Sunday, 18 November 2018

The 70-year-old that we should all be grateful for

The 70-year-old that we should all be grateful for

A FORMER nurse at Townlands Memorial Hospital in Henley has praised the National Health Service as it celebrates its 70th anniversary.

Dilys Smith was 22 when the service was founded on July 5, 1948 by Labour health minister Aneuryn Bevan, whose Ebbw Vale constituency in South Wales included her native village of Bargoed.

She says it made all kinds of medical advances available to ordinary people and was a huge help to those struggling financially after the Second World War.

Before then, people either paid doctors for treatment or had private insurance policies, often administered through mutual associations or their workplaces.

Mrs Smith, now 92, lives in Western Road, Henley, with her only daughter Janet Waters, who chairs the patient participation group at the Bell Surgery.

She says residents are lucky to have the practice and the neigbourging Hart Surgery as well as the £10.4million hospital off York Road, which opened in 2016.

The hospital has a rapid access care unit, which replaced the old hospital’s 14-bed Peppard Ward and offers services including antibiotic treatment and transfusions.

It operates alongside a minor injuries unit, podiatry, outpatient services, physiotherapy and out-of-hours GP services.

This is a far cry from Mrs Smith’s childhood, when her small mining community had a single GP funded by a local scheme that all workers paid into.

This proved invaluable when her husband, who worked in the pits, was injured by falling debris and the doctor saved his thumb by operating on site.

Mr Smith couldn’t continue working as a miner so the couple moved to Gloucester, where he got a job as a postman.

Mrs Smith had only had odd jobs in shops and as a nanny because she never completed her Central Welsh Board exams, the equivalent of GCSEs.

This was because she was struck down in her teens with Sydenham’s chorea, then known as St Vitus’ dance, a childhood ailment that causes muscle spasms and is caused by bacterial infection.

It is now treatable with antibiotics and neurological drugs but back then doctors could only prescribe bedrest.

Mrs Smith said: “There wasn’t much else they could do and most of the time the nurses just moaned that I couldn’t keep the bedsheets on. I survived but it knocked my confidence for a long time.

“When I was growing up I also had diphtheria, which was very common, and there were other diseases like scarlet fever, polio and tuberculosis which killed a lot of children.

“You could never have imagined that healthcare in this country would become as good as it is now. I get very annoyed when people moan because they don’t realise how lucky they are.”

Mrs Smith said the NHS had revolutionised healthcare.

She said: “We used to have one doctor who was on call 24 hours a day. If people were ill, he would visit them at home as well as checking up on them if they were off sick.

“They did everything back then and most procedures were done locally. There weren’t many levels of treatment — if your doctor couldn’t do it, you went to the hospital 16 miles away in Cardiff.

“Bevan was the idol of the miners and we thought the NHS was a wonderful idea. Money was short so being free at the point of access was a massive advantage to the general public.

“It meant everything to communities after the Second World War because the country was still recovering economically. We still had rationing and food shortages.”

In 1966, Mrs Smith signed up to a two-year training scheme in bedside nursing at the Gloucester Royal Hospital.

Candidates were trained on the job before taking exams in order to attract more people into the profession by eliminating the need to go to college. Instead, there were classrooms on site where nurses learned about every area of nursing, including the operating theatre and the casualty ward.

Mrs Smith said: “I’m a naturally very caring person and I thought, ‘right, come on, it’s time to sort your life out’. I hadn’t been doing much up to that point but realised it was time to pull myself together.

“All the training was done in-house, which is rare these days. You simply had an interview with the matron in front of some other ward sisters and they decided if they wanted to take you.

“Our class was full of people who all went off into different areas, from mental health nursing to infant paediatrics.

“I decided to go on nights and the first day after I qualified I was put in charge of an entire ward, complete with babies and very young children. That’s how it was — as soon as you’d passed, you were expected to start work.”

Back then, hospitals were run by matrons who also supervised the work of non-medical staff such as cleaners and caterers.

Mrs Smith said: “She would be round every day to check up on everybody, which was a good thing as she ensured everything was being done properly.

“Her standards were always very high and if you didn’t make a bed properly you’d have to do it again for her. There was no margin for error, either — it was either all right or it wasn’t.

“It was a very disciplined environment, much more so than it is today. Whatever the matron said was law and nobody could argue — they really were the kingpin, or perhaps I should say queenpin!

“They were the only layer of management apart from their deputy.”

Mrs Smith moved to Henley in 1979, four years after her husband died of a pulmonary embolism, and worked as a nurse at the old Townlands Community Hospital.

She said: “It was a journey from one extreme to the other as I’d been mostly dealing with young children but at Townlands it was mostly older people.

“There was Holton ward for men and Cooper ward for the ladies which was also used to look after children with learning disabilities.

“I was looking after about 18 beds on my rounds and I remember GPs used to come in and see their patients every day.

“I had to retire in 1986 because I was 60 and felt terrible about it so I volunteered to deliver the newspapers on Friday. Patients would ask for help with things like adjusting pillows but I wasn’t allowed to do that once I’d left.

“I was so happy there because we were one big family and I still see some of my old colleagues on the bus or at the market.

“There’s no single achievement that I’m proud of because it wasn’t that kind of job — it was making a difference in small ways every day.”

Mrs Smith said drugs and medical technology had improved hugely since 1948.

She said: “They can do amazing things, although I do feel they’re missing the personal touch because everything’s so fast-paced. I recently had a heart valve replaced at Hammersmith Hospital and it’s almost ‘one in, one out’ every day!

“However, they can treat conditions in ways they never could in the past. My procedure was done without opening my chest; they just pushed a balloon through a blood vessel to place the valve and I was home in less than a week.

“Things like that show how medicine has really come on leaps and bounds.”

Mrs Smith was among the thousands of people who marched through the streets of Henley when Townlands was threatened with closure in 2005.

She also joined the march in 2015, when the Oxfordshire Clinical Commissioning Group announced it was to close Peppard Ward without providing new beds in the new hospital. Following the protest, the group agreed to provide eight “on-demand” beds at the neighbouring Chilterns Court care centre.

Mrs Smith said: “Townlands is a very important part of life in Henley and but for those marches we wouldn’t have it any more.”

Another ardent supporter is Valerie Alasia, a former member of the Bell Surgery’s patient participation group and a co-founder of the Townlands Steering Group, which was formed to save the hospital.

The 81-year-old moved to Henley from London with her husband John, who died last year, after the M4 was extended in 1965.

In 1980 she was appointed to the West Berkshire community health council, a voluntary body which visited hospitals including Townlands every six weeks and reported patients’ comments back to NHS bosses. She served for 16 years.

Mrs Alasia, of Makins Road, also took part in the Townlands marches and says she remains concerned about the lack of beds at the new hospital.

As a child, she recalls having a family doctor who was funded through a mutual scheme.

Like many of his era, he practised alone from his home and ran his own dispensary. There was no appointment system so patients simply turned up and could wait several hours to be seen.

Mrs Alasia said: “Childhood disease was common and there weren’t any antibiotics so they were dangerous and quite often fatal.

“I caught scarlet fever when I was five and wound up isolated on an adult ward in a former workhouse infirmary. There were about six children’s beds at the end.

“I was looked after by nurses but not allowed visitors and ended up alone on Christmas Day while the nurses had their lunch. Those really were the days!

“My grandmother was taken ill with pneumonia in 1943 and she was very proud that she’d been given these pills called M&Bs, the same ones Winston Churchill had taken.”

She says the NHS has increased life expectancy massively.

Mrs Alasia said: “Men would retire at 65, then die within a decade or less but now they can expect to reach 85 or even 100, although that brings its own challenges for the system.

“The principle of free healthcare is vital and no politician will dare say otherwise, although there has been a whittling away of certain aspects.

“The service used to provide long-term elderly care until 1987 so Townlands would have been full of older patients but that has all disappeared. I remember it used to fully fund dentistry and opticians as well.

“Despite that dilution, it can never go completely because it’s vital that people can get the help they need without fearing the cost.

“There are always debates about our spending costs as a percentage of GDP compared with other nations but statistics can always be manipulated to suit your argument.

“However, expectations are now very high in all areas from waiting times to referrals and I think people expect services to be available whenever it suits.

“That has been an issue for decades as I recall discussions in 1990 about stopping people with minor injuries visiting A&E. It’s a tricky one with no obvious solution. The NHS is going to be around for a long time because nobody wants to go down the American route.

“I can remember an American friend of mine saying she was the only woman in her area who hadn’t had a hysterectomy. They were performing that procedure because there was money in it but these decisions should be made on clinical, not commercial grounds. The NHS should give people security when they need it.”

Over the decades, she and her husband have been patients of both the Hart Surgery, which was originally based at Speaker’s House in Hart Street, and the Bell Surgery, which used to be in Bell Street.

Mr Alasia was given six months to live after being diagnosed with cancer in 1990 but pulled through following surgery and radiotherapy at the Royal Berkshire Hospital in Reading. He was successfully treated again in 2002 and died of unrelated causes.

His widow has been undergoing treatment for skin cancer for the past six years and is now on yearly reviews. Doctors from the Royal Berks see her at Townlands, where she recently underwent a biopsy and had a small growth removed.

She said: “We’re so terribly lucky in having the two practices, both of which have expanded beyond recognition from their two little offices.

“It is also wonderful that more and more clinical services are being brought to Townlands.

“I’m told the RACU now works well after some delays and we’ve kept our minor injuries unit so all we really lack are beds. My argument has always been that, without those, you’re placing more onus on the carers.

“We faced a genuine threat of losing the hospital and the success of the campaign was a tremendous relief as we felt we had turned the tide but that was only the start of the battle.”

Dr Chris Langley, who joined the Bell Surgery as a partner on the NHS’s 50th anniversary, said: “Like many patients, the past 20 years have brought challenges but birthdays are a time to celebrate the positive, happy times and for the NHS there have been many.

“Andrew Lansley, the health minister from 2010 to 2012, described the NHS as a ‘national organisation but best delivered locally’ and the Henley area is a great example of this.

“Our primary care is delivered by four impressive GP surgeries, the Bell and Hart in Henley, Nettlebed and Sonning Common Health Centre.

“After several years of change due to retirements as well as ill health and GPs leaving the NHS, all are better staffed than ever.

“This is a reflection of the high regard with which they are held locally as many surgeries nationally face closure as they are unable to recruit staff.

“They will soon deliver more choice by employing nurse practitioners, a pharmacist and clinical paramedic, which will further help manage increasing demand for appointments.” Dr Langley said he was “delighted” at last month’s decision by the Friends of Townlands Hospital committee, of which he is a member, to accept the gift of an ultrasound machine.

He said: “We are incredibly lucky that Townlands has been redeveloped given the current state of NHS funding.

“All the local GPs have found the RACU to be brilliant. It responds quickly, the staff are always helpful and it provides a fantastic new service for the area.”

He said further services would be introduced, including “one-stop” clinics, minor surgery and CT and MRI scans. Some of these could be done on the building’s second floor, which is currently vacant.

Dr Langley thanked all those who had fought for Townlands’ future as well as volunteers such as drivers, health walk organisers and members of the patient participation groups.

He said: “On its birthday, I hope the NHS might get some of the presents it has made clear on its wish list. More staff, especially nurses, carers and GPs would be welcome.

“When it comes to cutting the funding cake, let’s hope that primary care gets a bigger slice as it’s getting tired of being asked to provide more with less.

“Like many 70-year-olds in Henley, the NHS has much to celebrate and with support from its friends can look forward to a happy and healthy future.”

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