The Practice of Medicine has
advanced so much in the last one
hundred years that it is worth
recording some of the changes that
have occurred in the Lenham Practice
during those years.
In 1900 Dr. Gray came to live in
Stanfield (the large house on the
east side of Lenham square) which,
it has been assumed, had always been
the Doctor's house. As was the
custom then, and lasting for the
next 50 or so years, the Doctor had
the Consulting Room in his own house
and worked on his own without any
ancillary staff, apart from his own
family and his domestic staff. His
formulary would have been limited,
but he had the reputation of being a
kind and wise Doctor. His concern
was shown during the First World War
when he made his house over tot he
Red Cross where 50 convalescent
wounded soldiers were nursed.
When he retired in 1934 he was
succeeded by Dr. Laird practising
from Stanfield until he joined the
RAMC at the beginning of 1940. To
maintain the Practice during the war
Dr. Richard Posner, a refugee from
Germany, was employed as a Locum.
During that difficult time he
extended the catchment area and
increased the number of patients.
Consequently, when Dr. Laird
returned in 1945, Dr. Posner
insisted on a Partnership and he
practiced from the house he had
bought in Harrietsham. Although
nominally a Partnership the two
doctors operated independently.
In 1948 the National Health Service
was inaugurated by Aneurin Bevan,
M.P. the Secretary for Health. He
stated at the time the service would
cost £250 million per annum, but, as
the facilities would be available to
all, he argued that the people would
become healthier and the demands
less. Consequently the cost would be
less in the future! General Practice
was to be funded with a Capitation
Fee for each patient registered with
the practice, a system dating from
Lloyd George's initial limited
Health Service in 1911. The initial
annual Capitation Fee was 14
shillings and 6 pence (72.5 pence).
this system lasted until 1965 when
the GP's charter was introduced and
the method of payment totally
revised. General Practitioners were
then encouraged to improve their
premises and employ Surgery Staff.
At that time the morale in General
Practice improved.
When Dr. Laird retired in 1953, Dr.
Posner offered a Partnership to Dr.
Anna Gardiner. Dr. Gardiner, a
Doctor's widow, was working in Kent
County Public Health Department and
was pleased to accept the offer. She
then took up residence in Stanfield.
Dr Gardiner had graduated at the
University of Glasgow along with
Dugald Baird and his wife May, and
they were lifelong friends. Sir
Dugald Baird became Regius Professor
of Midwifery at the University of
Aberdeen, which was relevant to the
subsequent development of medical
practice in Lenham.
Unfortunately in 1955 Dr. Posner
became ill and he decided to employ
an assistant until he was eligible
to retire with an NHS pension in
July 1958. So it was in 1956 Dr.
Robin Donald, an Aberdeen Graduate,
on the recommendation of Dr. Baird,
came to Harrietsham with a view to a
Partnership. Sadly Dr. Posner died
in April 1958.
The only ancillary help at that time
were 2 District Nurses, Nurse
Garrett and Nurse Shepherd and a
Health Visitor, Miss Featherstone.
Mrs. Donald and members of Dr.
Gardiner's family were expected to
be available at all times outside
Consulting Hours to accept messages
at the door or by telephone. In
Lenham Mrs. Jessup worked on a ad
hoc basis as a secretary.
In 1959 when the new surgery was
opened in Harrietsham, Mrs.
Blandford acted as a receptionist
there during consulting hours. Mrs.
Jessup then had a similar role in
Lenham.
By 1964 when the sizable basement in
Stanfield was converted to Surgery
premises, several part-time
receptionists were employed so that
the surgery was open all day. The
staff was able to take messages thus
freeing the doctors' families during
the working day, but not out of
hours or at weekends.
By 1960 because of new housing
developments in the area the
Practice was growing and it had help
from Dr Freda Reed and Dr Mary
Buchanan. However by 1961 Dr
Alistair Turner, a contemporary
colleague and friend of Dr. Donald
in Aberdeen, had joined the
Practice. When Dr. Gardiner retired
in 1965, Dr. Barbara Macpherson from
Faversham arrived as an Assistant
for 3 days a week. By 1967 a full
appointment system was in operation
with the surgery open from 0845
until 1800, so there were no longer
unlimited consultations lasting long
into the evenings. As well as a full
complement of receptionists and
secretaries, Sister Bradley was
employed as Practice Nurse and
Dispenser, having previously been a
Casualty Sister at Buckland
Hospital, Dover.
Unfortunately Dr. Turner died
suddenly in March 1969 at the age of
40 and there followed a great period
of upheaval in the Practice with
several Locums being employed.
During that time an Answering
Telephone Machine was installed
which did not accept messages but
told callers whom to telephone for
advice. However Dr. Macpherson was
able to introduce Dr. Martin Porter
in July 1969, and he in turn brought
in Dr. Ian McMullen so that by 1970
there were 3 full partners in the
Practice.
Increasing demands meant new
premises were required and in 1974
the Practice was able to move into
the purpose built Tithe Yard Centre,
which was thought to be more than
adequate at the time. This coincided
with reorganisation of the Health
Services so that no longer were
Local Authority Child Welfare
Clinics held in local Village Halls.
From 1959 the Partners had Clinical
Assistantships in the local
Hospitals, which helped to broaden
the outlook of doctors and maintain
interests in other specialties.
In 1976 Dr. Donald accepted the
opportunity of returning to his
native Scotland, although he had
enjoyed the opportunity of working
in Lenham. Frustrated by the
lengthening Waiting Lists and the
inadequate local Hospital
facilities, he realised there had
been no improvement during his 20
years in Kent.
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So when Dr. Donald Left Dr.
Porter took over the senior
partnership at the age of
34. Dr. McMullen was a
couple of years younger, and
with Dr. Hipkins younger
still, the practice was
distinctly youthful, and
rather green!
Dr. Hipkins had joined the
practice as Dr. Donald's
trainee and it was a great
pleasure when he agreed to
join as a partner when Dr.
Donald returned to Scotland.
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Dr. Porter continued Dr. Donald's
role as trainer, and was joined
after a couple of years, by Dr.
McMullen. Over the next fifteen
years they trained about 10
fledgling GP's. Being a trainer is a
great responsibility and extremely
rewarding. Almost without exception
the trainees or registrars as they
are now called, brought a breath of
fresh air to the practice together
with new ideas and challenges.
In 1983 Dr. Isobel Burch and her
husband, moved to Egerton. Following
a letter from Dr. Burch advising us
of the move, we met with her and
offered her a partnership. She
accepted and joined the Practice.
She bought with her the much-needed
balance of a female partner and was
an excellent addition to the
practice. In 1987 Dr. Burch's
husband was appointed Bishop of
Lincoln so Dr. Burch left the
practice. Dr Gerri McKeever joined
and filled the role of sole female
Doctor.
Dr. Graham Hagan was Dr. McMullen's
registrar at the time. He had fitted
in so well in the practice that the
three existing partners all wanted
him to take Dr Mckeever's place when
she left to join her husband in
practice in Hoo, north Kent. Dr
Hagan brought so much to the
practice - total dedication, loads
of ideas and a similar sense of
humour!
In 1990 the Tithe Yard surgery was
running out of room and a large
extension was added to the roof. The
extension was for administrative
staff and included a large common
room for meetings with community
staff and medical colleagues.
The old Harrietsham surgery in
Harlaw, closed its doors in 1991 and
the branch surgery moved to a new
purpose built surgery in Church
Lane. The building was part of a
Harrietsham Parish Council project
combining a community hall and ample
parking for both buildings.
The practice itself was changing. Of
all the changes which happened since
the early seventies, one in
particular stands out, and was to
change entirely the way medical
practice was run. This innovation
was, of course, the computer. In
1969, when Dr. Porter started there
was not a practice in the country
that had one. By 2001, when he
retired, there was not a practice
without, and now it would be
impossible to run a practice
without. But they brought with them
many changes, the greatest of which
was the staffing level. In 1969 we
had 5 office staff but by 2001 there
were nearer to 15. And when the new
surgery at Tithe Yard was built and
opened in1973 there was no provision
for this dramatic increase in staff,
so now the building is to small and
the practice will move.
In 1996 Dr. Hipkins decided to leave
the Partnership for a new practice
in Sittingbourne. He was a loyal
servant of the practice, a good
friend, and much missed.
Dr Anu Rao joined the practice in Dr
Hipkin's place, She restored a
welcome female presence to the
partnership. She was initially able
to pursue her interest in
Dermatology as a clinical assistant
at Maidstone Hospital but with the
increasing pressures of work at the
practice, all of the partners agreed
to withdraw from their various
assistantships, At the time, these
were in Ophthalmology, ENT and
Rheumatology, in addition to
Dermatology. This withdrawal from
Hospital work was part of a national
trend, lamentable for the loss of
contact between primary and
secondary care. It is hoped that the
new GP contract, due in 2004, will
allow the situation to be corrected.
On 17th April 2000, Lenham Parish
Council was proud to announce a new
project on the eastern outskirts of
the village. This project included
housing association homes, a new
village hall and a plot of land for
the new surgery. The Parish
Council's assistance in securing
this site and their patience with
the subsequent negotiations to build
the new surgery has been greatly
appreciated by the practice. We hope
that the new surgery will be
completed in 2004.
With the start of Dr Rao's family
and Dr McMullen's wish to reduce his
commitment prior to retirement, Drs
McMullen and Rao decided to job
share in 2000. This created a
vacancy which was ably filled by Dr
Andrew Taylor. He had trained in
South Africa and bought a wealth of
experience, especially in
Orthopaedics.
In 2001, Dr Porter decided that it
was time to retire. His career at
Lenham had spanned two generations
and he had acquired a large and
loyal following. Dr Porter's concern
for his patients, his medical
colleagues and his staff had always
made being a patient at Lenham
surgery or working there, a very
special experience. His retirement
was thoroughly deserved but a
considerable loss to the practice.
Dr Codlin joined the practice to
replace Dr Porter and sustained an
energetic and compassionate approach
to medicine, in similar measure.
In November 2001 another large
change occurred with the purchase of
a new computer system aimed at going
'Paper free' in line with current
development of primary care. The
buff coloured (Lloyd George) patient
medical record envelopes were
summarised electronically and
consultations recorded on the
computer directly. Unfortunately the
new system didn't come with typing
skills for the partners! The
increasing demands from the NHS for
reports on practice activity were
more easily met using the computer
system but the workload seemed to
continue to rise despite the new
technology. Letters, reports,
records, results continued to arrive
on paper and all needed to be
transferred to the electronic
format. Staff now had to deal with
information on paper and on
computers. Staffing levels rose
again.
Dr McMullen retired in May 2002.
Like Dr Porter he had spent 32 years
at the practice. He and his family
had first lived over the small
branch surgery at Harlaw,
Harrietsham. With his keen eye for
organisation, he had widely overseen
the administrative growth of the
practice in to the large
organisation that it is today.
Dr McMullen was replaced by Dr
Gruboeck in 2002. She had trained in
Austria and her arrival, for the
first time gave the partnership a
female majority. She retained a day
a week of ultrasound work outside
the practice.
Following the four additions to Dr
Gruboeck’s family, she decided to
leave the practice to spend time at
home. Dr Andrew Reed was currently a
long term locum at the practice and
was appointed her replacement. He
became full time to join Dr Hagan
and Dr Taylor, reversing the
previous female dominance. He
trained at the Royal London Hospital
in Whitechapel London, and completed
his GP training at Maidstone
Hospital and Marden Medical Centre.
He has an interest in Prison
Medicine and currently works one day
a week at a local prison providing
GP services to the inmates.
Acknowledgments to Dr Donald, Dr
Porter and Dr Hagan
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