Marching on to the brave new world

WHEN a horrendous explosion left 17 ironworkers dead or injured in 1858, the new town of Middlesbrough didn't have a single hospital. The shortcomings revealed by the disaster, at one of rapidly growing town's many ironworks, led to a meeting of the town's worthies, who went on to found a hospital.

This began a long process which saw the creation of Middlesbrough Workhouse Infirmary (later to become Middlesbrough General Hospital), North Riding Infirmary and a bewildering succession of smaller hospitals. They had their work cut out in a town where heavy industry and cramped, unhygienic living conditions combined to make Middlesbrough a distinctly unhealthy place to live.

Those early hospitals depended on private and voluntary subscription, including weekly pennies docked from the workers' pay. But by the 1920s Middlesbrough General was taken over and run by the town council and in 1948 the new National Health Service brought all the town's hospitals under state control.

Fast forwarding down the decades, virtually all of Middlesbrough's acute hospital departments are now under one roof - at the James Cook University Hospital, a £165m complex designed to serve Teesside, South Durham and North Yorkshire.

This Sunday, NHS staff past and present will take part in a procession to mark the end of an era on Teesside. Symbolically, walkers will set out from Middlesbrough General, North Riding Infirmary and the neuro-rehabilitation unit at West Lane Hospital and converge on James Cook University Hospital where they will enjoy a family fun day, beginning at noon.

And what a place it is. Experts say the huge 1,000-bed site is probably one of the best-equipped NHS hospitals in the country. Uniquely, every single major medical specialism is together on one site, providing a total of 64 individual wards and departments.

Among the £16m worth of ultra-modern medical technology installed at James Cook is a neuroangiography scanner made by Toshiba of Japan, an advanced piece of equipment used by brain specialists which is believed to be the first of its kind in any hospital in Europe. That is in addition to a new million-pound MRI (magnetic resonance imaging) scanner and all the other new equipment.

This is far cry from the 48 beds provided on four bare wards at the North Riding Infirmary when it opened in 1864, close to the Ironmasters district. If any of these bewhiskered, top-hatted Victorian founders could have been transported into the future to gaze on the sprawling new super-hospital in Middlesbrough's Marton Road they probably wouldn't believe their eyes.

Paul Willetts, assistant director of commissioning at the South Tees Hospitals NHS Trust, said many of the staff who have transferred from older hospitals to the new site have happy memories but they are delighted to be moving to a 21st century environment.

"The majority of staff who have transferred say it is time to go. Facilities are so much better. There is a really positive feeling from the staff," he says.

One of the staff transferring is long-serving Sister Sandy Relph, who started working at Middlesbrough General almost exactly 40 years ago. Her memories of the place go back a lot further.

"I was probably about ten and a pupil at the Newport Road junior school when I was brought up to wave at Princess Marina of Kent who was opening a new block," recalls Sandy, who is now 57.

Unlike the old part of the hospital, with its high-ceilinged Victorian-style Nightingale wards, that new block which opened in the 1950s had small four and six-bedded wards opening off a corridor - a revolution for those times. But when Sandy actually started working at the General, the care provided was very basic by modern standards.

"There was no intensive care, no kidney unit, no special care baby unit and certainly no kidney transplants back then, they have all come during my nursing career," she says.

"We didn't have specialised coronary care facilities for heart patients, they were just looked after on the ward like everybody else," says Sandy, who manages the hospital's genito-urinary medicine clinic.

"Today's patients expect and get high-tech care."

Sandy is hugely impressed by the facilities at the new James Cook hospital, although she knows it will take a while to settle in. "It is so big, but I suppose if you have a state-of-the-art new hospital with everything on one site, it's going to be pretty big," says Sandy.

"If they had closed the General overnight,it would have been dramatic, but it has been gradually closing bit by bit over the years. From being a big, vibrant hospital it got to be a quiet place. It's nice to bump into people you know again," she adds.

One custom she would like to revive at James Cook is to bring back carol singing around the wards at Christmas. "I used to take the children of the staff around the wards singing for the patients, It would be nice to do that again," says Sandy.

Among the huge variety of specialisms to move into the new hospital is the Ear, Nose and Throat department from North Riding Infirmary.

For nearly 40 years surgeon Vasant Oswal has been operating on patients at the NRI. Now officially retired, the 68-year- old still does regular sessions as an honorary consultant. Apart from complaining at the length of the corridors at the gleaming new edifice that is James Cook, he is impressed by the new facility.

"It's very good although it takes me 15 minutes to walk out of the hospital it's so big," he laughs.

When Mr Oswal arrived on a cold, drizzly day in November, 1963, after travelling overnight from Bombay (now Mumbai) in India he could hardly have imagined that he would be associated with the same hospital for the best part of four decades.

Back in the days of Beatlemania North Riding Infirmary was a very different place to what it was in the 1990s.

"I distinctly remember there was a bed of roses near the Newport Road side of the hospital and very few cars in the car park. We had a resident matron - Miss Hunter, whose name appeared on the hospital letterhead. Consultants were not mentioned as they were not employed by the hospital, they were visiting consultants," recalls Mr Oswal.

His work included 'whipping out tonsils from children's throats almost like clockwork', a practice which is now frowned upon.

Friday night was particularly busy in the days when Catholic families always had fish, with bones getting stuck in people's throats.

"A fish bone could be lodged deep in the throat and its removal consisted of examining it with the mirror in one hand and using a forceps in the other hand to remove it. This procedure needed an extreme degree of dexterity, since the image of the forceps is a mirror image. The forceps needed to be moved away from the fish bone to approach it," recalls Mr Oswal.

Each morning at precisely 8.30am the resident doctor - dressed in a suit, gold watch and red rose in his buttonhole - would tour the ward.

A question by the consultant to the patient 'how are you Mr Jones?' was expected to be replied: 'very well, thank you!'

Once established as a qualified surgeon, Mr Oswal went on to enjoy a distinguished career. Apart from winning an international prize on behalf of the NRI at a conference on laryngeal cancer in Canada in 1974, Mr Oswal pioneered the use of laser surgery in his particular specialism.

Ironically his long association with Middlesbrough has a lot to do with Libyan dictator Colonel Gaddafi. Mr Oswal was on the point of accepting a lucrative position in Libya in the late 1960s when the revolution which led to Col. Gadafi seizing power took place. The abrupt change of government meant his new job was no longer available.

Instead he applied for a new post back in Middlesbrough. The rest is history.

* We would like to acknowledge the help of Barry Doyle, author of A History of Hospitals in Middlesbrough. Copies are available from the James Cook University Hospital, costing £6.

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