Roodlands 1975 – 2000

Dr Roger J Kellett

I was appointed in 1975, but I’m very vague about other dates. James MacLean Ross was appointed to make Roodlands an acute hospital in, I think, 1953. Before that, Roodlands was a fever hospital and Dr McLean (who was a Haddington GP) remembered being in ward 5 as a small child (I think with scarlet fever) and having to speak to his parents through an open window since they were not allowed to visit him. Sister McDonald, who was the medical ward sister retiring in 1975, recalled how the wards used to have blazing open fires at either end. In the 1950s, the building, which is now outpatients, was the casualty department and the operating theatre. A wide link corridor was built to link the two surgical wards and the ‘new’ theatre suite was built on the end. Jim Ross decided he needed assistance from a physician and Dr Bruce took this on, visiting Roodlands once a week to do a ward round and a clinic. More input was needed and the demand for TB beds at East Fortune was reducing so Bob Littlewood, who had been a TB Officer but had Membership, was made a Consultant Chest Physician working alongside Dr Murray and Rose Donaldson. Bob also took on a general medical commitment to Roodlands and one of his registrars became based there together with a pre-registration house officer. The Haddington GPs had a GP maternity unit at the Vert Hospital. I gather that in the early 1970s this was little used and so it was closed. There was such an outcry that ward 5 at Roodlands was converted into a maternity unit with two delivery rooms but again at this was little used. An attempt was made to use it as a step-down unit for a number deliveries but it finally closed probably in 1974 having delivered only a handful of babies. When I was appointed it was lying empty and we were able to convert it to the second medical ward, which started operating just as Neil Davidson was appointed in 1976. We had a total of 34 medical beds and ran four general medical clinics and had regular Phase III students attached (two at a time). We took all emergencies although we tried to divert overdoses to ward 3 RIE. The local community was very supportive and for example the Dunbar Ladies Circle made a donation which allowed us to install what was then state-of-the-art cardiac monitoring equipment in the male ward. At this time the Surgical Unit also took all emergencies. It was not uncommon for Graham to operate on ruptured aortic aneurysms or do elective vascular work and Jim Ross was an excellent thyroid surgeon. They both did Orthopaedics and one saw RTAs [road traffic accidents] from the A1 lying in traction in orthopaedic beds. John Loudon operated weekly covering the full range of gynaecology.

East Fortune Hospital was a very active TB unit after the war and the Edinburgh thoracic surgeons carried out major surgery there. It was its own small community and for example both Bob Littlewood and Hugh MacLeod lived on-site when their families were small. There was a paediatric ward, presumably originally for TB but latterly for severe learning difficulties. After Dr Murray and Rose Donaldson retired, the hospital became increasingly a general respiratory unit but also started to take the elderly who needed long-term care. Iain Milne (the Ormiston GP) was appointed as geriatrician and gradually took over more of the hospital leaving 1 or 2 wards for Bob’s respiratory cases. When Bob retired, Neil and I kept on one ward of respiratory medicine for a short time but this was more to soften the blow for the staff of changing from an acute TB unit to geriatrics (largely long stay). My two young daughters loved to accompany me on Saturday mornings to see the dozens of cats, which lived round the wards and were fed by the patients and male charge nurse. By this time the learning disabilities ‘children’ were young adults and I remember one of our house officers correctly diagnosing gonorrhoea in a male patient who had recently attended a dance at St Joseph’s Convent in Roslin!

In 1975, the medical unit at Roodlands was staffed by Bob Littlewood and myself, a medical registrar and pre-registration house officer. Surgery had Jim Ross and Graham Meikle, a registrar and a pre-registration house officer (who ran the casualty department as well as the surgical wards). The juniors were on-call alternate nights. There was a little cross-cover between Medicine and Surgery, but basically the consultants were providing a lot of the cover. As we stepped up the Medical activity we changed the junior staff to two SHOs who were part of the Lothian rotation and two pre-registration house officers (PRHO)s. In the 1980s juniors’ hours became an increasing problem and we started to share medical cover with East Fortune. However a variety of practices became unsustainable in the modern age in a hospital, which is relatively close to the centres of excellence in Edinburgh. These included a casualty department staffed by PRHOs, vascular surgery, juniors working a 1:2 or even 1:3 rota, 24 hour emergency surgery, and eventually 24 hour acute medicine as well.

Because of financial problems in the East Unit, we looked very hard at Roodlands and East Fortune and it was this stimulus which precipitated the major changes with downgrading of the acute surgery and medicine departments and transfer of the acute geriatrics from East Fortune to Roodlands. These changes caused great distress to staff and the local community leading to the early departure of both Graham Meikle and Neil Davidson. But paradoxically I think it was these changes which made Roodlands sustainable in the long-term. We did continue to run a general medical ward because I felt there was a need for the treatment of some of the less acute medical problems locally. It proved very difficult to select suitable patients who were neither too acute for our facilities nor geriatric. The appointment of Diana Holton to the medical ward solved this in that she called into the ward daily (which I could not do) and was able to deal with more acute patients before they became a problem and also because, being a GP herself, she was able to liaise with her colleagues to select suitable admissions.

The decanting of the acute geriatrics from East Fortune left two long stay wards isolated on the East Fortune site. This was generally unsatisfactory particularly since proper upkeep of the large site was difficult to justify. It was George Brechin and George Rhind who between them managed to effect the conversion of the old nurses’ home at Roodlands into a beautiful continuing care ward for these patients. The only problem was this ward’s popularity. The population realised that it was more comfortable, more convenient and certainly much cheaper than nursing homes!

After making these changes it became clear that the future of Roodlands was as a community hospital. We already had a number of specialty clinics run by consultants from Edinburgh (ENT, gynaecology, orthodontics) but space was restricting further development. The recent expansion of the outpatient department (completed in 2000) now means that a full range of outpatient service can be offered from Roodlands.

The remaining problem for medicine and geriatrics at Roodlands was that George Rhind was a single-handed geriatrician and to some extent, I was single-handed in general medicine. As you know, George decided to leave since he felt his attempts to appoint a colleague were getting nowhere. This, of course, precipitated a crisis which was very favourably resolved with the appointment of Lewis Morrison and Andy Jamieson as the two new geriatricians, both doing some general medicine as well’.