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

printer icon

NHS:The Health Authorities

The final meeting of the H.M.C. was early in 1974 and the initial meeting of the Area Health Authority in March that year; the Chairman, Mrs. Thelma Margham and the Vice Chairman, Admiral J.L. Blackham and several other members of the Authority had been members of the H.M.C., which was now abolished and replaced by Area and District Health Authorities; and the administration of the Public Health Department, - Medical, Nursing, Midwifery Health Visiting, and Ancillary Departments, shifted from the Local Authority to the Health Authorities. The Regional Authorities remained.

It was originally intended that the Island should be managed by a District Authority which would be subordinate to an Area Health Authority, that would include Portsmouth and Southampton; it was, however, believed on the Island that no matter how fair the intentions of the managing bodies, our rural population of about 120,000 would have very little say and very low priority with the two massive populations on the other side of the Solent; representations had been made however, for the independence of the Island and were, much to the relief of the Island Authorities, accepted; and the Island H.A. remained on its own and answerable to the region, not becoming what must have been a very small component of a very large authority across the water.

Possibly the successful campaign for the Island to remain a separate county, eagerly desired and enthusiastically celebrated at County Hall, was one factor in the decision, since one objective of the new administration was that Area Health and Local Government authorities should be co-terminous.

The years of 1974 to 1992 were a time of increase in all directions; there were more nurses, though all too often not nearly enough, more doctors, senior and junior, (lots) more administrators, more money and more buildings; with the rising population more patients and especially more elderly patients; more clinics, more physiotherapists, occupational therapists, speech therapists, chiropodists, radiographers, laboratory scientists, pharmacists, secretaries, clerks, accountants, - where does the list end? There were perhaps no more gardeners, no more cooks and no more porters, without the intention of belittling in the smallest way the important service of these categories.

At the outset Francis Eade retired and Mr. J. Parker became the Area Administrator; G.F. Hardy continued as treasurer; Doctor F. Ellis Henderson was appointed Community Physician and Doctor R.K. Machell, the County Medical Officer left for another appointment; Miss Pilbeam was the Principal Nursing Officer, Mr. Tombs the Personnel Officer; these five with representatives of the Consultants (A.B. Oliveira) and the General Practitioners (J.G. Sandiford) and their deputies made up the Area Management team, which met monthly and reported to the Area Health Authority. They could co-opt others if necessary, for example Mr. W. Maden, the Area Dental Officer.

The A.H.A. continued with some changes in personnel until 1982; then in another re-organisation, Area Authorities were eliminated, the Island became a District with relatively slight changes, save in the titles of the officers, etc.

It was, however, at this juncture that Mrs. Margham retired and the Chairmanship passed to Group Captain Naylor who continued until 1988, when, to the expressed regret of his committee, he was not re-appointed; his place was filled by Mr. C.G.J. Bland, and after another two years by Major-General Brian Livesey, who presided over the last years of the D.H.A. and the first few of the new Isle of Wight Health Commission. The new District Authority after 1982 was known simply as the Isle of Wight Health Authority.

The new St. Mary's was planned and building began in 1983. The acquisition of a coat of arms was considered, and enquiries made to the College of Heralds as to the cost; and in due course suitable arms were provided for the I.o.W. Health Authority. Mr. Parker retired and Mr. A. Blee became the Administrator and in 1985 the District General Manager; and Mr. M. Powell became the Chief Administrator at St. Mary's.

The King Edward Foundation pointed out that a number of necessary services could not be available in the new hospital as planned; the plans would leave a need for an additional medical ward, a department of Ophthalmology and for Rheumatology and Rehabilitation and they might have added for Dentistry or Orofacial surgery and for Physiotherapy; and provision would be needed for mental illness and for the mentally handicapped and for the group classified as Elderly Severely Mentally Ill (E.S.M.I.); it was reckoned that a 60-bedded unit for mental illness would be needed as well as 98 beds for the class of E.S.M.I. currently accommodated at Whitecroft; and many suggestions as to their accommodation were made; also for the 96 mentally handicapped presently at Whitecroft; there was already a provision for 25 children at Castleview; the use of one or more wards at Ryde or Shanklin or the creation of group homes were all considered.

Changes in management were made at this time, the work of the hospitals being divided into the Acute Services; maternity, child health and primary care; mental illness; mental handicap; and the elderly. Each service would have and manage its own budget; and there were also to be Management Authorities for administration, for records, which now became 'Patient Services', catering, engineering, building, energy and estate management and miscellaneous departments; there were also the District Services to be considered - Pathology, Pharmacy, Personnel and Planning, Dentistry, Psychology, Catering, Domestics, Works and Supplies. With a new hospital looming up, the future of Ryde Hospital and the Casualty Department had to be considered. At this stage the local medical committee, the General Practitioners Committee, in 1982 thought it should be kept open. The available beds for the elderly, based upon the number of elderly in the community, were a long way below the national average. It was at this time suggested that General Practitioner beds, i.e. beds into which General Practitioners could admit and care for their own patients, should be retained at FrankJames Hospital and at Shanklin and Ryde Hospitals.

A preliminary measure to the building of the new hospital was the demolition of Barton Ward after a mere 18 years of life; and also of the small chapel near it. Some temporary rooms for community nurses had been set up under the trees between the main hospital and Barton Ward and these too had to go. Barton Ward was moved, name and all, to the pre-fabricated buildings which had been the up-graded Whitwell Ward for mentally handicapped boys and men, holding 37 patients who were now transferred to Whitecroft. 24 'low dependency' patients remained in Seaview Villa in the Lower Hospital.

Picture of St. Mary's Hospital under construction.
The shape of things to come - the new hospital under construction. Barton Ward and the Chapel have been demolished. Courtesy: Mr. J. Lewis

In 1964 about the time of the closure of the Royal National Hospital there were 16 consultants working on the Island and a number of visiting consultants coming from Portsmouth or Southampton or elsewhere for sessions weekly or less often. 25 years later the number of consultants increased to about 35 and new departments have been opened dealing with Paediatrics, Geriatrics, Dermatology, Rheumatology, Genito-urinary medicine, Dental surgery, Child psychology; Neurology, Cardiology and Plastic surgery are still provided for by visiting consultants. At the same time of course junior staff have greatly increased. In 1964 at St. Mary's there was one house physician who was required to cover the whole of general medicine and the geriatric wards, one house surgeon, one casualty house surgeon and one obstetric house surgeon.

At that time there was only one registrar working on the Island, a medical registrar who had previously divided his time between Ryde and the Royal National Hospital; now with that closed he worked at Newport and Ryde.

Increase in the resident medical staff at St. Mary's called for new accommodation and a new building to the east of the other hospital buildings was to be put up, now providing accommodation for five medical residents. It also allowed a trial in style and building technique preliminary to the new hospital; it was named Margham House in recognition of Mrs. Margham's services to the H.M.C. and the A.H.A. over the years.

At the start of the A.H.A.'s term of office the total nursing establishment on the Island was 769, - of which 698 worked in hospitals and 71 in the community. There were 1040 beds, all but five available for use, and an average bed occupancy of about 80%. In the first year 2753 patients were discharged or died.

At this time too, the non-medical and non-nursing staff employed by the Authority included 8 electricians, 1 general foreman, 8 fitters and plumbers, 6 labourers, 7 carpenters, 6 painters and 5 bricklayers; there were 10 area administrators and their assistants; and there were also 12 chaplains of all denominations giving services in the 7 hospitals. The central pharmacy for the group had been established by the H.M.C. years earlier; it remained throughout these years in the pre-fabricated building to the north of the main drive; in 1979 the pharmacy staff numbered 10, it was thought then that there should be two or three more.

The Ambulance Service, hitherto administered by the County, now also passed to the A.H.A.; the service had shared accommodation and to some degree management with the Fire Service; but this now came to an end and a building in Carisbrooke Road had to be leased temporarily, until a new Ambulance Station was built at St. Mary's with the entrance off Dodnor Lane.

When the Ambulance Service was taken over there were 12 ambulances on the Island. The introduction of a geriatric day hospital in 1978 substantially increased the load on the Ambulance Service. Ambulances continued to be stationed at Ryde, Shanklin, Freshwater and Cowes.

The headquarters of the H.M.C. had been at Whitecroft and these were taken over by the A.H.A., and an additional building, described as temporary, was set up to accommodate the administrative staff; 20 years later it is still in full use.

The new Authority, in one of its earliest meetings, had deplored the building of an industrial estate on the opposite side of Dodnor Lane; believing that it would be disturbingly close to a development for mentally handicapped patients which at that time was intended in the north east part of the grounds; but this of course never came about, although the industrial estate did.

The building of the new Obstetric Unit had been planned and set in train before the changes of administration, and the sound of pile-driving became all too familiar to those who worked in, or who were temporarily warded in, the Upper Hospital or Hassall Ward, - as indeed it did a decade later when the new St. Mary's was going up. The building which was never given a particular name, although the wards were named Osborne and Freshwater after the wards in the old St. Mary's previously used for obstetrics, was opened on July 15th, 1976, by the Duchess of Kent; and now at last the Island had a department which gave excellent accommodation for all aspects of obstetrics; for the mothers, the infants, nurses and midwives, Obstetricians, ante-natal clinics, neonatal care. Mr. and Mrs. W. Edwards who had had much to do with planning the building, had by then left the hospital, but were invited back for the occasion. It was the Chairman's particular desire to have a really first class department and it must have been with very great pleasure that she greeted the Duchess of Kent on that occasion. The Duchess did an un-hurried walk-about after the opening ceremony, meeting many staff and patients, and wrote subsequently recording her thanks to the members and staff of the Authority for an extremely happy occasion.

Picture of The Duchess of Kent with Mrs. Thelma Margham at the opening of the Obstetric wing, 1976
The Duchess of Kent with Mrs. Thelma Margham at the opening of the Obstetric wing, 1976 (also in the picture are Earl Mountbatten, Mr. G.R. Hardy & and Dr Ellis Henderson.
Courtesy: Mrs. Thelma Margham

The opening of this new department liberated the ground floor wards, hitherto used for obstetrics, and there was I think never much doubt about the use to which they must be put, although the claims of the department of Rheumatology and Re-habilitation were considered also; but the long awaited paediatric wards were at last established there after considerable re-building and re-modelling; and the new wards were still not entirely freed of the incubus of the corridor from surgical wards to the theatre; it was still a few years before this department was opened but, once available, it provided, I believe, a considerable improvement in the hospital service with the Paediatric staff, both senior and junior, able to work when necessary in close association with the Obstetric wards and neonatal nurseries. The rooms on the south side of the ground floor of the central block which had seen so many different uses, now became the Paediatrician's headquarters with his secretary's office etc. there.

There were changes in the Lower Hospital during these years. Day room accommodation in the two ladies' geriatric wards, Rookwood and Newport, had been altogether absent when the Geriatric Department was first set up in 1961; they had been up-graded about the time that Barton Ward had been built, and some attempts had been made to provide day rooms; but with the space available they were inevitably poor and crowded and, one must say, miserably inadequate. Large day rooms were built now for these two wards in the 1970s and a lift installed, a great improvement; and in the 1980s both wards in turn were once more up-graded, providing after much effort two acceptable modern wards. Newport became one of the principal medical wards for St. Mary's and despite the building of the new hospital still fulfils that function. In the changing scene this involved a loss of beds for the Geriatric Department.

A Geriatric day hospital was built and opened in 1978. After much planning and discussion a standard design, used in several other places in the region, was accepted and was built on the south side of the Lower Hospital with an entrance from Dodnor Lane. This has provided scope for Geriatric day patients, for their physiotherapy, occupational therapy and re-habilitation and training; and its facilities have been shared to a degree with the Department of Rheumatology and Re-habilitation, and out of hospital hours have provided a location for a stroke club. The men's ward in the Lower Hospital, St. Catherine's, which from the start of the Geriatric Unit was run on two floors was also substantially up-graded in the early 1980s with a new day room built on the north side facing the main drive; this has now become the Re-habilitation ward; the upstairs section which already had reasonably spacious day accommodation remained a long-stay ward for men for some time but that, too, has now been taken over for other purposes.

Of the two separate buildings on the west side one, before Barton Ward was built, had been the ladies admission ward for the Geriatric service and later had served as a re-habilitation ward; the other continued to house some of the mentally handicapped men and boys; the former, known as Holly House and formerly as Wootton Ward, has been considerably modified and has now come to provide offices for the Occupational Health Service and for Personnel Departments; the other, formerly Seaview Villa, also much altered, has become the Diabetic Centre, conceived and managed by Dr Arun Baksi. The third building in that line, once the Chaplain's and then the Master's house has since 1948 been used as offices and continues that function now.

In the Upper Hospital two small wards were separated from the main medical ward for coronary care or later intensive care; and similar provision of one single ward was made in the County Hospital in Harington Ward. There, also, a day room was built on at the east front of Cottle Ward.

The move of the Paediatric Wards to St. Mary's freed Victoria Ward, in Ryde, for other purposes; for some time it was used to accommodate patients moved from other wards in the hospital while these were being redecorated and later some orthopaedic beds were provided there; but it became, for a time, the in-patient accommodation for the Department of Rheumatology and Re-habilitation. However, when in 1985 it was decided to move all medical beds to St. Mary's the Rheumatology department, more concerned with day patients and out-patients, kept its headquarters in Partlands Avenue in the Department of Physiotherapy and has also shared the Geriatric day hospital.

Picture of the new St. Mary's Hospital

The introduction of hip surgery called for improvements in the theatre at Newport and it was not appropriate for Dental Surgery to use the same theatre; in 1979 a new Dental Clinic was opened at St. Mary's occupying rooms associated in the early days of the hospital with its first midwifery department.

In later years the remaining and larger part of this block was turned into a theatre with its ancillary rooms and recovery room for day surgery. The maintheatre was up-graded, the small adjacent ward, Bonchurch Ward, was used for orthopaedic surgery. At Ryde the operating theatre and associated rooms were up-graded in 1981/1982; but earlier than this in the 1970s the Casualty Department, now more correctly known as the Accident and Emergency Centre, was re-modelled again and two small theatres were made available there; and it remained the principal 'A and E' Department until 1992; at Newport the Casualty Department had sometimes, for lack of staff, again to be closed, or its operation limited to 9 a.m. to 5 p.m. on five days weekly. It had become partly dependent upon the work of retired practitioners, - and particularly, latterly, Doctor O'Meara, - for its medical staff, and when he finally retired it seemed for a time that it would have to be closed.

An early obligation of the A.H.A. was to assume managerial control of the pathology services, which up until then had been part of the Portsmouth and Isle of Wight service. With only one consultant resident on the Island this would not be achieved at once, and very soon there were plans to increase the numbers of consultants; at first a consultant worked here part time dividing his sessions between the Island and Portsmouth; but soon there was first one, then two and then three additional consultants residing on the Island and working full time there. The laboratory at Ryde continued in use, but the new department at St. Mary's became the headquarters of Haematology, Microbiology and Biochemistry, and large though it seemed in comparison with the earlier laboratory, it was soon found to be in need of expansion; and in 1979 two Portakabins were provided to give additional space for laboratory, storage, and waiting rooms; among other things the advent of anti-coagulant management had added very considerably to the load. A further Portakabin was needed in 1982 to give more room for biochemical work.

As the scope of pathology increased and the number of investigations rose exponentially, difficulties developed over out-of-hours calls. With the relatively small Island population, each sub-division of the Pathology Department could only have a few, - perhaps one or two - trained technicians working in that particular discipline; but each would not necessarily be able to carry out all the emergency investigations sought in other sub-specialities; moreover, up to about 1970 technicians had generally agreed to attend the hospital, if called out, regarding this as a purely voluntary concession; the increasing numbers of such calls made this no longer a reasonable expectation, and of course was it not feasible to send such emergency demands off the Island. Eventually a satisfactory agreement was reached with limitation in the types of investigation which could properly be regarded as needed in emergencies.

The Central Sterile Supply Department installed after 1974 more or less adjacent to the Pathology building, continued to draw its stock from Portsmouth, and Miss McKay remained the Liaison Officer; she retired in 1982 but continued after that for a while to work part time.

Whitecroft Hospital in 1975 besides providing psychiatric service and accommodation for the administration, also housed the central laundry for the whole group. The group laundry had in fact been there for many years and when Longford Hospital was first used for mentally defective girls and women in 1955 a number of them used to be driven daily to Whitecroft to work in the laundry there. This practice ceased, however, in 1959, and in 1976 the occupational therapy work going on at Longford Hospital was especially commended, and the Authority planned to 're-vamp' (to quote the actual word used in the minutes) the Catherine Bowen Home as an occupational therapy and general training unit. O.T. was an important feature of the daily routine of many patients at Whitecroft and by 1978 trained therapists were working there for some 69 hours a week with untrained assistants for about 164 hours.

The hospital accommodation for aged and demented patients, - the group sometimes known as the Elderly Severely Mentally Ill (E.S.M.I.) or now more commonly known as Alzheimer's Disease, had been a problem both for the Geriatric Department and the psychiatrists, which had mounted in proportion to the increasing number of old people on the Island. In the early years of the service, - and indeed before, - large numbers of them had been admitted to Whitecroft. When the Geriatric Department came into existence, - a dozen years after the N.H.S. began, - it was natural and proper that the psychiatrists should expect some easing of the load.

Over the next few years an amicable agreement was reached between the two departments, roughly that when old people became in need of hospital care, those with some physical disorder, such as a stroke, Parkinson's Disease, or a fractured limb, would appropriately be placed in the Geriatric Wards; when the disability was solely a mental failure, they should be cared for by the psychiatrists. A high proportion of such patients however reached the hospital by way of the A and E department, and had to wait on the medical or surgical wards for a vacancy; vacancies in the Geriatric Wards were usually few since they depended upon a discharge of resident patients; very many of these could only go to the County Council (Part Three) Homes; again an agreement was reached between the hospital side and the social workers as to the proper place for individuals; but since the Geriatric Wards on the one hand and the County Council Homes on the other were both substantially under-provided with the requisite number of beds (i.e. the number recommended for a given population of elderly by the Ministry of Health) both were inevitably and continuously under stress and always unable to do as much as was needed and as they would have wished; furthermore the continuous, and at times almost complete, shortfall in physiotherapy and occupational therapy on the Geriatric Wards for the first 15 to 20 years of their existence compounded the problem.

About the time of the establishment of the A.H.A., 14 beds in Thompson House at Whitecroft were allocated to the Geriatric Department and later after some work on the ward, these were increased to 29. This ward remained part of the Geriatric Department until the closure of the hospital when the patients were transferred to the Frank James Hospital in 1992.

In 1979 the bed complement at Whitecroft was still above 300 although only 248 beds were actually staffed and occupied. 130 patients had been discharged or had died in the previous year, and there had been 1724 attendances by day patients. The psychotherapeutic unit had been active at Frank James Hospital, for several years and other such units were also now available.

Along with the new St. Mary's a new hospital 'Newcroft' for mental illnesses was built, on land within the original allocation of 80 acres of Parkhurst Forest made over to the guardians more than 200 years ago. The Guardians had turned down the County Council's suggestion of building a mental hospital there about 1890, and it must be that the land now used was more or less what had been refused a century earlier. The contrast between Newcroft Hospital in 1992 and Whitecroft Hospital in 1948 is very great; it should be understood that Whitecroft in its day was considered, for example by the Commissioners in Lunacy, and the Inspectors from the Ministry of Health later, to be a good mental hospital, up-to-date with patients well cared for and with good occupational therapy. The contrast must be attributed to changes in ideas and management. Fifty years ago Whitecroft, with almost ten times the number of beds that there are now at Newcroft, and serving a population about 25% smaller than now, was overcrowded. Now besides Newcroft there are a number of psychotherapy centres, and houses for elderly patients classified as suffering from Alzheimer's Disease; and several centres where community services, social services, etc., co-operate with the psychiatrists; and of course there are a great many private residential and nursing homes. It is in such centres and homes that many of those who would have been patients in Whitecroft, or St. Mary's, in years gone by must now, with the help of their General Practitioners, be treated and managed. How successful and effective these changes are is, one is glad to say, a matter outside the scope of this book.

A feature of the new administration was the creation of Community Health Councils; each Authority included such a Council with members, 18 on the Island, appointed by Local Authorities, by the Regional Health Authority, and as to one third of them, by the local charitable organisations; these numerous organisations balloted among themselves for their representatives. The function of these Councils was, and is, to be a link between the people, i.e. the local population, and the Authority; they have been termed 'Consumer's Watchdog'; they have the rights to be consulted on major strategic developments in the area; to visit hospitals and any other properties of the Authority, e.g. clinics; and to receive and consider complaints relating both to the hospital and to general practice; they meet monthly and are entitled to send an observer to all area or district meetings for which an agenda is published. On the Island they consider, among other matters, such things as access for the disabled to hospital buildings, clinics, etc; and they have issued guides and information pamphlets.

The first Chairman was Douglas Gordon a former Mayor of Newport and Chairman of B.L.E.S.M.A., with Archdeacon Scruby his Vice-Chairman.

Many voluntary services have played perhaps an increasing part in the life and activities of the hospitals although they were not, most of them, new. The Guild of Past Patients at the Royal County Hospital was founded early in the 1950s and the League of Friends of St. Mary's had become a wide ranging business-like activity and a registered charity before the present phase. Among other things it now runs the hospital shop and cafeteria and had made many important gifts to the hospital, - the greatest one, which involved the energies of many members over years, being the Body Scanner, the accumulated funds for which amounted to nearly three-quarters of a million pounds; another item of major importance is the Endoscope Appeal Fund; but it must not be thought that gifts were limited to certain major items alone; they included such things as help towards the Coronary Care Unit at Ryde in 1971 and the day rooms in 1978 and the provision of two special baths, E.N.T. equipment, a hoist, stethoscope headphones and many other things. Their income is derived from subscriptions, donations, street collections and sales in shops and cafeteria; when Ryde Hospital closed the Guild of Past Patients joined the Friends of St. Mary's and brought with them assets of £10,000.

The W.R.V.S. managed and manned the canteens for Out Patients at Ryde and Newport, the latter jointly with Toc H, the Baptist Church, the Red Cross, and the Inner Wheel. Library services are of great value and I believe importance, to the patients; the library service for the Island was provided through a joint committee of the Red Cross and St. John's Ambulance, - with some contributions from the Friends of the hospital and Toc H. In 1962 Mrs. Ramsden, the County Organiser for the service, mentioned in her report that in all there were then 15 helping in the library service in one hospital or another; 7 of these had had some training in the headquarters of the (National) service; £43 had been available that year for new books and 56 new books had been purchased and 2 automatic page turners, - most valuable items for patients who are unable to use their hands. The library headquarters moved from Ryde to St. Mary's in 1964, and for a time part of the small building just outside the door into St. Catherine's ward was used for a central library. The Red Cross and St. John's also manage the picture library, and provide a trolley shop service for the wards; (sale of tobacco and cigarettes is banned).

The Voluntary Car Service has been operating since the beginning of the Health Service and indeed before that; at first entirely independent, it came to be controlled and organised by the Ambulance Service, - but of course drivers continued to give of their time and their skill, and the service has been much in demand. In 1975, however, while the Ambulance Service was in dispute with the management of the N.H.S. it was suspended for a few weeks except for emergency work. In May 1984 the D.H.A. paid a tribute to the service of the voluntary car drivers and a presentation was made to two senior drivers whose services had been outstanding.

Besides these various activities, actual voluntary work in the hospital under the direction of Sisters and others was undertaken for several years; the service was introduced in 1970 and the first report was considered rather disappointing; later Mr. Scorcher was appointed head of this service and was able to produce effective and useful results. This was a time when management and staff were more than usually concerned at the stress laid upon the nursing and also upon the portering and domestic staff, simply by the volume of work required. The use of voluntary workers aimed at relieving this stress by arranging for some jobs to be done by volunteers. The cynical may say that it was a scheme whereby some of the necessary work was done free of charge; alternatively it could be claimed that it was a useful way of harnessing the good will of the community and putting it to use to improve the service while encouraging the local population to feel that they were contributing to the effectiveness and value of their hospital. By 1975 Mr. Scotcher had a roll of 437 volunteers who had offered their services in one way or another. Many hours of work were booked for each week; work included transport for relatives to or from hospital; escorts to clinics or between hospitals; help with the hospital receptions; transport during ambulance disputes; and during an epidemic of flu, when many staff were off sick, help with actual nursing.

Apart from all this the writer can recall with gratitude a number of people who quite independently of any particular organisation regularly visited seriously disabled patients simply to talk to them, read to them, or just keep them company for a while; such visits are of very real value.

This does not complete the list. Many other organisations have made their contributions over the years - the Lions, the Rotarians, the Inner Wheel, the Buccaneers who provided the verandah for Barton Ward, the Townswomen's Guild, the Women's Institutes, Churches and Chapels, the Carnival Committees and others including many individuals who have made substantial bequests or donations.

At the Post Graduate Medical Centre, opened in 1966, Doctor Harland, the first clinical tutor was followed by Doctor Philip James, Doctor David Hide and Doctor Alan Logan. The medical centre and tutors and, indeed, all senior medical staff became affiliated to the Southampton Medical School, and some medical students from Southampton spend some of their time of clinical instruction at St. Mary's. Clinical meetings were held at first in the evenings but more recently there have been regular mid-week lunch hour meetings with talks by resident or visiting consultants and others.

Courses of lectures are given and during the 1980s refresher courses lasting a week for General Practitioners were established and became very popular, and now continue.

In 1984 the centre was enlarged, giving a much more capacious library and a small seminar room as well as other improvements; the library was named in memory of Mr. A.B. Oliveira. Now the nearby office block is providing an additional seminar room.

The Royal Isle of Wight School of Nursing founded in 1969 had an independent life of about 20 years, - during which time training for S.E.N.s, S.R.N.s and R.M.N.s was carried on. Many of the trainee nurses were Islanders, and there was plenty of local interest, especially perhaps in the annual prize-giving ceremony and award of certificates which was held for several years in the adjacent Isle of Wight College. Numbers, however, were always and inevitably small compared with schools on the mainland and in 1990 it finally ceased to have an independent status and was amalgamated with the Nurse Training School at Portsmouth; nurses may still undergo part of their training at St. Mary's, classes and lectures continue in the Training School now become the School of Health Studies; but it is controlled and managed from Portsmouth; the training of Island midwives has also moved to Portsmouth.

The Patients' services department was developed out of the old Records Department and its headquarters moved to the new hospital when it was opened and Ryde Hospital was closed in 1991. It has a central position in St. Mary's dealing not only with notes but with the arrangements of clinics, the reception of patients; and with lost property, claims for fares and with matters arising from bereavements. It has now a staff of 16. Storage of notes here as elsewhere has presented a problem; the medical staff, aware that all our past proclaims our future, would have liked notes to be kept indefinitely; this has not been possible but all notes are kept for a minimum of eight years from the time of the patient's last attendance and some categories are kept longer, indeed some indefinitely. Notes were formerly stored, among other places, in garrets of the House of Industry, in a shed near the entrance to Dodnor Lane which has been replaced by a more modern building for other purposes, and in the tower at Whitecroft. All these have been disused now and notes are stored in the new hospital; this has led to problems and the department has had to borrow space from the adjacent pharmacy which, perhaps unexpectedly, has needed less space than was allowed because of changes in prescribing customs and the amount of work referred to pharmacies outside the hospital.

It has not yet been possible to produce and obtain a diagnostic index, but it is hoped that this will be achieved.

In Ryde the Physiotherapy department established early in the days of the H.M.C. in Partlands Avenue remains the local headquarters with the office of the Superintendent Physiotherapist; together with the new Out-patient department in Swanmore Road and the nurses' home in Adelaide Place these peripheral components are all that is left now of Ryde Hospital.

In Newport for several years the Physiotherapy Department was established in the old building facing the Forest Road which came to house Forestside School; this was demolished when the relief road was built and the department then had to move to the Upper Hospital where the building of the new kitchens had liberated space hitherto occupied by the kitchens for the Upper Hospital, and the nurses' dining-room. From here up to the time of writing, the physiotherapy services for both the acute and community departments have been organised and managed. I am told that these two elements are shortly to be separated and that one, the acute service, will have to find a new location, but that is not yet history. Trained physiotherapy staff of all grades now number about 20 with about 11 untrained helpers, who receive some in-service training.

The administrative centre for Occupational Therapy is in the large one storey building projecting into the courtyard which used to be the boys' playground; for a long time this building provided training for the mentally handicapped patients in the Lower Hospital. Now the work of about 15 Occupational Therapists is organised here where there is also a wheelchair clinic and where the Speech Therapists and Chiropodists are centred. The Occupational Therapists have a major commitment at Watergate School. Adjacent to this department is the Orthotics workshop occupying a part of the buildings which used to house the mentally disabled men and later was a part of the displaced Barton Ward.

An internal Broadcasting Service was started in 1972, beginning with transmission to one ward, - Ningwood, which has always been closely associated with the Broadcasting Service and remains so now; the service extended in a few years to the whole of St. Mary's. It was, and is, housed on the two floors of the old Chapel of the House of Industry. It is a service run entirely by volunteers. For its equipment it depends upon grants from the hospital and from local and national charities and sponsors; the committee which organises it is elected annually as are the Station Director, the Station Manager and management team. The broadcasters have been trained with Radio Solent and some have gone on to professional appointments with regional and national services. Land lines have been set up to Fairlee and to Frank James Hospitals; these are extremely expensive commodities and to the regret of the service it was never possible to extend it so far as Shanklin Cottage Hospital, but it did reach Whitecroft. The service broadcasts seven days a week between 7.30 a.m. and 10 p.m. with always a request hour between 9 a.m. and 10 a.m.

The idea that patients would feel better and that recovery might be helped by an environment which is attractive, varied and even beautiful rather than dull and drab is not new. In the very early years of Newport Infirmary, the minutes refer to pictures being placed in the wards, and to grants for trees and shrubs in the grounds around them; when the Ministry put a stop to farmingand market gardening in hospitals, it still allowed flower gardens and the cultivation of beds and glass houses to provide cut flowers and plants for the wards and other parts of the hospitals; and the new St. Mary's has enclosed gardens onto which some of the wards and corridors look out, and the old pond, still patronised by plenty of ducks and drakes, has been landscaped, and provides a pleasant and desirable contrast from round the corner where, one might say, - Tall grey towers and long steel bars overlook a park of cars. Violet Pillingwho was appointed Occupational Therapist at Ryde and Newport briefly before moving to the Royal National Hospital in 1948, was herself a gifted artist and spent at least some of her sessions encouraging and helping patients to divert and amuse themselves by painting and drawing.

The Healing Arts Service is perhaps a further development of these ideas; led by Guy Eades, and established as a charitable activity supported by grants from local and national charities and sponsored by local organisations, it plays an increasing part in promoting recovery and well-being. The department concerns itself with the community as well as the hospital, aiming to stimulate participation in activities such as music, dancing and painting; and is also concerned with the design, decor and furnishing, etc. of the hospital.

Two other institutions related to and arising from the hospital but now independent of it and of the N.H.S. have to be mentioned.

The Hospice movement called for provision for those who could not expect a cure but required treatment and support. Fairlee Hospital had by this time ceased to be needed to any extent for infectious diseases; Dr Graham Thorpe and Mrs. MacGregor, the Matron, especially, urged that it should be put to the use as a Hospice, and after some alterations had been made it was opened in 1982 as a continuing care centre starting with 8 beds. Dr D. Murphy, a consultant physician, who came to the hospital in 1978, supervised it for the first few years with the help especially of Dr Mark Wilks; much additional building and re-modelling has been done and the old Lodge has been incorporated in the Hospice which now provides 12 single rooms with an additional 2 available for sufferers from AIDS, together with reception rooms, day rooms, offices, etc. In 1988 it was re-opened as the Mountbatten Hospice by the Duchess of Kent and became an independent charity; and in 1992 Dr N. Cole was appointed as Medical Director; besides the in-patient beds it provides an out-patient service dealing with about 16 out-patients daily and a Health Information service. It has its own nursing staff with a high nurse/patient ratio and works in conjunction with the three MacMillan nurses. Patients are admitted chiefly for respite care, staying for a few days or a week or two. The Hospice's income is derived in part from a contract with the Health Commission whereby it provides a number of beds for patients referred from the hospital or the community; it also depends upon subscriptions, donations, bequests and its own fund raising activities, and a very successful charity shop in Newport.

The former administrative block at Fairlee Hospital still provides kitchens for the Mountbatten Hospice as well as for Halberry Lodge and some other outlying institutions and part of it is available for a psychology service. Niton Ward has been abandoned being found structurally insecure; and a new building, Halberry Lodge, has been put up on the north side of the central lawn, a psycho-geriatric unit, also independent of the hospital.

The Clinical Allergy Research Unit conceived and founded by Dr David Hide, was for a time accommodated in rooms adjacent to the old restaurant and kitchens; it has now moved to Applegate, near the old entrance to the hospital, which was formerly a house for the Surgical Registrar. It awaits the building of a new department which will be on land to the south of the south hospital, i.e. on the old cricket ground, or what is left of it. Researches are carried out on food-related and respiratory tract allergy; clinics are held twice weekly and a number of patients with problems of allergy come from the mainland. It is the major pollen and mould recording station for the south of England and broadcasts the tree and grass pollen data throughout the hay fever season and reports to the European Aero-Biology Network.

The Private Hospital - The Orchard Hospital

One new hospital, apart from the new St. Mary's and the new mental hospital - Newcroft, - was built and opened in 1984, the Private Hospital. Lying at the west side of Fairlee Road about half a mile out of Newport, it started with 20 beds, all in single rooms and was later in 1990 enlarged to provide 34 beds. It has an operating theatre, X-ray Department, and Pathology laboratory, although some Pathological work is dealt with in the area laboratory at St. Mary's. Patients from the mainland as well as from the Island are accepted as are children; and self-referred convalescent patients are also admitted. Health screening clinics are provided.

In 1992 the hospital went into receivership, but it did not close, and was sold in 1993 to a consortium of Island men and was renamed the Orchard Hospital; there are now two resident doctors who live in adjacent bungalows belonging to the hospital. Physiotherapy is regularly available and Chiropody and speech therapy can be arranged privately if required.