1.        From Blunt Penknives to Jubilee medals - Barrie Davies
2.       Obituary, John Bywater - TMC
3.        John Wilner Reminisces

Either scroll down the page or click on an article.

To return to the Archive index
click here


From Blunt Penknives to Jubilee Medals

I’ve always held the belief that there are two kinds of doctors, the academic thinking types and those that enjoy getting their hands dirty. There is no doubt that I was one of the latter types which is why the whole idea of pre hospital medical care appealed to me. Having said that, I knew nothing about BASICS one afternoon in June 1978 when I was travelling along the M50 on my way to visit my parents in Swansea . A small mini bus in front of me swerved off the motorway and dropped 50 feet into a field. I climbed down to find that there was real carnage amongst the party of nuns that it was carrying. In retrospect, I was totally helpless and, if my memory serves me correctly, the only surgical procedure I was able to accomplish was to use a farmer’s blunt penknife and biro to put a makeshift tracheotomy airway into a young nun whose face was unrecognisable – she died some 2 hours later.

What the incident impressed on me most was that ambulance men in those days were totally ill equipped and fundamentally untrained to perform tasks which even many doctors were incapable of. Nye Bevan’s NHS had organised and cosseted GPs and consultants in ivory towers, but he had forgotten about the accidents and illnesses which, in 1977, were claiming around 8,000 lives a year – road and industrial accidents and MIs which had the audacity to take place outside A&E departments! It was at this point that I first learnt about the exploits of a Ken Easton and his pre hospital emergency care team in North Yorkshire .

John Murray, Dick Herbert, Reg Johnson, David Malcomson, Neil Jarvie and myself were the original group that tried to put the thinking of a Wyre Forest Primary Care Team (yes, we were the original primary care team in this area) forward to a very cynical and suspecting consortium of GPs, Consultants and ambulance men. Having said that there were also those, both professional and public, who wholeheartedly supported the concept and, with their help and encouragement, the fundraising efforts took off in February 1981. Our original timetable was that we hoped to purchase enough medical and radio equipment to put one ‘flying doctor’ on the road by April of that year. What happened was that the idea appealed so much to the public of the Wyre Forest that money came flooding in right from the start, and by the end of April six doctors were fully equipped!

I can’t speak too highly of the fundraising team and the very generous response from so many people. The Kidderminster Shuttle gave us the front page on many occasions and local radio conducted many interviews. The end result was that the Wyre Forest Flying Doctor Service took in some £100,000 over its 20 year existence and was one of the best financed of many pre hospital care services in the country. It also meant that we were one of the best equipped services and as new medical and communication equipment became available and was of proven benefit, it was added to the arsenal that we carried in our cars. Incidentally, the original official name of the squad was ‘ Kidderminster and District Primary Medical Care Service’ – the name Flying Doctor Service was coined by article writers at the Shuttle and, not surprisingly, it stuck!

The service also supported sister organisations – the casualty department (God rest its soul!), the local ambulance service and, more latterly, Heartstart (citizen CPR) all received help in both financial and training terms from the squad doctors. Similarly, we supported the birth of other immediate care schemes in other parts of the country. GP trainees who worked for the squad over the years and then moved on to more permanent positions in other parts of the country, took with them a complete medical and communication kit to enable them to start up quickly wherever they went.

It is difficult to quote statistics because, although a report was completed for each call-out, we never saw the need to log each time a bleep went off or when we were turned back from an aborted call. Similarly, we didn’t enjoy being asked by an eager public the emotive question ‘how many lives did you save ?’. Suffice it to say that over the 20 years we responded to between 5,000 and 6,000 calls of which, approximately 20% involved medical intervention not available from ambulance personnel at the time. The calls we responded to were so varied it would take many pages to itemise them. Naturally, road accidents were the commonest and they varied from simple car shunts to major multiples involving many injured. Cars hit by trains, cars driven into rivers, house fires, industrial accidents, shootings, drownings, plane crashes, farm accidents – the list could go on and on and included many calls to what should have been GP problems but, for whatever reason, ended up in our laps. We never refused to answer any calls but frequently resorted to advising the caller how it should have been handled!!

In the early 90s, extended training for ambulance men came into being and the squad doctors were actively involved in their training right from the start. There is no doubt whatsoever that the standard of training of the paramedics and the equipment carried by modern ambulances is a very, very far cry from that very first incident that I was involved with. It is certainly an enormous improvement but I am probably looking into a tin of angry worms when I say that the UK Paramedic is a very poor second best when compared to those in the United States . The UK level of training – in the initial training phase and more significantly in ‘on-the-job’ retraining and updating – leaves a lot to be desired. Money, or rather lack of it, has a lot to do with this but there is also an enormous difference in the structure of the ambulance service in the UK compared with the regimented and highly professional structure which exists in the USA. ……………. But I am straying from my remit !

BASICS, the British Association for Immediate Care was an integral part of the Wyre Forest Flying Doctor Service right from its very start. Indeed, as it came to its twilight years the name of the squad changed to ‘ BASICS Wyre Forest as part of an effort to nationalise the structure of pre hospital medical care. But, following the introduction of paramedics and emergency medical technicians, the need for doctors at the scene of incident became less and less, and the number of calls out dwindled. It became more and more difficult to justify a car laden with some £5,000 of equipment which was used only infrequently. Similarly, the hands-on experience which was a vital part of training was hard to come by.

From a personal point of view I think the final death throes of the squad started with an unfortunate comment made by a senior Hereford and Worcester ambulance officer. For some time the number of calls out had fallen significantly even though we were aware of there being serious incidents in the locality. The only time our bleeps seemed to go off was when they were followed by a radio call to turn out to an incident – ‘can you cover this for us doc as we have no vehicles available at the moment’. Naturally we were unhappy about this and brought it up at a meeting. There we were openly told that as far as he was concerned, he would use any resource available to him to maintain and improve his response times – even if that resource happened to be a GP in the middle of a busy surgery!

Relationships never really recovered from that point and ‘ BASICS Wyre Forest ’ finally closed its books in August 2001. The doctors either kept the equipment for use in their practices or it was passed on to other pre hospital care schemes around the country. All remaining funds were passed on to the Kemp House appeal and the charitable status of the squad came to an end after 20 very interesting, exciting and very rewarding years. The final reward came last year when Dick Herbert, David Malcomson and myself, the last three active Flying Squad doctors, were told that we had been recommended for, and had been awarded, the Queen’s Golden Jubilee medal for voluntary services to the community.

Barrie Davies

click here to go to the top of the page

horizontal rule


John Walter Bywater


John died suddenly on 29th April 2003. His career at York Street Practice in Stourport began in 1965, having previously qualified from Cambridge and St.Thomas's Hospital.

One of his main interests was Obstetrics and Gynaecology and the presence of Lucy Baldwin Maternity Hospital in Stourport was one of the deciding factors for him in moving to the area.  He also held a Clinical Assistantship in Gynaecology, for a number of years at Kidderminster Hospital .

As a colleague ,and friend, he was always entertaining company, having a wide range of interests, apart from medcine, whether it be countryside matters, local history or just local gossip.

As a partner he was always a reassuring presence possessed of sound common sense.

He retired in 1998 having previously steered the practice through it's enlargement into the adjacent York House in 1997.  Unfortunately his retirement was all too brief.  He leaves a wife, Louise, and two Children and three Grandchildren.


click here to go to the top of the page


horizontal rule


John Wilner   Reminisces


In1969, Kidderminster was an interesting place to join a medical practice. I had known the town from childhood as a point on the route to Wales where there were usually delays despite the best efforts of the policeman in his splendid spiked helmet directing traffic from the pulpit in High Street. This remarkable piece of local history had not long been dismantled as the town centre was remodelled and the first section of ring road completed. One effect of this was to separate the ancient parish church from Church Street ’s Georgian buildings where I was coming to work.

General Practice in Kidderminster     had a good reputation amongst Birmingham consultants and several had regular sessions at the hospital. Working at the old General Hospital Birmingham I learned from Professor John Malins that the largest practice in the town was looking for an extra partner. Gerry and I came to meet them and neither of us imagined then that we would still be here over 34 years later having raised a family and seen the arrival of grandchildren.

I joined Sam Wadsworth, John Russell, Geoff Campion and Peter Dutton in a practice already nearly 100 years old. Sam and John had come to general practice after war service and other practices in the town had similar senior figures. Jim Price worked on the other side of Church Street with “Red” Walker and their new arrival, Rod Summers, before later moving to Aylmer Lodge. Harry Buchanan and John Brotherton worked from Mill Street , nearly opposite to our present Church Street Surgery, before they moved to the new Health Centre. John Ball was building a practice with support from young Dick Herbert and Jimmy Jethwa. In Bewdley, Bob Miles had his practice, while Stourport appeared to be a Scottish outpost assisted by Joss Williams.

Kidderminster General Hospital was at the top of Mill Street but staff also worked at the Blakebrook Hospital , less popular with local people because of its workhouse roots. Surgical services had a good reputation with stalwarts such as Robert Gibbins, John James, Ken Forsyth and Nat Lalljee but medical services depended on visiting physicians from Birmingham (John Malins) and Wolverhampton (Pat Thorne.) This placed a heavy burden of responsibility on junior staff who relied a great deal on more experienced figures such as Walter Dunsby in the Path Lab and a few GPs working as Clinical Assistants.

By early 1970, both Rod Summers and I were recruited to support the resident medical staff and, for me, this involved regular ward rounds and setting up a basic cardiology service. Technicians were recruited and trained and ECGs reported. More challenging was the setting up of a primitive coronary care unit in a side ward of the old A block (long since demolished just before it fell down.) Staff were trained in basic skills and we had some success with the defibrillator and even temporary pacing for heart block.

Over the next few years there were rapid developments at the hospital after its designation as a District General Hospital . With a great deal of new building on the Blakebrook site (often hampered by engineering difficulties stemming from trying to build over a “brook”) and the appointment of local physicians its reputation grew steadily. Richard Taylor was the first full time physician in Kidderminster and his commitment together with the others that have followed made KGH an appealing place of work and training for junior staff. Many have then stayed on to work in local practices as trainees or often as principals.

Meanwhile in primary care there were developments, particularly with regard to vocational training. After a trainers’ course in 1973 we appointed our first trainee at Church Street since Graeme Wilcox in the mid ‘60s. In-house trainees have provided the Practice with 3 of its current partners. In 1979 we joined the MRC GP research framework in its first hypertension trial. This has continued to provide an intellectual and organisational stimulus through a series of other projects, some of which we joined at the pilot stage thanks to the enthusiasm of our nursing staff. It gave us a template on which to build a range of nurse-run clinics.

Fifteen years ago we began to computerise and although our start was somewhat hesitant the Practice now has a highly-competent team which has ensured real rewards in organisation and patient care. In 1990 we joined the first wave of fundholding practices and embarked on arguably the most controversial of the recent reorganisations of the NHS. “Purchasing and providing” continued much longer than expected after John Major’s surprise election victory but were swept away with the change of power in 1997, to be replaced by --- well, purchasing and providing. The PCT has a real challenge to ensure that primary care secures an adequate share of resources. This must include investment in services to provide care for patients as locally as possible. I believe that the model of  “Intermediate Care” which we have developed locally is an important part of that.

For Church Street Practice the biggest change followed the decision to build new surgery premises under the cost rent scheme and we were grateful for the support and encouragement at the FHSA of its Director, Clive Parr. We chose Roy Singleton of Gould Singleton as an architect familiar with the “red book” requirements and have remained fully satisfied with his design. The partners made the rash decision to invest proceeds from the sale of the old building by adding an additional storey to the new premises, a sale that took 10 years to complete! We moved to David Corbet House, named after the founder of the Practice, in February 1992. Georgian buildings have a quaint historical appeal but it is impossible to contemplate providing modern primary care from such a setting and the move was certainly made at the right time.

Looking back on 34 years in Kidderminster I see that I write as I were still part of the Church Street team and it is difficult to change that mind-set. We have seen many changes and not all have brought progress but I think I have been fortunate to work through some of the best years of the NHS. The job has often seemed a demanding one, not least to my longsuffering family. I am fortunate to have such good support at home as well as from colleagues at work to make my time here both rewarding and enjoyable.

John Wilner

 click here to go to the top of the page

horizontal rule

 To return to the Archive index click here