The Health Service Over the Years A Personal Report

by Sara John

“Daddy, what was that new very big word you just said?”

“I asked her what we were going to have for tea.”

“No, no, no, I responded, it was a big, long word, you and uncle Bryn were talking about it in Mam-gu’s house on Sunday.”

“Was it Nationalisation? ” he asked me.

“Yes, yes” I responded and tried to say it myself, “what is it?”

“I will tell you when you are older” he said, always to me a very disappointing answer. “Will I be older next week? Will you tell me then?” “Will there be another war?” I recall asking that question daily. It was usually part of the answer to any questions a child asked in the late nineteen - forties.

My father found it easier to surrender some of his off-duty time to respond to my endless questions, then he could settle down with his newspaper. And I would be put to bed.

Over a period of time, I was told a simplified version of what led up to the Nationalisation. Eventually the Coal Industry Nationalisation Act was passed. My father explained that it gave miners and their colleagues greater control over their own energies. Everything became quieter, more peaceful, the workforce seemed more confident, men and management were fulfilling the same aims. The industry was looking to the future, the workforce mattered more. Laws were passed, serious change was in the air. Life for the workforce, the management and all their families would become measurably better.

There was a lot more to come. I was very small but felt life was going to be different from now on. I recall visiting Mam-gu’s house on a Sunday evening and staying for supper along with a chapel’s worth of aunts, uncles and cousins. Grace was always said prior to Aunty Morfydd giving permission for everyone to begin their meal. Inevitably the conversation eventually turned to politics, the coal industry and competition from abroad. There was a remembered fear of the bad times following the First World War when Germany by paying réparations to the Allies in the form of cheap coal, upset world coal prices. This affected many joint agreements between the workforce and management that had been agreed and settled in the recent past. Thank Lloyd George for all that.

By this time of an evening, small persons such as myself were in the hall looking for their pink bonnet, pink gloves, purses with a little small change, but no sign of sweeties as they were still on ration. I was ready to go home and to bed and greet my almost bald teddy, I had cuddled him to severe baldness, and, as my father explained, there had been a war. An overload of worry for Teddies.

On the way home I wanted to know why Uncle Bryn was going to have an x-ray in Cardiff, was it anything to do with the pictures of Rays in my Animals of the World book. My father began to explain. The “old dust” had come up for popular discussion. Changes were being put in place along with new rules and regulations, in the main for the benefit of workers who, thanks to x-rays and wonderful pioneers such as Doctor Fletcher of Llandough Hospital, were being better cared for. At last.

Looking back now, it seemed that the next huge change in well-being came along in no time at all. However, it was on July 6 1948 that the next big one happened.

Up until that date, sick people had to pay for care, operations, diagnoses, false teeth, spectacles, walking sticks and wooden legs. Even for my generation, and with some of us with good memories, we cannot grasp the worries, realities and suffering that affected so many people before a scheme for free, health care for all was introduced.

However, in the middle of the previous century changes had begun to filter through society following the most welcomed bills that Lord Shaftesbury introduced to the generally disinterested House of Parliament. The growth of the non-conformist movement, seeking change, fairplay and a better all round standard of living also helped to grow awareness of the terrible conditions thousands were living in following the bursting success of the Industrial Revolution. A revolution that had ensured the investors, the risk takers, and sons of wealthy people had a fulfilling career ahead when it was clear they were not the inheritors of large estates, nor were they destined for the Church nor the British Army.

The health of the current working population determined the level of energy, health, ambitions and success for the next generation.

This was considered new thinking. It made sense but how to ensure that it would bring forth fruits? In July only two or three years after the National Health Law was passed, thirty-six million people applied to join the new, free at the point of use scheme, became available to all as the National Health Service.

The fear of illness, suffering and being a burden on your family had been banished. The tale of how it eventually came about, the politics, the ‘system’ that was so complicated behind the scenes all took a very long time. But it was completed and people who had not kept up with reading the acres of newsprint were in awe when they visited one of the new clinics or hospitals for the first time. So clean, so modern, so efficient.

My first exposure to this New World was going with my mother to visit a cousin who was in Church Village – East Glamorgan hospital. She had a tumour on the brain and was being prepared for an operation. Listening to ‘grown up speak’ by other relatives, I understood that it would be a first-time event in that particular hospital, and all totally free. My father explained to me that previously under the old scheme of things, she might not have had an operation at all. We went into the main concourse, all tiles and polished chrome, I was trying to take everything in to remember to tell my father, but I was mesmerised by the number of nurses and their uniforms. My mother explained their ranks, “Oh”, she said suddenly, “there is the matron”, in the midst of a group of very well starched young women. Matron’s elaborate headgear signalled to one and all, “I am THE matron”. There were many different coloured dresses for all the other staff I was observing. It was, I realised some years later, that it seemed we were in America. I had discovered story books about Sue Barton, I had them from the library, and any of the passing immaculate nurses could have been a friend of Sue Barton. The Book’s title always included her progression, through her training, Sue Barton, Student Nurse, Sue Barton Ward Sister and so on.

I was taken outside the building and shown some concrete steps leading up to one of the large windows. The window was open so I could wave to my cousin and blow her kisses.

That hospital visit cleared from my little brain the photographs of medical articles that I should not have been reading anyway. During the War and well before I was born my mother had been ‘The Housekeeper’ at a local fever hospital and had handy stories to use as a warning to me about what might happen if I did not eat my food, take medicine and finish my prunes. In retrospect a bit heavy handed I think, and totally unlike what was already happening in hospitals all over the country.

But how did all of this come about?

Outbreaks of plague, The Black Death as it was known, cholera, typhoid and many other highly virulent fevers spread rapidly in poor areas. In one of the tenements in the Royal Mile in Edinburgh the only way deadly infections could be managed at all was by bricking up a series of adjacent homes in the same building containing sick people. The inhabitants then expired either because of the disease or through starvation. The properties were not unbricked until discovered fairly recently.

There were few “hospitals” as such, usually owned and run by nuns and monks but with small numbers of beds, ten or twelve at most.

In the early 18th century there was just one Hospital in Cardiff. It was on the north side of Newport Road almost on the corner with the beginning of Queen Street, it was the Glamorgan and Monmouthshire Infirmary. This was not a hospital as we know it. You could not stay overnight. It dispensed medicines and outpatient care only.

From the eighteen seventies onwards, there was much discussion about the need for a larger establishment. Money had to be raised, there were no grants from head office in those days. The Marquess of Bute offered four acres of land on Long Cross Common for four thousand pounds, which was half its real value. That is where the “our” Cardiff Infirmary stands today. Leaping ahead of this story about the “Infirmary”- there is an excellent book by Arnold Aldis called Cardiff Royal Infirmary 1883 – 1983 Cardiff University Press 1984 explaining where funds came from and the problems to be overcome during an epic project.

For people living in the South Wales Valleys this was hardly a workable solution, every day with such a dense population at that time, women died in childbirth before the ambulance had reached Pontypridd, children with serious conditions, fevers, road accidents and others feared never seeing their parents again. The ambulance continued on its way, going along to Cardiff thumpity bump-thumpity bump thumpity-bump. A good twenty-five miles away.

Local people even when I was small, believed that when Valleys folk were taken to the Infirmary they would never return home again.

In the early years of the nineteen hundreds a number of Cottage hospitals were opened in the mining Valleys. Often with only ten to twenty beds, serviced by local and devoted doctors who still ran their own practices and with a small but permanent staff of nurses and a matron. The running costs were covered by various insurance type schemes. Men working in the coal industry were docked one penny, per man, each week. These funds were sufficient, along with Bazaars, Sales of Work, Bequests and “the kindness of strangers”. For example Madame Patti gave concerts in both Swansea and at Craig yr Nos to raise monies for such, often lifesaving, ventures.

Going backwards in time for a moment, how did this begin? who thought it could possibly be viable?

One of the first seams of steam coal was won – an odd word but the right word – in Dinas. The mine, despite an early Disaster, flourished and it was decided by the Management that they would dock the pay by one penny per man and would, themselves employ a fulltime doctor to care for not only their workforce but the their workforce’s family.

This is the real beginning of a health service free at the point of use. Taken up in later years by other mines and their owners, prior to Caerphilly Miners Hospital’s well deserved later fame.

You may wonder how, what might look like a small place of industry, could find enough men and enough pennies to fund such a venture. I will point out that at its peak The Park and Dare Works in Cwmparc employed five thousand men.

Dinas Works School was also opened and funded as a school for young children. They were taught to read, write, listen, play together and how to behave. This early place of learning was of course soon overtaken by new legislation regarding education.

Meantime hospitals were being built and added to in Cardiff as the City population grew and grew.

I have spent brief periods in some of them over the years. I have much to be grateful for.

The most interesting one historically was the “Fever Hospital” which gave Sanatorium Road its name. It was built in the eighteen seventies to care for the patients with cholera which was rife in Cardiff for a time. The hospital was built on stilts as the site was subject to flooding and haboured rats; a lot of rats. I was only there for a minor procedure but it was like going into a museum. Nothing appeared to have changed. All the plumbing was brass or copper and it took two patients to turn on the taps. It had been built to last and was clearly suited to giants. The gas lighting was still in place but not operational. The huge bathrooms had enormous baths, if you dropped your soap you had to swim around looking for it.

I had my son in Glossop Terrace Maternity hospital. I was there for two weeks. It was an extraordinary experience. The student midwives told me how lucky they were to have been accepted there. In their future, when fully qualified, they would be welcomed in any hospital in the country.

Needing to have some of my inner working parts rearranged I was fortunate to stay in St Winefride’s in Romilly Road. Mr Hilary Wade looked after me and he was a perfect gentleman from the old school. Sat on my bed, held my hand and seemed to have x-ray vision and knew about all my inner workings.

I was in a ward with three other ladies. The hospital was run as a Catholic establishment and as none of my fellow patients were Catholic, we were not sure what to expect.

We soon had a welcoming party of Nuns in traditional garb with black gowns down to the floor. Then we had a visit from Nuns all in white who were nursing nuns. We were each delegated a nun, the ones in traditional clothes, to look after our needs.

We were blessed before we went to sleep with our personal nun sitting on the bed.

First thing next morning in comes Sister Visitation who tells us she is eighty-four and as fit as a fiddle, waving about the racing pages of the Daily Mirror. She explained she had just come off the phone with a colleague from the Order’s HQ somewhere in the countryside outside Dublin. Who did we fancy for the three o’clock at Sandown Park? She had had a number of tips all written out on a sheet of paper tucked into her prayer book. One hour later we had all chosen our bets and given the money to this extraordinary lady.

That business, so unexpected, had brought us up to coffee time, or so we thought. Sister Visitation was back with a pen and notepad. And gone again. And back again with a tray of drinks. And I mean drinks. She had scurried across the road to The Romilly which she described as “our Local”. I had a generous wine glass full of Guinness which she said would build me up. She had specified various liquids for my room mates and insisted she knew what she was about. None of us were quite so sure. We survived but lost our money backing horses all of whom were known along with their mothers and fathers to Sister Visitation. And their aunts and uncles.

In complete contrast to The Sanatorium Road hospital, I had more re-arrangements carried out at the BUPA hospital along with a host Nurse and printed menus in leather folders and bedspreads that matched the curtains.

From my bedroom window in the Rhondda when I was a child, I could see the old Smallpox hospital on the brow of Penrhys mountain. It was demolished years ago but had done its duty as recently as 1961 when there was an outbreak of Smallpox. There were a number of deaths and it was all very frightening.

During the war my mother had worked at Tyntyla fever Hospital, as The Housekeeper and recalls three or four children to a bed during a very serious outbreak of diptheria. The hospital was built as five separate units, scarlet fever, diptheria, chicken pox, German measles and so on. T.B. patients were nursed in a different area with exceptionally large clear glass windows.

My most recent hospital stay was in the University Hospital at the Heath. It is overwhelming in scale but has wonderful staff who must walk many miles every day apart from performing their duties. I was very well looked after in every way, and I am now enjoying a clean bill of health. There is a lot more I would like to say. Stories for another time perhaps?