1.       Locality Purchasing gets go ahead
2.       We Are Survivors
3.       Steam Train Nostalgia
4.       Post Grad Centre - Proposed Extension - Walford Gillison
5.       Proposed PGMC Development
6.       Ever Thought About Buying Abroad? - John Murray
7.       Memories - Peter Cooper
8.       Richard Taylor
9.       Primary Care Centre - Barrie Davies
10.     Medical Society Annual Dinner 1997
11.     Post Grad Centre appeal - Graeme Wilcox
12.     Obituary - Dr Brian Lamb       

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LOCALITY PURCHASING
Gets the Go-Ahead


Probably the most significant organisational change in local health services in the last decade was agreed at the recent GPA Annua! General Meeting. By a postal vote of 36 to 8 it was agreed that the GPA Executive would pilot a locality purchasing scheme, the result of which would be for the Health Authority to past management and funding of local health services to the GPA Executive, which would then agree local spending.The executive will in due course set-up a management group led by Chairman Lynn Butcher to spearhead the changes.


The membership of the GPA Executive is now; Chairman Lynn Butcher, Treasurer John Wilner, Secretary Jim Goodman Members Bob Marriott, Toni De Cothi, Neil Jarvie, Richard Horton. The Executive now represents virtually all local practices including Hagley and Chaddesley. The only exceptions are now smaller practices at Wolverley, Cookley and Arley Kings.

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WE ARE SURVIVORS
(For those born before 1940 ..)


We were born before television, before penicillin, polio shots, frozen foods, Xerox, plastic, contact lenses, videos, frisbees and the pill. We were born before radar, credit cards, split atoms, laser beams and ball point pens; before dishwashers, tumble dryers, electric blankets, air conditioners, drip-dry clothes ... and before man walked on the moon. We got married first and then lived together (how quaint can you be?). We thought fast food was what you ate in Lent, a big Mac was an oversized raincoat and crumpet we had for tea. We existed before house-husbands, computer dating, dual careers and when a meaningful relationship meant getting along with cousins, and sheltered accommodation was where you waited for a bus. We were before day care centres, group homes and disposable napkins. We never heard of FM radio, tape decks, electric typewriters, artificial hearts, wordprocessors, yoghurt and young men wearing earrings. For us time sharing meant togetherness, a chip was a piece of wood
or fried potato, hardware meant nuts and bolts and software wasn't a word.


Before 1940, made in Japan meant junk, the term making out referred to how you did in your exams, stud was something that fastened a collar to a shirt and going all the way meant staying on a double-decker to the bus depot. Pizzas, McDonalds and instant coffee were unheard of. In our day, cigarette smoking was fashionable, grass was mown, coke was kept in the coal house, a joint was a piece of meat you had on Sundays and pot was something you cooked in. Rock music was a grandmother's lullaby, Eldorad9 was an ice cream, a gay person was the life and soul of the party and nothing more, while aids just meant beauty treatment or help for someone in trouble.


We who were born before 1940 must be a hardy bunch when you think of the way in which the world has changed and the adjustments we have had to make. No wonder we are so confused and there is a generation gap today.. But, by the grace of God - we have survived Alleluia!!

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STEAM TRAIN NOSTALGIA


Those members who were fortunate enough to attend the evening on the 7th March, were entertained to an absolute extravaganza of photographs of the now almost extinct era of steam trains. The presenter, Colin Garratt has travelled the world in search of steam engines - both living and dead - and has succeeded in acquiring a unique collection of photographs, of which we were shown just a small selection from Europe, America, India, China and others. More than half of the steam engines were built by the British in their heydey. As the President, Dr. Booth said in his introduction, Mr. Garratt has a photographic record of the most romantic period in man's industrial history, a period which is very sadly, and rapidly coming to an end.

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POSTGRADUATE CENTRE
Proposed Extension


Members, including myself, have been unclear about a timescale for the above since the Extraordinary General Meeting of the K.M.S. of last year. At the meeting it was agreed that whereas in the 70s our centre was in the vanguard of post-graduate education, other centres have now caught up and even overtaken it in terms of space, facilities and technology.


The P.G.M.C. Extension committee was poised to get the project under way when for the second time in three years the campaign was stalled by an outside event. in 1994 the much needed C. T. scanner appeal intervened. This year another worthy and crucial appeal has been launched for a Cancer Resource Centre by the League of Friends of the Hospital. Since a visit by a Regional committee looking at cancer services it appears that to be recognised as a cancer centre, we must have properly equipped premises for modern chemotherapy.As regards funding, many believe that the sources for a Cancer centre would be different from possible sources of revenue for the Education centre. However, all agree that the two campaigns cannot be run simultaneously. Management believe that the third of= a million pounds will be achievable by the Autumn for the Cancer unit. Trusts everywhere are being asked to fund Post-graduate education significantly these days, and a full business case will be made to the Trust for something near half a million on account of the increased numbers of medical and paramedical personnel from the community and in the hospital
needing access to the centre. It will be up to the whole community to try and find the remainder. As the Trust will be asked to I contribute, it is reasonable that I quotes from other architects should be considered, though I personally hope that Jim Chapman whO" came down to the last A.G.M. gets the contract as I believe he has the experience, energy and imagination for such a project. Quotes, surveys, interviews and plans should be completed over the summer and autumn, so that the real campaign can start early in 1998 As chairman of the appeals committee for the centre, this is what I hope will take place, however nothing is inscribed in stone these days.

Walford Gillison

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Proposed PGMC Development


There has been much debate about the future of our PGMC. This culminated in a recent landmark decision by the KMS to approve in principle a change to a multidisciplinary education centre. Why should there be such a change? At present we have a well supported postgraduate programme
and excellent dialogue between primary and secondary care. What we do not have is the physical resource to learn in a truly multi disciplinary environment. One could go on about the theoretical educational merits but at its most simple the way we learn should reflect the modern way in which we work i.e. as teams.


We have an urgent need for more tutorial and meeting space - current provision is inadequate and maintenance costs on the existing building will be high in the next 5 years. With the planned move of pharmacy we have an opportunity to expand the size and scope of the centre and, in particular, to get ourselves onto the 'regional circuit' with a larger lecture theatre. Such a rebuild is expensive (around 700K) and it is logical and necessary to
look to a partnership with the Trust for (very) significant funding to top up our own fundraising efforts. There are natural anxieties about the potential loss of control of 'our' centre. I am certain that doctors will continue to play the most significant role in any multidisciplinary centre and an appropriate governing executive committee would be essential. I believe that the time is right I to move to a high-quality showpiece! facility that reflects modern health care practice and will act as a district focus for our educational activities and magnet for future staff.

Paul Newrick

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Ever Thought About Buying Abroad?


A recent survey showed that 4% of British people own an overseas property or intend to buy one. Many more must dream of a red tiled farmhouse baking in the Mediterranean sun. When it comes to turning dreams into reality however, a large dose of common sense is required as the BBC film on British people who had moved to the Dordogne showed. Most had bought without knowledge or forethought and paid the penalty. It took us five years to find our ideal house in France and we saw some very odd things in that time.


A few simple rules will save a lot of trouble. First get to know your. area and be sure that you will like it long term - the climate in Winter, for example may prove a nasty surprise. You should then know the going rate for property the likely rates and taxes, not to forget the state of medical care. Estate agents will give you a guide to prices. Visiting an adequate number takes time so flying visits are unwise unless you have a reliable contact.


Secondly be sure of what you want and what you are prepared to pay which includes running costs- these will increase considerably if you have a swimming pool. The essentials such as roof windows and walls should be sound as re-roofing is a very expensive undertaking. A small garden, courtyard or terrace is essential which excludes many village houses. Restoration of old ruins is only an option for the very skilled handyman and is most difficult to cost. I doubt if you ever "see your money back".


Thirdly go through the proper channels. This means using a notary in most countries which will usually guarantee that there will be no legal problems over possession although there have been mishaps in Spain where there are separate freeholds for house and land. We have used French and Dutch notaries and have found them professional and reasonable in their charges. In France the notaire has to levy a large government tax on the transaction which adds to his bill. "Irregular" British estate agents who operate in some parts of France and who add their costs to-the normal commission are illegal and should be avoided. Having considered all the above points if you really like a property, buy it, because you wont regret it. 

John Murray

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MEMORIES from PETER COOPER


I first heard of Kidderminster in the early 80s and I liked what I saw - a new energetic DGH Psychiatric Unit looking outwards to the population it served. When I arrived here as a registrar in 1984 I was pleased to find that not only was the psychiatric service a delight to work in but the whole hospital and wider medical community seemed to have an ethos involving cooperation rather than defensiveness and to be of a very high quality. It was here that I learnt most of the things which I find valuable about the practice of my trade. I came back for the odd few weeks to do Consultant locums, just to make sure the place was still functioning and eventually returned in 1990 as a Consultant. I found that the old values were still intact; there may have been a bit more pressure from an increasing workload but it continued to be a stimulating and enjoyable place to practice.


I'm not sure how much my sense of disappointment is due to the workload or referral pressure accompanied by a decline in medical manpower, or how much it is due to the direct and indirect affects of health service reforms. Whereas in General Practice the reforms may have produced an increased pressure plus an increased sense of ownership and control, they have produced for me a decreased sense of ownership, an erosion of that sense of responsibility which comes from being responsible to a population and a pressure to replace this with a business driven ethic of payment for work done. I don't know how much the pressure of instability stimulates good work from businessmen; it has the opposite effect on me. I would have liked some sense of being able to worry about the work and not about the structures that support the work.


My appointment here was in general adult psychiatry with 4 sessions special interest in psychotherapy, both to do and to teach. Kidderminster seems to have been a very reasonable place within the registrar training rotation to provide such an appointment, with our tradition of psychological-mindedness and a regard for psychotherapy not as something precious but as a general psychiatric skill. As theyears progressed I found the pressure from other work made my special interest into more an evening hobby rather than part of my work. I have come to realise
the difficulties or impossibilities of doing what I intended to do. The idea of providing, at Kidderminster, a Sub-Regional centre for people with eating disorders has not only been delayed, but I have come to realise that with the present psychiatric manpower, it could not have been adequately covered by Consultant time.


At the end of last year I became aware of work being available in Mid- Wales and I applied, partly because of the reasons of the difficulty of the work here and partly because it would have been a return home. I realise that there  will be the same pressure on resources wherever I go, but I hope
I that will be able to have the resources to do my job almost to my satisfaction where I am going. Nevertheless it is with considerable sadness that I leave. Kidderminster has been the place where I grew up in my profession and still has within the medical community, a level of excellence and a degree of cooperation which is exceptional and I shall miss my friends here.

Peter Cooper

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RICHARD TAYLOR


I was born near Manchester and brought up in lovely country in Craven on the edge of the Yorkshire Dales. I started my education at a spartan preparatory school on Ilkley Moor. After this, school and university in Cambridge were luxurious even though I college accommodation was only heated by coal fires and ablutions were the other side i of an open courtyard.


After qualifying at Westminster in 1959 I did house jobs there, at Kingston and! The London Chest Hospital. I could not avoid National service and so chose a 3 year stint in the RAF on the understanding that I could continue with hospital medicine. As the service was so short of medical officers right at the end of National Service I saw very little hospital medicine and worked mostly on flying stations in Lincolnshire and Christmas Island. In retrospect, the latter was the highlight - a once in a lifetime opportunity to live on a tropical coral island with a superb climate and exotic birds s unused to humans that neither binoculars or telephoto lens were necessary. Escaping from the RAF I resumed my medical training with SHO, Registrar and Senior Registrar posts at St Stephen's and Westminster Hospitals. I was lucky to work for two super chiefs, Dr Frank Dudley Hart and Dr (now Sir) Richard Bayliss. During this period my three older children were born and we lived first in a shabby Victorian flat in Barnes, a tiny modern semi on Wimbledon common and then a lovely Edwardian House in Merton Park. We came to Kidderminster in 1972 and I joined John Peaston as the other general physician. From the beginning our house officers were excellent with very few exceptions but our SHOs were variable, to say the least. I shall never forget one gentleman who regarded all nurses as his personal slaves and another, so incompetent that I spent my time trying to prevent him seeing patients.


In 1975 John Peaston left for Canada and I was single handed for a few months. Luckily I had two excellent house ladies, Dr Pitchford and Dr Puttnam (inevitable known as Pitch and Putt) and Dr Mike Dew, the first of our succession of top class SHOs. Steve Booth arrived in late 1975 and as Bill Parker and Martin Lewis had already started life became easier and I took on the Chairmanship of the Medical Staff Committee for the
first time. With the first reorganisation of the NHS Kidderminster became its own District within the Hereford and Worcester health Authority and as Chairman of the MSC I was automatically on the District Medical Committee. In 1978 we had the satisfaction of moving into new A-Block which remains, in my opinion, one of the best standard designs for an acute ward block and, in 1981, the luxury of a 1 in 3 rota with Geoff Summers. The second reorganisation of the NHS made Kidderminster into a Health District itself and I had the privilege of being the first consultant member of the Authority. I really enjoyed this time and felt to have had an important role in helping to direct an efficient District, in my opinion, the best years of the NHS. In 1987 I left the DHA to become chairman of the MSC again. This time the correct title was Unit Medical Representative.


At a family Christmas party in 1989 I found a silver charm in my pudding. To everyone's amusement it was a wedding bell ! Sure enough, in 1990, after passing on my management roles, I met Chris and on a memorable day in September we were married. Georgina arrived in 1993 and we were amazed and charmed by the reaction of friends and colleagues. Because of the increasing impossibility of covering a share in general medicine and rheumatology, to say nothing of family commitments, I decided to retire at 60. My retirement parties were a joy especially one attended by about 30 ex SHOs going back to 1976 and one for rheumatology patients held in upper out patients on the last day it was used. I enjoyed my years as physician and rheumatologist at Kidderminster immensely because of patients and colleagues. I just hope the trust can continue to provide a first class service for the people of Kidderminster despite all the difficulties ahead.

Richard Taylor

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PRIMARY CARE CENTRE


By the end of February 1997 the Wyre Forest Primary Care Centre had been operating for 18 months. In that time there had been a total of 31,317 contacts with patients, divided into 11,404 (36.4%)  telephone advice, 15,846 (50.6%) consultations at the centre and 4,067 (13.0%) home visits.


The trends over that period showed that, as the lead nurses and doctors were becoming more experienced, telephone advice was being offered, and accepted, much more often and the rate of home visiting fell from 15.2% to 11.5%. More significantly, the number of complaints handled fell from 14 in the first year to 5 in the first 6 months of the second year. All complaints were satisfactorily dealt with 'in-house'.


In March 1997 a 20 week pilot study commenced when the Hagley and Chaddesley practices became involved in the PCC. Considerable debate about their inclusion took place before the study and a decision will be taken in July as to whether the practices' involvement becomes permanent. The inclusion of the Belbroughton practice in the PCC was voted against because of the possible distances which would be involved in home visiting.


Recently the PCC has become computerised using the VAMP out of hours software. Initial use of the system looks encouraging. The object is to obtain regular updates from the health authority of the patients of all practices involved with the PCC. Subsequently, an out-of-hours history of all contacts will be developed and shared with all the individual practice computers.

Finally, suffice to say that  discussion is taking place at the moment about observation beds linked to the PCC/A&E and an initial contact single point triage system. More news later!!

Barrie Davies

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KIDDERMINSTER MEDICAL SOCIETY ANNUAL DINNER 1997


Rarely has there been so much laughter at a Medical Society function. The President, Dr. Steve Booth, made an extraordinarily
amusing introduction of the guest speaker, so much so that thanks to barracking from his own table, he himself burst into laughter.
Eventually, having composed himself, he introduced the guest speaker, Dr. Phil Hammond, TV, radio personality and wit, ( 'Struck Off
and Die', 'Trust Me I'm a Doctor' ) and correspondent for Private Eye and The Independent. He 'gave up medicine to become a GP'
and then gave up general practice to move on to radio. We were entertained for another hilarious half an hour, largely on the subject
of items taken out of his Gladstone bag. Can any of the members present remember 'a cure for irritable bowel' or the meaning of 'T.F. BUNDY' - replies on a postcard please to the editor! Phil Hammond's final comment was 'I have never known such a happy, co-operative audience - I hope this was a compliment! There was an excellent attendance of members, guests and friends old and new, totalling over 120, and as always, Spring Grove House provided us with an excellent meal. ANSWERS for the next edition.

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Post Grad Centre Appeal

As you know, the Medical Society and the Trust are combining ideas to create a new and enlarged multidisciplinary education centre, either as an extension to the present building or as a new building depending on the funds available. As the building will no longer be a purely medical post graduate centre the present name will be inappropriate.

The steering committee have asked that we do research amongst society members for an appropriate new name for the centre. We have already had two suggestions - the Gibbins Centre and the Blakebrook centre but we would like many more ideas. Please forward any suggestions to the PostGraduate Centre administrator for discussion by the steering committee.

Graham Wilcox

 

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Obituary
H.H.B. Lamb

Former Wolverley GP Dr Harold Henry Brian Lamb died on 11th February 1997 aged 77 years. Brian, who qualified in Dublin in 1942, came to Kidderminster to do his house officer jobs and served the rest of the war in the navy.

He returned to Kidderminster and worked with Dr Bob Lurring at Church Street and on 1st January 1966 opened the surgery at Wolverley which was held in a wooden hut. In 1970 he stood as the liberal candidate in the General Election and was a parish and district counsellor for many years serving Wolverley and Cookley.

In 1977 he moved first to Brixham and then to South Somerset where he soon became involved in local politics.  In 1990 he opened the newly built surgery at Wolverley. He died still in the full harness of his public duties leaving his wife Renee and 3 daughters.

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