Builth Cottage Hospital, A Centenary History 1897-1997, by Gwen Davies
Foreword | Acknowledgements | Prologue Chapter 1 | Chapter 2 | Chapter 3 | Chapter 4 | Chapter 5 | Chapter 6
Chapter 7 | Chapter 8 | Chapter 9 | Chapter 10 | Chapter 11 |
Chapter 12 | Chapter 13 | Epilogue
The League of Hospital Friends, by Betts Pugh
Builth, Queen of the Wye, by Jim Davies
Chapter Twelve - RE-ORGANISATION
OF THE NHS IN WALES
The plans for the re-organisation of Local Government went ahead;
locally it meant that the three counties of Breconshire, Radnorshire
and Montgomeryshire were to be amalgamated and administerd by one
Authority, namely Powys. It was though feasible that the
unification of the Health Service in Wales should be introduced
at the same time. Consequently, in 1972, a Steering Committee
Document, outlining the arrangements for the re-organisation of
the National Health Service, was published, showing that Wales
would, in future have:
A Regional Authority (Wales)
Area Health Authorities
Community Health Authorities
Builth would come under the jurisdiction of Powys Area Health Authority,
with Chairman Brigadier Sir Michael Venables-Llewelyn, MVO and the more local
Community health Authority. Builth Hospital was most fortunate in having
County Councillor Mrs R M Thomas, of Cefndyrys, as its representative on this
committee. Mrs Thomas had been involved with all aspects of the hospital
for many years having served on the Brecon and Radnor Management Committee, and
the House Committee. She was founder member, and later President of the
League of Hospital Friends. She served on the Area Health Authority until
1991 and proved to be a doughty fighter for Builth on every occasion when a champion
was needed.
The first meeting of the Powys Area Health Authority was held
in the /County Hall, Llandrindod Wells, on 19th September 1973
when it was decided that the Mansion House at Bronllys should be
its temporary headquarters. This “temporary” measure
lasted for 24 years and ended in 1996 when a further structural
change moved the headquarters to St David’s Hospital, Carmarthen.
The radical changes that occurred in Builth during the 1970’s
gave the medical practice a whole “new look”:
1974 Dr Clifford Fenn had been succeeded y Dr Roger Harriss
1976 Dr Donald
Cameron had been succeeded by Dr Terry Watson
1977 Dr Kendrick Pugh M.C. had been succeeded by Dr Vivian Davies,
1978 Dr
Venn Pugh had been succeeded by Dr Martin Riley
1980 Miss Christine
Morgan had been succeeded by Senior Nurse S E Roberts
Although general surgery was still being undertaken by the General
Practitioners, with anaesthetics being given by Dr Vivian Davies,
major surgical operations were phased out, primarily because Builth
did not have a Blood Bank, and more emphasis was place on acute
medicine. Long gone were the days when Gillis was called
from the garden to donate blood to save the life of a patient!
If there was a decrease in surgical operations, this was certainly
not the case in other departments which saw an explosion in the
number and type of services being offered to an escalating population. The
changing face of the region was due to an increase in tourism,
the influx on “in-comers” buying homes in the area
and the huge numbers of people attending the Royal Welsh Showground
throughout the year. This was reflected in the number of
out patients treated and the hospital admissions which had doubled
in the ten years 1976-86.
In 1977, Mrs Gay nor Williams was appointed the first Occupational
Therapist at the hospital. Unfortunately at the time of
her appointment there were no premises available for her to hold
her clinics. This was soon remedied by the purchase of a “Portakabin” financed
by the “League of Hospital Friends” and other local
organisations. This enabled patients to receive occupational
therapy and physiotherapy.
Visiting consultants held monthly satellite clinics in obstetrics/gynaecology,
cardiology, orthopaedics, paediatrics, and rheumatology
in addition to general medicine and general surgery. These
clinics enabled local people to be treated conveniently near to
home. They saved long distance travel for patients in remote
areas and the elderly and apprehensive felt more secure in familiar
surroundings.
Nurses were no longer “living –in”. Consequently
in 1976 it was decided to demolish the nurses bedrooms and utilize
them to accommodate a Day Room here recuperating patients could
have some respite from the wards. One en suite bedroom was
left so that a nurse could be accommodated if necessary. This
project was financed jointly by the “Friends” and the
Area Health Authority.
The hospital continued with it s policy of providing high quality
care for the patients and coped admirably with the ever increasing
demand made on its services. A report submitted to the Area
Health Authority in 1968 following a tour of inspection by one
of its members said:
“It is always a delight to visit Builth Hospital as it has
such a happy home from home atmosphere. The patients are
well cared for reflecting well on the Matron and staff. The
gardener is to be congratulated on the well kept grounds and the
approach to the hospital is most attractive”.
Further improvements continued with the opening of a “clean
Treatment Room” to be used for minor surgical cases, this
was financed mainly by the League of Hospital Friends with contributions
from other organisations. A place commemorating this reads;
This clean Treatment Room was presented to the
Builth Wells Cottage Hospital by the League of
Friends and Local Voluntary Organisations and
Officially Opened by Mr M Morson Chairman of
League of Friends on Wednesday 15th May 1985.
The Management Committee had, for some time, been considering making
alterations to the female ward, so when the clean treatment room
was opened the operating theatre became even less necessary. Within
a short time the hospital again experienced a major upheaval, when
the theatre, a side ward, the labour ward and to everyone’s
delight, the old red ward, were completely gutted to be replaced
by a spacious new eleven bedded female ward. This tremendous
undertaking was paid for by the Powys District Health Authority and
was designed to their exacting specifications which stipulated exactly
how much space should be allowed between each patient’s bed
and the size and height of the lockers. This resulted in a
delightful, large, roomy ward which made movement for patients and
nurses so much easier, and although the massive alterations had necessitated
the closure of the old Female Ward for some ten weeks, all agreed
that it had been worth while.
Two years later is was the turn of the male patients to receive
new accommodation, when in 1987, a similarly spacious seven bed
ward was built together with an adjoining day room. Both
these were financed by the League of Friends with contributions
from others and officially opened by Mrs Betts Pugh Secretary of
the Friends on October 21st 1987.
Builth Cottage Hospital was now offering a tremendously
high standard of accommodation for both lame and female patients. It
also had a designated coronary care bed and three maternity beds. The
numbers of both in and out-patients had increased at a phenomenal
rate. These increases, together with all the new services
which were being offered, placed a heavy work load on the medical
staff. The area covered by the practice was considerable
being some 400 sq miles in size, with 7,500 patients to care for,
greatly increasing during the tourist season. The four partner
practice had been joined by Dr R L Gibbins, Builth and district
was supremely fortunate to have such a highly qualified and committed
team of young doctors whose skills and high standard of care could
not be faulted.
It is notable that prior to moving to Builth, four out of the
five doctors had experienced living and working in Third World
Countries. Consequently they brought with them the confidence
to make instant independent decisions which is a distinct advantage
for a General Practitioner in a remote rural area some distance
for a Medical Centre of District Hospital to possess. Although
all five doctors are General Practitioners most have a special
interest in a particular branch of medicine. This makes for
a very high level of skilled care for their patients.
Dr T M Watson practiced in the Soloman Islands and has a special
interest in obstetrics. Dr R L Gibbins worked in Thailand
and has a special interest in diabetes; an area in which he continues
to do research. Dr Roger W Harriss worked in Uganda and had
a special interest in tropical medicine. Dr Vivian B Davies
practiced general medicine in what was Rhodesia. Dr Martin
Riley has a special interest in cardiology. Dr Elaine Davies
joined the team in 1994 and has a special interest in women’s
problems; Dr Davies created a precedent in being the first lady
doctor to join the practice
The doctors hold twice daily surgeries in Builth with Dr Terry
Watson being mainly responsible for the Llanwrtyd area and its
surgery. They also run the medical side of the hospital wards,
caring for their own patients and covering their colleagues in
their absence.
The surgery in Garth Road was proving to be inadequate for the
ever expanding services which were being offered by the practice
and in 1991 the doctors moved to magnificent, new, custom-built
surgery in Glandwr Parc Builth, with accommodation for the five
doctors and multitudinous services which they supplied. The
practice, known as the “Builth and Llanwrtyd Wells Group
Medical Practice” is fund holding and responsible for managing
its own resources: it carries an administrative staff of
fourteen in addition to the doctors and the qualified staff who
provide the direct patient services. Theses services included
dietetics, psychiatric care. Diabetic, asthma and ante-natal clinics
in addition to well woman/man/baby clinics. In 1996 the
building was further extended to accommodate other services including
an exercise gym, giving the patients of the practice access to
the best medical treatment comparable with any other rural area
in the country.
The medical staff carry a heavy work load which be even more onerous
were it not for the support they receive from the administrative
and secretarial staff, both at the surgery and the hospital,
who oil the wheels. Miss Janet Morgan, the business manager
and locality administrator at the hospital runs her office with
immaculate precision, knows where everything is kept and can answer
all questions; the same can be said for Mr Linda Fletcher, practice
manager at the surgery.
It is the nursing staff, of course who are the backbone of a hospital
and Builth has always been fortunate in having a n outstanding
team of full time and part time nurses whose patients receive the
highest standard of profession care combined with a compassionate
attitude; an attitude which is possible unique to smaller community
hospitals. Senior Nurse Miss S E Roberts has devoted her
life to her nursing profession and, since 1980, to the Builth cottage
Hospital in particular, where she has been senior nurse, a position
she still holds. Her dedication was recognised in 1995 when
she was awarded the MBE for services to nursing, much to the delight
of her colleagues and the League of Friends, with whom she has
worked so closely.
Over the years the hospital staff has changed radically with many
more ancillary services being offered by physio/occupational therapists,
speech therapists, dieticians, a dentist and chiropodist. As well
as ever advancing X-ray facilities supplied by the radiographer. All
these, working in harmony with the health visitors and district
nurses, make up the strong team which supports the medical staff.
The other workers crucial to the smooth running of any organisation
are the domestic staff the people who keep the whole place on an
even keel, the porters, the cleaners and the cooks. The function
of all these has changed dramatically over the years, with many
of the services, such as cooking and cleaning being privatised
and put out to tender. Main meals are no longer in the domain
of a resident cook, but are supplied by an outside caterer. The
domestic staff are still mainly local and known to the patients,
the only difference being they are now employed and paid by an
agency and not the Health Authority as in the past.
Changes in direction made no difference to the excellence of service
received at the hospital, proved by the fact, that in October
1995 all members of staff were overjoyed to learn that they had
achieved accreditation for the high standard of care given to the
patients and the facilities offered by the hospital. Staff,
in every department had worked tremendously hard to obtain this
accreditation; the domestic helpers, the porters, nurses and administrators
had operated as a team to reach the very high standard demanded
by the assessors. It was a great tribute to them all that
their efforts had been recognised, proving once again that Builth
Cottage Hospital continued to give top-quality care and management.
Throughout the period form 1974 to 1996 the NHS seemed to have
a great desire to change its managerial structure. This led
to some confusion in the minds of the general public. Below
is a list of the titles held by the various Boards of Management,
applicable to the Builth Hospital since its inception in1897 when
a band of local men and woman ran the hospital on a voluntary basis.
1897-1948 Builth Cottage Hospital Management Committee
1948-1974 Brecon and Radnor
Hospital management Committee
1974-1993 Powys Area
Health Authority and Powys District Health Authority.
1993- Powys
Health Care NHS Trust
The Powys Health Care NHS Trust, which at the time of writing
is still in situ under the Chairmanship of the Hon Antony Lewis,
is the board which owns the hospital and supplies the services. The
stated mission of the Trust is:
To meet the recognised needs of patients, carers and purchasers
thought the provision of accessible, high quality, cost effective
hospital and community health care services.
The 13 member Board of The Dyfed Powys Health Authority promises
to ensure that: “The Authority maintains financial
accountability, effective management and performance and public
accountability”.
In 1990 representative of the Health Authority, the Hospital,
the League of Friends together with the Doctors, met to discuss
the future development of the hospital. After much discussion,
a three-phased 10 year plan was agreed on. The three phases
were: a) A new Physio and Occupational Therapy department, b) A
new Out-Patients Department and c) A Day Hospital.
The Portakabin, which had served well for fourteen years, was
well past it's sell by date and was much too small to accommodate
the huge increase in patients needing the services of the therapists. In
April 1993, the new physiotherapy department was declared open,
the ceremony being performed jointly by Dr Kendrick and Venn Pugh. The
building was funded by the League of Hospital Friends in partnership
with the Health Authority.
The enthusiasm of the members of the League of Hospital Friends
was such that they continued to press for phase two of the plan
to go forward and after a further meeting with the Health Authority,
plans were drawn up for a new Out Patients Department; and completed
in record time. The building was placed alongside the new
physiotherapy unit, and opened in 1994 by Mrs R M Thomas, President
of the “Friends”.
In view of all the improvements which had taken place, the strength
of the medical and nursing staff, the unabated enthusiasm of the
League of Friends, and the enormous amount of money which had,
so generously, been donated by various local organisations and
individuals, it was most disconcerting to hear from time to time
the rumour of closure. As these rumours got even louder in
1992, Mr Michael Jones, the then General Manager of the Powys Health
Authority, was questioned, and he confirmed that the future of
the Builth Cottage Hospital was assured. This gave everyone
some measure of satisfaction and the hospital continued with its
policy of giving patients the highest possible standard of both
community and medical care.
An account of this period of the hospital’s history should
not close without the telling of “Heulwen’s Story”;
a story which illustrates completely the necessity of retaining “Cottage
Hospitals”.
HEULWENS’S STORY
Many hundreds of patients have passed through the portals of Builth
Hospital, but there is on special person whose story encapsulates
the whole essence of what a “Cottage Hospital” stands
for.
In 1968 Heulwen Graham (nee Gittoes) was a beautiful 22 year old
girl with a young husband, Jimmy, and a baby son, Kerry. Tragedy
first struck when Jimmy was killed at the age of 26 in a road traffic
accident. Within two years a further appalling catastrophe
happened when Heulwen was struck down with a severe illness which
shortly led to her becoming completely paralysed, able only to
move her head. After a series of treatments at other hospital
she returned to Builth which became her “home” for
the next thirteen years, unable to move and having to be turned
in bed every four hours.
“Heulwen’s Corner” became the focal point of
the hospital with every visitor stopping to have a word. She
enjoyed listening to her radio and learned to type by using a rod
which she held in her mouth. Above all she had the company
of her family and countless friends. Taking pride of place
in the gallery of photographs which surrounded her bed, was the
framed autographed photo of her idol, the singer Tom Jones.
The loving care and high level of medical treatment which she
received from her doctors, the matron and all the nurses at Builth
Hospital can never be overstated. Always immaculate, Heulwen’s
lovely, long blue/black hair was kept in perfect condition by old
school friend Marion, of Cut Above, who voluntarily and on a regular
basis washed and styled her hair.
The long momentous days were occasionally broken when a group
of nurses, on their day off, would take Heulwen, in a wheel chair,
to a local hotel for n evening out. Even more of an adventure
would be when Colin Davies would drive her in Chippendale’s
furniture van to a hotel further a field for a birthday meal, always
accompanied by nurses and often by her brother Arnold. The
supreme highlight, of course, was the visit to Cardiff to hear
a “Tom Jones Concert”. The nurses had purchased
tickets, organised transport to be driven by Tony Prynne and arranged
for Heulwen to meet the singer personally. The agony was
that, after weeks of planning and rehearsing the words to say,
Tom was reduced to tears, Heulwen was speechless and could only
stare in wonder at her idol. But it was worth it.
Only her doctors and the nurses who had become her friends knew
of the long, dark hours of despair which Heulwen suffered, and
the frustration at not being able to even flick away a fly from
her face. To one nurse she confided that when she dreamed,
she was always running free.
Heulwen died in March 1983 at the age of 37, and the town mourned.
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