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The Fourth Statistical Account of East Lothian

Healthcare

Care of the elderly | Care of those with a disability | Childcare

Between 1945 and the 1970s, when healthcare became centralised in a purpose-built health centre on Preston Road, medical support in the parish was provided by a doctor's surgery with additional input from district nurses. For most of this period, this support was mainly the services of Nurse Bird, assisted by Jenny Fortune, who were closely involved with the care of mothers and babies, both before and after birth. Home visits were common, although an ante-natal clinic was run from the doctors' surgery.

Frances Buchanan recalls Nurse Bird, and childbirth in Prestonpans:

My mother had seven children, all born at home in Prestonpans. She found she was expecting her last child at the age of 45 and decided she would not attend the antenatal clinic run by the doctors at the surgery, because she felt embarrassed at being surrounded by so many much younger mothers.

When Dr Bolton, I think it was, noticed that she was not attending the clinic, he came to our house to fetch her along. My mother, a confident, self possessed woman running a home and six children, meekly obeyed! In fact, Dr Bolton had more than one motive. He felt an experienced mother would be of great value in giving advice on breastfeeding and he asked my mother if she would be willing to do this at the clinic. A familiar figure to everyone in Prestonpans from the 1940s to the 1960s was the sight of Nurse Bird, flying along on her bicycle in her nurse's uniform with her black medical bag behind her. When we were very young, we children thought Nurse Bird brought the babies to people's houses in her black bag! She was a local resident and was very much involved with the community of mothers in Prestonpans.

I remember one dark night, my mother decided her baby would soon be born and she sent me along to Nurse Bird's house to fetch the parcel that was always brought to the house before a birth. I knocked at the door and Nurse Bird appeared. When I explained my errand, she opened her shed and fetched out a parcel, sealed in brown paper. The shed was filled with these parcels and they were an essential part of the birth process in every household, but to this day, I have no idea what the parcels contained. Probably some older residents of Prestonpans might be able to shed light on this mystery.

But Nurse Bird did more than simply deliver the baby and then go on her way. Nurse Bird attended the birth of most of the babies born in Prestonpans in those days. In my own home, this meant we other children were sent to stay with an aunt while the birth took place. My mother, who always spent a long time in labour, told me that it was always a welcome sight to see Nurse Bird fetch "baby's clothes" from the airing cupboard and set them to warm in front of the fire: this was a sign to my mother that the birth would soon be over. [I can] picture her talking calmly and clearly to us children, encouraging us to watch as she bathed the new baby, all those wee faces in a circle round Nurse Bird and the new member of our family. In time, I bathed my own children the way she showed us, and to this day, I bathe a baby the way Nurse Bird taught me all those years ago.

At the start of this period, doctors were in private practice but within two years, the National Health Service had been established. By the 1960s, mobile health units such as X-Ray and collections for the blood donor service were visiting the parish. From the 1970s to the present, healthcare was provided via the local health centre, although it was not until the 1990s that any broader-based countywide healthcare facilities appeared in the parish. Services based at the health centre include: a mobile breast-cancer screening service; asthma, stroke and speech therapy clinics; chiropodist, and a physiotherapy service. In the community itself, Macmillan nurses are available for home care of cancer patients.

Some of the doctors who served the parish during the earlier part of the period, and their approximate dates of working, were: Dr G. McEwen (1945); Dr W. McEwen (1945-60s); Dr J. Black (1945-50s); Dr J. Bolton (1950s-79); Dr S. Termie (1950s-70); Dr M. Scott (1960s-70); Dr H. Caldwell (1960s); Dr M. Brown (late 1960s); Dr Kerr (late 1960s); Dr P. Gracie (1970s). By 2000, the Prestonpans doctors were Dr J. Reeks; Dr G. Scott; Dr I. McNeill; Dr M. Simmonte and Dr H. Thomas. The health visitor in 2000 was A. Henderson.

Dental care was on offer from the 1950s to the 1970s at the dental practice in the Old Manse, West Loan; the present day dental practice is on the High Street.

Care of the elderly

Up to the 1960s, the elderly were by and large cared for, and supported by, their families. The health visitor was the only professional involved; other 'outside' help came from church visits, and there were some social groups for the elderly. By the late 1960s / early 1970s the 'meals on wheels' service was providing a hot midday meal, delivered to the elderly in their own homes. From 1974, the Link Lunch Club was in operation based at St Gabriel's Church Hall (one of the few locations with wheelchair access); transport was available.

Care of those with a disability

From 1970, Prestonpans' community and councillors were involved in one of the most successful community and voluntary-based projects related to community care in East Lothian. They established a support group (transport provided) for disabled adults.

Promoting social welfare in Prestonpans: David Affleck summarises what happened:

In the summer of the year 1970, the new social work authority for Midlothian, East Lothian and Peebles started to appoint its additional staff, which included provision for occupational therapists (OTs) to work in the community instead of their traditional hospital-based role. It was quickly apparent to Marion Laing, the first of the two new OTs operating from Haddington, that there were adults in the Prestonpans area who were denied the opportunity to have social contact outwith their home and that those caring for them had little opportunity for respite. While the case of one young man was the most prominent, there were others with conditions such as multiple sclerosis that were classified as a physical handicap, as opposed to age-related disability. Some were wheelchair-bound with problems of access to transport.

The problem was not special to Prestonpans although there did appear to be a more identified group in that area. What was significant was the interest of Baillie Robert Hood of the burgh who wrote to the "The Scotsman" in November that year on the need for the new social work authorities to tap the strength of voluntary organisations in the new era of community care.

But there was a major practical obstacle. East Lothian (which then excluded Musselburgh) had not yet embarked on provision of purpose-built community centres at that time and the existing facilities did not have suitable toilet facilities or wheelchair access for those with major physical disability. However, with the leadership of Prestonpans Town Council, a room with storage space in Preston Lodge School was made available at a charge of 30p per hour which included the use of crockery and the new Prestonpans Day Care Centre was set up in May with 23 people attending and assisted by between five to seven enthusiastic volunteers. The concept of a self-managed group was a challenge to the new authority whose standard approach was to plan departmental activities, which they would manage. A budget cost centre was prepared on this basis with provision for lunches, materials and future expansion and most of all, committee approval for this new expenditure.

This was early days for community-managed ventures with the social work department in the role of enabler and while similar initiatives were then planned by the new authority in Midlothian, this was the only one that held on to the concept of being managed by the members with their own constitution. (Similar developments were to follow over the next ten years throughout East Lothian for the older people also affected by potential social isolation).

But this was not just a matter of setting up a day club. What marks the significance of Prestonpans was the action that then followed as the leading councillors of the burgh took on the challenge of the inadequate facilities. They could not do that alone. Alliances were needed with the adjacent burghs and "landward area" councillors of East Lothian County Council. By 1972, plans were being developed to set up a purpose-built day centre within a wider complex of a community centre with indoor sports facilities, a health centre and Cheshire Home; the site of the former Mary Murray Institute (the old Schaw's Hospital) was seen as the most suitable.

A meeting was convened with the other burghs of Tranent, Cockenzie and Port Seton to take these four separate projects forward before the planned reform of local government. A feasibility study was commissioned in which it became clear that Longniddry, Tranent and Port Seton would also expect new community facilities and health centres. By 1974, the only visible progress was the bill for the consultancy firm, except the initial study had identified the problems of the stability of part of the land at the Mary Murray site; this was to lead to the withdrawal of the Cheshire Home option.

Throughout this period of negotiation, Mrs Jean Nisbet had been involved actively as a volunteer and James, her husband, was to become a member of the new Social Work Committee which took office in May 1975. He found himself in an unusual role of frequently holding the balance of power between different councillor interests within the Labour group. At his death, it was said that the only thing he had failed to negotiate for Prestonpans was an airport! The combined authority aspirations had come to a stop, although in time, the new East Lothian District Council would go ahead with the purpose-built community centres at Longniddry, Tranent, Prestonpans and, in 1994, Port Seton.

The dream of the Prestonpans elected members was still alive however and it was agreed in 1978 that a separate but linked building should be planned for day-care requirements and the design of the new community centre should take this into account for later completion. Demolition of the old Mary Murray Institute took place in 1979. At the same time, the new Lothian Health Board advanced the plan for new health centre provision with considerable support of the local family doctor, Pat Gracie, who had been involved in the project development for the early days. Social work funds were under pressure but with the help of Councillor Nisbet, it was agreed that the day-care centre be funded under the new Joint Finance Programme involving health and social work authorities at a capital cost estimated at £120,000. Scottish Office approval was not immediately given. There was concern that the project would not relieve pressure on the National Health Service residential accommodation "since the majority attending would be living at home and would not attend direct from hospital". There were other issues about the catchment area and the availability of physiotherapy.

However, by April 1981, the Scottish Home and Health Department accepted the eligibility of the proposal at a cost of £119,000 over three years and the project of the purpose built day- centre first proposed in 1971 moved forward for planned completion in the spring of 1984. The new facility, to be named "The Nisbet Wing", was to be run as a social work department centre in accordance with the health board agreement

But there was a sequel to the development of the new service when it finally opened in 1985. Councillor Nisbet had died and the Rev Colin Morton, who had been elected as his successor, was immediately alerted to the concerns of the Prestonpans club members who were not happy about the size of the new provision and who felt that their historical position was under threat. Some of the volunteers were very vocal in their concerns, which reflected their own long commitment in the past 14 years. The members and volunteers then decided to continue as a separate group with continuing social work department support with materials and transport. A community-inspired project had perhaps been sacrificed to serve East Lothian as a whole in order to obtain public finance from the National Health Service. It would not have been financed otherwise at the time but its deficiencies for that wider purpose would be a problem for the future.

This brief account provides a wonderful example of the positive way in which local community leaders responded to the early challenge of community care at a local level. It illustrates the problem of funding, the need for negotiation with others and the dependency felt at that time by those in need on help from others.

Prestonpans has continued to support those with a disability: from about 1995 onwards, independent living for adults with learning difficulties was supported by the professionals / 'befriender' voluntary service.

Woodbine Cottage, East Loan (under ELCAP - East Lothian Care and Accommodation Project) and 'Clonavoe', Preston Road were opened c1997. Both provide homes for individuals with multiple physical / mental disability who require support. E.L.C.A.P.'s administrative base at Woodbine Cottage provides a contact service for volunteers willing to support individuals with physical/mental disability throughout the county.

At Cuthill in 1998, the Aberlour Trust provided housing for respite care for young people living with their families.

Childcare for working parents

Before the 1960s, the vast majority of working mothers used family members for childcare. This has remained the case throughout the period 1945-2000. Many grandmothers and, since the 1980s, a significant number of grandfathers, take over childcare when they retire from their own working lives.

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