The National Health Service celebrates its 60th birthday on 5th July. Rosalind Griffiths begins a two-part series by taking a look at the history of hospital provision in Shetland. Next week she will be speaking to some of the people who have worked in the service over the years.
THE INTRODUCTION of a scheme bringing free health care to all was positively revolutionary in 1948, when the country was still suffering post-war austerity and where rationing would still be in place for another six years.
The NHS, introduced by Minister of Health Aneurin Bevan, was to mean free medical care for all, regardless of ability to pay.
The NHS was to be funded entirely from taxation, and did away with means testing and removed the worry of doctors’ bills and cost of medication. In 1948, only half of all people in Scotland were registered with GPs and now, for the first time, they could benefit from free treatment, and, as other services such as dental and optical came under the NHS umbrella, free dentures and free spectacles as well.
There followed the innovation of mass immunisation, and the distribution of free cod liver oil, orange juice and National Dried Milk for babies, which saw a dramatic improvement in public health. However steps in public healthcare were being made in Shetland a hundred years earlier.
A smallpox hospital opened at the Knab, Lerwick, in a converted croft house in 1841. The isolated location kept infectious diseases away from the town.
In 1845 a storehouse and kitchen were added to the croft house and it became a four-bed fever hospital. It was replaced by a wooden hut in 1912, and was still used until the 1920s for emergencies.
By 1885 it was considered too small and the members of the local authority and the landward borough (the part of Lerwick beyond Burgh Road) combined to plan a new hospital.
The Lerwick Combination Hospital (so-called because of the co-operation between districts) was built on the site of the present Gilbert Bain Hospital in 1889 to combat the demand for fever beds. The first patient was the mate of a Danish fishing smack who was suffering from typhoid fever.
In 1920 a four-bed isolation block was added specifically for TB patients.
Two years prior to the opening of the Lerwick Combination Hospital, in 1887, the Shetland Combination Poorhouse was opened in the building which is now Brevik House (near the Lerwick Health Centre). Whole families would live there and people were born and would die there. Conditions were grim and the idea was to show the poor that idleness was less attractive than labour.
It was renamed the Zetland County Homes in 1920, to remove the stigma of the poorhouse. In 1949 it became a hospital with a matron in charge, and renamed the Brevik Hospital in 1951, catering for geriatric cases.
The hospital now known as Montfield was opened as the Zetland County Sanitorium in 1928 as the TB hospital. It also had a matron in charge until 1962, the last one being Matron Mary C. Johnson. In that year the hospital became part of the Gilbert Bain with ward sisters in charge. By 1971 there were three geriatric units in Lerwick – Brevik, Montfield and the old Gilbert Bain.
The Gilbert Bain Memorial Hospital (sold to Goudie’s in 1988) was opened in 1902 with nine beds. A 10-bed extension was added in 1912, financed by the Committee of the Fish Trade and handed over to the trustees. The extension was needed for an annual influx of between 8,000 and 10,000 workers who came to Shetland in the herring fishing season.
The present Gilbert Bain Hospital was opened in 1961 by the Queen Mother. Patients from the old Gilbert Bain and the isolation hospital were transferred there.
Babies were born at home until Lerwick’s first maternity annexe opened in October 1947. It was a group of huts at Midgarth, part of a naval base known as HMS Fox.
This was superseded in June 1962 by a maternity annexe (part of the old isolation block) adjacent to the main Gilbert Bain Hospital . The unit was demolished in 1990 when maternity care was incorporated into the hospital itself.
At the time of the advent of the NHS, housing and sanitary conditions throughout Shetland were poor. Retired county sanitary inspector Douglas Smith (who worked in the sanitary department within the remit of the Medical Officer of Health Dr Sandy Black, which also had district nurses as part of the department) recalled the days when there was virtually no piped water outside Lerwick and Scalloway. Forces boys coming home from the war had been used to hot and cold running water and indoor toilets in their camps, he said, and there was a great drive to improve housing standards.
A building boom took place throughout Shetland undertaken by small local firms. The first council houses to be built to accommodate returning servicemen were in Rayburn Road, Mossbank, followed by four in Sandwick and four in Weisdale. And they are still standing, despite the fact they were meant to last 10 years.
Piped water and proper drainage schemes throughout the whole of Shetland improved general health dramatically, at a time when the public were used to illnesses hardly heard of today such as scarlet fever, food poisoning and the occasional outbreak of typhoid.
In those days there was no pasteurisation of milk. Almost every croft had a cow and milk was given to neighbours, and there were many dairies, milk being bought and sold in pails.
The improvement in housing and hygiene standards since 1948 led to a marked improvement in public health.
At that time, according to NHS records, there were 17 deaths of children aged 10 and under and 16 deaths from TB. There were 298 births in Shetland, with five stillbirths, nine neo-natal deaths and one maternal death.
The illnesses prevalent at the time of the inception of the NHS, notably TB, have been virtually eradicated as medical care has progressed into the age of the CT scanner and phototherapy.