ninety years of service - University Hospital Southampton NHS ...

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hospital there was pressure to ensure that at very least the S.H.O.s should be properly instructed in the technique.In the early 1960s surgery on hydrocephalus by means of the Spitz-Holter valve became possible and the early closure ofspina-bifida was also widely advocated for all cases. Mr Rowntree accepted this policy with some reluctance. It led to agreat increase in the number of survivors many of whom had severe medical, surgical and social problems. As the fullimplications of this policy became apparent many difficult ethical considerations also came to the fore.On a National level the policy also resulted in an increase in the total surgical work load which together with thedevelopment of neonatal surgery led to a government working party calling for’ the establishment of Regional PaediatricSurgical Centres throughout the country. This pressure together with the fact that Mr Rowntree had been invited tobecome the first chairman of the reorganised Group Medical Executive Committee led to his resignation from S.C.H. andthe appointment in 1969 of Mr John Atwell as the first full time Paediatric Surgeon with Regional responsibilities. He wasshortly to be joined by Mr Neil Freeman. One of the best remembered persons in the surgical team was Flo Coady. Shecame to the hospital during the war years as a Red Cross volunteer and Mr Richardson recalls that at times she ran thetheatre almost single handed. She continued to work in the theatre in different capacities finally as sister for over twentyyears.Sadly in the end she had to resign because she had never done her general training. During her time in theatre she wasalmost obsessional in her devotion. She made herself available at all hours of the day or night seldom taking days off.When the theatre was not in action she would spend hours cleaning and polishing. Subsequently she continued toprovide a very valuable service running medical clinics or O.P.s.The Out-patients Department on the ground floor below Ward II was approached along a narrow and dangerous drive tothe side of the hospital. In 1950 it was in the charge of Sister Jenny Tutcher. There was a fair sized waiting hall with alarge fish tank in front of the seats and a small canteen with Gladys in charge, behind.To the left of the main entrance was the reception window and records office. A friendly face at the reception window canmake all the difference to an apprehensive child and it’s mother. We were particularly fortunate in having a succession ofwonderful people in the office starting with Miss Yeates and followed by Mrs Jean Foster and later by Mrs Carol Whealey.Some of the patients notes were stored in the office but the rest were in the old stables down the garden next to themortuary; an unpleasant trip for the staff on a wet day. Sharing the office with the records staff was a medical secretary.Next to the Records office, Miss May. the Lady Almoner, had a minute office shared with her clerk. In the corner was thepharmacy with a hatch into the waiting room and a preparation and sterilising room behind. Miss Stevens was thepharmacist in charge in 1950 to be followed by Mr Miller and later Miss Tracey.There were two smallish inter-communicating consulting rooms which housed the O.P. clinics. Each clinic was run in asomewhat different way according to tire consultant’s preference. He was supported by either sister or by a staff nursewho would call the patients in from the waiting hail outside. They would have previously been weighed and measured inCasualty. In my clinics sister also made any necessary follow-up appointments in the room before the patient left. Therewas usually a saucer of ‘Smarties’ on the consultant’s desk as well as a selection of small toys. In addition to theconsultant and sister there was often a G.P. Clincal Assistant or student in the room not to mention the patient and hismother. I was very fortunate in that once a week Dr Capes would be using the adjacent consulting room so that I couldeasily get a snap psychiatric opinion on a case without having to wait for a formal appointment. The size of the clinicsvaried considerably; if they were mainly ‘old’ patients there could be thirty or more in a session. But probably not morethan ten new patients would be seen at a timeIn the course of time special clinics such as cardiac, diabetic, psychosomatic, spastic, adolescent etc were establishedsometimes held jointly with a visiting consultant In addition there were dermatological, E.N.T., physiotherapy and speechclinics mostly for internal referrals only. Once a week the consulting rooms would be cleared for Dentals and a formidablelooking dental chair would replace the usual desk, with the anaesthetic machine in the adjoining room, Except for a fewyears during the war Mr Sanders ran the weekly dental clinic from 1939 until the hospital closed in 1974.The Casually Department was on the other side of the waiting room with it’s treatment room complete with a gas heatedsteriliser and anaesthetic machine. Many of the children presenting at the department were ‘casuals’ rather’ than truecasualties. It was a busy department which was always open. As well as providing a very valuable service, it also gaveimportant experience for the junior staff. Later there was strong pressure to close the department and the open hourswere reduced to 9 a.m. to 5.30 p.m.The Children’s hospital was not the only unit in Southampton which treated children :in fact in 1940 there were officially165 children’s beds in the Group of which only 65 were at S.C.H. . A 28 bed ward at the General Hospital admittedchildren mostly for Ts and As.. Orthopaedic children were nursed at the Royal South Hants Hospital and at Lord MayorTreloar’s at Alton. The Eye Hospital had a small children’s ward and at the old Isolation, then the Chest Hospital, therewas an old fashioned infectious disease block (Pavilion A.) as well as a modern children’s ward for cardiac cases. Laterwhen Dr McLachlan retired the paediatric staff took over the care of the infectious patients (including a few adults) inPavilion A. and included the unit in our junior staff rota.It was several years before we were allowed access to the babies in the Maternity Unit. Intensive care for neonates was
very much in its infancy and little specialised equipment was available. Intravenous fluids were either administered into ascalp vein or by cut down. Incubators were usually obtained on hire from Oxygenaire. When in 1955 the wife of aninternational banker en route for London, unexpectedly gave birth to premature twins in Southampton, a question wasasked in the House of Commons a few days later as to the number of incubators at Southampton General Hospital. Theresponse was very gratifying! Exchange transfusion for haemolytic disease of the newborn had recently been introducedand I well remember my first successful case in Winchester being reported on the local radio. Once the procedurebecame well established however, it began to take up an unacceptable amount of our time and became quite a problem.We were one of the first units to develop phototherapy for neonatal jaundice using our own home made apparatus ornatural sunshine when available. We also pioneered the use of a plastic oesophageal tube for feeding premature infants.During this period there was almost continuous pressure to close the Children’s Hospital on the grounds that it washopelessly out of date and that the average bed occupancy was unacceptably low. On this point we were able to showthat this was due to a very high turnover. The average stay in a bed at Winchester Rd being only a few days; in fact therewere periods of acute bed shortage. The medical staff agreed that the hospital certainly did need updating but stronglyopposed the suggested closure and transfer to the General Hospital. Then in 1956 an unexpected factor came to our aid;this was a very unpleasant outbreak, in Southampton, of sepsis due to anew type of staphylococcus (Phage type 00). Itwas believed to have arrived in the city via the ships from Australia and first presented in the general surgical wards aswound sepsis and in the Maternity Unit as breast abscesses etc. It did not take long to spread to the babies in theMaternity Unit or to Winchester Rd itself. The epidemic in Southampton lasted for about two years before it burnt itself outbut it was interesting to follow it’s very gradual spread outwards over several years to involve in turn centres throughoutthe whole country.At the Children’s Hospital we were able to point out the obvious dangers from our out dated sluices and lack of isolationfacilities. Local M.P.s became involved and in June 1958 Mr Howard M.P. for Southampton Test, tabled a question inParliament asking when the buildings of the Southampton Children’s Hospital would be replaced. The Minister of Health,Mr Derek Walker Smith, replied that improvements costing £20,000 would start almost at once. The Managementcommittee had reluctantly agreed to allocate this sum for a major facelift. Again it was argued that this was ‘money downthe drain’ and that an entirely new comprehensive children’s hospital should be built but funds for such an enterprise werenot available.Unfortunately the work necessitated the closure of the wards and in July1958 the in-patients were transferred to Willan ward in the Royal SouthHants Hospital and the gastro-enteritis babies to the Chest Hospital. Outpatientswere held in cramped conditions on the ground floor of the Nurseshome. The modernisation involved cubiclization of most of Ward I, theextension of Ward II and the provision of new sluices and other equipment.We ended up with 7 cubicles and 10 beds in Ward I and 8 cubicles plus twowards of 8 and 4 beds in Ward II. The work took longer than expected buteventually the hospital was reopened in June 1959 by Mrs Victoria King,chairman of the H.M.C., supported by three local M.P.s.The question of visiting was, for a long time, a thorny one. Until World War IIvisiting was allowed from 2-4 p.m. daily Sundays excepted but then itbecame confined to 1 hour on Wednesday and Sunday afternoons and in 1947 it was banned completely for fear of crossinfection. In 1950 however very limited visiting (1 hour on weekdays except Fridays and 1 hour on Sundays) was againpermitted though the parents had to wear facemasks. On a National level Dr John Bowlby and Mr James Robertson hadalerted public opinion to the possible psychological trauma suffered by young children admitted to hospital. Dr MaryCapes strongly supported their views and led a long campaign to liberalise visiting hours not only at the Children’sHospital but also in the other units in Southampton admitting children. In the former with the support of most of the staffshe was very successful and S.C.H. became quite a national model in this respect. ‘Free visiting’ (11 a.m.-7 p.m.) wasestablished experimentally in 1959. In the following year a successful appeal was opened by the League of Friends toprovide sleeping accommodation for two mothers in a small attic room on the second floor which was much appreciated.By the middle sixties the number of cases of rheumatic fever and nephritis had declined sharply and Bursledon becameincreasingly involved with psychosomatic and behavioural disorders. It was no longer necessary to have a residentmedical officer there. In place of the R.M.O. we established the post of Clinical Assistant which was held part-time by asuccession of married women doctors, the longest serving of these was Dr Jean Davies who was appointed early in the1960s and continued until the unit closed in 1988.During the sixties also we became increasingly involved with the care of children with chronic handicaps. Previously wehad been concerned mainly with the more obvious types of mental handicap such as Diran’ s syndrome but thesechildren tended to disappear into Tatchbury Mount or Cold East and we lost touch. Rubella embryopathy was relativelycommon until vaccination against German measles was introduced. Children with cerebral palsy were cared for by MrsWelch at her house in Rose Road and in 1951 at the purpose built Spastic Centre in Aster Road.In 1962 we were suddenly presented with a number of babies with stunted limbs and other serious malformations. It wassoon realised that these cases were being born to mothers who had taken Distaval (thalidomide) in early pregnancy.Many of these babies died but some survived with varying degrees of handicap. One of my cases (Graham) was bornwithout any limbs, eyes or ears, it was thus quite impossible to communicate with him although somehow he did seem
Page 3: FORWARDbyI.C.S.Normand. D.M. ,F.R.C
Page 7 and 8: In 1903 there was a donation of £5
Page 9 and 10: ubble of a house. However once the
Page 11: they could receive some schooling.
Page 15 and 16: throughout the South and the Isle o
Page 17 and 18: and his team pointed us in the dire
Page 19 and 20: enrolled for one year. At this time
Page 21 and 22: West Paediatric Club based on Brist
Page 23 and 24: ward of about 25 beds, in a separat
Page 25 and 26: This appointment although it was go
Page 27 and 28: neighbour had had an in-growing toe
Page 29 and 30: The house physicians assisted the v
Page 31 and 32: APPENDIX 1Medical StaffDr W. Maclea
Page 33 and 34: Lady Superintendent Later Matron.Mi
Page 35: Analysis of Admissions and Deaths f

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