often made the hospital their home. Residential accommodation, nurses’ dining rooms and on the ward sitting rooms reflected this dedication to the board and hospital. The General Hospital really became a training centre after the formation of the General Nursing Council in 1919. The school of nursing, attached to the hospital, was considered one of the very best outside London. The old GHN nurses badge accounted for a great deal when applying for nursing posts.

Re-union for nurses who completed their training at the General Hospital in 1964. L/R: (back row) Susan Weston, Ann Churchill, Alice Garner, Bridget Taylor, Chris Sawdon, Nan Andrews and Kate Ritchie. Middle row: Brenda Pounder, Rosemary Claire, Di Geary, Wendy Jarvis and Sue Bunce. Front Row: Pat Boce, Carol Adams, Janne Hill and Anne Houldsworth.

The fine new nurses’ home was opened by the Prince of Wales in 1923 and Pearson House was opened in 1941. As the General Hospital expanded an extension to the Memorial Nurses Home at 2 Park Valley was built. Nottingham's new joint School of Nursing was opened in January 1971. Sited at the General Hospital, it was also linked to the new University Teaching Hospital and later transferred to the Queens Medical Centre. In the 1970s a new and hierarchical system of nursing administration (the Salmon structure) was introduced. This change coincided with the wish of many nurses to lead an entirely non-hospital life except during the progressively shorter shifts when they were actually on duty. The concept of separate accommodation and eating areas gradually became eroded. Memorial House is now the headquarters of Nottingham Health Authority's Community Unit. Nursing is now facing its biggest challenge of all as he gears up for a training revolution envisaged by Project 2000.

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500,000th SRN

Mrs Bedford Fenwick, the first SRN in Britain and a contemporary of Florence Nightingale, was born and trained in Nottingham. So was Carol Green, who at the beginning of 1976, was invested by Mr Norman Barry, chairman of the General Nursing Council, with a special silver medal to celebrate the fact that she was the half millionth SRN to graduate in this country.

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CHAPTER 10

SUPPORT SERVICES

Hospital Team in 1973

A hospital is much more than a building bricks and mortar. It is about people – doctors, nurses, physiotherapists, radiographers, porters, domestics and all the many other workers, medical and lay concerned with providing support services. This chapter is a tribute to them. Space prevents it being all inclusive, mentioning every department and every member of staff who has contributed to making the General a hospital with a heart. If we turn the clock back to 1973, we see the General Hospital at the height of its powers. It was one of the busiest provincial hospitals in the country and, with the City Hospital, formed the bedrock of Nottingham medical services. In 1973 the hospital complex comprised the General Hospital itself with 529 beds; the Eye Hospital with 48 beds and the Pay Bed Wing with 46 beds. Pre-convalescent care was provided at the Cedars and Ruddington Hall with 116 and 16 beds respectively. The complex was covered by 1,500 full-time jobs, by 2,000 people with part-timers in many departments. The hospital had 100 consultants, (many part-time) including professors and lecturers at Nottingham University Medical School, for it was gearing up to accept its first medical students in May. In addition there were 90 doctors, ranging from house officers to senior registrars, 80 sisters, 75 staff nurses, 70 enrolled nurses, 45 nursing auxiliaries and 140 student nurses. Principal nursing officer was Miss S L Barnes and under her came a number of senior nursing officers and nursing officers, each with responsibilities in specialist departments. They were professional and technical staff, including 90 laboratory technicians, 20 physiotherapists, 20 radiographers and 15 pharmacists. There were five photographers, as well as office and administrative staff. There were 25 cooks, two bakers, ten domestic supervisors, 131 domestic staff and 63 ward orderlies, 13 operating theatre attendance and ten people in the sewing room, working full-time at mending linen and making uniforms. There were about 55 porters, together with switchboard operators and many more. The hospital secretary at that time was Christopher Spry. In 1973 the General Hospital was the accident centre for the area and took medical emergencies – patient sent urgently to hospital by their family doctor – on a rota basis with the City Hospital. A typical day in the life of the General was 25 January, 1973 when the hospital was on double take – that is, receiving medical and surgical, as well as accident emergencies. Between midnight and 8am, 15 cases brought into the Casualty Department were admitted. Another 30 patients came in as emergency cases during the normal working day of 8am to 5pm and midnight – a total 52 patients. The average length of stay for an emergency case at that time was 12 days at a cost of £75 a week. During 1972 the hospital treated over 17,000 in-patients and 147,000 attended the outpatients departments, including 38,000 new patients. The General was a regional centre for neurology – which meant it specialised in disorders of the nervous system. It had a coronary care unit to provide specialist attention for heart cases and a new intensive care unit.

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Doctors and staff treated everything from varicose veins to cancer, broken limbs to diabetes, overdoses and metabolic diseases, and, increasingly the degenerative diseases of old age. But young or old, the hospital stood ready and waiting to deal with the emergencies that involved most of us at some time in our lives. In this chapter, past and present members of staff of the General Hospital, recall their memories of working in many departments as part of the team effort.

Finance

During the first year of the General Hospital’s existence it cost just £900 to look after 44 patients. By 1947 – the final year as a voluntary hospital – £900 would have paid just two patients. Expenditure had risen to over £260,000 a year Most people hate figures and finances. But as Dr Frank Jacob records in his history: ‘Without finance, doctors would be unable to indulge in their hobby of trying to ease folk of their sickness.’ During the later years of Dr Jacobs’s career as a senior physician he saw the cost of running the hospital climbed to £68,000 in 1933, and the excess of expenditure over income was £6,451. Most of the income came from the Saturday Committee (£25,000) and annual subscriptions (£11,000). Potato Week contributed 57 tons of potatoes and other vegetables and Egg Week produced 116,000 eggs. At that time the hospital was spending £3,000 a year on coal, and its electricity bill was £1,600. It spent nearly £10,000 on drugs, dressings and instruments, including 214 miles of bandages, 72 miles of gauze, three tons of cotton wool and 100 gallons of cod liver oil.

Between 1948 Nottingham's voluntary and local authority hospitals were taken under the wing of the NHS. Hospitals no longer had to rely on legacies, gifts and grants but were funded through a fixed levy in the form of National Insurance. The aim was to provide a health service which was free to all at the point of delivery. A comparison with present-day costs is quite revealing. The average cost of an in-patient for one day at the General Hospital in 1948 was £1 6s 2d. In 1988 it was £72.

Mr Albert Holgate

Mr Albert Holgate started work in the Health Service in Derby in 1948 after ten years’ in local government. He was invited by Nottingham No. 1 Management Committee to apply for the Treasurers position. He was appointed in 1953, taking over from the committee's first finance officer Mr Jenkins, who retired on health grounds. Mr Holgate's term as Treasurer until March, 1974 spanned a very important period in the history of the General Hospital. He recalled: The Government subsidise the General before nationalisation. It had to do this for most of the voluntary hospitals. ‘Costs were much greater than pre-war and they could not meet their obligations.’ The big issue during Mr Holgate's early years was the future of the General Hospital.

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Its restricted site was always its problem. Alternative sites in Clifton, Ruddington and Wollaton Park were considered as a way of developing the General. At one stage the plan was to demolish the whole of the general except the Jubilee Wing. They were going to build a new block in Postern Street and extend the site, but they couldn't make up their minds. The then Health Minister Enoch Powell came on an official visit. We went up on the roof of the General and looked all around. He just made a decision. He said: ‘The General stays’ and it seemed as if everything was going ahead. They pulled down our offices and at one stage we were moving into offices near the Albany Hotel on a 21 year lease. But at the last minute the Department jibbed. We eventually moved to Thornton House, next to the Pay Bed Wing. We stayed at Thornton House for a few years until we moved to Queens Medical Centre when the first staff houses were built at Harvey Court. When planning delays developed on the Derby Road site and it was obvious that the General Hospital would be needed for a teaching role until the new University Hospital was built, plans were hurriedly advanced for the Trent Wing and a medical teaching centre near Postern Street. One of the conditions of planning was to make the car park on the site de-mountable so that another building could be built on the site at a later stage, if necessary.

Mr Holgate recalled the major changes in administration and management

When Mr Stanley was the House Governor he was the king pin. He was very conscientious and I got on with him very well. When he retired they thought that the General would collapse. But his successor Mr Gordon Davies was a very go-ahead Group Secretary. Working with a good committee and with Mr R D Atkinson as supplies officer, the management team worked well

Mr Holgate is proud that Nottingham was at the forefront in training finance officers. ‘We ran one of the first training schools. When I retired we had helped train six treasurers around the country and all of them came back when a surprise party was organised for me.’ His final comment on NHS finances: ‘There has always been a shortage of money in the health service and I think there always will be.’

Administration: John Stanley

John Stanley properly has closer links with the General Hospital in virtually any Nottinghamiam – he was born and grew up there. His father Mr Henry Morton Stanley took over from Mr McColl as House Governor in 1938, and was Group Secretary from 1948 until he retired about 1960. During the Second World War, Tower House was the family home. John Stanley recalled:

We used to get a bird's eye view of the air raids from W G. Player Ward. On the night of Nottingham's worst air raid, the severely struck areas were all aglow. Casualties were brought into the hospital from the Co-op bakery. The hospital was very active during wartime with regular convoys of wounded soldiers been brought in. Dad was often called out at night and on one occasion he was blown down the drain. I also remember hearing the German bombers coming over and seeing a Heinkel flying low over the hospital. The hospital was just missed on the night of the big raid. It must have been a near thing because I remember hearing the whistle of one bomb, which wasn't far away.

He remembers many of the great medical and nursing characters of those dramatic days, Matron Miss Plucknett, who took over from Miss Liddle; Sister Morris, who served in the Casualty Department, Sister Katie Wright and Sister Molly Denman.

All these were nurses in the old-style. I also remember Dr Rowe, who looked after me as a young child. My mother died in childbirth and I spent some time in my early years at a General Hospital, suffering from pneumonia and other ailments. The Matron Miss Liddle brought me up. She was certainly an authoritarian figure. I have strong memories of her. I saw her at her home in East Leake before she died. Her voice rang bells over me after 40 years.

His son says:

My father was a bit of an authoritarian, very strict, and a hard taskmaster. Maybe he was not all that popular at the time. But as far as the hospital was concerned, he devoted his life to the General.

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When we lived in the Tower House, her big rambling place, it seemed as if my father, his assistant Mr Cyril Reddaway and his secretary Miss Reynolds ran the hospital. The post of House Governor seized when the NHS was formed in 1948. Eventually the Tower House was used for another purpose and we moved out. After the NHS was established, more officers were appointed, responsible for finance, supplies, medical records and so on.

Mr Henry Morton Stanley

John Stanley reflects: ‘I view the hospital with affection. As well as the doctors and nurses, I think credit should also be given to the people they tend to forget such as porters, who were very helpful, and the engineering staff.’

Mr Cyril Reddaway

Mr Cyril Reddaway was appointed assistant to the House Governor Mr H M Stanley in 1938 and serve the hospital with great loyalty and skill for 30 years until he retired in 1968 as Deputy Group Secretary.

During the war I was on duty every other night. The hospital had an arrangement of yellow and red warnings. Yellow warned us to stand by and red meant an alert for something serious. I was on duty the night the Co-op Bakery was bombed. I remember seeing the burns casualties brought in.

Mr Reddaway played a leading part with his former chief, Mr Stanley, in establishing the Nottingham No. 1 Hospital Management Committee when the NHS was formed in 1948.

It became a bigger job administratively. It also brought major changes in the Committee with representatives coming in from other spheres. There are a lot more people to consult before decisions could be taken.

He is sad the hospital is closing. ‘In the old days it was like a large family,’ he reflects.

Mr Gordon Davies

When Mr Stanley retired, he was replaced by Gordon Davies, a brilliant manager and administrator, who was destined to play an important role in the development of the General Hospital during the 60s and early 70s. He came to Nottingham in 1960 to take the post of Group Secretary to the Nottingham No 1 HMC, having previously held a similar positions in Yorkshire. Although much of his career was spent in Yorkshire, he was a Mancunian.

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In 1968, he wrote an article in the Evening Post, outlining his views on the General Hospital.

The medical, nursing and other skilled staff of the hospital are justly proud of its highest traditions and of its reputation in medicine and surgery which is world-wide. Throughout two centuries of service, the hospital has never closed its doors, night or day, to anyone in medical need. The highest standards demanded of such traditions demand equally high standards of efficiency from the supporting services. It is the job of management primarily to insure that the medical, nursing and other skilled services are adequately supported at all levels. A hospital is a complex organisation. For every patient in a bed there are at least three supporting staff. Only a small proportion are in the front line as seen by the patient. The rest comprise a vast network of scientific and lay support behind-the-scenes. Hospital staff are required to work under continuous pressure and a vast proportion of them do so not merely to living but by reason of the innate and vocational satisfaction they derived from their contribution directly or indirectly to the welfare of patients. The majority of the staff employed at the General Hospital could earn half as much again outside – more easily and in better conditions. Yet they stay with us. These are the store warts who make a hospital, and who are indispensable to it.

By the end of the 1960s the administration had trebled, reflecting the increasingly sophisticated role performed by the General Hospital, which had grown into a small town of 2,000 people, including 450 patients. The important job of Medical Records Officer was carried out for many years by Bill Eades and later Ray Nutt became his deputy. Ray is now Manager of Medical Records at Queens Medical Centre. Meanwhile there was a regrouping in 1970 when Mr Davies became Chief Administrator of the Nottingham University Hospital Management Committee. He sadly died at a relatively early age in 1973, having devoted over 40 years of his life to the NHS. The Memorial Service at St Nicholas Church reflected the high esteem in which he was held by friends and colleagues. As part of his address Mr David Evans, chairman of the Nottingham University Hospital Management Committee, paid this tribute:

Mr Davies was the most humble and considerate men – not put out if he was slighted, generous to others in their mistakes and above all the man with a great capacity for friendship. I venture to say that there is no one who knew him who did not grown to admire him. Many of you will know of the load he was carrying by virtue of being Chief Administrative Officer of the University HMC, embodying as it does the largest development in the field of teaching hospitals this century. Then to have superimposed on this the chairmanship of the local joint Liaison Committee was an enormous assignment but he took it all in his stride. We therefore owe it to him to see that he set to achieve is, in the ultimate, attained.

Chris Spry

In 1973 Mr Chris Spry became hospital secretary – one of the new breed of managers who made hospital administration specialist career. He was later appointed assistant administrator for the South Nottingham District, before moving to Newcastle as general manager in 1981. He became general manager of Southwest Thames Region in September, 1989.

Others who made a significant contribution to administration at the General Hospital included Lionel Joyce, who did a lot to make the bi-centenary celebrations such a success and Paul Nesbitt, who is now General Services Manager for Bassetlaw Health Authority. When general management was introduced in Nottingham, Martyn Pickering became the first unit general manager of the General Hospital. He left in 1988 take up a post in industry and was succeeded by the present unit general manager Mr Philip Hogarth

Alan Burgoyne, Hospital Engineer

Whether it is a cooking problem in the kitchen, a failure in the power supply or a snag in the operating theatre, the hospital engineer is the man who must put this right. All other departments depend on this

111 key service. From the time the patient enters hospital to the day they leave; their comfort and welfare are often as much in the hands of the engineer as the medical staff. The engineer in charge of Nottingham General Hospital for many years was Mr Allen Burgoyne, who became group engineer of the No 1 Hospital Management Committee. He began his career in industry as a mechanical engineer in a textile factory and found the complexity of hospital machinery and equipment far more fascinating. In the days when the General was a busy acute hospital, the department covered their myriad range of jobs from making specialist instruments to maintaining complex electronic and mechanical equipment in operating theatres. In an interview in 1965 he recalled how his theoretical knowledge once sold the problem of the soggy steamed puddings. A new type of container had been brought into use followed by a spate of complaints from patients. The cooks could not solve the problem but the engineer did – the containers were being put in the steamers upside down!

Therapy Services by Sylvia Ellis, Superintendent Physiotherapist

Physiotherapy, Occupational Therapy, and Speech Therapy or all part of the rehabilitation services based at the General Hospital. Each profession has developed and adapted to changing needs. They help after accidents, operations and illness, and with general rehabilitation following strokes, teaching the patient to lead as full and active life as possible. From its humble beginnings of massage and exercise therapy, physiotherapy has grown into a thriving department, with approximately 28 staff, providing a service to all the in-patient areas within the General Hospital plus a busy outpatient department. The Outpatient Physiotherapy Department, based on the Ropewalk, takes referrals from consultants and patients own GPs, treating problems ranging from spinal conditions, fractures, arthritis and injuries caused by accidents and sports. On the inpatient areas, together with occupational therapy and speech therapy, much of their work with the elderly, helping them regain and maintain their independence. The Radiotherapy Unit and Oncology wards at the General are other areas in which therapists work. The first occupational therapist was employed at the General Hospital in 1980 using two rooms off the corridor leading to Seely Ward. With the conversion of the old Accident and Emergency Department in 1983, the Rehabilitation Unit was opened, and the occupational therapy staff establishment increased over the years to 12 at present. Speech therapy is a relatively young profession, but evidence suggests that there has been a service at the hospital since 1966. Clinics were originally held in a variety of borrowed rooms until in 1980 to the Department, which had swelled to about 30 staff, moved to Thornton House. The service for the General is now co-ordinated from Sherwood Wing at the City Hospital. All of the therapists have research staff based at Tower House as part of the Stroke Research Unit. The General Hospital has changed to great deal over the years, the rehabilitation services adapting to its needs. As the hospital goes through further major changes the three therapists will continue to provide the best service possible.

Pharmacy

Introduction

Pasteur dream of seeing contagious and virulent diseases wiped from the face of the earth. Powerful new drugs like sulphonamides and penicillin went a long way towards achieving that aim. They were equally important in the control of pneumonia, scarlet fever and other dangerous diseases. Another valuable drug was quinine in the control of malaria. Yet in the early years of the General Hospital, the dispensary was known as the Shop. Distilling herbs from the hospital's Herb Garden and running the dispensary was a responsibility of the apothecary who was assisted by an apprentice and two helpers. The first full-time dispenser was

112 appointed in 1837. Mr William Henry Crackle was head of the dispensary for 50 years and a brass tablet was erected in the hospital chapel in 1912 to commemorate his long service. Miss Francis Prince, who had been his principal assistant, was appointed Chief Pharmacist and continued in office until 1955. The original premises became entirely inadequate for the growing workload. A fine new dispensary, with sterilising plant and adequate storage, was provided in the new Ropewalk Wing in 1927. The pharmacy has seen startling changes during the past four decades. Only a handful of effective medicines were available to doctors in 1948. Indeed when the NHS was born, 50 per cent of the drugs had been employed by the Arab speaking physicians of the middle ages – and two thirds of those were known to the Greeks. Fleming’s discovery of penicillin in 1928 was the turning point and a massive research programme began to develop further antibiotics and other synthetic medicines. The 1949 National Formulary lists some fascinating items – thyroid extracts, intramuscular injection of liver and creosote to name a few. The 1988 edition lists 116 different compounds for the treatment of infections alone – from tuberculosis to viral meningitis.

Hospital dispensary, about 1900.

Miss Francis Prince

One of the great characters of the General Hospital was Chief Pharmacist Miss Francis Prince – and they had to change a few rules when she arrived on the scene because until that time meetings of her own profession were for men only. She came to the General Hospital as a pharmacy student in 1902. As an apprentice for four years she earned £10 to £25 a year, learning about pills, or ointment, lotions and linctus. Within 10 years she rose from assistant chief to Chief Pharmacist. The climax of a remarkable fifty-year career came in 1953 when she was awarded the MBE. ‘I count it as an honour for the hospital’, she said. Reflecting on her career, she added: ‘My predecessor was here 50 years. So in the last 90 years there have been only to Chief Pharmacists at the Nottingham General Hospital.’ She believed that two things played the biggest part in our lives – working and sleeping. ‘So why not only be interested in your work and if you have a comfortable bed you are all right.’ Recalling the 1914-18 war, she came to live at the hospital to deal with constant emergencies. And these were her memories of the night Nottingham was bombed during the Second World War. ‘I

113 got out of the car and drove through the streets where everything was burning until I reached the hospital at 2am the people poured in and I was kept pretty busy until 9am when I went for some breakfast.’ From the time of her appointment in 1912, the pharmacy department was run entirely by women. ‘There are few hospitals in the country that can make that boast. When I first came here they treated me as something quite unique – “We'll be having some women doctors next” muttered one doctor as she pointed to a group picture on the wall. In 1916 we did.’ When Miss Prince retired in 1955, she was succeeded by Mr Walter Smith, who served as senior officer level until he retired in 1983.

Walter Smith

Six months after taking his new position, Mr Smith became Group Pharmacist and remained in this role until 1973 when he became Area Pharmacist, responsible for the pharmaceutical services for the whole of Nottinghamshire. He said: ‘I spent a lot of years concerned with the General Hospital. I have a lot of happy memories. It was a very exciting period – never a dull moment. ‘He explained how the department had a good record for retaining female staff. ‘We were always fortunate in Nottingham because romance blossomed at the University. Many more girls are going into pharmacy because it is a good career. They used to stay because their husbands join boots or stayed on at the University to do a higher degree.’ This is Mr Smith's account of how pharmaceutical services developed at Nottingham General Hospital from 1956-1973.

Originally the pharmacy was part of the main building of the hospital – but when the Out-Patients Wing was built in 1927, Miss Prince saw the opportunity to acquire better and more extensive facilities. She argued her case successfully, the end result being the spacious department on three floors, which serve the hospital effectively until her well-earned retirement in 1955. By this time great changes had and were taking place in the pharmaceutical field, with the advent of modern drugs, such as antibiotics, steroids and other chemo-therapeutic agents. Modernisation and refurbishment of the department was urgently required. The pharmaceutical service for the General Hospital, and, to some extent, for other hospitals within the control of Nottingham No 1 Hospital Management Committee, was situated in the Out-Patients Wing of the hospital. The department consisted of three sections located on three floors. On the ground floor were the main dispensary and offices, providing a service for in-patients and outpatients. The dispensary was spacious, very necessary to accommodate the wide range of drugs and pharmaceutical preparations, and the staff required to provide the services. On the mezzanine floor the manufacturing facilities, both are sterile and non-sterile preparations were accommodated. In the basement, with direct access to Park Row, were the bulk stores for drugs and surgical dressings.

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Pharmacy Department, about 1950.

1956

In 1956 the Group pharmaceutical organisation concept, as suggested by the Instead Committee, on the ‘Organisation of the Pharmaceutical Services’ was initiated. This provided backup support to the pharmacists in other hospitals in the Group.

1959

The Pharmaceutical Services of Nottingham Eye Hospital were taken over, and the dispensary at the Eye Hospital closed. Considerable development followed.

1960

When the Skin Clinic, previously located on Parliament Street, moved to the General Hospital the pharmaceutical services were taken over and developed, providing a considerable increase in workload.

1961

With the increasing workload it was necessary to employ more skilled Pharmacy Technicians, and hence a training scheme for the Nottingham area was introduced. At this time regular meetings of all Chief Pharmacists in the area were introduced, to co- ordinate the various activities and exchange information on current practice.

1966

With the ever-increasing variety and range of drugs and preparations being used in the hospital, any prepared in the pharmacy department, it was found necessary to establish a Quality Control Laboratory. The well-equipped unit was staffed by a Senior Pharmacist and trained technicians. At this time the Sterile Products Unit was extended, and additional facilities provided to meet the ever increasing demands for sterile medicaments.

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1968

With the complexity of modern drug therapy, and the greater range and variety of drugs being used on the Wards and in departments it became clear there was a need for some pharmacy presence at ward level to provide first-hand advice on drug administration and storage. Thus a Ward Pharmacy service was introduced in 1968, whereby pharmacists visited wards in departments at regular intervals.

1970

To improve the Ward Pharmacy service, approval was given to appoint two Resident Pharmacists, who were in post by March 1972, to provide a 24-hour availability. A third appointment was made in 1972. They were accommodated in the medical and senior nursing staff quarters. Thus close relationships were established.

1972

At this time increasing use of radio-active medicaments in the treatment of certain forms of cancer was causing problems, hence it was decided to establish a radiopharmaceutical dispensary and laboratory within the Medical Physics Department, with a specialist Senior Pharmacist in charge. 1972 also saw the appointment of a Senior Pharmacist, Information Services, to provide information and advice on medicines and all aspects of drug therapy. The 24-hour ‘On-call’ service was further developed and strengthened. 1973

Increasing work-load required the Quality Control Laboratory to be extended, and the Sterile Products Unit to be re-organised with additional improved facilities.

The New Teaching Hospital

For some time considerable thought and effort had been given to the planning of the pharmaceutical department, and the reorganisation of the services at University Hospital. This steadily gathered momentum, involving many members of staff, in preparation for the opening of the University Hospital, and the transfer of medical and surgical units from the General to the department at University Hospital. Mr Smith paid tribute to the work of Deputy Chief Pharmacist Miss Joan Cooper in the continual development and upgrading of the department. During the last decade John Wilson has made a significant contribution as senior research pharmacist. Mr Steve Mayers is the Pharmacy Services Manager.

David Evans, first chairman of Nottingham University Hospital Management Committee

Mr David Evans, one of the leading figures in the health service for many years, has great affection for the General Hospital. Chairing meetings where medical representatives are putting contrary views requires consummate skill and diplomacy. His good humour and Welsh wit stood him in good stead and there was widespread regret when the Secretary of State decided not to extend his appointment as chairman of the Area Health Authority when his term of office ended in 1977. Formerly of the East Midlands leading bankers, he was involved in voluntary work and he had a keen interest in the NHS, especially League of Friends, even before he arrived in Nottingham in 1955. Mr Evans was Chairman of the Finance Committee of Nottingham No.1 HMC for 14 years. Through positions he held that local and regional level, he became immersed in 1967 in the major development of the new University Hospital and Medical School and in 1969 he was appointed the first Chairman of the newly founded Nottingham University Hospital Management Committee. But his first love was always the General Hospital.

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Members of the Nottingham University Hospital Management Committee, 1st April 1970. Back Row – left to right: Mr A Holgate (Treasurer), Mr D G Davis (Chief Administrative Officer), Cllr Miss N J Nairn, Dr B G Spilsbury, Mr L Ackerman, Mr N R Smith and Prof H K Weinbren. Front row: left to right: Dr R J Twort, Prof JR Mitchell, Mr J Anstey, Dr F S Dainton (Vice Chancellor of the University) Mr DL Evans, (Chairman), Miss M A Burr, Prof A D M Greenfield (Dean of the Medical School), Mr H L Holliwell. Members not on photograph, Prof R C Coates, Mr D W Daly and councillor Mrs I F Matthews

I would like to think there would always be a General Hospital presents. It was going to be closed a long time ago, but they always found a need for it and I think it would be a great shame to demolish the whole place and sell it for commercial reasons. Environmentally I think the Park and the General Hospital locality has a certain special atmosphere. Are we going to commercialise everything? I would have thought there will always be a need for overspill in some areas. If it is going to be bulldozed I don't think it should be done for the next 50 years I know that's a sentimental outlook two sentiment disappears from our lives altogether I think we are going to pay the price.

Mr Evans said he loved the Christmas festivities at the General Hospital. "There was a good feeling of camaraderie," he recalls. "People were pulling together. The annual dance was also a great event which many of the men in white ties and the sisters and nurses in ball gowns. The consultants drew names out of a hat and that was their partner for the evening." Mr Evans greatly admired Gordon Davies.

He came here at a time when things were in a state of flux. It was known that the General Hospital was to be superseded by the new University Hospital. Apart from the reorganisation which all this involved there were quite a few problems in relation to various specialities. Obviously a lot of medical people were understandably anxious to climb on the bandwagon. To sort these matters out in relation to personalities was not easy. He had great diplomacy and a very happy knack of pouring oil on troubled waters. He hid his light under a bushel. He did not get the recognition he deserved.

Mr Evans says another very good friend to Nottingham was Professor Jim Scott. A member of the Planning Team for University Hospital and Medical School, he was honorary physician to the Queen from 1980 to 1983. He retired in 1989 as Regional Medical Officer and was awarded the CBE in 1986. After opening a new dental department extension at the General Hospital in 1978, over 200 attended a reception in Mr Evans’ honour in Pearson House. Gifts were presented by Dr John Bittiner on behalf of the staff and Miss Yvonne Pearce on behalf of the nurses. The Trent Theatre Suite was renamed the David Lewis Evans Suite. In 1981 Mr Evans officially opened a new day room at the General Hospital in memory of his late wife Kate, who was for many years to chairman of the Cedars Hospital League of Friends. He has maintained a wide range of public interests and for many years chaired the European Ethical Review Committee, comprising eminent doctors and other professional people.

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Professor Tony Mitchell once described Mr Evans is a "a man who fulfils the requirements of an optimist in that he sees an opportunity in every problem while most of hours of mere pessimistic mould only see the problems in every opportunity."

Medical Photography, Ernest McLeod

The Medical Photography Department was established in 1948 in a converted decontamination unit in Postern Street and was one of the earliest departments of its kind outside London. It was set up in conjunction with the Radiotherapy Department, as part of an essential service involving clinical photography of patients. Mr Ernest McLeod became Chief Photographer. He joined the General Hospital staff in 1946 after serving with the Royal Army Medical Corps as a radiographer during the war. Mr McLeod who supplied the photographs and illustrations for Frank Jacobs A History of the General Hospital, recalled:

When I went to work in the Radiotherapy Department Dr Glynn Evans, who had come from the Christie Hospital in Manchester, how completely modernise the Department. New equipment, including deep x-ray therapy machines, were installed. Previously much of the equipment was obsolete. Dr Evans was the real founder of what became the Hogarth Radiotherapy Centre. Before 1946, radiotherapy was only used for superficial conditions and skin treatments. There was no real method for treating tumours with deep x-ray until Evans arrived. About this time, the Department started using the Parker Pattinson rules for estimating dosages. Two other doctors who came from the Christie Hospital made a significant contribution to the Department – Dr Finbar Cross and Dr William Fraser. Dr Evans was a keen photographer and it was decided to start a small photographic section to photograph patients before and after treatment. "I developed it into a Department for other specialities to use such as Dermatology. It was also used by orthopaedic staff for their work at the Gen Hospital, the City Hospital and Harlow Wood." Gradually the Department enlarged and moved to a new location in the basement of the Outpatients Department at the General Hospital. Later it moved to 12 rooms on the ground floor of Standard House. Medical publication were developed and when the University Department of Surgery was established that the General Hospital it began preparing a lot of material for medical students. Over the years extra staff were needed to deal with an increase in patients from 200 in 1948 to over 2500 in 1974. At that time the Department, headed by Mr McLeod had two senior photographers, three trainees, a secretary (who was also a qualified radiographer) and the medical artist worked in close liaison with the photographers. Most of the Department transferred in 1976 to Queens Medical Centre, where three sections – closed circuit television, graphics and medical photography – come under the heading of Audio Visual, offering both clinical support and teaching service. Mr McLeod, who retired in 1983, said: "I have very happy memories of the General. It was very compact and everyone knew everyone, while at Queens Medical Centre you only saw your immediate colleagues. It was quite a change."

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X-Ray Department, 1929

Medical Secretary/Administration: Mrs Doreen Bonser

Mrs Doreen Bonser started work as a medical secretary in the X-ray department in 1943. I.e. virtually did everything over the years and when I retired in 1971 I was in charge of administration in the X-ray department. When I arrived Mr Stanley was the Hospital Governor and I worked with Dr Rigby for a few months before he retired. At that time X-ray and radiotherapy were combined. Dr Walter Mowat took his place as head of X-ray and deep X-ray therapy. X-ray has always been in the basement of the General Hospital and radiotherapy was next door to it. When the two departments started to separate, radiotherapy spread onto the next corridor. It was there when the survivors of the Arnhem drop were brought in. A couple of the girls in the x-ray department married survivors from the Arnhem drop. At that time we had convoys of wounded men coming in regularly. So they used to come around in the afternoon and ask for volunteers. We would go across to the nurses’ dining room and have a bread and jam tea provided by Matron. When the convoy started to arrive with all assembled in the main entrance hall and put up trolley beds. Then an entourage would go round, headed by the consultants and sisters to assess each patient. For those needing x-rays, I would accompany a radiographer with a portable machine round the wards to do the x-rays, then with the cassettes down into the basement to have them developed. We had some German prisoners of war. We were issued with a little sheet with some German on so we could understand the basics. Mainly it was when they wanted a water bottle! One of the consultants, Mr Bill Brownlee was a real character. He drove a ball nosed Morris with a brass radiator, and always had his big boxer dog by his side. He was a huge man and always wore a black Homburg.

She added:

The X-ray Department was always busy. Originally we took down the x-ray reports in shorthand. Then we started dictating straight onto the typewriter. Any developed on to audio. Personally I think that was when the rot set in.

Mrs Bonsall remembers Matron Miss Plucknett, and many of the sisters.

At that time sisters in casualty wielded far more power than today. They kept their housemen in order. When Sister shouted everybody jumped. If she wanted a patient out of bed in the middle of the night, they got out of bed in the middle of the night. There was far more discipline. But the atmosphere was always good at the General. I was James plastered always happy there.

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Medical Physics: James Plested and David Challoner

The Medical Physics Department at Nottingham General Hospital not only gives a wide range of scientific support to the hospital but plays a key role in radiation safety. James Plested, the Principal Physicist and District Radiation Protection Adviser, started work there in 1957 and David Challoner, the departments Chief Technician Arrived a year later. At that time the department comprised two physicist and four technical staff. Now there are 18 staff, including three physicists. The department’s areas of expertise cover the mechanical engineering, providing maintenance and development programs for linear accelerators and servicing complex electronic equipment. Over the years staff have helped design new equipment, including a device for measuring reaction to movement in the limbs of spastic patients. About 80 per cent of the departments work involves the radiotherapy department with the scientific staff concerned with radiation physics and in particular dose measurement, checking the output of the machines and planning treatment programmes and methods. The radiotherapy department treats over 2000 patients a year with the therapeutic radiologists carrying out the dosage calculations and the scientific guidance from the medical physics department. Some of the work involves making moulds in the preparation of treatment for patients with head and neck cancer and the department is also responsible for the care and preparation of radioactive sources. It has an excellent record on safety. But in 1949 the hospital was the subject of a national incident investigated by the National Radiological Protection Board. A needle, containing radium, was left in a pan, which was allowed to boil dry. The needle became so hot that it exploded, scattering radioactive material around the building.

A roof area is made safe after a radium incident in 1949

All the woodwork and plaster was stripped out and the contaminated material placed in zinc troughs and capped with concrete. The material was later buried in a disused mine shaft at Clay Cross, Derbyshire. The Medical Physics Department has had several ‘homes’, including an old house on Park Row, where the hospital car park is now cited and a brick nissen hut near the present Hearing Services Centre. Then it moved to the top floor of the Outpatients Department before transferring in 1970 to its present base, in Oxford Street. The Department keeps a register, recording all the radium ever purchased, going back to the First World War. It was the first in the region to have a Cobalt Gamma Ray machine in 1958 and a six

120 million volts linear accelerator, which has been in use since 1967, and was the third of its kind in the world. Other equipment includes X-ray machines, treatment simulators and an eight million volts linear accelerator, which has been in use since clearly 1980s. Medical Physics became an autonomous department in the late 1960s until it was absorbed into the Radiotherapy Department when general management was introduced into the NHS. When Radiotherapy services move to the City Hospital in two or three years’ time, it is expected there will be two separate medical physics departments cited there. One of the General Hospitals Principal Physicists Andrew Przeslack is currently engaged in preparing specifications for advanced new equipment expected to be installed in the new Department of Clinical Oncology.

Long Serving Secretary

Miss MC Wilkinson was the longest serving member of staff at the General Hospital. She retired in 1972 after 46 years’ service. Miss Wilkinson was a member of the small secretarial team which dealt with all the paperwork for the hospital in the 1920s. From 1956 until she retired, she was medical secretary to Dr Miles Benton on the Radiotherapy Department.

Library

Nottingham General Hospital had a small library from its earliest days. By 1851 it consisted of 519 religious volumes and 252 other books. When the General Hospital assumed its teaching role in the 1970s there was an urgent need to expand the medical library. Professor Tony Mitchell, Foundation Professor of Medicine recalled: "At that time the Library at the General was in the cupboard with about 20 books in it. The Medical Library was run by an excellent lady, Mrs Lewis. We needed a library with journals and reading rooms for students." A new Medical Library and teaching centre were built in Poston Street in 1972.

Switchboard

A combined farewell was held at the Bramcote rooms in 1989 to thank switchboard operators at the General and Highbury Hospitals for years of sterling service. Nottingham Health Authority's new telephone system went live on 15 May, to receive and divert calls through three centres. Site services co-ordinator Carol Oxley said: "They have done a tremendous job. We are going to miss the switchboard operators when the changeover period finishes in a few months." Carol gave good wishes to Mick Inger in his new job at the City Hospital switchboard after 20 years’ service at the General – eight years as a porter and 12 years on the switchboard.

Switchboard operators at the General and Highbury Hospitals raise their glasses to mark the end of an era after Nottingham Health Authority’s new automatic telephone system went live in May 1989.

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Clerical Assistant: Mrs Johnson

Mrs Johnson, aged 92, of Sneinton was a clerical assistant on the wards when Miss Plucknett was Matron. Known to all her friends as Johnny, she recalled:

My job was arranging appointments for operations, arranging ambulances and arranging for patients to see the almoner. The housemen were as daft as I was. Dr Whimster was a perfect gentleman and lovely. Dr Proctor was a beautiful organiser. I liked Dr McCallum because we both loved football. I worked on Portland Ward most of the time, when Sister Copestake was the sister. Mr Field was a pet but he used to pinch my sausages. Mr Brownlee was a rumbustious and generous. Mr Sheehan always gave his sherry at Christmas time. He always joked that he could make mistakes carving the turkey but not on patients.

She is still a patient and friend of Dr Peter Toghill.

Social Work Department: Mrs Beth Tate

A team of social workers based at the General Hospital help to sort out some of the problems that await patients when they leave hospital. Belfast-born Mrs Beth Tate was principal medical social worker for many years. Interviewed in 1971, she remarked:

Many people still think others as almoners, although the word went out of date with the start of the NHS. Almoning was the oldest social work, dating back to the Middle Ages in the priories and monasteries. Patients like to know what is happening to them. They hate to feel they are being pushed around. At the General everyone is approachable and patients can ask questions. Some patients now are startled by the short time they have to spend in hospital. New drugs cut down this day hospital stay by days.

Mrs Tate later became head social worker for the University Hospital Group.

Ward Receptionist: Mrs Grace Cree

The Ward receptionist provides a vital link between relatives and friends of patients and ward sisters. At one time there were 22 of them. They were first employed in 1966 with the aim of releasing nursing from non-nursing duties. Mrs Grace Cree was a receptionist on Mabel Player Ward. She recalls:

We had a peculiar admissions system by casualty. Each Ward had a rotor system called "Take in" where your ward must have at least four empty beds, ready for emergencies. I would have two ring all the wards and ask them if they could "sleep out" patients in various stages of recovery to get these beds empty. There was no casualty ward at that time.

One of the traditions on the Ward was the bi-annual "clean down".

All the pillows and mattresses went away for storing. The painters would move in and wash down the walls and paint when necessary. During this time we would have an inventory which meant the counting of all the crockery, cutlery and so on. All this will be laid out on the bare beds and all counted by the assistant matron and woe betide us should there be any thing missing!

Mrs Cree later moved to Gover Ford, a neurological ward where the consultant where Mr Michael Espir and Dr Richard Godwin-Austin.

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These were the best years of my life. We were indeed a family from student nurse to sister. I in fact was the "mother" to them all. Such was the atmosphere at the General, I and others felt very sad at the closing of the wards.

Recalling Christmas time, she said:

We spared nothing to decorate the wards and keep the patients happy. It was always my job to decorate the ward. Having decided on a Victorian theme one year, I borrowed a shop window model from a local shop, not realising the things screwed off at the wrists, arms, legs, torso and head! I enlisted the help of the hospital van driver. As we emerge from the list we walked into the waiting visitors with these dismembered limbs. Above Mabel Player Theatre was the sign Operation in Progress. The visitors must have thought it was a Carry On film rehearsal. It seemed that everything happened to me. A few days later, I opened the Linen room cupboard and now sliding from the top shelf became a pilot shelled on top of me.

Porters: Alfred Boardman and M W Spick

In the early 70s, the General Hospital had a portering staff of over 600 men. The head porter at that time was Mr Alfred Boardman, who joined the staff in the 1930s. Mr M W Spick, who retired in 1987 after 12 years’ service as a porter, is greatly interested in the history of the General Hospital. He researched the hospitals many sellers and caves for a manuscript prepared to coincide with the Bi-centenary. Here is one anecdote from his days as a porter.

The patient was having blood samples taken. It was proving very difficult but after 10 minutes success was achieved. By now, however, he was looking decidedly under the weather. On the way to another department he asked me if they made black puddings in the canteen. Puzzled, I replied, "No, why do you ask?" "Oh nothing," he answered. Then after a pause he said: "Then what do they do with all this blood they seem to take every half- hour!"

Catering

The adage about an army marching on the stomach equally applies to the NHS – food is very important to patients and staff. Catering has come a long way at the General since 1782 when patients receive their allowance of 14 oz of bread, and 2 ½ pints of beer a day and 4lb of meat a week. It interesting to note how hospital meals have changed in the last half-century. A hospital booklet produced in 1934 to appeal for more funds, is full of statistics. The General was then serving 3000 meals a day. It used 16cwt of bread and 860lbs of meat a week and the food order included 653 gallons of milk and 430lbs of butter a year. By 1971, at the height of the hospital's powers, the weekly shopping order was for two tons of potatoes, 900lbs of meat, 700lbs of chicken and 700 gallons of milk and 800 loaves of bread. The catering officer at that time was Miss Lucy Topham, who welcomed new dining rooms and kitchen facilities as part of the Trent Wing development, including an extra-large deep-freeze and a microwave oven. The hospital had its own butcher and Baker. The kitchen provided a full 24 hour a day service but the daily routine really swings into operation at 6am when the cooks, and duty. From 7:30am patients break since go out to the Ward and from then on the work is non-stop, preparing for the issues, teas, and suppers.

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Hospital kitchens in the Trent Wing

When interviewed, in 1971, Miss Topham said: "Patients are shown the daily menu in advance and are allowed to choose the meal they fancy. I always vowed I would not have fish and chips on the menu but if we did not, there would be complaints." In 1971 the hospital employed 25 cups, two bakers, 10 domestic supervisors, 121 domestic staff and 62 ward orderlies. The hospital Domestic Services Manager and latterly Hotel Services Manager for 14 years was Jan Chesterfield. Unit Hotel Services Manager is now Mrs Cheryl Fewkes.

Ropewalk Wing, 1973

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Domestic Services: Joyce Rudd

Joyce Rudd started at the General Hospital on 1st May 1947 when she was in charge of all the staff dining rooms. After eight years, she was appointed domestic superintendent for the hospital. "That was an important changeover when lay people took over the control of the domestic services from the nursing side," she recalls. Joyce later became district adviser for domestic services based at the City Hospital. She retired in 1988 and was particularly proud to attend the 40th birthday party for the NHS at the Queen Elizabeth II Conference Centre in Westminster.

Hospital Laundry

The work of domestic services is now very varied, involving cleaning specialist areas, as well as wards and ancillary areas. Domestic staff also have responsibility in some cases for issuing linen and putting it away and serving meals to patients. Joyce is pleased that Nottingham hospitals have in the majority of cases on their own in-house tenders. As she concludes: "Nottingham should be very proud of this. It is a reflection on the efficiency of domestic services, which is not always appreciated."

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CHAPTER 11

A DAY IN THE LIFE OF CASTLE WARD

Since 1985, the General Hospital's role has been transformed with a majority of its beds now devoted to specialist services for the elderly. But it has the personal touch. That was clearly evident from the views of patients when co-author David Lowe observed a day in the life of Castle Ward. This 19 dead slow stream rehabilitation ward was formerly an acute medical ward when the General was a busy acute hospital. It was one of six wards completely refurbished in 1983 when 85 patients moved from Sherwood Hospital. Excellent bathroom and toilet facilities were installed. Ward manager Diane Jeffs says: "The emphasis is on rehabilitation. When patients are admitted or transferred to others, our sole aim is to get them back into the community, either to go home or some form of accommodation." Patients ranged in age from their early 60s to late 90s. The average length of stay is two to three months. During that time the emphasis is on individual, informal style of care to meet each patient's needs. Sister Jeffs says: "We have a flexible way of nursing patients. Patients are individuals with individual needs. They are not a diagnosis. Elderly patients have a lot of history and experience behind them. Even if they are frail and demented they are treated with compassion and dignity." The bulk of admissions, as transfers from the Queens Medical Centre, where they are assessed by Dr John Bendall, consultant physician and senior lecturer, in health care of the elderly. Sister Jeffs says: "We don't provide acute services. So that has to be borne in mind. Our doctor cover is fairly sparse because of the pressure on acute services." The ward runs with a strong emphasis on the team approach. To ensure continuity of care, each patient is assigned a primary nurse and an associate nurse, who is responsible for that person's care during their stay in hospital. The day begins at about 6am when patients who have woken up are offered a cup of tea by the night staff – comprising one trained nurse and an untrained nurse. As Sister Jeffs explains: "Patients get up when they want to. Some elderly people often wake up early by habit. But they can stay in bed if they want to." At 7.15am the night staff handover to the day staff. From around 8.30am the team of nurses, knowing the individual needs of their patients, will begin airing up for the day ahead as patients get up at a leisurely pace. Physiotherapist Margaret Pridmore and occupational therapist Julie Napper arrives on the ward at 8.30am. Some patients will be having dressing practice before breakfast is brought onto the ward by a team of orderlies or assistant ward housekeepers. Patients have a choice of having breakfast by their beds but most opt to sit at the table. At this time domestic's arrival on the ward to clean non- patient areas. Sister Jeffs says: "Some patients need help with feeding. We try to make meals as enjoyable as possible. It is a prime part of the day. All the patients look forward to their meals." Individual programmes of care and therapy then swing into action. Some patients may go off the ward for physiotherapy or it can take place on the ward with physiotherapy helpers working alongside the physiotherapist. Other patients meanwhile may be working with the occupational therapist or have an appointment with the hairdresser. Others may spend an enjoyable time at the Patients Club – one of the first of its kind in the country. Sister in charge, Janice Peck, previously Sister of Portland Ward, is enjoying her new role in the club working in a friendly environment and seeing patients achieve new goals by interacting with one another and enjoying each other's company. The weekly entertainment height is popular with volunteers from the community giving their time to sing, dance or play the piano. The accompanying beer or sherry is a tonic too! Some group activities, such as exercise to music, bingo, indoor gardening and bowls, aimed at meeting specific needs such as promoting independence, maintaining mobility or even lending a sympathetic ear to troubled minds. The club also arranges patient holidays. In 1988, for example, six patients and six staff spent a holiday in a hotel in St Helier. It is Janice's intention at all the facilities of the Club will continue to be provided for the patients in the new units being planned for the 1990s.

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The ward can call on the services of social worker and Jackson and health visitor Mary Charlton. The pharmacist and senior house officer, Dr Sally Derrick, while the other important members of the ward team. Dr Bendall also makes as much time available as possible to talk to patients and relatives.

Ninety-one-year-old Dorothy Andrews is helped by physiotherapists Mrs Margaret Pridmore (right), and Sister Diane Jeffs (left).

By 1.15pm the afternoon shift is coming on duty and the informal caring pattern continues with all the activities and meals geared towards slowly and steadily helping patients on the road to rehabilitation. Sister Jeffs believes an important feature of the ward is that patient should have privacy. She is enthusiastic about the high standard of care provided. As she says: "I have seen tremendous changes in the four and a half years I have been here. An innovative approach is encouraged and health care of the elderly is a good and exciting speciality."

Staff Nurse Mary Orme seen taking the blood pressure of 79-year-old Jessica Fox on Castle Ward.

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But what do the patients think? Mrs Jessie Fox, 79, was a patient on Castle Ward to give her husband Charles a rest. She has considerable experience of Nottingham hospitals. "I remember being in Peel Street with a complication over my second baby. That was 50 years ago and it was very different then – very strict. I've also been in the Queens Medical Centre and the City." Referring to her four-week stay in the General, she said: "I cannot thank them enough. I don't know what we should have done without them." Mrs Fox was looking forward to going on holiday to Jersey with five other patients. Mrs Alice Maimone, 93, hails from Swansea. She can remember Queen Victoria's funeral when she was a little girl. "I've been in hospital for 14 days. I fell at home and broke my leg, for the third time. But it's getting better. I have a lovely daughter and son who are very good to me. My daughter comes to see me three times a day when I'm at home. The caring hospital has been wonderful and I cannot thank all the staff highly enough." The walls of the entrance to Frank Jacob and Castle Ward are lined with superb photographs of famous doctors and past benefactors. Also on display is the breastplate commemorating the laying of the foundation stone, discovered during the building of the Jubilee Wing. The founding fathers would be proud to know that the high ideals of service and caring are still being maintained today.

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CHAPTER 12

PATIENTS MEMOIRS

In the early 1970s, more than a quarter of a million people a year had cause to say "thank you" to Nottingham General Hospital. They included patients given emergency treatment in the Casualty Department; those undergoing a serious operation or coaxed back to health after a stroke or heart attack. It all started with £500 – the legacy left by John Key, of York, two centuries ago. By 1971 the hospital had over 500 beds and an annual budget of £1 ½ m. Since his opening, the hospital has never closed its doors, day or night. The ideals of care and service have held good for over 200 years. In this section patients recount their experiences of the General Hospital.

Mrs N M Jackson

Mrs N M Jackson, aged 91, had her first experience of the General Hospital in 1911 – as a 13-year-old girl. She was seen as an outpatients for TB neck glands and was to be admitted later for an operation. But she was never sent for. In 1916 she was admitted as emergency in Mr Hogarth's ward, suffering from appendicitis and peritonitis. She recalls:

There was no pre-op injection, just a chloroform mask. No antibiotics, or pain killer drugs. Drainage tube was inserted and I had daily dressings. It was four weeks before the tube was removed. I had bed rest for all of the six weeks I was in hospital. There was no back rest, only pillows which slipped continuously. There was no bed table. Meals were served by nurses on a plate put on one's lap and collected by nurses. There was no choice of food. It was wartime and supplies were scarce. There were no eggs until relatives brought one and the patient's name was written on! Likewise no butter for midday dinner, no soups, a little meat, rice instead of potatoes and milk puddings without sweetening. Very occasionally we had fish. Visiting days were Sunday, Wednesday and Saturday 2pm to 4pm. No bed screens, no electric blankets. Very cold linen sheets. No ambulance.

In 1917 Mrs Jackson went back into hospital for another emergency operation. She went home after five weeks and at that time she thought she had only three months to live. Over the years she had four other major operations but none of them at the General Hospital. She recalled: "Nurses had a very

128 heavy job – taking round and collecting bedpans; taking temperatures, taking and collecting meals, taking and collecting water for washing patients and daily treatment to surgical wounds." Her sister was admitted as a private patient in 1953 and Mrs Jackson noted the big difference and conditions. "There was a comfortable bed, back rest, bed table, bed curtains, good varied food and follow-up for several years after returning home. Daily visiting was also allowed."

G Walker

Mr G Walker, now aged 86, was rushed into the General Hospital in 1935 after being in collision with a motorcyclist. He suffered multiple fractures and was semiconscious, loss of blood. He recalls:

I was given until midnight to live. My wife was notified and they allowed her to see me. There was a nurse each side of my bed taking my temperature and pulse. They tried to contact a blood donor (no plasma in those days). Eventually they found one, who was told to stand by. But as I started to come round my post increased. I was taken, bed and all too little room in the corridor, where they started to operate. When I came round I was in James Foreman Ward, with an incubator over me to keep me warm. I was fed liquids through tubes. I slowly recovered and was able to take solids. I remember the surgeon Mr Crooks, house officer Mr Brown, Ward Sister Kirk, Staff Nurse Jepson, Nurse Clark, Nurse Donegue and another nurse named Clark. The doctors and nurses were in attendance every day to attend to our wants. There were no porters, the nurses did all the lifting and brought all our meals. We had what the doctors prescribed – things like eggs for breakfast and sweets we supplied ourselves. We were allowed to smoke at certain times, 7.30am and 6pm in the evening for half an hour. We were allowed to read books and papers at certain times. The nurses came at 6am to wake us up, wash our hands and faces but we were not allowed to shave. A barber came twice a week to shave and trim our hair. The ward maid dust of the cabinets and floor daily, but the nurses had to clean the floors once a week, when all beds were moved to the centre of the room. Once a week the nurses came and gave as a bed bath. I was eventually put into plaster but had to be in bed for six months. I then went home for a few weeks to return again for a further operation and spent a further six months in hospital because some of my bones would not heal. Eventually I was sent to The Cedars on Mansfield Road to recuperate and from there was sent home. But I still had to attend twice a week for infrared treatment. We had to pay for the ambulance ourselves – 4s 6d (old money). After a certain time I was taken out of plaster and was allowed to walk about with crutches.

George Duckworth 1977

George Duckworth will for ever be grateful to Nottingham General Hospital for setting him on the road to recovery after a serious road accident. George, 43, a service fitted, of Marsh Lane, Newark was rushed to Newark General Hospital in 1977 after crashing his scooter into a lorry. Doctors managed to resuscitate him and on his way to the General Hospital, the overheard a radio message about a woman's suicide attempt. "It was just incredible," he recalled, "There was I fighting for my life, while she was trying to destroy hers." George sang oral surgeon Mr Michael Bromige for restoring his face – now smooth and unmarked – which was caved in at the jaw and nose stand bruised purple and blue. He paid tribute to orthopaedic surgeons Mr Alex Morrison and Mr C J Howell for their work on his smashed leg, which after intensive treatment mended fully. He said: "These doctors just come round the ward in their smart suits and they look like city gents. But all the time they are performing miracles."

Mrs G Parr

I am sending to you a word of thanks and praise to the old General. I broke my ankle in April, 1981 and the surgeon at Queen’s Medical Centre has mended it wonderfully but the two weeks there were so noisy with the open wards and the food on plastic trays and the papier-mâché bedpans. So when after five days I came to the General it was heavenly and the steel bedpans grand – and all the staff so kind although they worked so hard. The atmosphere of the Physiotherapy Department was lovely – so quiet and relaxing. Long may the old General reign!

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Miss J Herrick

The General Hospital was my second home from 1935 until 1947 as an in-patient and attending for treatment three times a week. I well remember Dr Snell and Mr Crooks, and Mr Birkett. I was only 15 when I first went in the wards with polio after Ray Dr Edwards came to see me privately at home. The highlight was one night – I believe it was May 1943 – when the first war wounded were brought to the General and the whole staff were on duty. We were kept awake with the comings and goings to the theatre and the surgeons worked continuously to perform operations and amputations. Two or three nights later they had some entertainment in the Round Ward (Jubilee Wing) and one particular lady (I never found out who she was) sang Jerusalem and all the soldiers were joining in the choruses. It was one of my most touching moments. Within a week they were out on the lawn with visitors, but after the visitors had gone they were playing ball games in their wheelchairs. I used to go to the Massage Room as it was known then, on the Ropewalk. Sister Tribell was in charge. It was a happy place even though my mum had to push me therein back in a wheelchair during hot summers and freezing winters, but we made it three times a week – no ambulance service for us in those days.

Harry Underwood

Donkeys years ago, firms had a hospital fund into which employees paid a penny a week, entitling them to admission and treatment at the General Hospital in case of necessity. Anyone not covered by the scheme had to get a "recommend" – the form signed by a doctor, JP, vicar, accountant, or professional person. In the early 20s my Dad had to get treatment. He went to a local resident, a JP, whose first words were "Got a bob?" He would sign anyone's form for a shilling! I went to the old Casualty Department with members of the family or with neighbours. Of course it was old-fashioned, Dell, regimental but with something the Queen's will never have. Warmth is perhaps the word. In 1979 I was in University Ward when it catered mainly for short stay overnight cases such as falls and minor accidents. Mr Selwyn, dental consultant, has some eight beds divided from the main ward by a glass partition for his patients after general anaesthetic. I was there for a week, in the main ward, however, some six beds had to be kept for emergencies, drunks, the "stroppy" ones, bedlam every night. In 1977 I went into the Aural Ward for a laryngectomy – that was the men's award for ENT problems. Women were in the adjoining Princess Mary Ward, now of course the Fraser Ward for which I like to think I am partly responsible. As a member of the Community Health Council I battled along with Dr David Morgan for more beds to cope with the increasing number of cancer patients requiring radiotherapy and chemotherapy.

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CHAPTER 13

THE VOLUNTARY SPIRIT

Mrs Grace Shelton

Nottingham General Hospital can recall its part in the First World War – thanks to the discovery owner now but containing the names and photographs of many wounded soldiers who were treated there. The album was compiled by Sister Gertrude Hare, a nurse who worked at the General Hospital over the war period. Its contents are a significant – and until now a scarcely illustrated – gap in the General Hospital's history. Mrs Grace Shelton, now 95, was a Red Cross VAD nurse for about three years in the First World War. She worked on the wards and in the temporary huts put up for the wounded soldiers. Her father Mr Richard Marriot, a solicitor, was a regular subscriber to the hospital. Nurse Shelton (then Marriot, worked with Sister Hare and is proud that she and colleague Gladys Pearson were on duty the same number of hours as the regular nurses. None of the Red Cross nurses received a salary but some young women were paid one pound a week to be "pro" for the privilege of cleaning wards and helping to nurse wounded soldiers in the temporary huts. All the domestic work was done by the nurses. It was a time of "loyalty, love, hard work and happiness," said Mrs Shelton.

Nottingham General Hospital, October 1916

As soon as enough empty beds were available to cater for another hundred soldiers, the entire hospital staff and many voluntary workers prepared for the admission of a new convoy and were at hand on the moment of arrival. Convoys of soldiers would descend upon the hospital staff at any time at night or day, but always the same routine was followed. Their clothes were burned, their bodies washed, their wounds treated and their stomachs filled as quickly as possible. "It says something for the standard of nursing," said Mrs Shelton, "that although many of the soldiers were bedridden for a number of months we never had a single bed sore… Nursing is looking after the patient, not just his infections." And compassion for the patients were singularly evident in Sister Hare's nursing care. Mrs Shelton recalled how a 17-year-old youth who had managed to join the forces although he was underage, came under Sister Hare's wing. He was so severely wounded that for several months Sister Hare kept him alive on champagne! She also had a soft spot for those soldiers who opted to sleep out and about me under all weather conditions. "We used to put rubber sheeting over them to keep them warm in winter," said Mrs Shelton. "Those were the days when adversity brought out the best in people." The wounded soldiers seldom voice a word of complaint. Mrs Shelton recalled how all the consultants in those days were honorary and received no pay for their work. At that time she lived on Park Close, next door to senior surgeon Mr R.G.Hogarth. "Apart from one of our neighbours who was a parson, all the rest were doctors. It was like Harley Street," she recalled. War had demanded that younger doctors joined the forces and the General Hospital itself was left with three surgeons – Mr Anderson, Mr Morley Willis and Mr Hogarth – to carry on as consulting and operating surgeons for the civilian and military population of Nottingham.

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Mr R.G.Hogarth had been appointed to the General Hospital in 1894 when the General’s 170 beds were attended by four Residents, to receiving the fat salary of £100 a year, and the other two, juniors who got no salary at all. In his book The Trent and I Go Wandering by Mr Hogarth paints a vivid picture of Mr Anderson – "quite the most dangerous bicycle rider I ever saw" – and recalls how the three surgeons were kept exceptionally busy, in fact almost worked to "breaking point."

1915: temporary wards built on the hospital lawn to house 150 wounded soldiers.

In the average number of soldiers cared for in the General Hospital increased from 66 in the first year to 203 in the last year of the war. In April 1917 another temporary building was financed by the Government and Mr Player to provide a further 53 beds, bringing the total number of beds for troops to 263. Hogarthian tales of the time suggests that war wounds sometimes brought with them curious coincidences. Mr Hogarth relates:

A man came into hospital after the battle of Marne and I remove the shrapnel from his right leg. The leg eventually healed and the man in due course returned to the front. Some 18 months later he was again wounded – this time in exactly similar place it in the other leg. Back he came to England – into an Ambulance Train – out at Nottingham and would you believe it, finding himself once again in the same bed as he had occupied before. Same surgeon, same recovery – but different leg!

Wounded soldiers in the terrorist huts, 1915

When Miss Marriot left to get married soldiers waved their crutches and cried out "Goodbye, Marriot." They gave her a silver teapot, which she treasures. One of her daughters, Miss Winifred Shelton, trained at the General Hospital and became a senior nursing officer at the City Hospital.

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Mrs Bella Page

The memories of Mrs Bella Page stretch back to the First World War. Her father Mr William Dawson succeeded Sir Louis Pearson as Hospital chairman and he was president of the hospital in 1938-9. Mrs Page recalled during the First World War that her father was called to help when four or five soldiers were stranded in a blackout after being taken to the Empire Music Hall for a night out.

My father contacted Sheldon's the cab people on Mansfield Road. They said they dare not risk taking the horses out in the blackout. So the men pulled the carriages down to the Empire and got the wounded soldiers back to the hospital. I was only five at the time, but I vividly remember the men in their light blue uniforms with red ties.

Mrs Page said the hospital had a great team of volunteers and in particular she recalled the sterling work of Cicely Evans who ran the Red Cross Library for many years. Mrs Page also worked in the Library and was a VAD nurse during the Second World War. Her friend Mrs Marjorie Milner, a former sister at the hospital said: "We always thought VAD stood for Very Adorable Darling!"

The WRVS

WRVS involvement with the General Hospital began in 1964 when they opened a shop in the nurse’s home for the benefit of nursing staff who found it difficult to find time to get out into the city centre stores. It ran for several years providing nurses with cosmetics, sweets and toiletries. In 1966 a cafeteria was opened in the Outpatients Department to provide light refreshments, Monday to Friday from 10am to 4pm. This was for the benefit of patients attending clinics and coming for treatment. It was proved very popular and well patronised project and is still functioning though at a somewhat reduced capacity due to the transfer of some services to other hospitals. The cafeteria is run entirely by volunteers, who are asked to give three hours of their time each week. At the request of the hospital a library trolley and confectionery/toiletries trolley service began in 1984. The library trolley service operates weekly, taking a wide selection of up-to-date books, provided by the County Leisure Services, to patients on all wards. The confectionery/toiletries trolley operates three days a week, visiting all the wards, to enable patients to buy the little "extras" that help to make life more pleasant in hospital. In late 1986 a reception/refreshment project was inaugurated in the Radiotherapy Department. This project is open from Monday to Friday 9am to 4.30pm. As Joan Etheridge, Hospital Organiser for the WRVS, says: "Our members offer a friendly greeting to all patients attending this department and we provide a reviving drink. But most important of all our volunteers have time to sit and talk when a sympathetic ear is needed." The latest project is the Merrifield Tearoom, opened in September 1989, providing a change of venue and an opportunity for patients and their visitors to sit in an attractive, comfortable room and enjoy light refreshments. It is opened from 8am to 8pm. WRVS members are on duty 10am to 1pm and 2pm to 4pm serving refreshments, and at other times refreshments are available from machine. WRVS City Organiser Joan Newman explains: "As our title implies we offer a service – all our members work with that idea foremost in their minds. We are not there just pour the drinks and serve the sandwiches but to help and talk when needed, no matter how busy the project may be at the time!" Over their many years involvement with the hospital, all profits made by the various WRVS projects have been returned to the hospital as gifts. This provides items chosen by the hospital to help improve the standard of life for all connected with the hospital, from TVs and curtains for wards, to complex medical equipment totalling in all many thousands of pounds. A cheque for £6,800 was presented to the Radiotherapy Department in 1987 to help provide a vital machine and the latest donation was £4,760 to the Ear Foundation Cochlear Implant Appeal. The money was used to help buy a diagnostic and processing device, used to "tune in" and implant for three-year-old Michael Batt of Forest Town Mansfield. It will also help other children benefiting from the operation. Mrs Newman said: "We have had a long and happy partnership with the General Hospital and I trust it will continue for as long as possible."

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Nottingham General Hospital Linen Guild and League of Friends

The linen Guild was formed on 13 December, 1921 with a membership of 79 ladies. At the time of writing there is one survivor of this meeting – Mrs McCraith now Lady McCraith, who is active and well and lives in Southwell. The aim of the Linen Guild was to make and supply linen and garments and provide money for patients in the hospital. The first president was Lady Charles Bentinck and Mrs W.G. (Mabel) Player was elected chairman in a post she occupied until 1941. Subscriptions were 2s 6d (12 ½ p) a year for the provision of two garments. Associate members paid 1s (5p) a year or one garment. Garments included bed linen and towels (made of linen), night attire, operation stockings, surgeon’s gowns, socks and shifts. The first year's list of needs included 40 yards of calico and red flannel. The activities of the Linen Guild mirrored the many social and political upheavals through the ensuing years. By 1924 all the linen in the hospital was being supplied by sewing parties and these continued for many years after the formation of the NHS. Indeed exquisite embroidery raised funds for the Guild until 1988, when the last sewing party was held as age and failing eyesight overtook its elderly members. Social functions to raise funds began to flourish – in 1924 saw the first fashion show, followed in 1927 by a tea dance. Regular dances and whist drives were held in All Souls Parish Hall, The Arboretum Rooms, the Mikado cafe (Long Row) and Morley’s cafe (Wheeler Gate). By 1929 regular annual fundraising market was established and this continued until 1988 as the May Market. During the 1930s social functions became more upmarket and a series of balls were held at various large houses in the neighbourhood. These would culminate in a cooked breakfast and drive home at dawn. In 1935, a series of boxes were installed in the hospital, which proved for many years a fruitful source of income. In 1936 Lady Robinson became President and 1937 saw the arrival of the matinee dansante. The approach of war clearly rings through the records. Why, one wonders, in early 1939, was a talk on "Women's Service in wartime" deemed unsuitable? At the same time Mr W.G. Player gave £42,000 for the construction of two new wards of 20 beds each. This threw an additional burden on the Guild, to which it responded magnificently in supplying the linen needed at the opening in 1941. Great difficulty arose that this time, as materials went on ration, and precious clothing coupons had to be surrendered by the ladies of the Guild in order to buy the new materials. Social events were severely curtailed both by rationing and the blackout. Functions were arranged only in the daytime and held at the hospital. Food was limited to biscuits and little else. The Guild helped in equipping a casualty clearing station, and in launching an appeal for blood donors. The AGM in 1941 included a talk detailing the storage of radium in the sellers during air raids, and gives a prophetic look at the derelict waste central Nottingham could have become had there been a leakage of isotopes. In 1943 Matron issued a dark warning over the use of cotton as a substitute for proper linen; though worse was to follow in the late 1940s when in 1949 inferior materials of an unspecified nature were supplied to the wards. In 1944, the Duchess of Portland had succeeded Lady Robinson as President. The approach of the NHS caused great concern amongst members. There was a feeling that the demise of voluntary hospitals might signal the end of volunteers to, and the authorities did little to discourage this idea. The dissolution of the Guild was discussed, but the powerful upheavals of Dr Godber (later Sir George Godber, Chief Medical Officer to the Ministry of Health) and the Matron Miss Plucknett persuaded the meeting that this was the wrong path to pursue. At this time emphasis began to swing away from the provision of linen and close to the provision of comforts and amenities to patients, both in hospital and at home. In 1954 the Guild was addressed to the care of the TB patient at home and another speaker with the gift of prophecy, warned of the new problems emerging in the care of the elderly. It was not until 1956 that the Guild voted to join the National Association and changed its name to "The Linen Guild and League of Friends." This was obviously a subject of anguished debate, and great fears were expressed over the independence of the Guild and its funds. For the first time, men were allowed to enrol. So the Linen Guild became one of the first League of Friends in the country. Its membership rose to nearly 1000 and the scope of its work widened considerably.

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From this time there was a steady progression of fundraising events and successful projects. In 1965 the Linen Guild finance the redecoration and relighting of the Hospital Chapel. Another useful project was the direction of a wireless mast for ambulance crews to contact base in the event of a major incident on the M1! An ambulance was presented to the hospital, and the Linen Guild acted as a parent and lent its charitable status to the Stroke Appeal in its early stages. During the 1970s and number of major projects were undertaken in providing 44 new beds for two wards, re-furnishing the Outpatients Hall and the X-ray Department and the refurnishing of the nurses bedrooms in Pearson House. During the decade, comforts and amenities for patients and staff provided by the league totalled over £40,000. By the late 1970s rumours began to circulate that the opening of the QMC would lead to the closure of the General Hospital. The Linen Guild was instrumental in the very determined fight to save the hospital and by the early 1980s it seemed that the hospital had a secure future. Mrs Mark Pearson, a stalwart supporter of the Guild for many years, described members as wonderful fundraisers. This was certainly true. The bicentenary of the General Hospital coincided with the Diamond Jubilee of the Linen Guild. To commemorate these two events, the League of Friends Not Only Raised Money for the Stroke Unit Appeal, but also raised £20,000 to purchase a minibus for the hospital. The minibus containing 16 seats which can be removed for wheelchairs, has been used to provide many outings for elderly patients. It was presented to the hospital by the Lord Mayor of Nottingham in 1984. By 1987, unhappily, the old fears resurfaced, and it was apparent that the site would be closed in 1992. This had the effect of stopping the fundraising efforts of the Linen Guild. However, funds are still given to furnish wards and to provide outings and holidays for the patients. In addition, and perhaps more importantly, members still organise functions to involved and entertain patients and these activities will continue until the final closure of the site in 1992. The authors are grateful to Dr John Savage, chairman of the Linen Guild and League of Friends for writing this section. He became chairman with Mrs Betty Wardle, a great supporter of the League, retired in 1988 after six years as chairman.

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Chapel and Chaplaincy

The beautiful chapel at the General Hospital, which has brought so much peace and comfort to patients, relatives and staff, was given by Sir Charles Seely about the same time as the building of the Jubilee Wing. 15 years later it was altered and improved by the Hospital Board.

Hospital Chapel

The Rev David Stoter writes:

Over the generations the chapel has been very important to a lot of nurses. I recently conducted the Nurses League Service, when the chapel was packed with retired nurses and some current staff. For a member of the older nurses their day used to start with compulsory prayers in the chapel. The chapel is seen by many of those nurses as being the heart of the hospital and the centre of care. On the walls are many plaques in memory of matrons, surgeons and doctors and chaplains. The chapel has a very strong spiritual force. Many love the chapel very dearly. Certainly it has proved to be a place where many of the present-day patients like to come. We have regular services, particularly on Sundays and special days. The chaplaincy is a team effort providing spiritual care irrespective of people's colour, race or creed. By spiritual and I mean everything that makes a person the individual they are – their experience, beliefs and situation. We are trying to apply our faith to the modern day and integrate that with the medical and nursing care going on in the hospital. We work closely with Daphne Fenton, the voluntary services organiser and volunteers who do a lot of valuable work at the bedside. This release chaplains so they can be involved in counselling and staff support work. We have three full-time hospital chaplains and some part-time chaplains. We all have an import, plus the Roman Catholic chaplains from the Cathedral and a part-time Free Church Chaplain as well. We will be looking at all of the moves in relocating services and trying to ensure that a high standard of care continues. The embodiment of two centuries of care at the General needs to be disseminated out and carried on.

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CHAPTER 14

STROKE – THE GREAT CHALLENGE

Every year about 100,000 people in Britain suffer a stroke – the third biggest killer after cancer and heart disease. This common but disabling illness can strike without warning. Local patients benefit because Nottingham is at the forefront of developments in rehabilitation – thanks to the Stroke Research Unit, which has become known nationally and internationally since the team was formed at the General Hospital in 1983. The salaries of this multi-disciplinary team – the first of its kind in Britain – are paid for by the city’s premier medical charity, known as the Nottingham Fights Stroke Association. It is based at Tower House, adjoining the General Hospital. Indeed the General Hospital has played a key role in highlighting the need to tackle the big burden which stroke places on carers, the community and hospitals. The £250,000 appeal was launched in 1981 and the raising effort gathered momentum during the General Hospital’s Bi-centenary Year. The Chairman of the Appeal Committee was Ronald Walton, who had a very special interest in the new unit. A year before, while on holiday in Greece he woke up one morning and could hardly see out of his left eye. During the night he had suffered a mild stroke. He recalled: ‘It demonstrates the way a stroke strikes, suddenly, unexpectedly, without any pain or anything of that sort. Members of the original steering committee responsible for directing research were Dr Roy Boyd, Dr R. B. Godwin-Austin, Dr W. Jeffcoate, Professor Tony Mitchell, Dr Alan Whiteley and Mr Paul Nesbitt. The first members of the research team were Dr W deWeerdt, Mrs F. Nouri, Dr.N. Lincoln and Miss L. Smith. Dr S. Ebraham and Dr D. Baker were also involved in the development of the Stroke Unit. The present secretary to the Stroke Unit is Mrs Adele Dudley and secretary of the Nottingham Fights Stroke Association is Mrs Hazel Johnson. The Stoke Unit was conceived as a memorial to the Bi-centenary of the Nottingham General Hospital. The concept was a programme of research into the rehabilitation of stroke sufferers funded by the appeal. It was run in parallel with a specially designed ward at the General, funded by the NHS. I was not intended that patients would be admitted immediately after suffering a stroke but would be selected from local hospitals to which they had been admitted as specially suitable for treatment under the research programme.

Actress Miriam Karlin unveils a plaque to open the Stroke Unit, 1983. On the left is Mr Ronald Walton and Lord Mayor Councillor Arthur Wright with Mr Eric Poyser on the right.

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After delays, a ten-bed stroke unit was officially opened on 2nd December, 1983 by actress Miriam Karlin who unveiled a plaque in the hospital courtyard. The first co-ordinators of the stroke unit were Dr Graham Mulley and Dr Alan Whiteley and the ward was based in excellent accommodation in the Trent Wing. Central Television gave a generous donation to the appeal as a ‘thank you’ gesture for enabling a film crew to shoot sequences in the hospital’s Jubilee Wing for a scene in the drama series Shine on Harvey Moon. Among the many fund raising efforts for the appeal was a sponsored fancy dress wheelchair push, organised by the Physiotherapy Department at the Queen’s Medical Centre, which raised £1,220. The General Hospital League of Friends also donated £5,000 to the second phase of the appeal, which was launched in May 1985. The Stroke Unit in Beeston Ward, was gradually expanded to provide 15 beds for male and female patients, aged from their early 20s to late 80s.They were referred from local hospitals after a visit from a doctor. The treatment is continuous by all members of the rehabilitation team, including doctors, nurses, an occupational therapist, physiotherapist, speech therapist, a social worker, a clinical psychologist, a dietician and a pharmacist. The unit aims to help each patient achieve his/her maximum potential for recovery after a stroke and assist them to look after themselves. It also aims to teach the patient's relatives how they can help in the rehabilitation of the patient and continue their fight against the ravages of the stroke at home. Liaison nurse ensures that adequate help is available at home through the community services and discusses with families any likely difficulties after discharge from hospital. Relatives are encouraged to be involved in a patient's care on the unit and a relative’s support group is organised. Beeston Ward retained the same name and philosophy of care when the unit transferred to the City Hospital in February 1989. Meanwhile the research programme undertaken by the Nottingham Stroke Research Unit continues to be closely allied with clinical practice on the stroke ward. All the researchers – there were additions to the team in 1989 – are doing work which has direct application to the rehabilitation of stroke patients. Mr Harold Jowett, Chairman of the Nottingham Flights Stroke Association is particularly proud that the high quality of the research team's work has attracted many thousands of pounds in grants on merit against nationwide competition. Over the years, more than £500,000 has been raised. Mr Jowitt thanked the many people who have worked so hard to make the charities such a success. He also paid tribute, in the Associations first annual report, to the contribution of Professor Tony Mitchell and Dr Nadina Lincoln, coordinator of the Research Team. Mr Jowitt says:

Stroke is almost a Cinderella among those medical charities which deal with the major disabling illnesses. Misconceptions abound; stroke is by no means only an illness of old age. Only half of those who have first strokes are 75 or over. For the future, because stroke is so common and potentially disabling, there is much more work to be done. In addition to money we need more volunteers to swell the small band who sent Fusiliers has given as much good publicity and added so much to our funds.

Jeweller Michael Radford is one of the live wires behind the Nottingham Fights Stroke Association and a walking/driving testament to the work they do. In 1983 he suffered a brain haemorrhage and stroke and was told he would never walk again. Research occupational therapist Fiona Nouri referred him to Derby for special tests and driving simulation to determine his fitness to drive which he passed. I never jumped I'd be a will to drive again. The unit gave me the confidence to carry on making the effort. They gave me the strength to walk tall and have a go at life and life,’ he recalled. As well as doing all he can to help the Association, he visits patients who have suffered a stroke and is actively involved as vice-chairman of the new stroke drivers club – the first of its kind in Britain.

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CHAPTER 15

SOCIAL ACTIVITIES

In this chapter, contributors recall the magic of Christmas and other social activities at the General Hospital.

Christmas 1931 – by Nora Jacques

Ancient hostelries and tall, closely packed tenement houses still nestled at the foot of the General Hospital when we celebrated Christmas 1931.

Townspeople came uphill to visit all stay in the wards, too throng Casualty and Outpatients with the dramas of birth, death and living. The Hospital gave warmth to them; in their turn they gave warmth and life to our City’s heart. To the youngest nurses in training the spirit of Christmas came early with the ward lights streaming from the hospital building silhouetted by the crescent moon and frosty air. ‘Merry Christmas Nuss’ was the cry from the flower-seller whose cough they’d helped to ease. Homeward, along the dimly lit streets were to be ‘One of them from’t ‘Ospital’ brought greetings all the way. The route took us past places with magical names. Moot Hall, King Charles Walk, Standard Hill, Spaniel Row, Hounds and castle Gate, Friar and Walnut Tree Lanes. In the bitter cold, they also glamour in the glowing coke Brazier's of the stores where we bought our ‘fish and twopenorth’ on the night of the Ward Sisters’ Dinner and Ball. And our hospital itself? No postcard that we could to destruct homes with news of the bed for admission. Those who were well enough, but had no-one or know where to go, stayed with us, their presence helping to make Christmas a family one, as did those too ill, or still in their contraptions on the Accident Wards. All who could, helped refurbish the Fairy Dolls and make decorations. They were delighted as their Ward was transformed by many helpers, including some x-patients who came to bring as greetings. Both in the dark watches of the night and in the day, we turned often to the Christmas tree, its fairy and her softly shining lights a friendly symbol of home. In the hospital Chapel, the short nightly service for the staff coming off duty rang with sounds of carols; the Outpatients Hall was busy with rehearsals for the concert to entertain patients, staff and friends from home. Like all Christmas shows, young nurses became chorus girls and staff nurses, budding actresses. The humour from our two Irish doctors – the darlings of all hearts, whose dialogue as to old ladies having a Barney – or should it be Blarney had is laughing so much it hurt. The ladies of the Linen Guild, who worked so hard all year to raise funds to provide necessities for bedding, towels etc. Came with gifts of lovely matching dresses, jackets, trousers and cardigans for the children and babies who would have to spend the great day with us. Nottingham people, big and small local firms, helped keep the funds rolling in all year. Hospital ‘Saturday Fund’ collectors, groups who collected and gave to the Hospital foods and fruits in their seasons, came to visitors, bearing like ‘The Wise Men’ precious gifts of toys and seasonable delicacies for times were hard at that year. Christmas Eve. Kitchen staff who had laboured so hard and cheerfully making mammoth puddings and goodies, were busy putting last-minute touches before despatching to the wards. Last parcels packed, only in the shopping done, tomorrow all would be on duty all day, ensuring smooth running in emergencies, a happy day as a Family. Santa had delivered a well-filled stocking for every patient, extra for the expected emergencies who were sure to arrive in the night. Daily round done, nurses ‘on’ for the night of Christmas, we day ones collected our cloaks and a lighted lantern to go in procession around every ward, singing the best loved, requested carols. The music was played on a little folding organ that had played carols for the soldiers in the Great War – Sister treasured this instrument. We arrived first in the circular Children's Ward where are poorly babes seemed like little cherubs as we sang ‘Away in a Manger’ and Holy Child in the Crib. We wound through the awards – the word for everyone, singing their carols, the Spirit of Christmas very near and real.

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Singing over, hot Coffey and mince pies awaited us in the Outpatients Hall canteen, everyone endeavouring, as is the way of the young folk, to ensure twelve happy months. As we went to our beds in the nurses home, the Theatre lights ablaze for an emergency ‘Op’, the scent of ether and chloroform was heavy in the air. A new-born baby crying lustily – would it be Carol or Noel we wondered? Casualty full as ever this night. The accidents of industry replaced by those of a more celebratory nature. The emergencies of life with air and many who had just walked up the hill to say ‘Thank you for God Bless’ as the midnight bells heralded the birth of the little Lord Jesus. Pandemonium and had reigned in the Children's Ward when Santa's visit was revealed on Christmas morning. Greetings exchanged, breakfast over, first treatment is done and the bells of St Mary's and St Peters ringing out over the city. Christmas day had begun. In its honour, fires burned in the wards huge fireplaces. Those well enough to be up sat around them in the easy chairs. Some of the beds were wheeled to the fireplace and table end. The very ill stayed quietly, able to see but not to be disturbed by the excitement. Since early morning hospital chaplains had been carrying the Christmas message to their parishioners for Christmas time. Matron, immaculate in her long powder blue dress and flowing white visited every Ward and Department, greeted everyone and admired decorations as she ensured all the patients were as happy as possible, leaving behind a sense of well-being. Tables and bed tables were laid, cracker and favour on each one. Twelve noon the noble Turkey carried in. Carvers of the Day the Consultant Surgeons and Physicians of their Ward, amid lots of laughter.

Dr Whimster continues the tradition of the consultant carving the Christmas turkey.

This feast over, rest-time for the patients, nurses going in turns to their cold lunch where they found presents for each from Matron and the Hospital Chairman. Like the Sisters and Resident Doctors, their festive dinner would be on another day, off duty doctors helping with the servings, – mirthful experience. Rest over it was time for titivating, changing into new finery as the patients prepared for their visitors who would stay to tea. Everyone ready, eagerly waiting, who would be the first in? The children at home, Mum, Dad, young husband or wife. Boyfriend? Or Grannies sweetheart, for it was their Golden Wedding. Guesses were forgotten as the visitors arrived, deserting the household awhile to join their loved ones spending Christmas with us.

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Evening, the songs over, the daily round done, night nurse back once more, we returned to the Nurses’ Home and bed, content with the giving and receiving of great comradeship. The people of Nottingham also enjoyed Christmas around our hospital which they loved and supported as it belonged to them.

Staff, students and friends bring the festive spirit to the Radiotherapy Department.

The Last Hospital Ball

The last Hospital Ball, one of the principal events in the county’s social calendar, was on 16th December, 1938. It was held at University College and the Nottingham Journal described ‘the swirl of melody and a blaze of colour as some 700 dancers took to the floor.’ Both the Great and the Lower Hall were used for dancing. The Refectory became a supper room and the lower corridor of the University buildings were used for buffets and loungers. As Frank Jacob reflected: ‘So ends the last Ball, the last remains of the old glory of the Anniversary Festival. For next year we were at war – and since the war food restrictions have prevented its revival.

Christmas in the 40s by P Roebuck

When I first worked at the General Hospital in 1946 it existed on Saturday flag days. I received the sum of £2.19s for 48 hours a week. More than anything I remember Christmas time and how marvellous it was. Each patient was allowed 5s (25p) for a Christmas box from the hospital. I was a ward orderly at the time and Sister and I used to go all over town for weeks looking for suitable presents. I used to go to Marsden’s on Milton Street and they donated cakes, sausage rolls and pork pies to feed the whole ward. The pleasure of decorating the ward. I never had a Christmas Day or Boxing Day off for ten years but it was a pleasure. At 12 o’clock the surgeons or doctors used to come to the ward to carve the turkey and help serve the dinners. We too had a fine Christmas when just like the Army all the doctors and sisters used to wait on us (including auxiliary staff). After the dinner we all trooped over to the Outpatients Hall where we danced until midnight, but sadly all this altered after 1948 when we were nationalised.

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Christmas Protest

A decision to separate the doctors from the sisters at the 1970 Christmas dinner and dance at Nottingham General Hospital sparked off a protest from the angry Sisters. For the event – to which the sisters had been inviting their doctor friends for nearly 30 years – had been the highlight of the year. One said: ‘we don’t mind what we pay for a dinner. It’s the entertainment that counts. And without the doctors it will fall flat.’ The secretary Mr Stuart Vere said that the event had been cancelled because it was ‘physically impossible to fit all guests at the Outpatients’ hall, where it was held.’

Dinner dance, 1960s

Mrs. Elizabeth Swales

I remember the Special Christmas Days for the patients when the Consultants and their families came to help serve the Christmas dinner and entertain the patients. Even in wartime a special tea was provided for the visitors. The staff Christmas dinners were served a few days after Christmas on a rota system. In summer there were tennis matches and special teas. The Nurses Social Club organised outing for swimming cycling and rambling. Occasionally we organised dances for wartime charities.

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CHAPTER 16

FIGHT TO SAVE THE GENERAL AND BICENTENARY CELEBRATIONS

The role of the General Hospital has greatly changed since the opening of University Hospital in 1978. The new complex was visited by the Queen, who named it Queen’s medical Centre, incorporating a fully integrated district general hospital and a Medical School At its gravest hour in 1980, the General Hospital looked doomed to closure but public opinion refused to let the grand old hospital die. Staff collected 20,000 signatures for a protest petition after it was disclosed that the General would gradually be run down to enable Phase Two of the Queen’s Medical Centre to open. Health workers asked; ‘How can it be right to close down the General, especially when the Trent Wing was only opened in 1972?’ An action committee was formed and they lobbied the then Health Minister Dr Gerard Vaughan when he visited Nottingham in 1980. They explained how strongly they felt about closure of a hospital, which was two years short of two centuries of care.

Save the General Hospital Campaign Badge

The League of Friends also vigorously supported the fight, arguing closure would lead to a worsening health service for people in the area. The League’s then Chairman Mrs H. Holliwell said: ‘The General Hospital has a long tradition of the highest standard of nursing care. Massive investment has recently gone into upgrading its facilities. The latest in a long line of proposals being put before the Area Health Authority would result in the old, much-loved hospital, standing high above Nottingham’s city centre, ending up with just 56 beds in two wards in use together with the pay bed wing, plus a number of out-patients departments. At that time the General – including the Eye Hospital and pay bed wing – had 465 beds in use. A total of 121 surgical and orthopaedic beds closed when Neil Ward and the Jubilee Wing were mothballed in 1979. But the authority had already given assurances that every effort would be made to use the full resources available in both Nottingham’s University and General Hospital to ‘the best advantage of medical endeavour.’ And the report added: The feeling within Nottingham that the General Hospital’s facilities and long history of services should not go to waste is fully understood.’ By February 1983, after lengthy and complex negotiations, the authority was able to issue a draft statement spelling out a secure future for the General. Radiotherapy in-patient and out-patient services would remain at the General and top priority would be given to expanding and improving services for the elderly. The target bed complement would be about 200 and a 20-bed stroke unit would open 1983-4. The hearing service centre, breast screening unit, special clinic, dental department, public mortuary and some out-patients’ and support services would continue at the General. In spite of worries about the hospital’s future, the bi-centenary celebrations proved a great success. Lionel Joyce, then deputy sector administrator and secretary of the organising committee recalled a talk he gave to the Mechanics Institute: ‘I was absolutely overwhelmed by the strength of feeling about the General Hospital. People were saying; ‘This is our hospital and we paid for it.’ The Committee sought to resuscitate that spirit for a year. Mr Joyce declared: ‘I am going ahead on the basis that the General definitely has a future.’

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The first event in the bi-centenary programme was a service held in the hospital courtyard on 12 February, 1981 to commemorate the laying of the foundation stone 200 years previously. A commemorative plaque was unveiled – an exact replica of the inscribed brass plate, which had been buried underneath the foundation stone in 1781.

Service of commemoration, the reading was given by Mr. D. Mackay, Hospital Administrator, taken from Philippians, Chapter 4 verses 8 to 9:

“Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things.”

The bi-centenary year was launched on 18 September, 1981 – 199 years to the day since the first patients arrived at the hospital – with a civic reception. About 250 people attended the function at the Council House. Guests included representatives from each department, past members of staff and also representatives from organisations associated with the General Hospital. The Lord Mayor Councillor John Arnold paid tribute to the dedication of the staff. Mr. Eric Poyser, the then chairman of the Area Health Authority said: ‘The hospital is blessed with a wonderful staff.’ He felt the hospitals’ role would change in the future to concentrate on the rehabilitation of patients. Other events included a concert at the Albert Hall given by the Frankfurt Radio Symphony Orchestra and an aids for the disabled exhibition and an arts competition organised by occupational therapists in the South Nottingham District and Social Services. A scrubber’s ball, organised by the Domestic Department at the Sherwood Rooms, revived a tradition which had lapsed for several years, and the Medical Records department organised a fancy dress bi-centenary disco. Clarendon College arranged a programme of events, including an art exhibition and classical concerts to coincide with the bi-centenary celebrations. Clarendon College students also baked a bi- centenary cake. A toast to the Nottingham General Hospital was proposed during a bi-centenary ball at the Sherwood Rooms and local dignitaries, firms and organisations gathered at the Council House for the official launching of the Stroke Unit Appeal on 28 April, 1982.

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Chas ‘n Dave appeared at a Theatre Royal Concert organised by Radio Trent which raised £4,200 towards equipment for the Children’s Hearing Assessment Centre. One of the interesting events was an exhibition of photographs, medical equipment and other artefacts, past and present held in Anderson Ward. The event was opened by Mr J. F. Sheehan, a distinguished former surgeon and senior consultant at the hospital. The exhibition gave a glimpse of the General Hospital and of the advances in medical science and practice over 200 years. Among the exhibits on display were surgical instruments used by Joseph Thompson who began his career at the young age of 15 by serving a five year apprenticeship with the surgeons and apothecaries at the General Hospital. He eventually became honorary surgeon in 1889. The items were presented to the General Hospital by Joseph Thompson’s grandson and granddaughter Mr A. Thompson and Miss D. Thompson of the Ropewalk.

Museum of medical equipment

Nottingham Nurses League helped finance a reunion of former hospital staff, in the Outpatients’ Hall attended by 150 people the Linen Guild and League of Friends organised a bi- centenary market, which raised £1,300 for the Stroke Unit Appeal. The English Sinfonia and Nottingham Harmonic Choir held a Beethoven Concert as a special tribute by the City Council to the hospital. Perhaps the most memorable event of the General Hospital’s bi-centenary was the re- enactment on 15 September, 1982 of the original opening in 1782. The day began with a grand 600- strong procession from the General Hospital to St. Mary’s Church via the Old Market Square. It was led by the Regimental Band of the 4th and 7th Royal Dragoon Guards. To the rear was a bi-centenary banner carried by members of the hospital staff dressed in eighteenth century uniforms. The banner was followed by members of staff from each department, representatives of other Nottingham hospitals, and officers of Nottingham Health Authority, members of the Bi-centenary Organising and Appeal Committees, as well as representatives of the police, fire brigade and ambulance services, trade unions, the Linen Guild and League of Friends, the WRVS and other voluntary workers and the Nurses’ League. The procession retracing the steps, as far as possible, of the original route, also included civic and ecclesiastical dignitaries. As in 1782, the ceremony did not proceed exactly according to plan. The procession moved off with members of the clergy still in the General Hospital still changing into their vestments. Finding themselves left behind, the church leaders had to scuttle at rather undignified pace to catch up! At the end of the procession, there was a Service of Thanksgiving at St Mary’s Church. Present and former members of the hospital staff and friends of the hospital were first to enter the church. Music was provided by the Band of the South Nottinghamshire Hussars T.A.

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Later, the Nottingham Hospitals Choir entered the Church in procession, followed by the arrival of civic dignitaries and Members of Parliament, headed by the Lord Mayor, Councillor Peter Burgess, the Sheriff, Councillor The Rev. John Pennington and the Chief Executive of Nottingham. St Mary’s Choir then entered the church, followed by the ecclesiastical procession, led by the Archbishop of York. The service commenced with the Bidding given by the Vicar of St Mary’s Church, Canon M. J. Jackson, and Prayers of Thanksgiving led by the Rev John Slow, Moderator of Nottingham United Reformed Churches. Nottingham Hospitals Choir sang ‘I was Glad’ an anthem by Sir Hebert Parry and Benjamin Britten’s ‘Jubilate Deo’ was sung by St Mary’s Choir. Readings were given by The Rev Denis Wakeling, Bishop of Southwell and by The Rt Rev James McGuinness, Bishop of Nottingham. Prayers of Intercession and Rededication were led by The Rev David Stoter, the Hospital Chaplain, and an Address and Blessing were given by the Very Rev Dr Stuart Blanch, Archbishop of York. The service ended with the singing of the National Anthem. Staff and invited guests then returned to the hospital where a buffet lunch was provided. Afterwards, a tour of the wards was arranged for the ecclesiastical dignitaries to meet patients and staff. A charity ice spectacular at Nottingham Ice Stadium on 17 October, 1982 included a special performance by Jayne Torvill and Christopher Dean. The annual civic ball at the Council House was dedicated to the hospitals bi-centenary and a specially commissioned entertainment entitled What’s Up Doc? Devised by Evening Post theatre critic Emrys Bryson was performed at a charity gala evening at Nottingham Playhouse on 31 October. The cat comprised Malcolm Sinclair, Noele Gordon, Dulcie Gray, Richard Digby Day, Gregory Doran, Renee Anderson and Viviaenne Ross. The Playhouse was completely packed and a highly enjoyable evening raised £3,537 for the Stoke Unit Appeal. Another event which captured the public imagination was an exhibition of the Prince and Princess of wales’ Royal Wedding gifts at Pearson House on 7 January, 1983. Meanwhile the fight to save the General Hospital was stepped up with health unions announcing their ‘total opposition’ in May, 1984 to proposals to run down the site.

Commemorative Bi-Centenary Glass Tankard

The then District Administrator Brian Blisset confirmed the possibility of selling most of the buildings on the outer area of the hospital to bring forward the relocation of radiotherapy services at the City Hospital. Key elements of the plans included the use of six wards in the Trent Wing and four wards in the Medical Wing for geriatric, elderly, mentally ill and stroke patients. All authority-owned property on the Ropewalk, with the exception of the Dental department would be vacated and sold, and a review would take place of other buildings on the main hospital site. The Action Committee to Save the General Hospital responded by accusing Nottingham Health Authority of acting with ‘unseemly haste’ to condense or pull down most of the hospital. But the General retained an important role in radiotherapy, medical physics and outpatients and became a leader in health care of the elderly, severely mentally ill patients transferred from the

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Coppice Hospital in 1984 to converted accommodation in the Trent Wing. The wards were renamed Orchard and Hastings after their former ‘homes.’ A new club, capturing the atmosphere of a 1930s-style pub, opened where elderly confused patients could sip a sherry or enjoy a beer – and draw on past memories to keep alive their interest in the past. Another memorable event in 1985 was the visit of ballet stars from Sadler’s Wells to stimulate long stay patients. Soloist Jenny Jackson picked out nursing director Peter Fox to walk her round on her points. She assured him later that she’d had worse partners. In 1986 the pioneering Ballantyne Ward for elderly women patients who need special rehabilitation after suffering fractures transferred from Highbury Hospital to the General. And the continuing long term future of the hospital seemed assured when the Trent Region gave the green light for a £1.3m development in August 1986. This involved a new day hospital and converting accommodation in the Trent Wing to re-locate 48 long stay elderly patients from Saxondale Hospital. But at the end of 1988 health chiefs briefed 700 staff about moves to reconsider the future of Nottingham General Hospital. A full scale review of the hospital’s viability was ordered. On 15 April, 1988 it was announced that W. G. Player Ward would close because of structural faults in the flooring. On 22 September, 1988 a vital estate strategy report was presented to the Nottingham Health Authority. One of the recommendations was the closure by the early 1990s of the General Hospital, which was costing about £6m a year to run, plus another £1m for lighting and heating. There was support for the principle of selling the site and reinvesting the proceeds in a new and more appropriate accommodation. The Evening Post Comment article described the plan as a sensible solution. But it concluded: ‘We must ensure the spirit of love and care, so much in evidence at the General Hospital, will not be lost in the move to new locations.’

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CHAPTER 17

FUTURE SERVICES

By Unit General Manager, Philip Hogarth

What does the future now hold for the General Hospital, both the buildings and the services that remain there in 1990? Many of the buildings on the site are now over 200 years old. Because of the large numbers of transfers of services that took place in the early 1980s when the University Hospital opened, there is now a large infrastructure supporting a much reduced number of in-patient and outpatient services. The development of services on the site over the last 200 years or so has left an inheritance of a complex, sprawling group of buildings, corridors and departments that are confusing to both patients and visitors alike and create numerous difficulties for staff working in them. It also means that a lot of the site does not meet the increasing demands and standards imposed on buildings in the health sector. Health and safety regulations covering fire precautions, control of asbestos, food hygiene, and prevention of Legionnaires Disease all pose on the General |Hospital a need to invest large amounts of money to bring the buildings up to the required standards. At the same time, the supporting engineering plant and equipment is now near or beyond the end of its useful life. In 1988, the health Authority published its proposals for rationalising a number of the buildings and sites it owned in Nottingham. Amongst these, was the general Hospital should close, with a target date at the end of 1992. This would allow the site to be sold with the proceeds being pushed back into the achievement of the Authority’s overall strategy for health services. The plan envisaged that all acute medical services should be based at one of the two district general hospitals in Nottingham - the University and City Hospitals – with non-acute residential and day hospital services being based in a network of ‘local centres’. Earlier decisions had already been made on the transfer of certain major departments including radiotherapy and genito-urinary (more commonly known as the Special Clinic) departments. Planning for these is now being brought into line with the new timetable and both departments will transfer to new accommodation at the City Hospital by the end of 1992. The remaining Care of the Elderly wards are now planned to move from the General to local centres within the same period, and detailed planning is now underway to transfer the dental and hearing service departments to the University Hospital. One of the results of the public consultation was that it was agreed to be desirable that a number of the services do not need to be on district hospital sites but need to be in a readily accessible, preferably city centre, site, to enable easy access by the general public. These include the out-patient physiotherapy service, breast screening, and the headquarters for the Community Unit, including speech therapy and clinical psychology. One of the options for housing these facilities is to retain part of the General Hospital site, possibly the existing Ropewalk Wing, but a final decision has yet not been made by the Health Authority. Once health services have been moved off the site to new locations, the Health Authority will be free to sell the buildings and land. It is obviously in the Health Authority’s interest to ensure that it obtains the maximum return from this sale, and therefore there have been detailed discussions with the local planning authority and possible local developers. The site is obviously an important one within Nottingham City centre, and will offer considerable opportunities but also considerable enthusiasm for using the site to enhance tourism for Nottingham, given its close proximity to the historic Nottingham Castle. There is no doubt, whatever its future; it will continue to be an important and active part of the Nottingham community – perhaps for the next 200 years!

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CHAPER 18

FUTURE USE OF THE SITE

In 1989, Mrs Grace Cree wrote to the Evening Post to ask: ‘In view of the proposed closure of the General Hospital, why can’t the outer portion be retained as a hospital museum?’ She described the hospital chapel as unique and argued that the site adjacent to the castle would be a tourist attraction. Mrs Cree added:

During my work at the General as a ward receptionist, I discovered a wealth of potential. When new cupboards were fitted I found an old bible, dating from the early 1880s. I handed it to the librarian who was amazed it could have lain there in an old cupboard for so long. The visitors to the Castle and the new Robin Hood Centre would only have to turn the corner. Don’t let us loose our lovely General altogether. Old equipment and beds could be easily displayed. There are quite a lot of old pictures and plaques from bed donors, such as the Player family and Shipstones Brewery – plus many more wealth Nottingham families.

When plans to demolished part of the General Hospital complex, including the Jubilee Wing, were first disclosed in 1981, immediate concern was expressed by conservationists. The Jubilee Wing, built in 1897 by Alfred Waterhouse, who was responsible for the elaborate Prudential building on King Street and Queen’s Street, which contains the city’s housing department, is an excellent example of Victorian architecture.

Artist’s impression of the re-developed General Hospital Site.

Professor Tony Mitchell, Foundation Professor of Medicine at Nottingham University, author of the booklet on the Nottingham hospitals, Vice-Chairman of the Nottingham Civic Society and a keen conservationist, was asked for his opinion on what should happen to the General Hospital after the closure in 1992. Would he like to see any parts of the hospital preserved?

The Eye Hospital has already been preserved, having been turned into the headquarters of the Nottinghamshire Family Practitioner Committee. I don’t think anyone one would go to the stake to preserve the Pay Bed Wing or the Ropewalk Wing and that probably applies right the way down Park Row where the little Georgian houses start. So I would have thought there is a big site there available for appropriate development. The houses on the West side of the Ropewalk backing on to Park Terrace and Thornton House, I think they will be secure in their own right. They are listed anyway and in a conservation area. Moving down, the multi-storey car park on Park Row is an absolute monstrosity that was forced on us by traffic and parking policies of the City Council. We had to knock down some quite nice Georgian houses, including the original hospital shop to put up that thing.

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The Jacoby Fever Hospital and the Ransom Building will probably have to go, I guess, as well the John Storer Clinic and Postgraduate Centre. But what about the Bridge of Sighs with the statues and the T.C. Hine bits? They are much more difficult.

Professor Mitchell certainly thinks the round Waterhouse wards of the Jubilee Wing have potential for being turned into a medical history museum.

Demolition of the Trent Wing

The Park Row façade of the main building which was once the accident wing could all go. You could then strip back to the original 1780s building with the T.C. Hine extension, get rid of the Trent Wing, leave the nurses’ home and Jubilee Wing and get rid of anything in between. The difficulty over the re-use of the Jubilee Wing concerns fire precautions. But it is an interesting building. I would have thought the Civic Society element might say the 1780’s building, with the T.C. Hine extension, the Jubilee Wards, the Nurses Memorial Home, and the houses around Standard House, Thornton House

Re-development of the Jubilee Wing

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Medical writer and author Stephen Morris is also enthusiastic about retaining some part of the General as a museum. He has already helped to establish a doctor’s surgery at the Brewhouse Yard Museum. He was taking his daughter around the museum in 1983 when he discovered that curator Suella Postles had space in the street of shops she was setting up. So Stephen researched and designed a surgery and dispensary and fitted it out in an authentic style of the 1919-39 period. All the instruments on view came from his uncle’s attic – and everything else is authentic. He said: ‘I would very much like to see part of the General preserved and it would link up very well with the Brewhouse Museum. ‘It would be absolutely ideal and is something I would fully support.’ Such a scheme would serve as a lasting reminder of the General’s great contribution to health care in Nottingham.

Former Jubilee Wing Ward, now an open-plan office

Perhaps the spirit of the General is best summed up by Dr. Frank H Jacob, honorary consultant to the hospital for many years. He wrote an inscription on the fly leaf of a copy of his book in Matron’s office it reads:

To love sick folk and to love helping them. To give a friendly welcome to our fellow- travellers on the road of life.

These are the ideals of all those who work in and for hospitals.

And these are the ideal which the General Hospital has been proud to maintain

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APPENDIX 1

WHAT WAS SO SPECIAL ABOUT THE NOTTINGHAM GENERAL HOSPITAL?

By Paul R. Swift B.A.

Honorary Archivist, Nottingham University Hospitals N.H.S. Trust

To all former members of staff and to members of the public who frequented its many portals; as more than twenty years have passed since its closure, the question I ask: ‘What was so special about a collection of grade two listed buildings on the fringes of the Park Estate that was once the Nottingham General Hospital?’ What was it about the place when during its bicentenary celebrations in 1982 the word hospital closure was mentioned, did members of staff and public fight a campaign that persuaded those in authority to keep the place open, at least for a little longer? Also why is there a tendency to reminisce about the old place as representative of some golden age, when it’s many generations of consultants, matrons, and managers were God fearing, and when opinions of those in authority were respected and never challenged? To begin answering this question, although the General Hospital complex looked totally out of place to house modern healthcare facilities, could it be that at heart we are all sentimentalists. In other words, is it that we love old buildings rather in the same way as we love steam engines? Although physical reminders still remain and have been scoured of all the elements, what is it about standing in the same spot where the Trent Wing once stood that can hold those who were its employee’s in a trance as memories of the old place come flooding back? Could it be that the General Hospital was special because of its convenience? Were we as its patients, visitors and employees spoilt by its location - right in the heart of Nottingham? Take as an example the convenience of the hospital’s Casualty Department; no inconvenient hike across town to the Q.M.C., just one bus journey, taxi fare or dare I say ambulance ride to the top of Park Row. For its employees too there was the convenience of shopping in town during lunchtime. No need to expend your precious hour walking all the way to the Victoria or Broad Marsh Centre’s, just a short walk down Park Row to the Co-op on Upper Parliament Street or to the shops adorning Chapel Bar and the West End Arcade. It is interesting to note, since the closure of the General Hospital all those small shops and businesses outlets including the Co-op have all long since gone.

People may accuse me of describing the former Nottingham General Hospital as something utopian, that isn’t so. A hospital, weather as a member of staff or public, is a place where the emotions of happiness and sadness come in equal measures. The General was just like any other hospital, some days were good whilst others not so. What separated the General from all other hospitals, especially its neighbour across the other side of town, the City Hospital, when the General was opened on September 18th 1782, it was always a hospital. In other words, it began life as a hospital and remained so until its closure in 1993. Unlike the City Hospital that began life as a Poor Law ‘Institution.’ As regards to its seniority, it could be said the City Hospital is older by 57 years, as it can trace its historical roots to 1725 to a Workhouse on York Street, when in actual fact the City Hospital we know today was opened on March 18 1903. What also separated the General from the City Hospital was that the General was established entirely on private and charitable donations, whereas the City was founded on government legislation. Consequently, many of its presidents were members of the aristocracy; people like Lord Middleton who lived in Wollaton Hall and the Duke of Newcastle who lived in the present day Nottingham Castle, and who, during the hospitals construction, donated an acre of land. Apart from the association of members of the aristocracy, it also attracted local industrialists as well. These were industrialists like Sir Jesse Boot and Sir Thomas Shipstone and of course the Player family.

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It was the Player family that provided the funding for many extensions to Nottingham’s Hospitals. Giving money not just to the General Hospital but to the former Women’s Hospital on Peel Street and the former Children’s Hospital at Forest House as well. Apart from its charitable status, what also gave the hospital its air of regality was that its consultants were given the jealously guarded title of honorary.

The air of regality that the General portrayed extended itself to local business directories as well. In an official pre-1939 Nottingham Handbook under the title of ‘Principle Hospitals’ it says:

‘Nottingham General Hospital stands on Standard Hill, and owes its foundations to public munificence towards the close of the eighteenth century. It commenced its work of mercy in 1782, and its buildings have been frequently enlarged since then to cope with increased appeals for its services.’

It goes on to say:

‘The hospital depends largely upon subscriptions, donations and legacies and the income from a small capital investment. In addition to the resident medical staff, a large honorary staff of physicians and consultants attend daily to see out-patents.

This grand narrative of ‘public munificence’ and ‘its work of mercy’, comes in stark contrast to the one sentence devoted to the Nottingham City Hospital, that goes on to say:

‘CITY HOSPITAL – A large well appointed general hospital of 985 beds, formerly the Poor Law Infirmary, but now undertaking every type of medical and surgical work for all classes in the community.’

When contrasting the two very different descriptions, one can now begin to see the esteem the General Hospital was held in. With charitable donations being its main source of income, before the inception of the N.H.S. in 1948, hospitals similar to the General were referred to as ‘Voluntary Hospitals.’ In essence, voluntary hospitals were the most prestigious; they aimed to provide quality of care to a number of patients. They were generally well managed and had the ability to choose their staff and maintain discipline.

Finally, and to encapsulate all that has been written, what made the General so special; firstly it was its pre-1948 voluntary status that gave it its air of superiority, secondly the General Hospital represented an age of deference; an age which was more formal, where rank and status were treated with equal amounts of respect. Thirdly, and like our love of old buildings and steam engines, the General Hospital represented a kinder world that revolved at a much slower pace than it does today.

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APPENDIX 2

MATRONS OF THE GENERAL HOSPITAL

1782 – 1821: Miss A. Richardson, Miss E Beardsley 1821 – 1831: Miss M. Bell 1831 – 1846: Miss L. Langton 1846 – 1858: Miss Stevenson 1858 – 1868: Miss Oldershaw 1868 – 1871: Miss Pedgrift 1871 – 1873: Miss Gregory 1873 – 1879: Miss Spragge 1879 – 1892: Miss A. Rimmington 1892 – 1918: Miss G. Knight 1918 – 1924: Miss H. M. Kendall 1924 – 1941: Miss. I. Liddle 1941 – 1958: Miss M. C. Plucknett 1958 – 1970: Miss R. M. Ross 1971 – 1972: Miss G. W. Hayre

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APPENDIX 3

MANAGEMENT OF NOTTINGHAM GENERAL HOSPITAL

MONTHLY BOARD:

Until 1948, The Nottingham General Hospital was governed by the Monthly Board. The hospital’s 165th annual report lists the officers for the years 1947. President: L. Col. N. Gervis Pearson, DSO, MC. Vice-President: W. G. Player, Trustees: R. Hon. Lord Trent, William Dawson, Lt. Col. N. Gervis Pearson, J. Ashley Player, W. G. Player. Monthly Board: Chairman: Lt. Col. N. Gervis Pearson. Vice-Chairman: William Dawson. Sir Louis Pearson was Chairman of the Monthly Board 1942 – 1944. Lt. Col. N. Gervis Pearson was Chairman of the Monthly Board 1944 – 1947.

UNDER THE SHEFFIELD REGIONAL HOSPITAL BOARD, 1948 – 74

Chairman: Sir Basil Gibson CBE, JP. 1947 – 1956 Sir Albert Martin, CBE. 1956 – 1968 Ald. S.P. King OBE, JP. 1969 – 1974

Nottingham No. 1 Hospital Management Committee

Chairman: Lt. Col. N. Gervis Pearson, DSO, MC. 1948 – 1958 Mr H. Lister Holliwell, 1960 – 1969

Nottingham University Hospital Management Committee, 1969 – 1974 Chairman: Mr D. L. Evans

UNDER THE RENT REGIONAL HEALTH AUTHORITY Chairman: Sir Sydney King, OBE, JP, 1973 – 1982 Sir Michael Carlisle 1982 –

Nottinghamshire Area Health Authority (Teaching), 1974 – 1982 Chairman: Mr D. L. Evans, CBE, JP, 1974 – 1977 Mr R.A. Wilson, 1977 – 1979 Mr E. S. Poyser, JP, 1979 – 1982

The General Hospital was administrated as part of the South Nottingham District (Teaching) of the Nottinghamshire Area Health Authority (Teaching).

Nottingham Area Health Authority, 1982 – Chairman: Mr E. S. Poyser, JP, 1982 – 1986 Mr D.L. White, 1986 –

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APPENDIX 4

LIST OF SENIOR MEDICAL STAFF 1782 – 1948

Honorary Physicians and Honorary Surgeons and Honorary Aural Surgeons Assistant Physicians Assistant Surgeons A.R. Tweedie J. Davison J. Hollis H. Bell-Tawse S. White T. Wright E.J.G. Glass J. Storer J. Rigsby H.B. Lieberman T. Smith J. Attenburrow R.A. Marshall W. Mardsen J. Wright I.A.M. McLeod C. Pennington W. Wright A. Young J. Clark H. Oldknow A. Manson G.M. Wright Honorary Anaesthetists H. Payne H.C. Attenburrow M. Hall B. Eddison T.B. Gilbert-Smith J.M. Davison T. Wright R.W. Herrick G. Howitt J. Thompson T.W. Smart R.S. Hutchinson J. White I.R. Spark J.C. Williams J. Littlewood A. Gordon C. Storer J. Bedard J.C. Buckley W. Gill A.C. Taylor K.S. Crawford W. H. Ranson H.O.Taylor W.T. Robertson A.R. Anderson Pathologists B. Morris J. Thompson J.O. Brookhouse R. Chicken J.K. Clark H. Handford R.G. Hogarth E.A. Horne W.B. Ransom W.M. Willis C.H. Cattle C.H. Allen Radiotherapists F.H. Jacob W.F. Neil W.T. Rowe A.M. Webber G.C.D. Evans J.W. Scott F.C. Greg F.H. Cross H.S. Wallace F. Crooks W. Crawford J.L. Davis Honorary Assistant J. C. Buckley F.C. Hunt Orthopaedic Surgeon S. Gill J. Swan P.H. O’Donovan J.F. Sheehan A.N. Birkett J.D. Proctor J.H. Brownlee W. S. Whimster T.B. Field R.J. Twort Honorary Dental Surgeons Honorary Radiologists H. Blandy R.A.C. Rigby G.W. Harris J. Battersby W.J. Mowat R.J. Glaister F.M. Gordon T.G. Battersby

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APPENDIX 5

LIST OF SENIOR MEDICAL STAFF 1948 – 1988

The authors faced formidable difficulties in attempting to compile a list of senior medical staff who have served the Nottingham General Hospital since the formation of the National Health Service. Since 1948 there have been no published annual lists of consultant staff. So our list has been obtained from the yearly “medical directories” and some former colleagues’ memories. It is as complete as we can make it but some names may have been inadvertently omitted. The inclusion of a name may not always indicate that the doctor concerned has consultant status. Not all the doctors mentioned had their clinical commitment at the General Hospital.

Accident and Emergency Dental Surgery J.R. Hampton (Casualty) M. Atkinson R.J. Glaister R.B. Tattershall D.J. Henry T.G. Battersby R.E. Knight S.L. Ireland General Surgery P.A.M. Weston T. Taylor S.H. Davis D.G. Gould F. Crooks P. Selwyn J.L. Davis Anaesthesia M.R. Bromige F.C. Hunt M. Campbell-Wilson J.H. Brownlee I.R. Spark W.M. Gray A. Gordon Dermatology E.Z.B. Masterman J.C. Buckley T.B. Field K.S. Crawford A.D. Frazer J.F. Sheehan M.E. Webb D.I. McCallum J. Swan W.D. Munro E.N.M. Johnson H.H. Renyard J.P. Kwella P.E.Kilby D.W. Daly A.F. Roper P.O.C. Kinmont J.D. Hardcastle H.N. Chambers B.R. Allen G. S. Makin M.J. Eggington A.N. Fawcett T.E.J. Healy Gentio-Urinary Medicine B.R. Hopkinson D. Leivers C.A.S. Pegg G.D. Flowerdew J.B. Bittiner J.B. Bourke A.K. Bannister R. Stratham J.Doran P. Ford C.J. Bignell J.M. McCormack Health Care of the Elderly J.R. Armstrong General Medicine R.J. Coultas T.H.D. Arie W. Hain P.H. O’Donovan S.K. Mukherjee T.J. Hawkins J.D. Proctor A.M. Trueman S.Z. Hussain W.S. Whimster R.M. Kupfer P.F. Tatham R.J. Twort R.B. Boyd B.A. Waldron R.G. Evans M.J. Bendall M.J. Harrison J.M. Macfie N.K.G. Smith A.D. Jardine M.V. Wells A.J. Byrne P.J. Toghill Neurology S. Makin M.J.S. Langman C.J. Bowley J.R.A. Mitchell M.L.E. Espir R.M. Jones M.S. Knapp R.B. Godwin-Austen J.P.J. Curran S.P.Allison D. Jefferson A.M. Whiteley

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Neurosurgery G.F.M. Hall J.G.M. Howat A Kertesz K.A. Fitzpatrick G.S. Clarke-Maxwell B. Jones D.C. Gill J.C. Taylor B. Lawson M.J. Harris E.M.P. Ball Obstetrics & Gynaecology J.B. Foote Radiology D.R. Ryrie P.T. Edington J.S.P. Jones W.J. Mowat A.W. Maxwell R.E. Cotton F.M. Gordon T.E. Blecher C.H. Wood Ophthalmology P.G. Smith E.J.S. Townsend A.E. French R. Levy J.H. Young J.L. Dyson A.H. Morris H. Goldsmith G. Walker A.F. Barrett N.P.R. Galloway P.D. James E.J. Roebuck G. Gordon-Napier P.A.E. Jones D.R. Knapp A.H. Booth I.M.P. Dawson P.G. Small G.E. Robinson A. Stevens B.S. Worthington H. Fraser A.M. MacKay S.S. Amar S.N.M. Rizk H. Ngan D. Knight-Jones Plastic Surgery J.B. Preston N.P. Galloway H.M. Price S.M. Haworth M.H. Kinmonth R.H.S. Gregson D. Wynn-Williams Orthopaedic-Surgery M. Deane Radiotherapy

A.N. Birkett Psychiatry F.H. Cross J.B. Campbell F.M. Benton S.A.S. Malkin A.D.M. Douglas W.D. Fraser A.B. Morrison H. Fisher G. Jarratt J.P. Jackson T.R. Forsythe M. Sokal W. Waugh W.L. Jones P.F. Wale H.J. McKim-Thomas J.S. McGregor D.A.L. Morgan N.J. Barton D. Macmillan A.D. Fraser R.C. Mulholland W.W. Roberts E.M. Bessell C.J. Colton W. Fabisch C.J. Howell C. Rose Rheumatology and G.F. Milligan M.J. Craft Rehabilitation Medicine J.K. Webb Z. Finkelstien H. Merskey S.A. James Otolaryngology (Ear, Nose G.D. Banks A.J. Swannell and Throat Surgery) L.C. Hurst D.H. Bossingham Z. Fenton E.J.G. Glass E. Arkle Thoracic Surgery I.A.M. Macleod T.J.N. Bates A.R.A. Marshall E.G. Gordon W. Buckley A.Young E.G. Oram J.S.A. Linton J.F. Neil G.M. Woodis R.C. Barclay T.B. Hogarth G.M. Baird F.D. Salama K.E. Thomas A. Minto W.E. Morgan K.B. Gibbin J.E. Cooper P.J. Bradley D.A. Toms Urology R.R.A. Coles (Medical) I.B. Pearson M. Collieson P.Bates Pathology A. Aveline W.M. Gray R.J. Turner A.E. Kulatilake E.A. Horne P.J. Tyrer M. Dunn H.M. Rice R.K. Baruah

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APPENDIX 6

BIBLIOGRAPHY AND PICTURE CREDITS

Many references have been used in preparing this history. The authors gratefully acknowledge the following sources:

A History of the General Hospital by Frank H. Jacob, printed by John Wright and Sons, of Bristol, in 1951, and published by Simpkin Marshall Ltd. Nottingham’s Hospital by J.R.A. Mitchell, published by the Nottingham Civic Society. Nottingham General Hospital, 1782 – 1900 by Suzanne Heeley, published by The Nottinghamshire Historian, Issue No 41, 1988. One Hundred Years of Nottingham Life: The Centenary Lectures delivered at The University of Nottingham, 1981. Nottingham General Hospital, a special Nottingham Evening Post publication to mark the 40th anniversary of the NHS in 1988. Nottingham General Hospital, a booklet published by Nottingham University Hospital Management Committee. Victorian Nottingham, A Story in Picture, Volume 13, by Richard Iliffe and Wilfred Baguley, published by the Nottingham Historical Film Unit. The Development of Orthopaedics in the Nottinghamshire Area by William Waugh, 1987. Distributed by the Department of Orthopaedic and Accident Surgery, University of Nottingham. Harlow Wood Orthopaedic Hospital, Golden Jubilee 1929 – 1979. The Story of Medicine by Vernon Colman (Hale). At Your Service, an information booklet published in 1969-70 by Nottingham No 1 Hospital Management Committee. Bagthorpe to the City, Story of the Nottingham Hospital, James Macfie. Nottingham and Midland Eye Infirmary, Annual Reports, 1868-1889

Picture Credits

Photographic and Illustrations used in this book were from a number of sources. Every endeavour has been made to obtain permission to reproduce copyright material by apology is offered to any whose rights may have been inadvertently infringed.

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