In this chapter
A unique expertise in artificial limbs
In 1947/8 a further extension of the Limb Fitting Centre and factories took place at a cost of £30,000.
By this time the Hospital and Limb Fitting Centre had become an even more important national institution. In the report of the Ministry of Pensions for the period 1939 to 1948 the following appears:
“At the Queen Mary’s (Roehampton) Hospital, London, the Ministry has concentrated the headquarters of its service in the artificial limb field. Close to the surgical wards of the hospital the Ministry has established a large limb fitting centre which is used for the various processes of fitting and training in respect of new amputations. It serves as a centre for the Greater London and Home Counties Area for the purpose of adjustments, repairs and after-care services for the limbless. There are two main factories in the grounds. Thus in Roehampton there is a concentration of experts and research in artificial limb matters which is unique.”
At the end of the War, Roehampton’s reputation stood high. The new Limb-Fitting Centre attracted visitors from many countries and all available expertise was shared with the Allies. The Centre was built by the Governors, who continued their building programme after the War. Roehampton was a “compound”, rather than a single institution, the word was applied by George Perkins, who was continually exasperated by the administrative complexity. Howard Sutcliffe, Honorary Secretary and Treasurer 1946-59, likened the organisation in 1950 to an equilateral triangle, with the Hospital, Limb-Fitting Centre and artificial limb factories at the three points, and the Governors at the centre. By that date, however, an event had already taken place which was to reshape that organisation yet again, namely the establishment of the National Health Service in 1948.
The Ministry of Pensions hospitals were exempted from the legislation initially, though it was recognised that they would come into the Service later, and so Queen Mary’s was not affected at first. The right of everyone covered by the NHS to artificial limbs, however, ended the Governors’ function in making them available (except for a handful of private cases) and their role greatly changed. It was the end of an era, which can be symbolised by two events: in 1951 Queen Mary attended the Garden Party for the last time (she died in 1953), and in March 1953 Lady Falmouth planted a white acacia tree on the main lawn in memory of the ladies with whom she had founded the Hospital in 1915. She herself died later that year, aged 92. Queen Mary left instructions in her will that the Princess Royal should visit the Hospital regularly.
After 1948, the Governors no longer had any administrative responsibility at Roehampton, as all those functions were now performed by the State. They still owned the site, and their income from rentals and investments increased during the 1950’s and 1960’s. In 1971, when the assets stood at £200,000, the General Council was disbanded and replaced by a new Board of Trustees, whose objectives reflected the changing policy evolved during the previous 20 years. Like their predecessors, the Governors, the Trustees were made up of representatives from the ex-servicemen’s associations and related bodies traditionally associated with Roehampton. They became increasingly determined not to allow their income to accumulate. They had always provided amenities for patients, and this was continued, but they adopted a much more liberal welfare policy, aimed at helping widows and dependants as well as ex-servicemen themselves. The Department of Health and Social Security War Pensioners’ Welfare Service, BLESMA (British Limbless Ex-Servicemen’s Association) and other charities were approached in an attempt to seek out needy cases. The Governors were also prepared to fund surgical and medical projects which had particular reference to the war disabled.
The Health Minister eyes empty beds
The backlog of cases produced by demobilisation meant that initially the work of the Ministry ‘of Pensions Hospital continued without being affected by the NHS. Indeed Leon Gillis, in a report produced in 1950, commented on the increasing number of the First World War pensioners admitted during the previous year. Nevertheless, numbers were bound to fall eventually and changes to result.
In 1953, there was a transfer of powers from the Ministry of Pensions to the Ministry of Health, and the Ministry of Pensions Hospital Service was closed down by 1950. In view of the unique nature of Queen Mary’s, however, it was once again treated as an exceptional case. The annual report of 1955 explained:
“The Hospital remains under the direct control of the Minister of Health in succession to the Minister of Pensions, and will continue primarily to accommodate disabled ex-servicemen. However, the Governors are pleased to know that the Minister of Health has in mind the use of spare beds in the Hospital by suitable Health Service patients provided this can be done without affecting the priority of admission of the war pensioner and that the Charity Commissioners are prepared to approve such an arrangement.”
The South West Metropolitan Regional Hospital Board, faced with a shortage of beds in Battersea and Putney, pressed the Minister to transfer Queen Mary’s to its control for development as an acute general hospital. This was dismissed as “wishful thinking” by the Ministry at the beginning of what were to prove long and complicated negotiations with the Governors. The problem of how to integrate the Hospital into the NHS was not finally resolved until 1960.
The first NHS patients
The first NHS patients to be admitted to Queen Mary’s were plastic surgery cases. As empty beds became available, the consultants admitted patients from the waiting lists at their own teaching hospitals and in 1954 it was proposed to move the Regional Plastic Surgery Centre from Rooksdown House, Basingstoke, to Roehampton. The plan took five years to come to fruition: the new Burns and Plastics Unit being opened on 1st April 1959. Sir Harold Gillies, still active though long past retiring age, finally agreed to pay monthly visits to Roehampton. The Governors also approved the use of beds by the Bronchitis Research Unit based at the Brompton Hospital.
The building work needed for the Burns and Plastics Unit, which included the expansion of the Pathology Department, involved moving the Tropical Diseases Unit to different wards. FEPOW interpreted this as a threat to the Unit, and expressed its concern through the Roehampton Council of Governors to the Minister. This conflict of interest (although there was much good will on both sides) characterised the problem of administering Queen Mary’s, but it was increasingly obvious that a permanent solution must be found. The problem was eventually solved after lengthy negotiations between the Ministry of Pensions and the Ministry of Defence when the newly built Queen Elizabeth’s Military Hospital at Woolwich was commissioned. The FEPOW unit from Queen Mary’s was transferred on the 18th April 1977 and remained there until
Queen Elizabeth’s was closed at the end of 1995. Other arrangements were then made to continue the facility to FEPOWs undergoing Tropical Disease Investigations.
In 1959 the number of beds was reduced from 608 to 408, of which 94 were unavailable because of the difficulties of recruiting staff to what was becoming an isolated institution. By this date civilian patients outnumbered pensioners by about 2 to 1.