Professor Harold Ellis qualified as a doctor in the same month the NHS was was created in July 1948. “I’d been a student at the Radcliffe [Hospital in Oxford] for three years, went away for a fortnight’s holiday, came back and it was now the National Health Service. Honestly, we didn’t really notice it – there wasn’t great big notices up around the hospital or anything. The nurses weren’t running around with NHS badges on their bosoms. Everything just went on exactly the same way.”
The biggest concerns were from senior medics: the consultants, surgeons, physicians, and anesthetists. They had been “honorary staff” as Professor Ellis calls them, who gave their services for free and earned their money in private practice.
“For them it was a revolution because they didn’t know what their financial situation was going to be. That was the main reason for them violently opposing the NHS for months and months.”
Under Bevan’s scheme, the hospital consultants were to be either full-time salaried specialists or to serve as part-time consultants, paid for the sessions they covered in the health service and allowed private practice outside their sessional hours. The majority opted for the second option. The new salaries for both GPs, who had previously owned their surgeries and sold them upon retirement, and consultants were generous. “Nye Bevan made a wonderful statement with his wonderful Welsh voice: ‘I stuffed their mouths with gold!’. The doctors had no argument to that. With one shot of his pistol Bevan had the consultants on his side. And the difference to patients was remarkable.”
History of the NHS
How the NHS was created forms the tail end of his new book, Tales of the Operating Theatre and other essays, in which Professor Ellis reflects on his 70-year career and comprises first-hand accounts of some of the most remarkable moments in medical history.
“You’ll find it’s brilliant,” he laughs. “It should be, it’s my 28th book.”
Born in Stepney Green in the East End of London in 1926, Professor Ellis was the youngest of four children and his parents were both dress makers.
“I’d always wanted to study medicine, no idea why. The only doctor I knew was our GP. I ended up getting a scholarship to read medicine at Oxford, which coincided with the outbreak of World War Two.”
After spending two years training as a house surgeon in Oxford, Professor Ellis went on to practice as a graded surgical specialist in the Royal Army Medical Corps until 1952, treating soldiers injured in the Korean War who had spinal and head injuries.
“The first paper I ever wrote was on spinal tumours in soldiers in the British Medical Journal, in the 1960s. The surgery that I was doing has now completely altered, new operations have come in. The cranial surgery I did in the army was crude – using a hammer and chisel to get into the skull. Now they use electric saws.
“I never used fibreoptic surgery – the very first gall bladder removed laparoscopically [using keyhole surgery] in this country was in 1989, the year I retired, by one of my ex-trainees and he phoned me up afterwards to tell me. I wished those kind of machines and tools were around when I was operating.”
Changes to surgery
He continued his career as a surgical registrar, working at hospitals in London, Sheffield and the Radcliffe in Oxford again. Asked what the biggest differences to surgery were he saw over the course of his 40-year career, Professor Ellis grins.
“Where do you want me to start? Have you got the next 6-7 days? Nothing I did in 1948 would compare to what I was doing 20-30 years later, mostly because of medical and surgical progress. The diseases changed, treatment changed, drugs changed, the operations changed. Things you’d see every day as a student disappeared – like tuberculosis. Every ward, when I qualified, had patients with TB in it.
“There was a TB hospital in Oxford with about 200 beds, full of patients. At the [main] hospital up the road a sixth of the patients had TB, you’d go to an orthopaedic clinic and swarms of patients had TB. You’d see them every day. It was very common for doctors and nurses to get it as well, from the patients.”
Professor Ellis was afraid of catching polio as a medical student but was confident he had developed some kind of immunity to TB from growing up in the East End.
“Most doctors today will never have seen a patient with tuberculosis, unless they work in the third world. We had outbreaks of poliomyelitis as well until the polio vaccine came in in the mid-1950s. I was one of the first in the queue to get it.
“When I was professor of surgery in the 1980s, AIDs came in. All of a sudden you had wards full of AIDs patients, all the staff were petrified they were going to catch AIDs.”
‘Anatomy doesn’t change’
Professor Ellis, a former Vice President of the Royal College of Surgeons, founded the academic surgical unit at Westminster Medical school in 1960, where he practiced as a professor of surgery until his retirement in 1989. He then went to teach anatomy at Cambridge University from 1989 to 1993, before moving onto teach clinical anatomy at Guy’s and St Thomas’ Hospital, in central London. He is also the author of the textbook Clinical Anatomy which is now in its 13th edition.
“Unlike surgery, anatomy doesn’t change. The body hasn’t changed since I dissected my first corpse in 1943. The students love me because I’m so old and tell them stories. I don’t teach using a word processor – just a bit of chalk on the blackboard.
“I made it quite clear that as soon as I retired I wasn’t going to see any more patients or do any more surgery. Once or twice old patients would ring up and ask: ‘You operated on me 22 years ago, can you see my daughter?’ But I had to say I’d retired. I’d advise them to see my ex-trainee though, although even he’s retired now.
“I enjoyed my time as a surgeon but I knew right from the start it’s a finite thing and was going to stop eventually. I’ve been in the theatre about 10 times since I retired to see my trainees doing all these wonderful things and had great admiration, but I never thought ‘move over, let me try’. Just like an old pilot I imagine, going for a ride in a Spitfire but you don’t want to fly it yourself.”
Now 93, Professor Ellis lives in Finchley, north London, still married to his wife, Wendy, although he can’t quite remember for how long exactly.
“I know we’ve had our Golden wedding anniversary so it’s 60 something years. I was determined not to marry anyone in the health service profession. I didn’t want to come home at night after a day at the hospital and talk about bed pans. I met this lovely girl and she said I was the very first doctor she’d met. I thought ‘I’m going to marry this girl’. Took me years to persuade her though.”
He believes the NHS embodies the advancements there have been in medicine, but is fearful for the health service today.
“It’s got terrible problems. The remarkable thing is that, when the health service started, people would say – and you won’t believe this – it will get cheaper, because people are going to get better: cripples will become fit, active people and so on. Absolute rubbish!
“Every year, more and more people like me are getting older and older and requiring medical care. When I was a student if you were treating a 75-year-old patient on the ward, one chief would say: ’75?! There’s no point in treating him, for God’s sake!’ Statistically he should have dead for five years.
“Some of my old teachers would not operate on the elderly, saying ‘You’re 70, what do you expect me to do?’ These days people are having heart surgery at 90 years of age – and that costs a lot of money.
“Other countries may have different health systems but you have to decide what you’re going to spend your money on? Are you going to buy a new battleship or a new hospital? I know what I’d prefer to do.”Read More