Editorial
DOUBLE JEOPARDY

We are a profession under siege nationally, in a county which no longer appreciates our worth. Here in Wyre Forest the profession has achieved a Health Service which really is the envy of the rest of the West Midlands. Without a doubt we are the jewel in the crown of Regional Health Services. There are many reason for this - the Kidderminster Medical Society itself has played no small part over the past twenty years. However, another very major factor is General Practice which has taken upon itself the burden of many/services not in our contract thus relieving secondary care of much routine time wasting work. The end result of this appears to be that the Health Authority assumes we will do this work forever therefore relieving secondary services of the mundane, reducing the needs for beds etc. Furthermore there is an assumption that we shall take on even more once A & E is phased out.

At the last meeting of the General Practitioners' Association it was suggested that we should do exactly the opposite. FANTASTIC! Sense at last. In support of our local hospital we should in fact reduce our in-house secondary care services to the bare contractual minimum. The Health Authority obviously has no idea how much we do, how much money we save them and how efficient we are in Wyre Forest. let us show them before it is too late.

Patients may suffer inconvenience. I doubt that they will complain if it is for the sake of retaining their local hospita.. There is a GPA meeting on this issue - in effect a work-to-rule-on 6th July. GP's please make sure you get there. Cast your votes to support our local hospital and to show the Health Authority that they cannot destroy that which is so good in Wyre Forest.

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Symphony Hall
3rd January: 1998

Once again, through ttle music of Strauss, Lehar and Supee, the CBSO wove its musical magic for the start of 1998. The New Year Concert at Symphony Hall in Birmingham was the 'Viennese Night' - and it was a sell out. Fifty, members of the Kidderminster MedicaI.Society with their guests enjoyed the unique atmosphere and wonderful music through the varied programme of Polkas and Waltzes to the Radetzky march for the final encore,

A truly impressive performance by the CBSO under the baton of Barry Wordsworth, and a special tribute to the lady on the bass drum. Although for me, Symphony Hall is always a pleasure to visit, one aspect does not generally meet with universal acclaim - I refer of course to the cost of interval refreshments. I was interested to observe some Society members and their innovative ways of solving this problem! A wonderful night and a great start to 1998

Chris Smith

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New Member - Chris Wilkinson

As a fairly new member of Kidderminster Medical Society, I was glad to write this brief introduction about myself as requested. I was born in 1967 in Stourbridge, where I was later educated at Elmfield school and King Edward VI College Stourbridge. I studied Medicine at Birmingham graduating in 1992. My pre-registration House jobs were at Dudley Road and Queen Elizabeth (Birmingham) hospitals. Although not from a medical background (my father is a Baptist Minister) I had wanted to become a General Practitioner since the age of about 14. An ambition that remained with me throughout my training. After my Vocational training at KGH and Church Street Practice, I was delighted to be offered a Partnership at my training Practice which I took up in February 97. After six months I have no doubts regarding my decision to accept.

At present I am still single but have recently become engaged to Samantha who at the moment is working as a primary school Teacher in Halesowen. We plan to get married in August of next year. I am an active member of a Baptist Church in Wollaston, Stourbridge. I have a special interest in Romania that stems from my Elective there in 92. Since then I have returned about seven times. I have many friends there and it has been fascinating to observe the changes in that tragic but beautiful country. I enjoy mountain walking particularly in the hills of Snowdonia. I have an appreciation for classical music and regularly attend concerts and Operas. I especially enjoy the German operatic repertoire. My first six months as a Kidderminster GP have been both happy and rewarding. I hope the future years will be the same.

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New Member - Paul Williams

I was born in a small village in Yorkshire, the youngest of four children of the local GP and, despite seeing him up at all hours and working hard for a pittance, decided to follow in his footsteps. I trained at Birmingham University qualifying in 1988. I enjoyed Med School life and became fully involved especially on the social side. I was a member of the rugby club but despite my obvious speed, agility and ball handling skills was unable to hold a guaranteed position in the fourth team even though they often hadn't enough players to field a full squad. I don't think they realised my full potential.

I made up my own VTS around the Midlands but managed to include the almost obligatory 12 months in Australia. I was in half a mind to stay longer but the pull of cold drizzle, reduced earnings and higher taxes became too much to resist and I returned to Birmingham. After a period of locums and a spell in a practice where I was introduced to the delights of a dysfunctional partnership I joined the very epicentre of excellence in General Practice, Northumberland House Surgery when I replaced Jimmy Jethwa in the Summer of '97. I am interested in most aspects of General Practice but in particular children's health, obstetrics, ENT and minor surgery.

I live with my wife and two little girls aged 3 and 1 in Ombersley and when time allows I like the occasional game of golf or squash i but I'm sure the parents reading this: will appreciate that any spare time is usually spent in a state of near exhaustion in front of the TV
 

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RETIREMENT  -  JANETTE ADAMS

Jan came to Wolverley in 1967 and after a few years of locum work in Stourport and Church Street she joined the Wolverley surgery in 1970 that had been started a few years previously by Drs. Lamb and Scott. Apart from a two year break in the mid 70s she has been in active service there ever since. Her time, there has seen many changes both to the surgery and i to General Practice. On her return to Wolverley she was in partnership with Philip Hughes before going single handed in 1987. Under her astute stewardship the practice list grew and by 1989 an extra pair of hands was needed and I feel very lucky that my pair were the ones she chose. Whilst I have had the pleasure of working with Jan we have had to contend with the new contract and the advent of fundholding and it is a credit to her that we sailed through those uncharted waters unscathed. Not only has she made a success of General Practice but at various time she has been an Industrial Doctor at Hartlebury Mill, Steel Stampings, British Aerospace and National Standard. We still have a very friendly working relationship with the latter two and it is nice to see representatives from both here today. Furthermore, she has acted as medical adviser to both the K&DHA and the NWHA as well as spending some time as a Police Surgeon. In 1995 she was honoured by her peers by being ejected President of the Kidderminster Medical Society. In that same year she was intimately involved in the setting up of the PCC by being its inaugural treasurer, a post she relinquished only a few weeks ago at the AGM. I am sure, Jan, that you would agree that all this as well as rearing three children would not have been possible without the support given to you by your husband, Tony. In the ten years that I have known him I have often been grateful for his advice and I can only wonder at the array of advantages that must accrue from being married to him.

Jan, you and I first met in 1987. We were introduced by Bill Parker, the Geriatrician for whom I was then working. He heard that you were looking for a locum and he pointed me in your direction. When the words Jan Adams and locum are mentioned together most people who know her immediately assume that she is going on another exotic holiday. This occasion was somewhat differen1 as in fact she was going sheep-dipping. Yes she and Tony were sheep farmers once - yet another venture successfully undertaken by them. I fell in love with Wolverley and, resisting advice from many quarters to seek employment elsewhere I continued to do locums for Jan as well as in other surgeries and I was delighted when we formed our partnership in November 1989. I would like to thank you, Jan, for the support you have given me over the past ten years. You cheery good nature has never wavered and I don't think that there has ever been an angry word spoken between us. I have learned many things from you and especially how to organise a moderm General Practice which really is a small business now. The care you show your patients is something we can all try to
emulate and is mirrored by 1heir affection for you. You will be missed by all of us but your life is now entering a new phase.

The poet, Philip Larkin, said that "You can't put off being young until you retire". Well you obviously don't agree with that as the plans you and Tony have are not for the fainthearted or weak-willed. For those of you who are not aware they intend to start circumnavigating 1he globe next year returning to these shores in the middle of the year 2000.

We all wish you Bon Chance and Bon Voyage and after so many years of working in the NHS perhaps you would like to take the words of Homer with you as your new motto; "I am not bound to swear allegiance to any master - Wherever the wind takes me I travel as a visitor".

Kevin O'Connor

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LETTER FROM SRI LANKA

A few weeks ago. I received Newsletter No. 17 of the Kidderminster Medical Society. As on previous occasions, I enjoyed reading it: I must thank Dr Graeme Wilcox and his colleagues on the Editorial Staff Committee for sending me this newsletter since April 1995 in spite of my prolonged silence. The number of times I tried to write a short letter in response, but had to give up, is beyond belief!

Last week, I received several cuttings from The Kidderminster Shuttle of 9.11.97 through a friend: they showed Dr Taylor and pictures of a crowd near the Rowland Hill statue in Vicar Street. As a keen philatelist I used to nod at HIM each time I visited my Barclays Bank branch at Oxford Street. I am really sorry to hear of the trouble at the Kidderminster General Hospital; as far as I knew it. this hospital served the needs of the townsfolk and many others. I am glad to have been associated with it I hope and pray that your efforts at saving the hospital will be fruitful and that they will lead to complete success.

Now I shall try to give a brief description of the past 12 years, since I left Kidderminster in 1985. Having spent the greater part of my professional life in England and too little over here in Sri Lanka I intended to practice surgery in the private sector. in a small town, on a modest scale. Thus, we chose a nice spot by the shore of the lake at Kurunegala. This is a town in the 'midlands', 52 miles from Colombo and 22 miles from Kandy. the Second City of Sri Lanka. Kurunegala is a forgotten city but it is steeped in history and legend. This was once the seat of a king, late in the 13 Century. They speak of Marco Polo having visited the town around 1294 AD, on his way back to Venice from China; from the number of polo mints left around. I believe the story. In the vernacular Sinhala, "Kurune" = Elephant and "gala",: rock Our lake is bordered on the East by a huge granite rock, and its sloping side bare of any vegetation making it resemble a slumbering elephant closely As legend has it. one moon-lit night a princely suitor due to wed the daughter of the local king. was tempted to view the dowry lands from the temple grounds at the summit of the rock: his chair was pushed to the land on the rocks below, by supporters of a rival suitor They say you can meet the victim on moonlit nights. still riding his white horse!

Our dream house by the lake "Waters Reach" was completed after two years and we moved into it on 1 st May 1987 I carried on with my surgical practice at a well-equipped and adequately staffed nursing home. in the centre of the town: As the distance between home and place of work was less than half a kilo metre, I was able to vi9it my patients two to three times daily, run clinics and cope with emergencies at all hours. It was a nice set-up until fate stepped in. ' In 1989 I developed a severe cataract in the right eye: I had to undergo implant surgery at the Kandy General -Hospital. in September 1989. I decided to retire from active practice and applied for my NHS pension. Fortunately, not only did my pension come through but also 1 made a rapid recovery from the lens implant surgery. My numerous interests helped me during these difficult times. Frequently. I receive pleas for medical and surgical help from past patients as well as friends but I had deliberately lost touch with surgical progress, having given up reading the journals: thus I had to refuse these pleas. However, when The Armed Services of Sri Lanka appealed to me for help, I ran out of excuses. We are at war and they wanted my help. This explains how I worked for six weeks at the Front, in Jaffna, doing stretches of a week or two at a time. I was flown out from Colombo to the Army Base Hospital at Palaly, in Jaffna. in transport Antonov aircraft piloted and crewed by Russians. Each time they fly high over enemy territory to the sea around Jaffna, drop like a stone to ground level and come in fast to land at Palaly Airport- The crash of heavy shell firing, throughout the day takes some getting used to ! As one might imagine, emergency surgery under these circumstances is difficult, but the injured men were grateful. On 25.4-97 I was invited to a special cocktail party at the Army HQ in Colombo I was the oldest doctor among the list of 20 guests that evening. Each of us was presented with a heavy 18 ins. High brass shell case with our names engraved (individually) as a token of thanks for work done at the Front: the presentation was carried out by General Daluwatte, the Army Commander-in-Chief. I had met him several times at Palaly during the six weeks. Since May 1997 I had to decline all further appeals to help at the Front.

Life has been quieter since then. We listen to a lot of music ranging from modem, to early jazz and classical music. I have a good collection on cassette, of music recorded from Radio 3 during many years I spent in England. I have a dated, yet good Penguin CD Guide which helps me to select my purchases; one such is the Elgar Cello Concertol/Jacqueline du Pre/LSO/Barbarolli. I think this is superb. Having had lessons in the pianoforte, at weekly sessions with a kind lady teacher, I can claim to play my piano well (??) During the day I do a lot of DIY maintenance of the cars, house etc. I look forward to Thursdays for that is when the Waters Reach Contract Bridge Club meetS, regularly, for a bit of chatter and a lot of bridge. We can boast of being the only bridge club in town; we have existed for 5 years! As far as reading is concerned. we were members of the lending library at the British Council in Kandy until 2 years ago. Now, travel is tiresome and we had to give up. t have my own collection of books gathered lovingly from old bookshops in places such as Bewdley, Hay-on-Wye, Warwick, Victoria (London), Edinburgh etc. I have yet to complete reading all books by Nevil Shute. We subscribe to the (Manchester) Guardian Weekly coming to us by airmail. I have TV/video but I possess a small powerful radio set capable of picking up most stations on shortwaves. So, I listen to BBC, VOA. Australia, Holland, France, Norway, Sweden, Japan etc." especially at night. I love to sit on a deck-chair in the lake-side patio, situated on the East side of our house and admire the view of the lake and the rock, with all the changes in colour that occur from sunrise over the rock to the reds that cover the bare granite late in the evening before the sun slides way from the Western sky. We have a sundial and a bird-bath in our garden, the latter is so popular that birds queue up to have a dip. The range of birds to be heard and seen is remarkable; golden orioles, with their unmistakably rich warble, the incessant chatter of "seven sisters" the twittering of honey birds etc. it is almost too much!

Last but not to be forgotten is our own Nessie: yes. we have a huge, ugly black and yellow spotted monitor lizard, living in the depths of the lake. He is reputably harmless. if one can keep out of the way of the swishing tail! He has climbed over our wall twice, during the past 5 years, and applied for admission to the bridge club Both times he has been refused!

Lucien Gunaratne

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VALEDICTION - Walford Gillison

Now that over a year has flown by since retirement, I wanted to say., among other things, how much I appreciated the thought as well as the generous cheques that I received. John Murray would say that they were an indication of your anxiety to be rid of me! I have an excellent camera, a C.D. player and some golf irons to show for everyones generosity. The professional at Kidderminster says that since retirement my bad shots are marginally better!

My start at Kidderminster in 1973 was most exciting. Richard Taylor and John Murray were already appointed; Bill Parker and Olaf da Costa soon followed. We were delighted to be surrounded by a quality of General Practice almost unknown to us as senior registrars in the big cities. The quality of referrals made out-patient clinics a pleasure rather than a matter for dread. In those days consultants were given a lump sum on arrival for new equipment and my £2,500.00 ( a lot of money in those days !) went on our first gastroscope. Negative laparotomies for radiologically suspected peptic ulcers and cancers were abolished and we even picked up the occasional early gastric cancer  thus saving far more than the initial outlay. However, Steve Booth's welcome arrival meant my weekly endoscopy list could again be used for operating. Although we had just started to use staples to reduce the number of A.P. resections, Philip Armitsead's arrival gave colo-proctology a much needed up- grade as well as providing a surgical vascular presence. He also introduced regular, open Audit meetings which I found very educational and improved standards. Later, David Baxter-Smith, contributed valuable urological expertise and a considerable number of supra-pubic fistulas dried up following his attentions. I also relished his wit and his ability to do the Telegraph crossword before lunch 1 I was glad to introduce video-assisted laparoscopic ( 'key-hole' ) surgery to Kidderminster before I retired. Having attended a training course in Edinburgh, I knew we had to have the facility in Kidderminster to manage at least cholecystectomies in this way. Once again, the League of Friends came to the rescue when management could not fund this essential equipment. We owe the League so much; this is seldom acknowledged by politicians who claim to run the Health Service.

Finally, I value the excellent professional and social relationships I have formed over the last 23 years with medical colleagues and a devoted nursing staff. I was delighted to be replaced by two excellent colleagues who continue quality surgical provision. The fight for the survival of Kidderminster as a DGH is now on. Success depends on this proven quality of hospital and community medical care. I offer my best wishes and continued support in this fight.

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THE CROFT, SUTTON PARK ROAD

It is with great sadness and nostalgia that the Editor sees the Croft on Sutton Park Road is to be sold by the Regional Health Authority. Many of the older practitioners of Kidderminster will have spent some of their most exciting, frightening and rewarding professional hours in the Croft when it was the Kidderminster Maternity Unit. When the Editor first arrived at Kidderminster 95% of Kidderminster deliveries were either in the community or in the Croft and only the rare highly complicated case was referred to the Maternity Unit at Bromsgrove under the care 01 the then consultant Mr. Kenny. It was unusual to refer a case in labour and we were expected to use forceps, to deal with retained placentas, use the Ventouse and if necessary put up drips etc. in the Croft setting; if need be supplies of blood and anaesthetist were provided by the hospital.

The history of the Croft is quite interesting. It was sold to the Local Authority on 5th May 1947 by J.F.C. Brinton, A. Hughes, S. Vemon, the Mayor, Alderman and Burgesses of the borough of Kidderminster. The property was then vested in the Ministry of Health on 5th July 1948 by virtue of section 6 of the NHS Act 1946. I am afraid we have no information on the history of the house and land prior to 1947. As far as I know it immediately became the Kidderminster Maternity Unit (before that time all Kidderminster deliveries were home deliveries). By the time I arrived it had been in existence for 17 years and was a very successful unit with figures comparable to any unit in the County. All GPs had admitting rights and most used them. Any G.P. that did not wish to attend their patients passed over the in-delivery care to the clinical assistants (in particular Sam Wadsworth and the Church Street practice). Interestingly, the Lucy Baldwin in Stourport worked very differently and all

 deliveries there were under the care of clinical assistants (the York Street practice until the early '70s when open access was agreed. When Mr. Kenny retired there was a rapid move towards hospital care and this move was supported by general practice. In the late 70's or early 80's the Maternity Unit at Kidderminster General Hospital was born and the Croft was turned into administrative use. We were promised that at some stage in the future the Croft may be returned to clinical use but as the years have passed it has become more and more obvious that it is now surplus to requirements and I note that there is planning permission in for the site to be turned into housing. It is now a memory and I fear another casualty of modem medicine.

Graeme Wilcox

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