After the NHS

 

The advent of the National Health Service in 1948 affected the practice badly. Shortly after Herman retired Tuckett and Easton left to become hospital consultants. For Tuckett the option of being both a general practitioner and surgeon no longer existed. Although he opted for a full time surgical career in 1950, he would still come into the surgery every Thursday morning and see minor surgical cases or those who just needed putting on a waiting list for a surgical procedure. These were some of the earliest outreach clinics in the NHS.

 

Also, from now on the partners are all still well known in Tonbridge and the memory of their personalities and work is still fresh in patient’s minds.

 

Theodore Dewey, known as Dore, qualified in 1926 from Cambridge and St. Thomas’ Hospital, gained experience at St. Thomas’ and the Victoria Children’s Hospital, Chelsea before joining the practice. He had a reputation as a very skilled obstetrician. He joined the practice in 1930. Apart from medicine, his great love was gardening at which he excelled, and on which he expended a great deal of money in developing the garden at his home, Warders. He retired in 1962 and died in a road accident in 1978.

 

Stuart Leslie Melville (served 1945 – 1977) qualified at the beginning of the war in 1942 from Cambridge and Kings College Hospital. After service in the Royal Naval Volunteer Reserve in the South Atlantic and Far East, he joined the practice in 1947. As junior partner he was expected to give the anaesthetics for surgical procedures at the Cottage Hospital and for obstetric emergencies at the Tonbridge Nursing Home, although he had little training in the subject. 

 

On Easton’s departure, Stuart Gordon Adam Forsyth (served 1949 – 1987) arrived.  He had a qualification in children’s diseases, which gave him the opportunity to look after the paediatric wards at Pembury Hospital when the consultant paediatrician was away. Vocational training for general practitioners started in the 1970’s (prior to this experience had to be gained in hospitals, which was often inappropriate for the problems faced by general practitioners). Stuart Forsyth became the first trainer of GP’s in the practice and also for a time ran the local vocational training scheme.

In 1963 Lloyd’s Bank wanted to expand and terminated the lease. It was very difficult to find alternative accommodation, but eventually the practice was able to rent the first floor of Hanover House, further up the High Street. This had originally been an Elizabethan manor but a small part of this original building had been left when the rest of the property was rebuilt in late 19^th century. The premises that the practice took, which had all originally been the bedrooms, were large and difficult to heat, and approached up a grand staircase. Below was a dental surgery.                             

 

They were a great improvement, with hot and cold running water in each room, and space for a small laboratory. There was also room for a nurse to assist in minor procedures for the partners and treat patients of her own. At the same time an appointment system was introduced which made life a great deal easier for the partners. The patients were not always so sure about the changes.

                                                                        Figure 2: Hanover House reception in the 1970's

 

The general practice service nationally was in a state of seemingly terminal decline in the early 1960’s. To counter this, the government introduced the General Practitioner’s Charter in 1966. There was an immediate increase in the services that could be offered to the patients and in the staff employed. The surgery was kept open from 9.00 am to 7.00 pm by a succession of receptionists. The partners were able to dictate all their letters to a couple of full time secretaries and nurses employed by the practice widened their expertise. It was not long before nurses, district midwives and health visitors employed by the local health authority became attached to the practice and worked from Hanover House. All these changes coincided with the early years of John Hawkings (served 1963 – 1995) and John Ford (served 1965 – 1996).

 

When these two arrived off duty was poor. Each partner had one half day a week, which started when you had finished your work after1.00pm. In winter this could well be at teatime. You were on duty again at 11.00pm. One partner worked each weekend and ran a Saturday evening surgery, whose most frequent attenders were patients getting off the bus outside Hanover House on their way to the cinema. The other partners had from lunchtime on Saturday until 11.00pm on Sunday off. The junior partner was expected to do the work of a partner who was on holiday. You were expected to attend your own midwifery cases at all times unless out of the town on holiday. Babies were delivered at home, or at The Maternity Home in Tunbridge Wells. Only first babies, and mothers who had had previous difficult labours were booked for a hospital birth.  

John Ford had an interest in psychiatry and worked as a clinical assistant in the Baltic Road Clinic in Tonbridge for eight years. He was also a founding member of the board which set up the local hospice service, now based at Pembury. Another great interest of his was medical history. This lead to him being appointed as medical historian to St Thomas’ Hospital and researching the history of the practice, which continues to this day.

 

Hanover House, although a great improvement on 121 High Street, was far from ideal. Patients found difficulty in parking their cars and in climbing the stairs. The practice was expanding in the number of patients and in the treatments that could be offered. The secretarial load enlarged alarmingly with the burgeoning paperwork of the National Health Service.

 

 So led by John Hawkings, the town was scoured for suitable premises that could be adapted to meet the needs for the foreseeable future, or for a plot of land on which to build.  The only site that proved adequate was Warders, a large Victorian house that had previously been lived in by Bunting and Dewey.    After conversion, it was opened as Warders Medical Centre in 1987.

Other changes were occurring. Out of hours work was shared with other local practices by TTDOC (Tonbridge and Tunbridge Wells Doctors On Call) of which John Hawkings was a director during its formation. Continuing pressures on space led to the acquisition of a bungalow that was built in Dr Dewey’s garden, which became ‘Little Warders’, again under the guiding hand of John Hawkings.

 

The first female partner, Sue Allen was appointed in 1987 and the partnership continues to grow, there now being eight partners. A computer was acquired in 1989, but it was to be another 10 years before it replaced the system of paper records that dated back to 1911.

In 1998, on the 50^th Anniversary of the NHS, BBC Breakfast News was broadcast live from the surgery.

In same year, we applied successfully to take over a single-handed practice in Penshurst. The addition of these patients resulted in the practice having a list size of almost 16 000, making it one of the largest practices in Kent.