Clement clarke 100 year anniversary book by Gill Assheton

The Clement Clarke story commences with the company’s humble beginnings in 1917, when Clement Clarke Dispensing Opticians was formed. It then sees the company begin a successful collaboration with Edgar Fincham to produce the first British slit lamp and the Fincham Ophthalmoscope. In this publication you will witness the company expand its spectacle frame-making business by setting up its first Eye Clinic in the 1920s and discover how this aided the conception of the National Eye Service and influenced the NHS ophthalmic services we know today. Celebrate the launch of the revolutionary new Synoptophore in the 1930s, and learn about its use in the orthoptic testing of RAF servicemen and how this impacted the Battle of Britain. See why Clement Clarke Limited diversified into artificial eye production, facial prosthetic reconstruction and the manufacture of sight safety flying goggles during the war years. Find out about the company’s entry into the respiratory market in the 1940s, with the development of an early inhaler, followed by a revolutionary new general anaesthetic machine, the Marrett Head. Moving through the 1950s, we see the company relocate to Harlow to enable integration of the medical and aviation communications operations into a single factory. During this decade Clement Clarke Limited also forms a successful

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partnership with Dr. B.M. Wright to produce the first portable peak flow meter. The book explains how, in the 1960s, sight testing services by opticians became a recognised Health Act and, with the increased demand for spectacles, a huge programme of modernisation commenced at manufacturing subsidiary Hanwell Optical Company. In the 1970s, we see the ophthalmic division of Clement Clarke Limited amalgamate with Airmed, and the company reform under the new name Clement Clarke International (CCI). We also learn about the company’s expansion with its purchase of John Weiss & Son Limited. CCI is then acquired by the Haag-Streit AG optical group in the 1980s and the internationally-renowned HaagStreit Group we know today was formed. The company’s UK-wide dispensing optician stores were then sold to the high street chain, Boots PLC, resulting in the formation of Boots Opticians. The 1990s sees a focus on innovation and the development of new products, many of which have become the gold-standard in their field and are still used in modern practice today. Moving into the present day, this book describes the separation between the ophthalmic, respiratory and telecommunications divisions and the sale of Clement Clarke Communications to the MEL Group. It concludes with an overview of how the current three remaining companies Haag-Streit UK, Clement Clarke International and John Weiss & Sons - continue to support Clement Clarke’s original vision, employing cutting-edge technology to make a significant difference in the medical sector.

THE CLEMENT CLARKE CENTENARY - THE FIRST 100 YEARS... 1917 -2017

In 2017, Clement Clarke Limited marks its centenary year. This commemorative book celebrates the long and varied history of the company.

The Clement Clarke Centenary

1917 -2017 The first 100 years...

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The Clement Clarke Centenary

1917 -2017 The first 100 years...

CLEMENT CLARKE – THE MAN The Early & Military Years Clement William Clarke was born in Marylebone in 1883. In 1899, he became an apprentice to George Spiller Dispensing Opticians, located in Wigmore Street, London. After serving his five-year apprenticeship, Clement was promoted to Junior Assistant. Through the years he progressed steadily; in 1910 he was appointed General Manager and by 1913 held the position of Managing Director. A year into WW1, Clarke left Spillers and joined the 13th Middlesex Regiment, where he served for two years. He was discharged from the military on medical grounds in 1917.

The Businessman Upon returning from the Great War, Clarke refocused on his business career in the optical industry. Known for his boundless energy and enterprising initiative, he purchased the goodwill of Leslie Pullar, dispensing opticians, and Clement Clarke Dispensing Opticians was established. During the early days, the premises were quite small, comprising just the showroom and first floor, and the business consisted of only four staff members: Clarke (known affectionately as ‘The Governor’) and three other staff from Spillers. Business in the early days was challenging and the staff would often need to remain at the workshop until after midnight to ensure the day’s work had been completed.

THE CLEMENT CLARKE CENTENARY Clarke's obvious interest in ophthalmic instruments was pursued with the same vigour and enthusiasm as his original entry into dispensing optics. After the company's first sale of compasses to the War Office in 1917, he actively promoted other instruments that were available at the time. The first of these was the original Malton self-luminous ophthalmoscope. In 1921, he was introduced to Edgar Fincham and H.H. Emsley, both of whom assisted in the design of the Clement Clarke ‘Elliot Halometer’. This initial association was the beginning of a long and rewarding partnership which would benefit the design of British ophthalmic instruments for many years. In the years which proceeded, Clarke encouraged Fincham to undertake development of the first British ‘slit lamp’ in 1924.

The Family Man Dedicated to Charitable Work Clement Clarke had four children: two daughters, Marie and Diana, and two sons, Alex, born in 1907 and John, born in 1921. Both sons joined their father in the family business and would later both become Chairman. Clarke loved the town of Whitstable and the allure of the sea and had moved to the town in 1917 where he remained until the late 1930s.

1917-2017 THE FIRST 100 YEARS Professional career aside, he was a member of many organisations and was active in both charities and local politics. From 1923 to 1926 he was a member of the Whitstable Urban District Council and for some years, was a prominent member of the Tankerton Hospital Committee of Management. Whilst in this post, he instigated and formed a voluntary organisation called the ‘X-Ray Boys’ which focused on a variety of fundraising activities with the purpose of providing the Whitstable and Tankerton Hospital with its first X-ray equipment.

The End of an Era Clarke remained dedicated to innovation and experimental work until his death in July 1946. He had been heavily involved in the development of specialist diagnostic and training equipment for the Air Ministry during the Second World War. His key innovations during this period included the development of the famous MKIV flying goggles, night vision testing equipment and plastic artificial eyes. Difficult wartime conditions left their mark on Clarke’s health and following his death, Clarke’s son Alex became the new company Chairman. John Clarke re-joined the company after serving his country in the RAF as a navigator and would also one day serve as Chairman. Both sons were determined to continue their father’s legacy.

1917-1 9 2 9 The roaring twenties was a decade characterised by flapper girls and jazz music, though was also a time of massive unemployment and deprivation. In 1921, unemployment reached a post-war high of almost 2.5 million. In contrast, manufacturing was flourishing and companies which had supplied goods needed for the war effort prospered. The 1920s were seen as an entrepreneurial and innovative time for optical, scientific and industrial

development. This was particularly evident in the British ophthalmic industry which was recovering at an accelerated rate, building on traditional strengths in manufacturing, coupled with newer pioneering designs in ophthalmic instrumentation. Clarke grew the business substantially during this time, moving to new premises, opening additional branches UK-wide and expanding manufacturing facilities. It was also an exciting and inventive period for the company with the launch of new diagnostic devices.

First British Slit Lamp Developed During the 1920s a long and rewarding partnership developed between Clement Clarke and leading surgeons and innovators Edgar Fincham and H.H. Emsley. This partnership benefited the design of British instruments for many years and pioneered the previously non-existent cooperation between the surgeon and the physicist. Clarke encouraged Edgar Fincham to take on extensive development work and, in 1924, Clarke produced the first British slit lamp. The Fincham slit lamp developed microphotographs showing sections of the human retina and was the first to combine the illuminating and viewing systems. The new ability to adjust both of these features simultaneously enabled a much faster and simpler clinical examination for the busy surgeon.

NATIONAL EYE SERVICE IS CONCEIVED Clarke set up his first eye clinic in Ealing in 1928. He believed that the patient would be better served if refraction was performed by an ophthalmic surgeon, which would usually only be possible by arranging a costly private appointment. The British Medical Association approached Clarke for guidance in operating a scheme that could provide the general public with the facilities of a consulting surgeon at a moderate cost. As a result of this, the National Eye Service was coined. This marked the beginning of a new approach to eye care and would later be used as a model for the NHS provision of ophthalmic services.

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Fincham Ophthalmoscope Launched In 1926, Clement Clarke and Edgar Fincham developed the Fincham ophthalmoscope which retailed at just ÂŁ9, including the battery and case!

The Ophthalmic Industry Grows

CLEMENT CLARKE EXPANDS After opening the first branch outside London in Torquay in 1920, Clement Clarke Dispensing Opticians expanded rapidly. During the next few years, branches were opened regularly and by 1929, ten retail stores were in operation throughout the United Kingdom.

The growth in the UK manufacturing industry following the end of WWI was reflected in the sales of Clement Clarke products. As the volume of sales increased, it was necessary for Clement Clarke Ltd. to expand manufacturing facilities. In 1927, a new workshop was opened in Torquay to cater for the needs of local customers. Shortly afterwards, a new factory, the Hanwell Optical Company, was also opened in Letchworth. Here, they undertook prescription frame making and repair work.

1930 -1 9 3 9 The 1930s marked Britain's largest and most profound economic depression of the 20th century. Particularly

prosthesis. This ground-breaking work was prompted by those living with horrific injuries sustained during WWI.

hardest hit were the industrial and mining areas in

Clarke was determined not to let the economic

the North of England and Wales. The Midlands and

depression affect the company and continued to

the South fared better, largely due to new developing

expand its number of branches. Clement Clarke Ltd.

industries in these areas. On the 3rd September

shifted production from surgical devices to orthoptic

1939, Britain declared war on Germany and mass

equipment and plastic contact lenses. The decade

enlistment soon followed.

also saw the company embark on innovative work in prosthetics and the development of both plastic lenses

The early 1930s saw a boom in the development of

and acrylic artificial eyes. Both of these would go on

synthetic plastics which would open up a wealth of

to be important developments in the war effort. At the

possibilities in many future UK industries. Eminent

start of WWII, the company set up an emergency fund,

surgeons were beginning to explore and develop

financed by staff, to assist those severely affected by

the art of plastic surgery and facial reconstruction

the conflict.

ALLIED INSTRUMENT MANUFACTURERS (AIM) FOUNDED In 1937, Allied Instrument Manufacturers (AIM) was established by Clement Clarke in Pratt Street, Camden Town. The new company was a joint manufacturing venture between Clement Clarke Ltd., C. W. Dixey & Son Ltd, Alfred Hawes & Son Ltd and Curry & Paxton Ltd. The pooled resources allowed the companies to work from a properlyequipped factory, enabling the improved manufacture of devices.

FIRST SYNOPTOPHORE LAUNCHED The 1930s witnessed Clement Clarke Ltd’s involvement in producing a host of vital new products for the ophthalmic profession. The development of the first Synoptophore greatly enhanced the company’s growing reputation. Its basic function was to correct a squint by muscular exercise, rather than surgery, whilst simultaneously improving the vision in the offending eye. The first models were named the ‘Royal Westminster’ and the ‘Moorfields’ and were launched in the UK in 1931.

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THE FORMATION OF A PROSTHETICS DEPARTMENT

Optical products

Contact Lens Production Begins In 1935, Clement Clarke Ltd. began producing ‘first-class’ plastic contact lenses in Wigmore Street. Clarke’s lens technician, E. Plaice, was trained at Utrecht University under Professor Weve and Dr. Thier in the art and production of plastic contact lenses. These would mainly be used for service personnel, such as night-fighter pilots during WWII. Although the company’s efforts were mainly focused on manufacturing moulded glass haptic contact lenses, the technique of making plastic contact lenses was developed in collaboration with the Royal Marsden Hospital, originally in producing lead eye shells for protection against deep ray therapy of the orbit.

were not the only thing which interested Clarke. In 1934, the first attempt to produce facial restoration was made in Wigmore Street. It consisted of a thin silver-plated copper mask which was painted to match the patient’s skin colour. Although crude, this was a great success and allowed the patient to resume a normal life. Encouraged by their previous success and requests from the medical profession, experiments were conducted to find a more suitable material. Clement Clarke Ltd. obtained the rights to use a gelatinous compound which had been pioneered in Hungary by Professor Skutta Árpád and, as a result, the Prosthetics Department was formed. The success of the Prosthetics Department resulted in the company being approached by Westmore Brothers Studio in Hollywood and Britain’s Pinewood Studios to produce prosthetics for the 1930s film industry.

Plastic Lenses & Artificial Eyes Developed During the early 1930s Clement Clarke’s Instrument Department worked with COIL in the development of plastic lenses. The high-quality spectacle lenses, branded ‘Igard lenses’, were produced by pressing two pre-formed Perspex blanks between optically-polished stainless steel tools. Spectacle lenses were strictly rationed during WWII, so a steady supply of Igard lenses significantly helped the company’s spectacle sales both during the war and immediately afterwards. In September 1939, England declared war on Germany and the supply of German-made glass artificial eyes ceased. Research immediately commenced to find a substitute, resulting in Clement Clarke Ltd. experimenting and developing the first plastic artificial eye made from acrylic resin. The work included the fitting of artificial eyes for children who had been blinded by the bombs.

John Clarke Joins the Company The company was continually expanding and, by 1939, 36 branches were in operation, all operating with National Eye Service clinics.

John Clarke began his career within Clement Clarke Ltd. in 1937 at the age of 15, starting at Idris Yard, Camden Town (Clement Clarke’s Instrument Department). In 1939, he joined the RAF as a navigator to contribute to the war effort and served until 1946. John’s career with the company went on to span nearly 50 years.

1940 -1 9 4 9 The start of the decade saw the British people enduring the bombing of towns and cities in the Blitz. Rationing of food began in January 1940 and, by 1943, virtually every household item was either in short supply or was unobtainable. As the war ended, the British Treasury was near bankruptcy and the period known as the Age of Austerity began. During the early 1940s, the British government mobilised its citizens and, by 1944, a third of the civilian population were engaged in war work, including over seven million women. Factories switched from the manufacture and assembly of usual products to the production of armaments and other items for the war effort. The New Towns Act of 1946 led to the expansion of towns around London, such as Harlow, in order to

Sighted Safety Lenses for the War Effort Clement Clarke and Squadron Leader Philip Livingston had begun a close collaborative relationship in 1929 when they worked together on the development of anti-glare spectacles and goggles which had been used to help pilots in the strong Iraqi sun. At the beginning of WWII, Livingston requested the expertise of Clarke to begin work on the development of a new kind of innovative RAF flying goggle, incorporating interchangeable, sight-corrective lenses. This Clement Clarke-patented invention became known as the MKIV flying goggle. This proved to be a highly fruitful collaboration and resulted in the development of many RAF sight testing and training apparatus for pilots. Livingston wanted to relax the testing standards as too many good pilots were failing medical examinations. Working together, Livingston and Clarke

accommodate the capital’s population overspill and led to the creation of new industrial centres. The NHS began operations in July 1948, promising to give ‘cradle to grave’ free hospital and medical care for everyone. There was a sharp rise in births during these postwar years – the so-called ‘Baby Boom’. This led to the development of the company’s first respiratory product, an anaesthetic machine, used during childbirth. The company designed and manufactured numerous items for the war effort, including goggles, instruments for night vision, oxygen masks and headsets. When the war ended on the 2nd September 1945, difficult wartime conditions had left their mark on the company’s dispensing branches, as it was estimated that one in three opticians had been called-up.

developed tests and equipment that would help retrain and correct the sight of competent pilots. Some of the equipment produced included the Livingston Threshold test, the Tilting Table test, the Rotating Perception test, Night Vision testing equipment, Binocular Gauge and the adoption of orthoptic training in the RAF – notably, the use of the Synoptophore to help train and correct the pilot’s defective vision. These changes in the medical selection process made it possible for the RAF to put forward an additional 2,000 pilots for training duties – an increase of some 30 squadrons. This undoubtedly contributed to the success of the Battle of Britain and the RAF’s air supremacy during the conflict. Over 650,000 pairs of goggles were supplied to the RAF, making Clement Clarke Ltd. the largest contractor of sighted goggles during WWII.

Production of Oxygen Masks Commences Following the company’s success in the development of the MKIV flying goggle, Clement Clarke Ltd. was approached by the Air Ministry to manufacture the new ‘E’ Type RAF oxygen mask for the rapidlyexpanding squadrons. In 1942, Airborne Equipment formed as a subsidiary of Clement Clarke Ltd. Initially located in a back garden shed in Hastingwood, Essex, production soon increased and larger premises and more staff were needed. By the end of the war, many thousands of masks had been produced.

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THE CLEMENT CLARKE CENTENARY

CLEMENT CLARKE DIES During the war, Clarke took on the majority of responsibility for the running of the company. Many of his staff were on active service, as were his sons, John and Alex. This burden took its toll on Clarke’s health and he died suddenly in 1946. His death was met with great sadness by all who worked for him. His eldest son, Alex Clement Clarke became the company’s new Chairman.

THE FIRST RESPIRATORY PRODUCT The company’s first association with respiratory equipment came in the late 1940s with the development of an early inhaler. This development, along with the company’s involvement in the production of oxygen masks during WWII, led to Dr. H.R. Marrett approaching the company with his revolutionary new general anaesthetic machine. The machine, known as the Marrett Head, recycled carbon dioxide, which was a true innovation in its day. Under Managing Director George Dickinson, Clement Clarke was approached to develop the Marrett Head commercially and an initial production run of machines was commissioned by the War Office. Due to product demand, in 1949 additional space was rented above AIM Parkway to increase the production facility. Clement Clarke Ltd. filed patents on a new portable anaesthesia inhaler called Airlene, used by midwifes for an expanding population of ‘Baby Boomers’.

Introduction of the NHS After the war, the government were intent on improving the country’s social services and, as part of these plans, decided to introduce a National Health Service. The organisation of the proposed optical services was helped by the experience gained in running the National Eye Service (an idea originally conceived and adopted by Clarke during the 1920s). In 1948, the new service became available and the offer of free optical care and spectacles resulted in chaos. Unsurprisingly, the optical trade was inundated with work. Material was in short supply and manufacturing capacity was completely inadequate. This deluge led to long delays and much criticism of the optical profession. It was not until the first charge was imposed on spectacles that business returned to a more stable level.

Artificial Eye Contract Awarded by War Office

Following the perfection of the artificial eye, Clement Clarke Ltd. was asked to investigate the possibility of mass-producing these eyes for use in the services during the latter part of the war. In 1944, a contract for 30,000 eyes of differing sizes and various colours was received from the War Office. Handmade methods were too slow, so the company developed a compression moulding technique using ICI acrylic powder and incorporating a photographic iris. As all existing production space was fully occupied, a special laboratory was opened in Whitstable, Kent to undertake the work.

CHANGE OF NAME

In 1947, Airborne Equipment changed its name, becoming Airmed Ltd., a name which would later become synonymous with headset quality. Shortly afterwards, John Clarke became the Works Director for the newly-formed company.

1950 -1 9 5 9 Conditions in post-war Britain had been grim and previous levels of prosperity did not return until the 1950s. British manufacturers dominated the home market and in 1952, they produced a third of the national output, employed 40% of the workforce and made up a quarter of world manufacturing exports. Many people today nostalgically regard post-war Britain as the golden age of the Welfare State. The new NHS instantly became Britain's largest employer and, by the beginning of the 1950s, spending on the NHS was exceeding expectations. In 1952, this led to the introduction of a one-shilling charge for prescriptions. The General Optical Council (GOC) was formed on 7th July 1958 when a sight test cost just two shillings.

THE MOVE TO HARLOW

London's Great Smog of 1952, which killed 4,000 people and affected 100,000 more, resulted in thousands of additional cases of asthma. It is suggested that the health effects of the Great Smog likely still persist today. The company continued to develop products to meet the needs and demands of the day, most notably, the design and manufacture of the Wright Peak Flow Meter which was developed to enable the diagnosis and management of asthma. The decade also saw Clement Clarke Ltd.’s entry into the communications market, integrating microphones within oxygen masks, which led to the mass-production of stateof-the-art headsets. In 1958, the company became one of Britain’s largest private optometry dispensing retailer outlets.

In 1951, production moved from AIM Parkway to the Temple Fields Estate in Harlow, becoming the first factory in the new town. This relocation enabled both the medical and aviation communications operations to be integrated within a single factory. Production of general anaesthetics machines was also moved to the new premises, along with oxygen masks and flow meters.

Appointed Haag-Streit AG Distributor In 1958, Clement Clarke Ltd. became the UK distributor for Haag-Streit AG. This enabled the company to adopt Haag-Streit’s world-class slit lamps, Goldmann tonometers and kinetic perimeter.

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The development of the Airlene Inhaler Having recognised the need for portable anaesthesia, the company worked with Lawrence A. Cox to develop the Airlene Inhaler, which utilised a new anaesthetic agent from ICI called Trilene. The company started commercialising the product in both the UK and USA in the early 1950s and users were convinced it would become the new standard of care. However, the development of increasingly effective and safer products would supersede both Airlene and Trilene, whereupon they faded into history.

The Start of the Wright Partnership

John Clarke Becomes Chairman

Clement Clarke Ltd. began a highly-successful partnership with Dr. B.M. Wright of the Medical Research Council. This resulted in the development of the first portable peak flow meter – aptly named the Wright Peak Flow Meter.

Sadly, in 1958, Alex Clarke died suddenly. By this time, the company had overcome the issues associated with the advent of the NHS, which Alex had been actively involved in. Clarke’s younger son, John Clarke, succeeded Alex as Chairman and took up his new position in the company’s headquarters based in Harcourt House, Cavendish Square. This was a new role for John as he would now be working with both dispensing branches and the Hanwell Optical Company for the first time.

The Wright Peak Flow Meter played an important role in providing objective measurement of airway narrowing, thus facilitating the diagnosis and management of asthma for millions of patients worldwide.

An Entry Into Telecommunications During WWII, the company’s general activities in the production and assembly of oxygen masks included the integration of microphones. This business continued into the 1950s and, with the renewal of Ministry of Defence contracts, led to the development of telecommunications headsets, marking the company’s entry into the communications market. In 1958, Clement Clarke Ltd. worked in conjunction with the British Overseas Airways Corporation to develop the first Civil Aviation Authorityapproved Lyta headset for use with a mask in the event of decompression. The same year also saw the company’s entry into the private flying market with the launch of the Airlite 62 headset.

1960 -1 9 6 9 The ‘swinging 60s’ is considered a period of undoubted prosperity and cultural and social change. Despite the economic weaknesses and a decline in the relative competitiveness of the UK economy, the 1960s was still an era of full employment and rising real wages. In fact, there were serious labour shortages in the manufacturing industry. The original intention at the start of the NHS was that sight testing should be carried out in hospital ophthalmology departments. However, lengthy waiting lists encouraged services to be developed beyond this. Sight testing services by opticians were finally recognised under the Health Services & Public Health Act 1968, which made provision for General

Ophthalmic Services of sight testing and the supply of spectacles. Due to an economic downturn, 1968 also saw the reintroduction of previously abolished NHS prescription charges by Prime Minister, Harold Wilson. The growth and prosperity in the 1960s is reflected in a period of extensive development and expansion within Clement Clarke Ltd. The company invested considerably in the modernisation of existing outlets as well as expanding the number of shops the group had in operation. The spirit of innovation was as evident at this time as it had been in the early days, illustrated through the development of the Friedmann Visual Field Analyser and the advancement of Airlite headsets to meet the ever-changing needs of the 1960s communications market.

CONTINUED GROWTH & EXPANSION Under John Clarke’s leadership, the 1960s were a time of huge growth and redevelopment for Clement Clarke Ltd. By 1968, the company had 48 optician shops and over 560 employees. Export sales also grew, with overseas sales representing 33% of turnover of instruments sold by the group. To finance future growth, it was decided that the company should go public. In 1969, Clement Clarke Holdings PLC was formed, and was responsible for the financial control of the various trading outlets and the management of future expansion.

Modernisation Programme Undertaken In order to satisfy the increased demand for spectacles, a huge programme of modernisation and reorganisation commenced at manufacturing subsidiary Hanwell Optical Company Ltd. State -of-the-art automatic machinery was installed, and plans were made to concentrate production in two factories instead of three.

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Friedmann Visual Field Analyser Launched The company worked closely with Mr Alan I. Friedmann to develop the first visual field analyser, launched in 1967. Friedmann worked at the Royal Eye Hospital in London and the Friedmann Visual Field Analyser (VFA) was the first quantitative static measurement system. The instrument was designed to examine the central visual fields and helped with the early diagnosis of glaucoma. The Friedmann VFA was regarded as simple to use and was the fastest and most sensitive

instrument available in this area of ophthalmology at the time. It checked the sensitivity of the eye within a 25 degree central field of vision. The patient viewed an intermittently projected electronic flash through a series of hole patterns.

The instrument became instantly popular and continued to gain success through the 1970s and early 1980s.

Airlite Headsets used on Concorde Throughout the 1960s, the telecommunications range of equipment continued to be marketed under the Airmed and Airlite brands. The company was, by this time, operating from a large factory of 20,000 square feet and exporting worldwide. The highly-specialised headsets continued to be favoured by the Ministry of Defence for use on ships and submarines, and there was also an extensive and growing use of the expanding range of headsets in airport ground control and civil aircraft.

Artificial Eye Production Continues

The range continued to be improved and enhanced to meet the changing demands of the market. When civil aviation went ‘supersonic’, the headsets were adopted for use in the prestigious Concorde.

Improving the understanding of asthma The 1960s was an era of fundamental research in asthma medication and management. Treatments that opened airways and prevented airway inflammation were undergoing intensive research. The development of the first inhaled steroid was only made possible by the careful selection of patients using peak flow measurements. Today, steroids are the mainstay of asthma management, benefiting millions of patients. Dr. Ian Gregg, working at the Brompton hospital in London, embarked on a study of over 2,500 people that established normal values for peak flow measurement. Dr. Gregg formed a close association with Clement Clarke Limited, advising the respiratory team on the clinical implications of the company’s developments.

During the 1960s, Clement Clarke Ltd. continued to produce handmade artificial plastic eyes at Wigmore Street where they were cleverly able to exactly match the colouring and size for each individual patient. While the eyes were more commonly used for war veterans who had been injured while serving their country, the company also received some humorous requests for special eyes. One lady yacht-woman requested a spare eye with her club burgee painted on the iris! Similarly, a WestCountry farmer asked for a special bloodshot ‘drinking’ eye to be created, in order for it to match his good eye at the end of farmers’ union functions!

1970 -1 9 7 9 The 1970s proved to be one of the most challenging economic decades since the 1930s. It was an era of industrial confrontation, rampant inflation and an unwelcome return of mass unemployment. The postwar economic boom had come to an end. Prices of goods and raw materials began to rise sharply and the exchange rate between the pound and other currencies was unstable. Many industries and services were affected by strikes, causing friction between the trade unions and the government. Britain joined the European Economic Community,

more widely known as the Common Market, on 1st January 1973. Despite being given access to the biggest market in the world, greater competition from the continent would have a massive effect on Britain’s manufacturing industries for decades to come. The NHS was reorganised in 1974 to form Regional Health Authorities. In 1979, Margaret Thatcher was elected as the country's first female Prime Minister. Despite the difficult economic climate, the company saw a huge period of invention. Working with respected pioneers in the ophthalmic and respiratory fields resulted in the launch of innovative products such as the Perkins Mk1 Tonometer and Mini-Wright Peak Flow Meter. The company’s headset range became CAA-approved and it experienced substantial growth in sales of its Airlite brand. The company also expanded through acquisition, with the purchase of John Weiss & Son Ltd.

CLEMENT CLARKE INTERNATIONAL IS FORMED Airlite headsets In the early 1970s, the ophthalmic division of Clement Clarke Ltd. was amalgamated with Airmed and the company was reformed under the new name Clement Clarke International (CCI). The headquarters of the company were located in Harlow and provided unified design, manufacturing and sales of all the group’s products under one roof, including ophthalmic diagnostic, medical, aircraft and industrial instruments. By the late 1970s, CCI had 95 optical retail outlets, comprising 68 dispensing branches and 27 ophthalmic opticians.

dominate the market

By 1975, Airlite headsets dominated the private flying market with most products approved by the Civil Aviation Authority. The Ministry of Defence remained a major customer and the range was also used in TV and film studios, as well as in ballooning expeditions, including altitude records.

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Broadening the Use of Peak Flow Measurement CCI continued its innovative work with Dr. B.M. Wright and built on the epidemiological work of Dr. Ian Gregg and Dr. Andrew Nunn, establishing ‘normal values’ for peak flow which made the peak flow meter a ‘must-have’ diagnostic tool. With widely-recognised utility, the need existed for a lower-cost, but still highly-accurate, plastic

device that was suitable for largescale manufacture. This development created the plastic peak flow gauge which launched in 1972 with support from Allen & Hanburys Ltd., (now GSK, who remain to this day a major CCI customer). Further improvements followed rapidly with the Mini-Wright Peak Flow Meter launched in 1976.

became widely-accepted because of its accuracy, affordability and portability. Numerous clinical studies were made and data from the Mini-Wright has underpinned most modern asthma treatments. It proceeded to win the Design Council Award in the 1980s.

The Mini-Wright Peak Flow Meter

Partnerships with Pioneers in Glaucoma Management The 1970s saw major innovation with CCI working extensively with medical professionals and physicists, continuing the pattern of invention started in the 1920s. The company worked particularly closely with Professor Edward S. Perkins and Mr Alan I. Friedmann, both considered pioneers of modern glaucoma management. In 1965, Professor Perkins developed a prototype hand-held applanation tonometer at the Department of Experimental Ophthalmology, Institute of Ophthalmology, University of London. Partnering with CCI, clinical trials were published in 1969. During this time, with the production of the Friedmann VFA still in full swing, Friedmann assisted with the development of the Perkins tonometer by trialling aspects of the new Mk1 device as a beta tester. In 1971, the Perkins Mk1 tonometer was manufactured and launched, with immediate success. Accolades followed and, in 1975, the Perkins Mk1 won the Design Council Award, presented by the Duke of Edinburgh. During 1977, initial designs for the Diag hand-held portable slit lamp with keratometer attachment were drawn up. The Diag became the precursor to the Haag-Streit OM 900 Ophthalmometer/ Keratometer. Professor Perkins frequently discussed the use of the Diag to measure the curvature of the cornea and the axis of rotation of the eye in myopia studies at this time.

Bringing 184 years of experience into the Group! The company’s policy of controlled expansion was further strengthened with the purchase of John Weiss & Son Ltd. from Mappin & Webb Ltd. John Weiss & Son Ltd’s origins extended back to the 18th Century when John Weiss, an Austrian immigrant, arrived in London, forming the company in 1787. It has been designing and manufacturing high-quality surgical instruments for the ophthalmic industry ever since. The retail element of the business operated from a modern showroom in Wigmore St., London, whilst the manufacturing facilities were located in a separate factory unit, also in central London. This acquisition expanded the group’s interest in optics as well as complementing its range in diagnostic and medical instruments, both at home and overseas. John Weiss continues to be the leading domestic brand and today boasts over 3,000 instruments in its portfolio, successfully exporting to over 40 countries worldwide.

1980 -1 9 8 9 The 1980s was a period of economic volatility. The decade started in severe recession with unemployment rising to three million in 1981 – a figure which continued for much of the ensuing ten years. After recovering from recession, the UK experienced a long period of economic expansion. Towards the end of the decade the growth rate reached record post-war levels. Thatcherism dominated the glossy and brash 1980s. Under PM Margaret Thatcher’s premiership the Conservative Party introduced widespread economic reforms including the privatisation of industries and the deregulation of stock markets. The decade also experienced a ‘property bubble’ and poor industrial relations resulted in major industrial action, notably the beleaguered 1984-5 miners' strike.

In 1982, Thatcher promised Britons that the NHS is "safe in our hands" and in 1985, the optical market dispensing function (supply of spectacles) was deregulated. This fuelled intense competition, to the benefit of both patients and the wider NHS. Patients were empowered by the introduction of the optical voucher scheme which contributed to a rapid growth in the use of spectacles and contact lenses, and influenced the improvement of clinical standards in sight testing. Before 1985, the technology of sight testing had shown little change in the previous 60 years. The 1980s, however, saw a rapid rise in standards with new technology improving the accuracy of sight testing, enabling practitioners to detect conditions earlier via screening. The deregulation of the optical market resulted in the sale of the company’s dispensing optician stores and the divestment of the non-dispensing optics business to Haag-Streit AG.

THE DEVELOPMENT OF NEW OPHTHALMIC PRODUCTS The Perkins Mk2 hand-held tonometer was developed and manufactured in 1985. Upon launch, it sold 1,500 units in the first year, securing its position as the number one portable tonometer in the UK ophthalmic market, replacing the popular Perkins Mk1. Production of the Synoptophore (Major Amblyoscope) – previously undertaken by an external manufacturer – was moved to the company’s Harlow premises in order to improve the quality of the manufacturing process and better manage the supply chain. The company continued to develop and launch other new ophthalmic products, including the Videophotorefractor, Steinbach Contrast Sensitivity Test and CXL 2 portable slit lamp system.

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Boots Opticians is Established in the UK In 1987, all of the company’s UK-wide dispensing optician stores were sold to the high street pharmacy chain, Boots PLC. In addition, Boots PLC procured Curry & Paxton Ltd. – an acquisition which resulted in the formation of Boots Opticians Ltd. forming the UK’s second largest retail optics chain. The sale of dispensing optician shops enabled CCI to focus on and invest in its ophthalmic equipment business. This paved the way for the development, manufacture and launch of a number of new products.

New Distributor Partners CCI Purchased by Haag-Streit AG CCI was offered as a going concern by Boots PLC and was purchased by the highly-respected Haag-Streit AG optical group of companies in 1989. This marked a massive expansion by Haag-Streit AG which, under the directorship of Walter Inäbnit, also purchased similar organisations in the USA, Germany and Switzerland at this time. This formed the internationallyrenowned Haag-Streit Group we know today, which presently operates in more than 20 countries throughout Europe, America and the Far East and employs over 1,000 staff.

Throughout the decade the company’s core strategy was to develop its product portfolio through partnership. During this time, CCI forged a number of important relationships, many of which are still going strong today. Ophthalmic distributor agreements were signed with Luneau, Canon and Sonomed. This enabled the organisation to expand its portfolio of ‘practice essential’ products, such as eye charts, prisms and lenses, and also provide a more comprehensive range of larger diagnostic devices, such as retinal cameras and ultrasound equipment. In 1987, Haag-Streit AG launched the BQ 900 slit lamp, and CCI became its UK distributor. The BQ 900 soon became the standard for those requiring advanced slit lamp microscopy. It proved to be one of the most popular Haag-Streit slit lamps and is still purchased by UK eye departments today.

1990 -1 9 9 9 Margaret Thatcher resigned on 22nd November 1990 and was succeeded by John Major. The UK experienced a major period of depression in the early 1990s – officially the longest in Britain since the Great Depression some 60 years earlier. This was characterised by the infamous ‘Black Wednesday’ of September 1992 and the crash of pound sterling, resulting in mass unemployment and social discontent. 1993 marked the end of the recession with the UK and Ireland experiencing rapid economic growth and falling unemployment which continued throughout the decade.

INVESTMENT, EXPANSION & DEVELOPMENT

In May 1997, a new Labour government came into power under the leadership of PM Tony Blair. The 1990s saw great advances in technology, notably the invention of the World Wide Web which would go on to become the key business tool used throughout all industries and sectors. The Blair government introduced a number of strategies to cut unemployment, including an expansion of the public sector. There followed a focus on NHS reforms to combat the rising costs of medical technology and medicines, and a desire to increase standards against a backdrop of an ageing population. This included the controversial outsourcing of medical services to private health companies. In 1996, the company moved to larger premises in Harlow. This enabled a substantial investment in state-of-the-art factory machinery to increase manufacturing output and meet growing consumer demand.

Joining the Haag-Streit Group strengthened CCI’s position as a major player in the ophthalmic, respiratory and communications industries and further enhanced its reputation. Becoming part of a global Group offered exciting opportunities to penetrate further markets throughout the world, and export sales grew dramatically in the early 1990s. Throughout the decade, with the backing of the wider Haag-Streit Group, the company invested heavily in research and development to design future ophthalmic, respiratory and telecommunication products. In addition, major awareness campaigns were undertaken to promote and build the Haag-Streit brand in the UK and the organisation worked closely with other Haag-Streit companies worldwide, forging valuable partnerships that still exist today.

New Portable Slit Lamp with Haag-Streit Optics In 1996, the company launched a new portable slit lamp. Boasting dual functionality, the BA 904’s ergonomic design enabled both handheld examinations and traditionalstyle examinations, using the easy-to-assemble head and chin rest. The 904’s hand-held operation allowed it to be used to examine patients who could not comfortably sit at a larger slit lamp, for example, paediatric, wheelchair-bound or bed-ridden patients.

1917-2017 THE FIRST 100 YEARS

THE CLEMENT CLARKE CENTENARY

Expanding Our Position in the Respiratory Market With strong growth in peak flow meter sales due to prescription availability, it became increasingly important to manufacture the Mini-Wright on a large scale. To meet this objective, CCI invested in automation and the Lanco line was installed in the new premises in Harlow. It was also important to become less reliant on a single technology and so a period of innovation and investment commenced. This saw the development of a range of portable electronic spirometers: the VM1, VMX and VM Plus. The organisation also created the In-Check which focused attention on the importance of inspiratory flow in the correct use of portable inhalers. In 1996, the company acquired and integrated the popular Medix range of nebulisers, transferring production to Harlow. It also launched the Able Spacer and Flutter. These important steps laid the cornerstones of the business today.

CCC Awarded Prestigious Headset Contracts Clement Clarke Communications’ varied range, which boasted excellent noise attenuation and audio quality, offered specialist headsets for multiple applications, from general office use to the harshest operational environments. The company continued to be awarded prestigious contracts with the Ministry of Defence, the RAF and NATO and its products were keenly adopted by the emergency services, air traffic control operators, TV/ radio stations and national airlines. 1991 saw the launch of the Airlite Delta 100, which was developed for the aviation industry – more specifically, helicopter and private flyers. Further product launches included the Airlite 91 and Airlite 2003T.

Tonosafe – a Global Success Story In 1996, the company began designing a disposable tonometer prism in response to the threat of crossinfection, specifically HIV and herpes simplex. Launched in June 1998, Tonosafe was a low-cost, disposable prism, which reduced the risk of infection without compromising the performance of Goldmann applanation tonometers. Tonosafe has evolved to become a major, global success story. Still manufactured in the UK and undergoing continuous investment and development, Tonosafe is sold in 137 different countries worldwide and is recognised as the gold-standard in disposable applanation tonometer prisms

The Pelli-Robson Contrast Sensitivity Test

Designed by Professors D.G. Pelli, J.G. Robson, and A.J. Wilkins, the Pelli-Robson Contrast Sensitivity Test measures the ability to differentiate between light and dark (contrast). The testing of contrast sensitivity on a regular basis is key to detecting early signs of diseases such as Parkinson’s, glaucoma, and cataracts. The Pelli-Robson quickly became, and still remains, the gold-standard. In 1998, the company worked closely with Professor Robson to secure an agreement to manufacture and distribute the Pelli-Robson Contrast Sensitivity chart worldwide.

2000 - PRESENT DAY In 2001, the government increased taxes and borrowing for additional spending on public services, notably the NHS. The economy shifted from manufacturing, which had been declining since the 1960s, and grew due to the services and financial sectors, while the public sector continued to expand. Unemployment was consistently below 1.5m during the first half of the 2000s – a level not seen since the late 1970s. The 2000s have been a time of both celebration and change in the NHS. 2008 marked its 60th anniversary and the achievements of the NHS were celebrated at the London 2012 Olympic Games. In 2013, it underwent major changes in order to deliver the ambitions set out in the Health & Social Care Act. This included budget allocation, assigning key decision-makers and service commissioning.

services. The companies were distinctly named: HaagStreit UK (HS-UK), Clement Clarke International (CCI) and Clement Clarke Communications (CCC). In 2015, Clement Clarke Holdings (CCH) was also established. The focus on innovation – an ongoing theme in every chapter of the Clement Clarke company history – has been no less evident over the past 17 years. Partnerships with carefully-selected third party manufacturers has enabled HS-UK to continue offering cutting-edge ophthalmic equipment, meeting the everchanging demands of the industry. CCI has continued to bring new respiratory products to market and has produced numerous scientific papers about exciting product developments.

The decade saw a more structured separation between respiratory, ophthalmic and telecommunications

A FOCUS ON CORE PRODUCTS At the turn of the 21st century, HS-UK refocused on both its core UK-manufactured products and goldstandard Haag-Streit AG devices.

has guaranteed the high-quality standards that hundreds of thousands of Tonosafe disposable prism users take for granted.

The company has continued to invest in the development of established products, such as the Perkins hand-held tonometer, BA 904 slit lamp and Synoptophore. These instruments continue to be embraced worldwide and are still considered the gold-standard today.

HS-UK has continued to distribute and support the comprehensive Haag-Streit slit lamp family in hospital ophthalmic clinics UKwide. Still recognised as the best in the world, HS-UK continues to ensure that the service and support provided reflects the quality of the slit lamp products.

Sustained growth in the sales of Tonosafe has been the direct result of ongoing investment in pioneering manufacturing technology. This

The company is also keenlyfocused on the Octopus perimeter, widely seen as the successor to

CCI Rekindles Innovation Since 2010, CCI has filed six patents and published more than 30 scientific articles on product development. The A2A, Able Spacer and DispozABLE Spacer devices are now its biggest selling product group. In addition, it has also developed the Flo-Tone inhaler technique whistle which guides patients to better inhaler use. The company also continues to create revolutionary training tools for pharmaceutical companies. CCI has pioneered the use of antimicrobial polymers to help maintain the hygiene of its devices and has collaborated with academics – the University of Manchester, for example – to create mobile apps to support the acceptability of CCI products. Today, CCI stands at the forefront of the respiratory medical device sector, is highly-respected as an innovator and is the first point of contact for inhaler technique training.

the Goldmann, and the LENSTAR biometer – a device that continues to revolutionise the field of cataract diagnosis.

CCI Expands its Nebuliser & Disposable Range Having acquired and transferred the Medix nebuliser business, CCI extended this activity in 2002 by also obtaining the Lifecare range of nebuliser and oxygen therapy disposables. Medix nebulisers and Lifecare accessories are still widely used by the NHS, often in life-saving situations. They stand out as robust and reliable devices that provide many years of service. CCI transferred manufacture of Lifecare to Harlow in 2011, building a modern moulding facility to ensure excellent component quality.

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1917-2017 THE FIRST 100 YEARS

Expansion of the HS-UK Service Division Since the 1930s, the company has provided repair services on its product range and, over the years, the service offering has been developed and expanded. The HS-UK Service Division employs a team of Field Service Engineers covering the whole of the UK. This team is fully supported by a department of in-house Service Engineers and help desk staff located at its purpose-built workshop facilities and call centre in Harlow.

The Service Division offers a range of service solutions, from standard Gold, Silver and Bronze service contracts to tailored bespoke contracts and out-of-hours services, customised to meet the needs of individual hospitals or clinics.

loan stock offering, PAT testing and IT/network services.

In addition, the HS-UK Service Division offers pre-sales consultancy, pre-delivery inspection, equipment audits, equipment relocation, first-line user maintenance training,

The HS-UK Service Division is committed to the critical area of maintenance and support, and strives to limit equipment downtime, giving customers full peace-of-mind.

commercially available in 2006 and was quickly established in the NHS as the gold-standard for imaging structural changes in the retina. This led to an increase in the number of NHS ophthalmic departments purchasing OCT equipment.

NHS Initiatives & Manufacturer Relationships In December 2001, the National Services Framework (NSF) for Diabetes standards document was published, outlining specific standards of care for people with diabetes. This was followed by the Diabetes NSF Delivery Strategy in January 2003 and the Diabetic Retinopathy Screening Programme which was rolled out nationwide. In 2007, ‘pump priming’ capital funding was made available, with local healthcare providers allocated a share of a national fund of £28m to equip their service to test for diabetic retinopathy. This led to an increased demand for digital retinal cameras. Optical Coherence Tomography (OCT) equipment became

To quickly meet hospital demand and to ensure that the HS-UK product portfolio supported these initiatives, HS-UK negotiated distributorships with third party equipment manufacturers, such as Heidelberg Engineering Ltd.*, Canon*, Optovue and CenterVue to distribute, support and service OCT and retinal imaging products. This led to a substantial increase in the sales of products such as the Spectralis OCT, Canon DGI and DRS retinal cameras.

A New Group Company In 2012, Clement Clarke Holdings Ltd. (CCH) was created to support each of the four UK operating companies: HS-UK, CCC, CCI and John Weiss & Son Ltd., enabling them to focus on their particular business models and growing market share. Utilising centralised support operations in Harlow, CCH took responsibility for six core functions: HR, IT, Quality Assurance, Quality Control, Site Services and Logistics, including direct report responsibilities to its parent company, Haag-Streit Holdings. CCH currently employs 34 people with a variety of skills and competencies to underpin the services provided.

Many of these third party distributorships are still strong today and enable HS-UK to continually provide innovative technology. More recently, HS-UK offered the first commercially available OCT-A in the UK, with the inclusion of Optovue’s AngioVue in its product portfolio. *HS-UK no longer has a distribution agreement with this manufacturer

CLEMENT CLARKE HISTORY TIMELINE 1939 Plastic lenses & artificial eyes developed

1949 Airlene Inhaler development commenced 1956 Airmed selected by MRC to introduce Wright Peak Flow Meter

1931 Synoptophore launched

1917 Clement Clarke Dispensing Opticians founded

1910

1942 Airborne Equipment founded

1926 Fincham ophthalmoscope developed

1920

1935 Contact lens production begins

1930

1934 Prosthetics Department formed

1924 First British slit lamp launched

1949 Marrett Head commercially produced

1946 Clement Clarke dies

1940

1950

1944 Contract for 30,000 artificial eyes awarded by the War Office

1937 Allied Instrument Manufacturers (AIM) founded 1937 John Clarke joins company

1947 Airborne Equipment becomes Airmed Ltd

1960 1958 Airlite 62 headset launched

1941 Sight safety flying goggles produced

1941 E-Type RAF oxygen mask manufactured

1927 Hanwell Optical Company founded

1946 Alex Clarke becomes chairman

1958 Appointed Haag-Streit AG slit lamp distributor

1951 Company moves to Harlow

1958 Alex Clarke dies, John Clarke becomes chairman

1989 CCI purchased by Haag-Streit AG

1971 Perkins Mk1 launched

1998 Tonosafe disposable prisms launched

1976 Mini-Wright Peak Flow Meter launched

1971 John Weiss & Son Ltd acquired

1990 1992 1996 VM1, VMX and VM Plus portable electronic spirometers launched

1980 Mini-Wright selected for Design Council Award

1967 Friedmann VFA launched

1974 Clement Clarke International 1985 (CCI) formed Perkins Mk2 tonometer launched

1970

1969 Clement Clarke Holdings PLC formed

1980

1975 Perkins Mk1 wins Design Council Award

1975 Airlite headsets dominate the private flying market

1977 Diag portable slit lamp produced 1972 Plastic peak flow gauge developed

1998 CCI communications division renamed Clement Clarke Communications (CCC)

1990 1987 Opticians stores sold to Boots PLC

2012 Clement Clarke (Holdings) admin/support division formed

2000 1996 BA904 slit lamp launched

1996 Medix range of nebulisers acquired

2015 Flo-Tone inhaler launched

2005 CCI ophthalmic division renamed HS-UK

2002 CCI acquires Lifecare Hospital Supplied Ltd

2010 2011 Perkins Mk3 launched

2014 CCC sold to MEL Group

2017 HS-UK Service Division expands

We would like to thank the following for their contribution to this book; Richard Clarke Janine Clarke Brian West David Wilkinson Neil Handley, College of Optometrists Lizzie Baker, MEL Group Ian Knight, MEL Aviation Limited Philip Riegel, Haag-Streit Diagnostics Weibke Raethcke, Haag-Streit Surgical Alex Massa, Haag-Streit USA Hilary Dolby & Michael Bench, John Weiss & Son Limited Dean Johnson, Haag-Streit UK Mark Sanders, Clement Clarke International Royal College of Anaesthetists Royal College of Ophthalmology Federation of Manufacturing Optometrists Imperial War Museum – Duxford Boots UK Corporate Records & Archives The Wellcome Library British Pathé Production by Haag-Streit UK Marketing Department, CCI Marketing Department & Gradient Creative; Sharon Mills Rebecca Seymour Victoria Chapman-Brown Gill Assheton Catherine Bannister Keely Rumble Alastair Taylor © Clement Clarke Holdings. Edinburgh Way, Harlow, Essex CM20 2TT. E&OE. December 2017

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THE CLEMENT CLARKE CENTENARY - THE FIRST 100 YEARS... 1917 -2017

In 2017, Clement Clarke Limited marks its centenary year. This commemorative book celebrates the long and varied history of the company.

The Clement Clarke Centenary

1917 -2017 The first 100 years...

22/11/2017 11:57