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The Fourth Statistical Account of East Lothian

Healthcare

Medical care in 1945 was mainly a frontline family doctor service operating from two surgeries by a Dr Badenoch and a Dr Hislop, backed up by a district nurse living in a designated house. By 1948, the general practitioners became part of the NHS but still worked as independent practitioners with a surgery as part of their property. While GP practices evolved elsewhere, some single-handed practitioners continued. By the 1970s, Dr Denys Brown had a partnership link with Dr MacDonald of Dunbar, but the surgery at 'Kiloran' was his responsibility. The increasing pressure on GPs and expansion of the population in the 1980s led to the building of the East Linton Health Centre, Station Road, which is now served by three doctors with a link to the Dunbar practice team.

The era of professionals living and working in the same community has changed, as has the concept of a working week; emergency cover now comes through the Dunbar Health Centre management arrangements. The new health centre, which opened in 1984, offers an opportunity for some outpatient clinics. This reflects the drive to bring services closer to patients. However, the increasing specialism and high tech. nature of healthcare also encourages centralisation of some skills and treatment. While the potential of the practice nurse and community-based nursing is again being addressed, some residents now also have their health needs met through private care and a similar trend is to be found in midwifery services.

The challenge of delivering health needs in the patient's own home is probably best met with the specialist nursing services provided by charities such as the hospices and Macmillan cancer care staff. Chiropody, incontinence and dementia services, three challenges for the health service with a growing older population, are still to be met with patients seeking the service elsewhere.

Care of the elderly in East Linton took the form of a residential home in the provision of Prestonkirk House, which had been established under the Poor Law legislation to meet the needs of the old county of East Lothian. In 1970, the interior of the building still reflected the Poor Law image despite having been a local authority service from 1948. In its layout, men and women were segregated into different dormitories and day rooms, coming together for dining, but with separate garden areas. The male dormitory on the upper floor still had neither curtains nor floor covering, while the room for women had net curtains covering the lower window area. One could understand a reluctance to enter these conditions by choice and a more attractive residential care home was purchased by the county council at Waverley Lodge, Gullane in 1969.

Within the home at East Linton were a number of adults with what was then described as a 'mental handicap'. A few had local family links but, for most, East Linton had become their home. Provision for travellers and vagrants had continued to be provided by the home until the 1970s; however, this form of lodging-house care was subsequently to be withdrawn as a local service. The title of the managers also changed from 'governor' and 'matron' to reflect a more caring environment which people were assessed to pay for. All welfare services were provided from outwith the parish, the exception being a meals-on-wheels service run through the WRVS by local volunteers. In 1980, a one-day-a-week lunch club was established which provided the opportunity of social contact and a break for some carers.

The main frontline of welfare support for those with disability and frailty continued to be family, friends and neighbour goodwill, backed up by a dedicated home care welfare service which received more recognition after it became part of the social work organisation in 1975. In 1993, responsibility for the remaining residents in the home was taken on by ELCAP, a not-for-profit organisation set up to provide community support for adults with a learning disability. Like other institutions of its kind, the home had offered the opportunity for local employment and while some staff moved to other jobs in the field of community care, a number of staff with long service retired over the period of the change.

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