Nottingham Hospitals History

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THE NOTTINGHAM EYE HOSPITAL

Adapted from the book of the same title by Mr. N. R. Galloway


2018: Looking up Park Row from Maid Marian Way, Nottingham

Circa 1900: Looking up Park Row from Chapel Bar, Nottingham

Early Personalities


Charles Bell Taylor was a surgeon at the Eye Infirmary from its inception. He was an Edinburgh graduate, qualifying in 1854 and gaining his Fellowship of the Royal College of Surgeons in 1867.

He built up a large practice and became well known throughout the Midlands. It is said that he had a striking and magnetic personality as well as great surgical skill. He was teetotal and "never had days illness until he died of influenza in 1909." He lived at Beechwood Hall Mapperley Park. He had a reputation for is kindness to the poor and for his fondness of animals. He was still operating at the age of 80 years, his hand being still as steady as in his prime. Although a local man he obtained his medical education in Edinburgh, London, Paris and Berlin. His wide reputation as an eye surgeon caused him to be elected president of the Parisian Medical Society.

Another personality, Robert Brundenell Carter came to live in Nottingham at the end of the 1850's and was originally in general practice in North London and did not take up ophthalmology until he was over forty took an active role in establishing the Nottingham Eye Infirmary.


The Infirmary in St James’ Street


In 1866 the original Eye Infirmary was moved to number 56 St James’ Street. The property was still rented but in St James’ Street it was slightly near the General Hospital and more part of the old town. At that time the population of Nottingham was 74,531 (it was only 11,000 in 1750), the population of England was 20 million and Queen Victoria was 47 years old.

By 1878 the Nottingham Eye Infirmary in St James’ Street was very much a running concern. It was governed by a body of eminent townsfolk and the Duke of Newcastle was president. A new rule was passed at the time which stated that "no operation shall be performed by any of the surgeons without the presence of one of his colleagues or of someone accustomed to assist in such cases." In 1879 the 6th Duke of Newcastle died, and on 6th March 1879 it was agreed that John James Robert Manners the 7 Duke of Rutland should be asked to take on the presidency. A reply was received saying that he would kindly consent them "using his name in this way". Not long after this it was noticed that William Cavendish-Bentinck the 6th Duke of Portland had been contributing five pound a year to the hospital and so, in March 1890, it was tactfully decided to ask him if he would become vice president. The post was accepted.

 The Eye Infirmary as it had become known as rented from a Mrs Campbell, and although reluctant at first, she agreed to sell the property to the Eye Service. In 1879, the unit occupied space of 870 yd.² and was valued at a price of £1740. Eventually it was purchased for £4000, rather more than had been anticipated by the governing staff. They were very keen to expand because the demands on the service were considerable and in fact patients often had to queue outside in the cold.

Considerable sums of money were coming in in the form of legacies and donations from local businesses and working men's associations. For example, an amateur performance of "She Stoops to Conquer" raised £11.1.6d and quite amazingly in the winter of 1882 the bizarre and fancy-dress ball organised by the Rev St Maur Willoughby, a committee member, raised as much as £1500 which is a huge sum of money in modern terms. In the 1880's the unit is referred to as the Nottingham and Midland Eye Infirmary, perhaps competing with the Eye Department in Birmingham which was known as the Birmingham and Midland Eye Infirmary.

In the 1880's a new extension was built in the form of a covered waiting area and space for more carriages. The consulting room was given a facelift by having lino put on the floor and was also provided with a new hearthrug.

This early Eye unit was staffed by visiting honorary doctors and surgeons. To be appointed they have to do have worked for six months in Nottingham and to have "the necessary medical qualifications." It seems that the hospital was one very much by the lay committee and the working doctors did the basic doctoring. There were some complaints about the service; for example, a lady from Oxton Hall wrote in to say that a young girl in service had had to wait much of the day and even then, was unable to see the doctor being told that he was away. She had had to leave Southwell at 8.00am and did not return until 8.00pm. Presumably she lived in Southwell and perhaps journeyed to Nottingham in the carriage provided by her employer. There seemed to be good grounds for criticism. Dr Appleby Stephenson, a long-established visiting surgeon was duly called to task. In his own defence he said that he had his own busy practice and had been called away to London that day. He was reminded of rule 23, which stated that "a surgeon unavoidably absent shall engage one of his colleagues to attend in his stead and if unable to do so shall provide a duly qualified substitute provided by his colleagues." A letter was written to the girl’s employer but a further letter was received from her again criticising the service. The matter seems to have been settled by reprimand and tactful correspondence.

Apart from physicians and surgeons interested in the eye, the eye unit was also attended by a dentist and in the 1890s, an anaesthetist offered his services but it is not stated whether he was given the job. All these honorary medical posts would have been unpaid but the doctor involved would have gained prestige by doing the work and this indirectly benefited his private practice. There was of course a traditional matron and when a new candidate was needed in 1895 the committee recommended that she be "under 35 years of age, married and without encumbrance and paid a salary of £40 per year. Although she did not comply with the strict terms, Miss Heaton was appointed to the post and was giving a starting salary of £50 per year.

In 1895 to members of the medical staff retired; Dr Appleby Stephenson who had attended from the early days of the unit and Dr Truman. Dr Ernest Cory Kingdon and Dr William George Laws were appointed in their place.

Dr Ernest Kingdon was ophthalmic surgeon to the Nottingham Children's Hospital as well as surgeon to the Eye Infirmary. William Laws like Dr Kingdon was also an Edinburgh graduate, but continued his training at St Thomas's Hospital and then as a clinical assistant at Moorfields. He gained his Fellowship of the Royal College of Surgeons in 1892 and was assistant editor of the Ophthalmic Review 1899-1909.


The New Eye Infirmary on the Ropewalk


After the turn-of-the-century, the management committee under the chairmanship of Alderman Ford was beginning to consider the possibility of moving to larger premises. As the result of a competition for the best drawing, plans for a purpose-built hospital by the local architect Arthur Marshall, were approved. Tenders from 27 different builders were received and Thomas Barlow was eventually accepted to do the job at an estimated cost of £8,828. Much consideration was given to the ceremony of laying the foundation stone, which took place on 5 April 1911.

At this stage before the First World War and before the move into the new premises the staff of the hospital comprised:


POST    ANNUAL INCOME


Matron                                             £ 70.0.0.

Nurse                                                £ 30.0.0.

Senior probationer                          £ 14.0.0.

Junior probationer                          £ 10.0.0.

2nd junior probationer                    £ 10.0.0.

Cook                                                  £ 25.0.0.

Housemaid                                       £ 21.0.0.

Ward maid                                       £ 16.0.0.

Bedroom maid                                 £ 14.0.0.

                                           £210.0.0.




Outside the former Main Entrance to the Eye Hospital, the Foundation Stone that was laid on the 5 April, 1911

The Duke of Portland, who had been made president the previous year, has indicated that he would be unable to open the hospital as planned in March 1912. However, the Duchess agreed to perform the ceremony in his absence. Accordingly, on 13 March 1912 at 3:30pm the new hospital on The Ropewalk was duly opened. Guided tours for the general public were carried out during the following few days.

The property on St James Street was sold after a few months for £1600, a sum which was considerably less than its purchase price.

The Nottingham Evening News gave a fine account of the opening describing the new unit as "the most complete and up-to-date institution of its class in the country." Each Ward was fitted with a glow light for night use on a new system by means of which one switch only is used for giving a light of varying degrees of strength from the faintest glow to the full strength – a most useful feature."


The Eye Hospital opened on 13 March 1912 by the Duchess of Portland

The First World War


By the beginning of the wall the eye service had become well established in the new premises on The Ropewalk, which is close to the site of the Nottingham General Hospital and near to the centre of Nottingham. The general management committee of the Eye Hospital comprised of Messrs Bradshaw, Armitage, Eberlin, Heymann, Stubington, Herbert, Young and Ford. Alderman Ford, a prominent member of the management committee for many years, died just before the war started and the chairman pointed out his important contribution to the purchase and development of the new eye hospital.

Dr Thompson Henderson was one of the honorary eye surgeons on the staff. He became known at a national level as a member of the Oxford Ophthalmological Congress and was elected to the Ophthalmological Society of the United Kingdom in 1903. He was a tall imposing man and at times had disagreements with his colleagues. A slight divergence of opinion between himself and the management committee occurred in 1913 when it turned out that he had "dismissed" a cleaning maid. The committee wished to know on whose authority he had been acting and he was called to task. He explained that he had only been expressing an opinion and regretted the incident, seemingly to the committee's satisfaction.


World War One: Blind and partially sighted soldiers outside the main entrance

After the war was declared, both Dr Thompson Henderson and Dr Herbert volunteered for medical service. Dr Reid, who had been an assistant in the hospital to Dr Laws, was appointed in their place.

At the outbreak of war, the war office asked all hospitals to erect a distinctive sign indicating that the building was a hospital. This was to be a protection against the possibility of aerial bombardment. The committee considered this and decided to take no action. By the end of 1915 several high cases had been admitted from the war zone but also perhaps surprisingly there was an increase in the number of children being seen. This prompted a memo to the school medical officer asking that children should be seen by his department first.

Sir Charles Seely, who had been a vice president of the eye hospital since 1869, died in 1915. His son, also Sir Charles Seely, accepted the post of vice president in his place.

In January 1917, the hospital received a letter from the Nottingham and Notts branch of the National Union of Women Workers asking that women should be represented on the Boards of Management of hospitals and similar institutions. Around this time the hospital did advertise for a lady assistant ophthalmologist specifying the sex in the advertisement.


By the end of the war the honorary medical staff comprised of:


                                          William George Laws.          T.B. Gilbart Smith.

                                          Thompson Henderson.          J. Herbert.


Dr Laws had been active on the committee during the war and for example initiated an artificial eye service. Nottingham subsequently became known nationally for the provision of artificial eyes thanks to the work of Mr Steer Wardman and later his son, dispensing opticians from the firm of Brooks and Wardman. In 1918 Dr Laws suffered the sad loss in action of his eldest son and his health seemed to suffer after this. In 1918 consideration had been given to building a 5 – 10 bed Ward on the roof of the hospital and Dr Laws offered to put his son's estate towards the cost of this.


The staff salaries for 1919 are of interest:


                                                                   Matron                           £100

                                                                   Sister                               £ 75

                                                                   Staff Nurse                      £ 65

                                                                   Probationer                     £ 18

                                                                   Outpatient Assistant      £ 75

                                                                   Dispenser                        £ 70



Between the Wars


A perfect background to the history of the hospital service between the wars is provided by the address to the British Medical Association by the president Mr Robert George Hogarth at the Annual Meeting held in Nottingham in 1926. Robert George Hogarth was a well-known and respected general surgeon who joined the staff of the General Hospital in 1894 he wrote a book, which is an amusing and reflective account of his life in Nottingham, and some of his thoughts and ideas on the future of medical services are well expressed in this address. At the time of the BMA meeting in 1926, the Ministry of Health has recently been created and even then, the State was beginning to exert its regulatory powers. Here is a quote from Robert George Hogarth's address:

 

"but now that the idol of State socialism has been set up for our worship we may be sure that sooner or later the theorists will attempt to invest the Ministry of Health with increasingly autocratic powers, and we will seek to transform the whole medical service of this country into a State service, with State hospitals, State examinations for degrees, and the State payment of doctors. This would be a perfectly logical development in a socialist State, nor can it be pretended that such a system could not be worked. But whether it would be as efficient as our present system, whether it would be as acceptable to the general body of the people, and whether the vastly increased costs would be repaid by equivalent advancement of medical knowledge or improvement in the public health, there is room for the very gravest doubts."


Robert George Hogarth seemed to have a remarkably clear view of the future. Nevertheless, even before the Second World War, there was a growing feeling that the voluntary hospitals did not provide a fair system of health care. In 1937 Councillor H. Emmony, who was to become a board member of the new Nottingham Number One Hospital Management Committee after the inception of the National Health Service, spoke to a men's Conservative Association about discrimination between those with and without poor relief for entry to the Eye Hospital. He was reported as saying: "the sooner the health department started its own eye department the better for the city." This opinion may not have been so widely held at the time and especially not by the medical staff at the hospital.


The Second World War


In January of 1938, 70 patients were admitted and 54 operations were performed 10 of these under general anaesthesia. 2620 patients were seen in the outpatient’s department and 442 foreign bodies were removed. Compare this with July of the same year when 91 patients were admitted and there were 53 operations. The outpatient attendance was 2469 and 575 foreign bodies were removed. These figures show a steady throughput in spite of the season and a considerable increase in the number of foreign bodies removed. The number of patients seen did increase gradually through the early years of the war. The outpatient department with open every morning at 9.00am from Monday to Saturday and although there were no official afternoon clinics the morning clinics did sometimes extend over lunchtime.

The annual reports of the wartime period show that there was support from an enthusiastic nursing staff and regular dances and parties were arranged by the hospital. The nurses were treated to a regular Christmas outing to the pantomime and there was carol singing by the nursing staff. In these times there was always some patients in the hospital over Christmas.

At the 84th Annual General Meeting of the Eye Infirmary in 1944, the Duchess of Portland took the chair as president. The Duke of Portland had died the previous years and had been president himself since 1912. Other members of the committee included names such as Derbyshire, Brownsword, Broadhead, Harlow, Eberlin, Mowl, Rothera, Wilson and Purser as well as three surgeons who were ex-officio members. Mention is made at this meeting of the increasing number of patients needing attention and it is true that the total annual figure rose from 30,701 in 1942 to 33,304 in 1943.


The Finances of the Eye Hospital before the Advent of the National Health Service


It is worth considering how the hospital paid its way before the health service became totally state funded. The income was divided into "ordinary" and "extraordinary". Ordinary income came from subscriptions from working people's groups, societies, Lodges, and congregational offertories. As an example, the Nottingham and District Health Fund supplied regular payments. It was originally called the Nottingham and Notts Saturday Fund and was started in 1873 by the Reverend Canon Morris of St Mary's Church and ceased with the inception of the National Health Service in 1948. For each subscription one pound in 1943, for outpatient recommendations would be given. Outpatients requiring medicines had to pay three pennies a week and inpatients paid one shillings and sixpence the day towards the cost of board, washing and nursing unless financial responsibility was accepted by a public authority or contributory fund. "Ordinary income" was in this way also derived from direct payments by inpatients, outpatients and from the private wards. A private bed cost one pound a day. Further monies were obtained from investment income (about 10% of total income in 1943: the hospital held several thousand pounds in government stocks and bonds and railway shares) and there was a state grant at this time to cover a proportion of nurses’ salaries (from the Rushcliffe Report of 1943).

There was also a Government Emergency Hospital Scheme, which provided a grant towards the cost of the casualty service. "Extraordinary" income came from legacies and this amounted to about 5% of total income in 1943. A subscribing group or individual could apply for a free place on behalf of the patient and the applications were considered by the honorary surgeons. For example, in 1912 letter was written to the Reverend Pearson of Stathearn asking if any local funds might be available for one of these applicants. In the same week an application was refused on the grounds that the patient had tuberculosis of both eyes and this would require many months of inpatient treatment. In this instance it was decided to apply to the "County Insurance Committee". If a surgeon seemed to be admitting too many free patients then this could be questioned by the management committee. As in the present day, the surgeon had to exercise humanity tailored by cost.

There is an interesting note in the report of the committee for 1943, which reads as follows: "the government has now made known its proposals for a comprehensive National Health Service. Discussions are proceeding among all the many interests involved."

In fact, discussions for a scheme to coordinate hospitals and health services throughout the country had been ongoing for some years, culminating in the National Health Act of 1946. The takeover was postponed until 5th July 1948 when 15 regional hospital boards were formed and hundreds of hospital management committees.





The Arrival of the National Health Service


The government White Paper on the NHS was considered by the management committee in 1944 and the following year there was some concern about the suggestion that the Eye Hospital should be absorbed into the neighbouring General Hospital. At this time the hospital had expanded to include several properties adjoining the site and there was a plan to extend to better accommodate the patient load. Rental income was also being received from these properties. These plans were successfully modified on advice from the Ministry of Health and in 1947 it was made clear that for the time being they would be shelved.

 In September 1947 it was agreed that the honorary medical staff who up until then had relied on their private practice for income, should be paid initially £300 per annum. The following month notice was received that the Eye Hospital would be taken over by the Ministry of Health. The hospital together with the General Hospital will be run by the Nottingham Number One Hospital Management Committee, which in turn was responsible to the Sheffield Regional Hospital Board.

 In May 1948 the Minister of Health requested the transfer of all documents relating to securities to the government and purse at a stroke all local wealth disappeared. Sister Cox, the mainstay of the hospital retired at this stage after twenty years of service, as also did the past chairman of the committee J. N. Derbyshire. Mr Derbyshire had been a member of the management committee for 40 years, an indication of the remarkable service given by lay people in those days. Also, the patronage of the Eye Hospital by the Duke of Portland also during that transitional period lapsed. However, there are no records available that indicate the Dukes lapse of patronage.

 Although the NHS was introduced in 1948, this was just the start of several years of complex negotiations before it could be recognised as up and running. Private funds still kept coming to the hospital although all its capital assets had been appropriated. The Eye Hospital management committee continued as such albeit unofficially, until in 1949, an official house subcommittee was formed of:


   4   lay members

   2   medical members

   3   members from the number 1 management committee


The lay members work Messrs Dunn, Rothera and Russell Moore and also Mrs Broadhead with Norman Patrick Galloway and George Gordon Napier as medical members, and from the No.1 hospital management committee were Messrs Emmony, Norweb and Roberts. Mr Roberts was an ex-miner who by his cheerful presence and support kept alive some of the old espirt of the original unit, which is applied to carving the Christmas turkey.


The Eye Hospital Nursing School


For much of the nineteenth and twentieth century the matron was a very important figure in the running of the hospital. The Nottingham Eye Infirmary was fortunate in that it had a series of very competent people who occupied this post. Miss Drakes was appointed in 1919 and retired in 1942 to be replaced by Miss Amy Lee and over the later part of the century Miss Molly Edwards maintained a tradition of devoted nursing replacing Mr Lee in 1952. Miss Edwards retired in 1972 and was replaced by Miss O Doherty. Sister Wooley's name must be mentioned here as the person who put so much work into the running of the nurses training school for so many years.

After the Second World War, there was a very active Ophthalmic nursing school in Nottingham and this provided a core of staff with a strong loyalty to the unit. The nurses training school was officially opened by the matron of Moorfields Eye Hospital in 1953.


The Eye Infirmary was separate from the General Hospital in that it had its own dispensary, switchboard, kitchens and outpatient department. All the staff and maid's "lived in", as well as the resident doctor. The nurses all undertook two years Ophthalmic training. The regime was strict but fair. No one was allowed out after 10pm and all nurses had to be in before that time. A signing in book was kept in the front hall of the hospital for this purpose and all the nurses had to sign in. Woe betide anyone who was late without permission – it was "on the carpet" in front of the Matron at the next day!

The nurses work from 7:30am to 8:30pm for 5 ½ days each week and were allowed two hours off in the afternoons. The monthly wage was about £2 per month. There were two accommodation properties belonging to the hospital, one at 25 Regent Street, where the Matron and night staff resided, and one at 3 Oxford Street, where the nurses and some of the kitchen staff resided.

The Eye Infirmary itself was well set out for its task love treating patients with eye problems. The upstairs all top floor contained a private patients suite of six rooms, a female ward and a large children's ward as well as Matron's office. The downstairs or lower floor contained 4 wards, the doctor’s office, operating theatre, staff dining room and the outpatient’s department. It should be noted that during the Second World War, from 1939-1945, one ward was set aside for the treatment to members of the armed forces. At night and man came into the hospital to put up the "blackouts."

The sterilisation of instruments was carried out in the top floor kitchen, in a fish kettle. There were coal fires in all the wards and these were lit and tended by the porters. There was no access to the top floor by lifts. The only lift was a food lift use for moving the prepared food to the various wards at mealtimes. All meals were prepared and cooked on the premises and milk was delivered in a churn up until about 1967. Matron would daily feel the jugs with milk for distribution to the various wards.

Patients were taken to and from the wards to the operating theatre by a team of porters. Until the inauguration of the National Health Service, patients attended the casualty department with either a recommendation from their place of work or after a small payment had been made. Daily, matron made her round of the wards, insisting on spotless cleanliness and she made it her special business to talk to the patients and discuss the daily ward routine with the ward sister and nursing staff.

At the beginning of World War II, the dining room was reinforced with wooden beams and all patients who could be moved were moved down there when necessary at the onset of air raids. This was the only air raid shelter! With the onset of the NHS the first hospital nurses’ badge was designed by the Moorfield College of Art and was issued in 1947. It is interesting to note that between 1936-1947 cataract patients were kept in bed for three weeks; on the third day after the operation they were sat up on bed rest and were fed by a nurse.


Later Years of the Eye Hospital


A number of important changes occurred in the early 1950s. The young NHS was underway and there was a new monarch, Queen Elizabeth II; many new faces were seen in the hospital. Miss Edwards had been appointed matron and a new young consultant George Robinson was imposed after the retirement of Dr Thompson Henderson. To celebrate the Queen's coronation, the hospital purchased crested turkey in different colours for the different wards as well as a new Union Jack, waxed buntings and a large television set. It is interesting that the waiting list at that time was 6 to 9 months for cataracts, not too different from today's figures.

 Mr Richard Wilson, fresh from the Royal Air Force, took over the secretary's post from Mr Russell Moore at this time. Richard Wilson served the hospital for many years in a highly competent manner, no doubt a reflection of his training in the forces. He retired shortly before the move to the new teaching hospital in 1975.



It was around this time that a scurrilous episode was reported by matron to the committee. One of the house surgeons had reported the loss over his wallet. It subsequently turned out that he had invited two nurses to his room. They had visited him to drink fruit juice after a game of ping-pong. The committee was assured that the nurses concerned had been interviewed and a re-occurrence of such an event was unlikely.

Private funds were still at this stage being received by the hospital and being earmarked for the use of the hospital. In 1950 the question of patients paying to be shaved was raised in the house committee. Apparently, patients unable to shave themselves were paying for this and it was pointed out that this was against ministry regulations. Accordingly, arrangements were made for the barber to be paid four shillings an hour for this task.

The hospital did continue to receive donations from generous benefactors and it was thanks largely to the generosity of Elizabeth May King that the unit was extended to take up the increasing workload. In 1960 and new ward unit and casualty department was opened. It was at this time that Mr Norman Patrick Galloway retired as senior surgeon and was asked to declare the unit open and was given a vote of thanks proposed by councillor John Roberts who was the chairman of the house committee, a dedication was performed by the chaplain at the hospital Canon A. Inglis. Two years later a patient's day room and the new dining room were opened as a further development to the new extension. The Chairman of the Sheffield Regional Board A. V. Martin was present at this latest ceremony. The regional board had financed the raising of the lift to the new level. This latest extension was on the roof of the original building. There was a plan to build an operating theatre on the roof of the hospital however, the plan was eventually shelved as the prospect of a move to the new teaching hospital (Queens Medical Centre) loomed insight.

Compared with some eye hospitals, the Nottingham Eye Hospital always had a well-run optometry service so that patients could have their glasses measured and ordered in-house if they wanted. Geoffrey Thompson was the first Ophthalmic Optician and Miss Nina Tomlinson was the first dispenser. After the move to the Queens Medical Centre, Martin Rubinstein took over as Senior Ophthalmic Optician and under his guidance the service expanded considerably so that the various measurements on the eye now demanded by modern eye care were carried out with great efficiency.


Patient Care in the 1970s


As the move to the new teaching hospital and the closure of the now much respected Eye Hospital came closer, it is worth remembering some of the advancements in treatment that had appeared in eye surgery. Cataract surgery was becoming more sophisticated and the success rate was up to 90%. Most patients no longer needed to where the thick glasses which were previously required after the operation and day case surgery was beginning to appear. Many different types of antibiotic were available and corneal grafting had become a routine operation. This allowed the patient’s damaged or diseased cornea to be replaced by a healthy cornea from a deceased donor, thereby restoring the site to the eye in many cases.

Most operations were now performed under the microscope and very fine stitches had become available, hardly visible to the naked eye. (Modern eye surgery has eliminated the need for stitches altogether by the use of extremely small incisions and further refinement of instruments.) Engineering advances at that time also allowed the design of instruments which could be inserted right into the eye of especial use in the treatment of retinal detachments.

An important development from the point of view of patient care occurred as a result of the building of the May King extension. The basement area was built as an outpatient department extension which allowed for the use of special clinics. These clinics would be devoted to special eye conditions, for example retinal detachment or glaucoma. Methods for examining the eye had become much more sophisticated over the years; the inside of the eye could now be photographed and the testing of the field of vision had become more accurate.



A New Medical School in Nottingham


In the late 1960s the proposed new medical school in Nottingham was not much more than a small brochure. This fast project for the first new medical school of the century had originated as a recommendation in the Pickering Report of 1965. Single-storey buildings on the University of Nottingham's Highfield campus were used as temporary quarters and new personalities appeared on the scene. Tony Mitchell, Prof of medicine and Prof David Greenfield were important figures in the initial establishment of the medical school. When the first medical students arrived in 1970 there was great enthusiasm to teach them and they must have experienced a very special form of medical education in spite of the disadvantages of the temporary quarters. The group said medical students in their fourth year came in threes and fours to be taught in the theatre and clinics of the Eye Hospital. The Eye consultants had teamed up with the Ear Nose and Throat consultants to provide four weeks of training in "special senses," which was felt quite inadequate at this time. There were two reasons for this; firstly, recruitment of ophthalmologists at that time was important because there was a shortage of consultants and secondly, we felt that there was a need for better training of general practitioners. Some of us also gave core lectures on the whole class of first-year students, which may have helped a little.

There is no doubt that the eye service benefited considerably from the arrival of the Medical School. Up to that time there had been no formal neurology service in Nottingham and the introduction of this speciality provided important support for the eye unit. During this period, the hospital which had been the very latest thing in 1912 was becoming cramped and overworked. The outpatient department was continuously running with a permanent queue of patients and the operating conditions, an acceptable then, would have been disallowed by modern standards. The prospect of moving to a completely new department in the proposed new teaching hospital was a dream which the more cynical of us thought would never happen.


1970: The first intake of Medical Students

EPILOGUE


The Move to the Queens Medical Centre


During the 1960s, plans were drawn up for a huge teaching hospital to be built near the ring road on the west side of the city. The site chosen was originally an industrial/housing estate and was also considered to be waterlogged, due to the fact that it was close to the River Leen. When it was heard that the architects explaining the project it seemed enormous but a wonderful and fitting place for a new medical school for the 20th century. In particular, some consideration was given to methods for delivering mail in situ gigantic complex. A number of ingenious systems were considered but, in the end, "the pedestrian method" was considered most suitable. The internal postal service has had occasional problems but the decision seems to have been the right one at the time. Plans for a new unit had already been drawn up which incorporated a small academic unit for two consultant ophthalmologists. This seemed like a death knell for local ophthalmology; the split unit with each half fighting one another and never agreeing; unnecessary duplication of expensive equipment; a "second best" team left behind in the old eye hospital. This was not needed or wanted. In the end a compromise was reached in which neurology agreed to stay behind at the general hospital for the time being and allow us to fit together in one unit in the new hospital.


1969: Before construction of the Queen’s Medical Centre

The new hospital was planned as a large central area with four "towers." Each so-called tower was a building in itself. The first to be built was to house the medical school and the other three the various clinical specialities. The operating theatres, outpatient department and accident and emergency departments were to be in the central area. The Eye Department, in keeping with current thinking, was to be split into casualty and outpatients and then two operating theatres in the main theatre complex. The Eye Hospital moved into the fine new outpatient’s department, near the main entrance of the hospital in 1978. This meant, for consultants, the trip into town to do theatre work and to do ward rounds but more importantly all case note had to be transported to and fro which cause problems for acute admissions when there was sometimes unavoidable delay in receiving the notes in the ward. In 1980 to the rest of the unit moved into the University hospital. Originally the title "Queens Medical Centre "referred to the teaching school and the term "University Hospital" referred to the whole hospital but with the usage the whole hospital has become "The Queens Medical Centre" or "QMC". The problem of course did not end with the completion of the move into the new hospital. Wards were still a long way from the operating theatre and the outpatient department separated from both but one major problem was the delay in commissioning the second operating theatres for reasons which were not always clear to the staff of the unit. Another problem was the need to develop a proper academic Department of Ophthalmology. This would provide a centre for research and postgraduate teaching and in turn help to recruit high-calibre staff.


Circa 1970’s: The Queen’s Medical Centre after construction

The Academic Department of Ophthalmology and the New Unit


(Personal reflection of Mr Nicholas Galloway)


From the early days of the medical school, when the eye unit was housed in the Eye Hospital, it was clear that a proper academic Department of Ophthalmology was needed in Nottingham. As a first step it was decided to appoint a senior lecturer. The doctor appointed would have the option of sidestepping into a consultant post at a later date and the University would not have to provide the funding of a professorship and staff all at one go. After quite lengthy negotiations the post was agreed and in 1986 Stephen Vernon was appointed senior lecturer and foundation member of the Department. It was thanks to his efforts and the foundation that he laid that subsequently a full academic department was built up in the new teaching hospital. Another colleague who put in many hours of hard work towards the Department firstly of the unit in the teaching hospital and then, once we were established there, towards the building of a self-contained unit as an extension of the University Hospital was Stephen Howarth. It was his dogged perseverance and careful liaison with management that started the ball rolling but several years were to pass and some new changes in the department were to occur before this project eventually came to fruition.


In the 1990s a small revolution occurred in the Ophthalmological Service in Nottingham. Prof Harminder Dua was appointed in charge of the academic Department with Winfried Amoaku as his lecturer. Stephen Vernon became consultant in charge of the glaucoma service. The arrival in 1993 of three other consultants in this period, Richard Gregson as paediatric ophthalmologist, Gavin Orr as retina surgeon and Richard Downes that as orbitoplastic specialists provided a new impetus for the much-needed expansion of the service. As the technical side of eye surgery advanced so the number of elderly patients was increasing and the numbers attending and waiting for treatment were creating an impossible situation. We also felt much hampered by the wide separation of the different functions of the unit. Planning began in liaison with our colleagues from the Ear Nose and Throat Department for a new department built out from the existing hospital and comprising both our disciplines together with the academic departments. Stephen Howarth still continued his work with this enormous project. Richard Downes with his military background took on the post of clinical director at this time and became an important figurehead in the negotiations. Fortunately for us Private Finance Initiatives were in vogue at that time and this mechanism paved the way for the building of the New Wing, opened in the year 2000 which now proudly stands on the site of the Queens Medical Centre.


This book is a history of the ice service in Nottingham and it has never been the intention to describe present-day ophthalmology all to give an account of the current staff in the unit. This is an ever-changing scene but those who have been associated with the service, patients and staff alike might be interested to know that 7848 operations were carried out on the unit in 2001. In the same year, 11,782 new patients were seen and 42,921 follow what patients. The present Eye Department is known internationally and patients can be assured that it is one of the most up-to-date units in the country; all the latest techniques used in modern surgery are available. The pattern of eye disease has changed considerably since the service originated in 1859. Much of the eye disease that was seen in younger people has been largely eliminated by medication and preventative measures, but there is still a lot of blindness from injury and disease. The increasing number of elderly people in the population has brought an increase in the incidences of disease associated with ageing, in particular, age-related macular degeneration, glaucoma and cataracts. Cataract surgery has become extremely effective that it demands large numbers of skilled personnel and equipment; the treatment of glaucoma is also becoming more effective and easier for the patient. Macular degeneration remains a major problem for the elderly and we must hope that the extensive worldwide research towards effective treatment of this condition will soon start to bring results.


The former Nottingham Eye Hospital

All that remains is just the facade of the building as a visual reminder of what once was there, as the building behind the facade is a complex of luxury apartments.

The original Eye Dispensary in Nottingham was established on July 22nd 1859 at 23 Park Row, the street running up from Chapel Bar in Nottingham towards the top of Standard Hill adjacent to the Nottingham General Hospital, which was founded in 1782 and was close to the site where King Charles I raised his banner in 1642 at the beginning of the English Civil War.

The hospital was run by a committee, chaired by the 6th Duke of Newcastle, Henry Pelham-Clinton. There were 18 other members of the committee, a number of whom were clergymen from the local parishes and there were also two general surgeons George Eaton Stanger and J. N. Thompson.


RETURN

Photograph courtesy  of  Jonathan D'Hooghe

Photographs taken of the former Nottingham Eye Hospital before closure in 1982

Eye 01 Eye 02 Eye 03 Eye 04 Eye 05 Eye 06

To enlarge, click on individual  photograph