Isle of Wight Hospitals - A History of the Isle Of Wight Hospitals ~ NHS: The Hospitals

A History of the Isle Of Wight Hospitals by E. F. Laidlaw

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NHS: The Hospitals

The Royal Isle of Wight County Hospital

Ryde Hospital was always handicapped in its development by lack of space into which it could expand. It was, and is, bounded on three sides by roads, any space on the fourth, south side, being limited to a narrowing wedge as two roads, Swanmore Road and West Street converge. The nurses home built in a very pleasant garden had good space around it, but was too far away to serve for any extension of the main hospital, although near enough to be convenient as a nurses' home.

A house in Swanmore Road, adjacent to the hospital, was bought by the H.M.C. and served for an extension of the X-ray Department, with a flat upstairs for a resident doctor; and later a second adjacent house allowed further extension; but to get more space, accommodation had to be found in nearby Partlands Avenue. Ultimately, three houses in line were required; these three were joined by covered corridors and served as a physiotherapy centre for Ryde. When a new Nurse Training School came into operation at St. Mary's the training school at Ryde closed, but that house was added to the ancillary departments of the hospital. The upstairs of these houses provided a flat for the resident medical staff, a nurse's flat and accommodation for ambulance staff; all these, like the physiotherapy centre itself, were connected to the hospital switchboard.

Ryde Hospital continued throughout this phase and indeed until 1990 to provide the main Accident and Emergency Department; the problem for the administration was to make this separate from the Out-patient Department, - which in the first place had shared accommodation with it; the Out-patient entrance at that time had been in Milligan Street and in the masonry above the closed door, one can still make out the words 'Out-patient Entrance'. Plans for a new Out-patient Department and for improvement of the Casualty Department were produced in 1950. Before that, hutted accommodation for out-patients had been considered. Now, however, some rooms occupied hitherto by nursing staff on the north side of the ground floor were converted into an Out-patient Department and about the same time rooms in the front of the hospital, which had been part of the resident staff quarters, were re-arranged, giving an entrance hall and a sitting-dining room for consultants on the south side of the main entrance. On the north side was the telephone switchboard and beyond that the dispensary, later called the pharmacy.

About this time the hospital was invited and agreed to take over the work of the old Ryde dispensary, which for several years now had been situated close to the hospital in the angle between Swanmore Road and West Street, now the Ryde headquarters of the Red Cross.

Work on the new Out-patient Department and the construction of an entrance to it from West Street and also the upgrading of the Casualty Department continued until 1957; during this time also, the hot water system for the hospital was renovated and cubiculising (or later cubicularisation!) of the wards was begun. Meanwhile the ground floor of the Milligan Convalescent Home was taken over as the headquarters of the Records Department and as a Secretary's office; and on the first floor there was a dining-room for the nursing staff, also used for some other purposes, including for a time, meetings of the Medical Advisory Committee. Further improvements in the Out-patient Department were to come in 1960.

From time to time, the minutes of the Hospital Management Committee and the County Hospital House Committee mention a roof garden at Ryde, proposed and possibly planned; I have been unable to find anyone who recalls the real thing and I do not think it can ever have come into being. In 1972-73 the X-ray Department was further enlarged and the Casualty Department, now known as the Accident and Emergency Department, was also re-designed and improved. In-filling of the available space around the Out-patient Department provided more consulting rooms and offices for medical secretaries and others and a way was made through from the Out-patient Department to the Records Office and the rest of the old Milligan Block. The old lift, built about the beginning of the First World War, needed replacement and a new one was built, the old shaft providing space for new storage cupboards.

Private work had always been carried out at the County Hospital to a modest extent and at the start of the N.H.S. two categories of private wards were generally allowed to be used in hospitals; single wards, and amenity beds which would be small wards with two or three patients only. At Ryde there were eight and later nine single wards in the building named in memory of a former Treasurer and Chairman, Aubrey Wickham; these were on the first floor at the north end of the hospital, more or less over the Casualty Department and where formerly had been the wards for infectious diseases. They were available for private patients, but it was always agreed that in case of necessity, for whatever precise reason, a single room might be taken for other patients, and this was occasionally put into practice; for example, when boys had to admitted from the Borstal Institute; this principle prevailed both before an after the National Health Service. It maybe mentioned here that small number of private beds were also available in Shanklin Cottage Hospital and at the Frank James Hospital. There were never any at St. Mary's despite repeated requests that there should be a few, especially in the Obstetric Department.

St. Mary's Hospital

At the start of the N.H.S. there was still a Lay Superintendent or Master, Mr Bennett, at St. Mary's who had authority over and responsibility for the non medical and non-nursing components of the hospital as well as Forest House his assistant, Mr. Hunt remained for a time after he retired, and became the assistant to Mr. J. Keech who was appointed Hospital Secretary to St. Mary's in 1950. From the start, and indeed for several years before 1948 it had been recognised that St. Mary's would have to be the site of the principal general hospital on the Island. This was propounded by the C.M.O., Dr Fairley in 1944 and was reiterated from time to time. The idea was of course challenged by the medical staff at Ryde, but I think that after 1948 there was never any serious doubt in anyone's mind about it. However, several years later when it came to actual planning of the new district hospital the consultants collectively proposed that the Whitecroft site should be preferred for development and they pressed the point with some enthusiasm; their opinion, however, was unsupported by the H.M.C. or the Regional Board and was quickly rejected by the Ministry.

It may be of interest hereto recall a much earlier suggestion of an alternative site for the development of the Island's hospitals. In 1928, when Ryde Hospital committee was looking for more room, Sir Guise Morris suggested that Ryde Hospital should be abandoned, and a new hospital set up on the Westwood Estate, on the North side of Lushington Hill. This suggestion was immediately rejected, but it is diverting to speculate for a moment on the idea: the estate, which then may have reached east-west roughly from top to bottom of Lushington Hill and north-south from Lushington Hill to Brock's Copse Lane: would have been large enough for the whole hospital complex: it was central - near both Ryde, Newport and East Cowes and not that far from Cowes; and it was close to the ferries at East Cowes and Fishbourne. It might have made a quite considerable difference to the whole evolution of the Island.

In the early days of the N.H.S. the wards at St. Mary's were given names of different villages or districts on the Island, and Womens' Institutes in these localities undertook to adopt the wards and to take a special interest in them.

There were two exceptions to these names. The first, Rookwood Ward was 'adopted' by the prison staff at Parkhurst. The name 'Rookwood' was an authorised euphemism for Parkhurst Prison, rather in the same way that 'Forest House' was adopted as an alternative name to the Workhouse; it meant that letters could be written or reference made to residence without using the term Parkhurst Prison; this was how Rookwood Ward acquired its name, which remains. The second case later in the hospital's history was Hassall Ward named after the founder of the Royal National Hospital at Ventnor, this ward to some extent taking the place of the R.N.H. after it was closed.

Before it could function as an adequate general hospital, many additions and alterations were needed, and all were aware of this: requests, demands and plans were made by the Regional Board, the Hospital Management Committee and the Medical Advisory Committee from 1949 onwards; but money for building was always limited and until much later and in a different phase of the hospital's life, it was more or less accepted that additions had to be provided piecemeal; and the pressure of needs together with limitation of the funds led, from time to time, to curious plans which happily were abandoned before they were seriously worked out; - such was the Regional Board's plan in 1968 to have all general medicine and surgery at St. Mary's and to use Ryde for Ophthalmology, E.N.T. surgery, and Geriatrics.

When the district hospital was eventually planned, on paper, the Regional Board suggested that the Lower or South Hospital should be demolished, the geriatric patients accommodated there being moved to the North Hospital! The first date given for the completion of the new hospital was 1971!

The first new building at St. Mary's was the one-storey Out-patient department and X-ray room north of the porter's lodge; these were available in 1950 and were soon extended to include rooms for a chest clinic; over the years there were many additions to this building, partly in the form of Portakabins and partly by rather more permanent buildings.

The amount of work required in the chest clinic declined gradually and its rooms were usedat times for physiotherapy, for dentistry and for radiotherapy.

The records department obtained a more permanent and enlarged foothold there in the 1970s and the X-ray department was considerably enlarged. An earlier improvement had been the building of a new waiting hall for out-patients separating them from casualties, together with three further sets of consulting rooms which gave accommodation for the increasing number of clinics held there.

The hospital pharmacy, or dispensary as it was at first called, was at the start housed in a hut attached to the Upper Hospital; during 1952 the need for enlargement was obvious and a 'prefab' building was put up on the north side of the drive opposite St. Catherine's Ward and served right up to the opening of the new St. Mary's. An extension of this building provided three flats for resident doctors and another flat above the old lodge was similarly used for a time; throughout the years of the H.M.C. this porter's lodge housed the switchboard; the rooms extending eastward from the lodge, originally intended for the reception of patients being admitted to the H of I, were used as offices for the hospital secretary, his assistant and his clerk and the Social Services and for a time the Lady Almoner attached to the hospital.

The increase in nursing staff of course led to a need for more residential accommodation; at the start nurses had resident quarters in the middle block of the Upper Hospital on its upper floors; the southern wing provided a flat at first for the matron, later for the assistant matron, and some offices; the north wing which lay over the nurses' dining room and the kitchens for the Upper Hospital provided quarters for sisters and nurses. In the Lower Hospital (or H of 1) rooms were provided over the boardroom and the east end of the main building was now used as a nurse training school. In 1952 a new nurses' home was built, a long one-storey building looking south-east, to the east of the Upper Hospital, providing rooms for about twenty nurses. This building of course is still in use, though not for nurses.

Later the nurse training school was established at St. Mary's, - a new building below this nurses' home with lecture rooms, library, laboratory, etc. and this was opened by Lord Louis Mountbatten, in 1969 - who gave it the name of the 'Royal Isle of Wight School of Nursing'; also a further nurses' home was built below the training school, as mentioned above.

In the early years of the H.M.C. all the wards at St. Mary's were heated, and hot water supplied, from individual coke ovens and boilers for each ward. The boiler house lying to the east of the Lower Hospital near the gate in from Dodnor Lane supplied heating for the main Lower Hospital buildings and steam for the laundry and the kitchen there.

The existing boiler had been installed about 1920 and Bill Shepard has given an entertaining account and picture of how it was hauled up from the quay to the hospital. Now over about two decades the heating system was brought up to date. Two new oil-fired boilers semi-automatically controlled were installed in place of the old one and the heating and steam extended to the whole of the Upper Hospital as well as to the outlying parts of the Lower Hospital, the Out-patient department, etc.

Much had to be done for the Upper Hospital especially for those wards which had regularly to accept emergency admissions, and for the theatre, the layout and ancillary rooms for which had to be extended and modernised. In 1959 there was still no lift for the upper wards, which housed all the medical patients; all patients unable to walk upstairs had to be carried up. During 1960 a major scheme of upgrading was undertaken for the medical and surgical wards, familiarly known as Upper B and Lower B; a lift was provided in the centre block of the hospital and the whole of the four wards were to some degree modernised and their toilet facilities improved. This work lasted over some months and during that time the medical wards were moved down to one of the separate blocks on the west sideof the Lower Hospital which had been vacated when the mentally handicapped women and girls moved from St. Mary's to Longford. These were old fashioned buildings, one ward occupying two floors with about 30 beds. Each floor was divided into a number of rooms, there was no lift, all patients and meals had to be carried upstairs; there was one bathroom on the ground floor; to provide an adequate medical service over a period of several months on such a ward must have been extremely difficult.

Once this work was completed, the medical and surgical wards were far better able to deal with the emergency and planned admissions which were required; about this time too a medical registrar was appointed for the first time.

The Regional Board had not originally contemplated having to provide any ward or beds to take the place of the R.N.H. when it closed; it was, I think, supposed that the few cases of Tuberculosis which still required hospital care might be sent to Portsmouth, and other provision was not necessary.

However statistics revealed that over the decade a significant number of Island patients had been occupying beds there, and that loss of all these beds would leave the service seriously impaired. After several plans had been considered, a new ward to the west of the Upper Hospital and linked to it by a covered corridor was built with 28 beds. This ward was at the time the most modern in the Island hospitals and was built on what was then called the racetrack principle.

It included eight single wards, two double and four 4-bedded, which gave scope for accommodating special groups of patients, - e.g. those with Tuberculosis or other infections. The wards were around the periphery of the building, and bathrooms, storage rooms, clinical rooms - including a small theatre where bronchoscopies and later other endoscopic procedures could be done - were in the centre of the block; these central rooms were lighted by top lights, the corridor roof being about 18 inches lower than the central and peripheral rooms. They had oxygen and suction laid on to each bed. The disadvantage of the plan was that from the nurses' station in the centre of the ward at best only two out of 28 patients could be seen.

This ward was occupied on April 15th 1964 and officially opened by Mark Woodnut, M.P. shortly after this; he named it Hassall Ward commemorating the founder of the R.N.H.

Another separate new ward - Barton Ward - was built at St. Mary's soon after this, to the south of the main hospital, with 30 beds, for men and women intended for the Geriatric service; it was opened in 1967 by Mrs Barton, acouncillor and member of the H.M.C., who had for a long time interested herself in provision for old people; - the Chairman remarking that if there had not been a parish on the Island named Barton we should have had to create one.

Before it was occupied it was allocated not to the Geriatric Department but to the Obstetric service, the existing Obstetric ward being in urgent need of upgrading; labour wards and a small operating theatre were provided in the single rooms of Barton Ward and this occupation continued for about a year, - the ward then becoming available for its original purpose, an admission and assessment ward for the Geriatric service.

About this time a small chapel was built just to the east of Barton Ward; it was available for all denominations. This new chapel had two small stained glass windows which had been removed from the chapel of the Royal National Hospital when it was demolished. Like Barton Ward it had a short life. They were both among the first casualties when the new hospital was built.

The next important building at St. Mary's was the Postgraduate Medical Centre. Continuing instruction and education for practising doctors had by now become a well recognised need; opportunity to keep in touch with new practices which develop so much more rapidly now than they did earlier; and every hospital group was now expected to provide a centre where lectures, seminars, tutorials and discussions could take place, and where there would be a good library giving access to a reasonable selection of medical journals and books. Some pioneer work in this line had been done by the Isle of Wight Medical Club which was started in the 1930s by a group of doctors, some G.P.s and some working in hospitals, who met once a month, at first in their own and each other's houses, and later in one or other hospital, to hear someone talk on a subject of interest and to discuss it. Accommodation limited the numbers of doctors who could participate, and the club for several years restricted its membership to 30; but this left out an increasing number and by the end of the 1950s it was agreed that the club must be opened for all doctors practising on the Island; it has to be confessed with regret that lady doctors were for some years excluded, a decision to admit them deferred because a single adverse vote sufficed to defeat the proposition that they should be invited to join!

Some attempts at further meetings had been made earlier; the local branch of the B.M.A. arranged three excellent lectures at intervals, one year in the 1950s, and after the new Out-patient Departments were opened in Ryde and in Newport, Doctor Harland, as Postgraduate Clinical Tutor, arranged a meeting once a month at these hospitals alternately, at which cases were discussed and demonstrated; but it was not until the Postgraduate Medical Centre was opened by Lord Rosenheim, President of the Royal College of Physicians, in October 1966, that the club had a really adequate meeting place, - and its meetings were before long replaced by regular weekly clinical meetings at mid-day on one day of the week, arranged by the clinical tutors, with a speaker, sometimes from the Island staff, often from the mainland, especially from Portsmouth or Southampton. The cost of this new centre was paid in part by the doctors, all the hospital consultants and many General Practitioners contributing. A handsome pastiche 'the Birds' was presented to the centre by the artists who created it - Daisy Krishmanna and Elisabeth Greene: it hung there for about 25 years, before being moved to the new Hospital where it will be seen by more passers-by.

The X-ray Department in the Out-patient building as mentioned was substantially enlarged and modernised and a second consultant appointed; but it was still necessary for all in-patients who required X-ray examination to go down to the Out-patient building, many of them of course had to be taken down by stretcher or in a wheelchair. An accessory X-ray room and equipment was now provided, the room built filling in a gap on the south side of the corridor leading to the theatre and to the two small wards associated with it.

The new kitchens and dining room (or restaurant), built on the north-east side of the hospital and reached by a long corridor from the Upper Hospital, were opened in 1973 and were associated with a new style of delivering meals to the wards. Hitherto, meals had been served on the wards having been taken to them in hot-lock cabinets; there were separate kitchens for Upper and Lower Hospitals and adequate serving kitchens on each ward; once good trolleys were available which would plug in to the mains supply on reaching their destination, it was generally possible for food to be kept properly heated up to the moment of serving. This was the old style. In the new system all meals were served in the kitchen itself and taken on covered plates in trolleys, kept hot, to the wards.

Each system has, perhaps, its good points and its less good. Ideally with the old system the ward Sister served each patient; she knew her patients and gave each one what she judged he or she would like, would need, or be able to manage; the serving of the main meal of the day was often something of a nodal point in the day's programme and a minor but important ceremony; in the Brompton Hospital where I worked as a junior for a year, it was sometimes dubbed by the (often Irish) nurses 'High Mass'. The new system lost all that. Helpings were of standard size when delivered and those who served them saw no more of them, never knowing whether they were consumed or wasted. The trolleys designed for indoor corridors (albeit long ones) found the going difficult up and down the paths leading from the Upper to the Lower Hospitals and round many corners; and at first spillages occurred; and the deliveries took a surprisingly long time so that the meals in different wards had to be staggered over a period of an hour, which was sometimes inconvenient in other ways.

The new kitchens were able to produce and serve meals for the whole hospital, patients, staff and visitors, and the staff dining room became a popular meeting place for meals and a convenient one for informal meetings after post-prandial coffee, etc. Included in new buildings were offices for the catering supervisor and dietitian, stores, changing rooms, etc. This new department, like some others, was to have only a rather short life of no more than about twenty years before it was replaced by the new hospital; it has become in part a linen store and in part serves other purposes.

Further over to the east side of the grounds, a new store was provided; hitherto the hospital stores had been squeezed into the wing which had been previously the hospital chapel; or into the basement; or wherever else room could be found; for example, in the old barn near the back gate onto Dodnor Lane. The new store must have been a great improvement for the engineering, building and maintenance departments and it also provided good accommodation for the central sterile supplies; a new telephone exchange was provided adjacent to the store, - moved from the porter's lodge where it had been since 1949.

On the north side of the open square, formed by the new dining room and kitchen block on the west and the stores on the east, was the new Pathology laboratory. Up until nearly this time one Consultant Pathologist had worked alone on the Island with his staff; the department was, as it always had been, associated with the Pathology service in Portsmouth, and some of the routine work was done there; also, as mentioned, a small department functioned in the Royal National Hospital up to the time of its closure; and visiting technicians held clinics in Shanklin at the Arthur Webster Institute and in East Cowes at the Frank James Hospital; but most of the work was done at Ryde or at St. Mary's. Now the new department was intended to provide adequate accommodation for all types of Pathology at St. Mary's; but the laboratory at Ryde remained open and, so long as a large proportion of both in-patient and out-patient remained there, work continued at Ryde as there was obvious need for it; moreover the new department at St. Mary's had soon to be enlarged by the addition of Portakabins.

Resident medical staff had increased in numbers and, for the registrars, three small houses were built, - the first by the then main entrance, - Apple Gate, - and two later ones off Dodnor Lane, Almond-Gate and Cherry-Gate.

New nurses' homes had been built, but it was the custom among nurses at the time to live out rather than in; consequently there was accommodation to spare and the upper floor of the old nurses' quarters, in the middle of the main hospital, was for a time converted into quarters for a Houseman.

When the relief road for Newport/Cowes was built, the hospital had to surrender a large corner of its ground, as already mentioned; the cricket field had from 1950 onwards been used as a helicopter landing pad; the hospital was in fact the first in the country to make use of the helicopter service; later after this field was reduced in size helicopters landed on the sloping field below the nurses' home, where just now a new landing pad has been marked out. A further part of the cricket field was taken about 1978 for the building of the Geriatric Day Hospital.

Another new building was the hospital Social Club which since then has remained a popular and much used centre for social activities for the staff.

With all the new building, the human side was not forgotten; visiting hours in the early days had been extremely limited: so late as 1949, for example, visiting in the childrens' ward (at Ryde) had been limited to one hour a week on Sundays, for parents only. Now in 1968, the committee decided on unrestricted visiting in all wards, with some limitations in childrens' and surgical wards. Sadly, this led to unanticipated difficulties: some relations and friends mistakenly thought that they would only show proper concern by remaining by the patient's bedside, or chairside, for long hours; that their anxiety for the patient's progress would be deemed commensurate with the length of their stay: and some, it must be said, were prepared to use the ward's day-room as avicarious television lounge. After a few months, visiting had to be limited to 5.00 p.m. - 8.00 p.m. or 2.00 p.m. - 8.00 p.m. on Sundays, with sisters being given discretion to impose restrictions locally.

Whitecroft Hospital

At the start of the N.H.S. Whitecroft was acknowledged to be overcrowds this remained the case and was attributed especially to the large number of elderly patients, and in 1953 there was consideration of building an annexe for 76 beds to house some of these patients, and also of a 'Mental Deficiency Unit of 84 patients; it was first suggested that this should be in a ten acre area (Hungry Hill) within the grounds of Whitecroft; it was also proposed at one time to purchase Gatcombe House as a convalescent home for mental patients: neither of these schemes went any further.

The annual report in 1955 mentioned that of 271 admissions during that year, 73.8% were voluntary; there were 42 deaths, of which 36 were in patients over 65. The report refers to Out-patient clinics at Ryde, St. Mary's, Frank James and Whitecroft and to E.C.T. Out-patient clinics at Whitecroft; also to domiciliary visits.

The next year, Longford Sanatorium became available and a transfer of women and girls from St. Mary's was soon arranged; the commissioners of the Board of Control, reporting that year, approved the use of the Catherine Bowen Home for 16 girls; they commented on the shortage of nursing staff at Whitecroft, - a national problem - where there were then 37 male and 26 female nurses plus 10 part-time women, 9 students and 8 ward orderlies at night; they gave a favourable report upon the amenities and general management of the hospital; later that year the annual report for Whitecroft mentions the hope of converting farm buildings into geriatric accommodation. It was in this year that an additional consultant was appointed at Whitecroft. The building of a 'mental colony' off Dodnor Lane close to St. Mary's had been another of the earliest projects considered by the H.M.C. though obviously it never came to fruition; another plan was the establishment of a central laundry at Whitecroft which did come about.

A rather different, unexpected, question arose in 1957, namely the legality of patients at Whitecroft serving as beaters; presumably local shooting parties patronised by or joined by the staff needed such assistance; the opinion of the Board's Legal Adviser was sought, and was non-committal!

Throughout this phase, as before, many residents at Whitecroft and in the mentally defective wards at St. Mary's worked in the hospitals. Four-fifths of the patients in Whitwell Ward in St. Mary's did work of some sort there, receiving five shillings weekly plus a half to one ounce of tobacco or cigarettes or sweets. Men worked in the gardens or on the farms while they existed; and women worked in the laundry or in the hospital.

In July 1958 a particularly troublesome strain of Staphylococcus aureus ('phage 80) was causing concern at Whitecroft; it was deemed advisable to empty one large ward so it could be cleaned and fumigated; 45 patients were transferred to the Royal National Hospital and a few others to Fairlee and others were housed temporarily in the large hall at Whitecroft.

In March 1959 Thompson House was opened, taking patients back from the R.N.H. and a number from St. Mary's; named after the late Alderman Thompson who had been associated with Whitecroft for 38 years. The wards at Whitecroft had been given names, - the Medical Superintendent was invited to choose the names and had selected national poets and explorers; in 1960 reception wards were created partly by the change of use for the Superintendent's quarters; the training schools and occupational therapy departments were improved and in 1963 a chapel was dedicated. The two new wards in Thompson House were given the up-to-date names of Neil Armstrong and T.S. Eliot.

By 1968 the closure of Whitecroft was in the air, - a working party advised the building of a mental health centre and short stay beds at St. Mary's, - not to await the building of the district hospital; and in the following year some progress was made in transferring elderly patients from the hospital to residential homes. Old fashioned treatments were being abandoned; four padded rooms were abolished, - one remained but unlocked; and new forms of treatment were being adopted which would themselves in time become outdated. An anaesthetist visited regularly for a time to assist at electro- convulsion treatment, and for at least two years Mr. Wylie McCissock from the Atkinson-Morley Hospital visited to carry out Frontal Leucotomy for a few patients; for this purpose the theatre at St. Mary's was used. In 1971 the position of Medical Superintendent was abandoned, Doctor McBryde who had replaced Doctor Gordon-Brown in 1966 remained as one of three consultants; the next year the psychiatrists decided they could give the best service if the Island were divided into three sectors, each consultant accepting responsibility for one sector. The Island like all Gaul was duly quartered into three halves and the arrangement continues at the present.

Frank James Hospital

Throughout the Health Service, the rule was that hospital beds were allocated to consultants who had the right and obligation to admit and discharge patients; every patient must be, at least nominally, under the care of a consultant, who must accept responsibility; this was straightforward enough in general hospitals; in the Cottage Hospitals such as Frank James it necessitated a certain change in style. The General Practitioners however continued to staff the hospital as they had before and to share the on-call duties; if they wished to admit one of their own patients, this had to be done by agreement with the appropriate consultant whose name appeared on their notes; alternatively patients from the locality who found themselves in one of the general hospitals might be transferred, given a vacancy, to the Cottage Hospital, and there attended by their own doctor, while nominally under the care of the consultant who admitted them in the first place.

In fact the paucity of operating theatres in the group led to the Frank James very soon being used in part to supplement the surgical accommodation; regular operating lists were done there in E.N.T. work as already mentioned, by Dr Crosskey in the first place; in general surgery, in Orthopaedic surgery, and in Gynaecology; and inevitably a good deal of ward space was taken up by these patients and the number of beds available for local patients admitted, at the request of the local doctors, diminished. In 1964 a childrens' ward, which I think was, sometimes at least, referred to as Carat Ward, in recognition of the many services and contributions made by Mr. E.G. Carnt, was taken over as a Gynaecological ward.

Nurses and domestic staff had originally been resident with rooms on the upper floor; by the 1970s, there as elsewhere, most nurses and domestics lived out and space was available for other purposes. A psychotherapy unit was opened in 1972, using part of the upper floor and conducted by Dr Ian Thomson for several years.

To complete the story of the Frank James, in October 1976, the hospital was temporarily closed for refurbishment and re-opened in March 1977 when a decision was made that casualty facilities should no longer be available, and in 1988, as the N.H.S. prepared for further economies, and as the imminent opening of the new St. Mary's called for review of the Health Authority's institutions, that Frank James Hospital should be kept open and should be developed as a community hospital; and this was further considered in a consultancy document in 1990. The mens' ward, in particular, was remodelled to give a number of small wards.

Then in 1992 Geriatric patients from T.S. Eliot Ward which was closed were transferred to the Frank James Hospital.

Recently the building formerly used as a mortuary has been converted into a small chapel available for all creeds and denominations; and the two small stained glass windows which were originally in the chapel of the Royal National Hospital and later moved to the short-lived chapel at St. Mary's have now been installed there.

Shanklin Hospitals

Shanklin Cottage Hospital, like the Frank James, besides providing some beds for the local population continued to play an important part in the surgical services for the whole Island. A wing had been built providing eight private or amenity beds; besides these there were six beds kept for children, - usually a weekly list of tonsillectomies; and eight or nine others for medical or surgical patients; surgery included general surgical, orthopaedic and gynaecological lists, done generally by one of the General Practitioners with qualifications and experience. The small wards were re-decorated and re-arranged and a small glass fronted day room was provided.

As the years went on there was much concern and discussion about the future use of the hospital; the demand throughout this time was especially for beds for the elderly sick, and the feeling was that when medical cases were admitted they usually came in that category, and that such patients were unlikely to be discharged unless after a long wait they were transferred to the Geriatric Wards; consequently there was a very small turnover of patients. The declared intention was to retain the hospital as a local community or General Practitioner hospital; lack of adequate funds made it impossible to fulfil this plan, and the hospital was closed with the intention, or at least the hope, of re-opening it in time; but sadly a fire seems to have put an end to this hope.

At the Arthur Webster Institute sessions were held on five days a week for physiotherapy, and an orthopaedic surgeon attended twice weekly. A consultant in psychology held one clinic a week and the psychiatric social worker attended there on three evenings and a speech therapist once a week. And there was a dental surgery there and a social club for patients; finally the buildings provide a garage for the Ambulance Service; there was a caretaker's flat until 1982 when as part of an 'economy drive' it was felt that a caretaker was no longer necessary.