Dr. Dermot J Ward recalls a slightly bizarre ‘messenger boy errand’ to the Old Bailey when he, as a trainee, was able to guarantee the Judge of the supply of a mattress to admit an .’Could you take those case notes up to the Old Bailey for me?”
The Old Bailey was the internationally famed Criminal Court in London, and that “Ward” turned into certainly me in my first psychiatric education job. It was the early Nineteen Sixties. The representative psychiatrist in the query (who made the request) became well-known as a forensic psychiatrist.
Perhaps a little eccentric, he turned into recognized to ask gents approximately to escort a daughter who had invited her out for an evening, to sign a word of criminal accountability, protective the daughter’s safety for that evening, not against the law. He has long gone to his reward.
He has been quite near retirement. As it occurred, I became no one of his clinical crew. I thought the request of my messenger boy errand was also peculiar—good education jobs inside the National Health Service (NHS) have been more difficult. Mine turned into titled Peripatetic Registrar and worried 4, six-month schooling intervals in 4 special district fashionable psychiatric hospitals one among which become committed to what changed into then referred to as intellectual handicap.
The latter becomes no longer than the most famous career desire, and people who would possibly overstay (voluntarily) their stint in mental handicap may want to discover it more difficult to return to general psychiatry.
Driving to Old Bailey
But let’s return to our major topic, the case notes for the Old Bailey. Being a minor petrolhead, I was not unhappy to power up in my nearly new Yellow/Black trim Austin Healey Sprite and parking the open sports activities car properly up close to the Old Bailey. That’s the manner parking turned into then (now a bar of gold might do best for starters). However, on entering the pubic region of the Court, I discovered a respectable who confirmed me the right ready vicinity.
With time to spare, I glanced at the paperwork, looking forward to my contact. The accused guy changed into, superficially, a pleasing older chap who allegedly had positioned a hand on a younger lady’s knee in the path of a day cinema overall performance; an analysis of schizophrenia was cited. In passing, disinterested, I thought it was all psychiatrically slim, but no skin off my return. The right psychiatrist is an idea I could doubtlessly carry out properly for the court hearing.
The witness container
Suddenly, the cozy atmosphere dissolved as a court professional escorted me toward the witness box, and it dawned on me that I had predicted that I would provide this case to the Court. I won’t forget that as I ascended the steps to what seemed almost the gallows, I observed a younger policewoman, bless her, smiling encouragingly at me, possibly noting my exsanguinated face. But I needn’t be involved pretty so much. The Judge did now not ask me penetrating questions, which could have uncovered the self-esteem of my weak diagnostic information of the affected person. I, too, became aware of the Court’s preoccupation with “Disposal,” i., E. Had I a psychiatric mattress into which the patient could be admitted? I had one such. And so off we set, the affected person and me in my golden yellow chariot for a health facility mattress in Horton Hospital Surrey.
Breakfast with Powell
It turned out to be when I had that breakfast with Enoch Powell. That healthcare flesh pressure had already eroded medical institution-affected person mattress numbers in all clinical specialties (however greater so in psychiatry). Eventually, the national stage decreased to nigh impossibly low ranges properly. Already, as later could turn out to be clear, Powell had in mind his notorious Hospital Plan for England and Wales, 1962. Not for long after then should a younger trainee medical doctor in psychiatry country with self-belief, “Yes, I even have a bed,” as passed off on that Old Bailey summer’s day.
The Hospital Gazetteer
In my years as a trainee in the UK, as much as senior registrar level among the early ’60s and the past due 1980s, I had practiced in a single substantial vicinity (North Middlesex, nevertheless there a few psychiatric) fashionable clinics, New End Hospital Hampstead, Horton Hospital (in which Henry Rollin was a renowned impact), then Roundway Hospital Devizes (for the Bath, Bristol scientific regions) and my remaining psychiatric health facility in England, Graylingwell in Chichester.
The British Medical Association, now not always appeared as a fearsome defender of NHS clinical personnel and the scientific profession, produced in 1962 an ebook titled The Hospital Gazetteer. It aimed to give scientific trainees beneficial facts about each health center within the NHS. I even have my replica, nonetheless!
But I point it out right here for just one reason. It lists each NHS sanatorium’s 1962 clinic bed numbers in that year. Thus, the lack of such a lot of hospital beds is discovered:
New End had 222 beds; Horton Hospital had 1,524; Roundway Hospital had 1,213; and Graylingwell had 1,210. These indexed hospitals (aside from the North Middlesex) no longer exist. Now, primarily middle-elegance home architect-designed housing/apartments inhabit the old health facility foundations. This general health center mattress loss touches 6,000 beds for the areas mentioned.
Declining influence
The effect the senior medical team of workers had in planning and working vital scientific services has declined. As an instance of this disempowerment, at first, the NH, S award couldn’t be closed without the agreement of the accountable consultant. When it passed, I protested strongly towards completing one of my wards and dispatched a copy of the relevant correspondence to my medical defense agency. Any expectation that my endeavors might convey a few stays at the proposed ward closure changed into marvel, wonder, unnoticed.
Still, I even have the reminiscence of that Old Bailey summer season’s day: I can utter the paranormal guarantee to the decide, ‘Yes, we have a mattress’.
