The history of the Combe Down surgery

PRESENTED TO THE COMBE DOWN PRACTICE BY DAVID CARR ON HIS RETIREMENT

WRITTEN AND COMPILED HIS WIFE JACKIE IN THE HOPE THAT SOMEBODY WILL ALWAYS BE INTERESTED ENOUGH TO CONTINUE RECORDING THE HISTORY OF A SUCCESSFUL AND HAPPY PRACTICE

August, 1997

© Jackie Carr 1997

Cherish the old, to understand the new – Chinese Proverb

On the Ordnance Survey map of 1884, the tree lined Avenue leading to Combe Down village, shows, on one side, a large green, known as Firs Field, and on the other, two solid detached houses, side by side.

On the left Stands Gort-na-Crane, which romantically translates from the Gaelic as Fields of Sunshine. This can be accurately dated as being built in 1867, during the late Victorian period. Its companion, next door, with the less imaginative name of Combe Villa, is similar but slightly older, probably built between 1854 and 1859, bringing it within the early Victorian period.

The first owner of this desirable property was one Thomas Hanks (1816 – 1893), a pork butcher, who, in 1862, sold the house to John Spence (1814 – 1881), a builder, although, in fact, John Spence had been recorded in the Post Office Directories of 1859, as already living in the property. Whether Mr Spence built the house for Thomas Hanks is not known, but he (Spence) was already living in Combe Down (South Parade Cottages) before moving into Combe Villa. From 1859 until 1868, both he and his wife were recorded as living there, she as Managing Lodgings and he, as Builder.

The next twelve years found firstly, John Barnard (1812 – 1880) and then the Rev Joseph Newton (1838 – 1916) renting the property. In 1880, another man of the cloth (obviously good tenants!), the Rev Edwin Trevelyan (1818 – 1894), MA, lived there. The whereabouts of Mr and Mrs Spence is unknown. One is led to assume that during this period both Mr and Mrs Spence passed away, leaving the house to Miss Spence, their daughter, who, on the 29th November 1888, sold the property to her tenant, the Rev Trevelyan for £555.

By this time it had changed its name from Combe Villa to Combe Park Villa.

Edwin Trevelyan was married to Ann and they had three children, Basil, Christian and Laura. Basil later became a surgeon and practised at Montpelier, Bath.

In 1895, on the death of his mother Ann, Basil sold the house for £525 (£30 less than his father had paid for it seven years previously) to William A Jones, a London surgeon, therefore starting its medical connections.

One can only guess whether Mr Jones was an extravagant spendthrift or had an expensive secret vice, but somehow he ran into money difficulties.

He found himself in debt to Evans & Owen, a large department store in Bartlett Street (now the Antiques Market) and to get out of trouble, he mortgaged the property to Henry Sumsion of the Mason’s Arms in Combe Down. In 1895, he borrowed £500 and then borrowed a further £50 in 1896.

Finally, in 1897 he released equity to Sumsion and paid no more of the loan. Sumsion now owned the freehold and rented the property back to Jones until 1897.

About this time, the name of the house changed yet again to the one we know it as now – Combe Down House, probably to disassociate it from the debt scandal attached to its previous owner!

In 1898, Henry Sumsion (1847 – 1898), brewer, died. In a Will made in 1896 the property was left to his wife, Ann (1855 – 1933), who in the same year, rented the house to Dr Cyril Morris, the first doctor to practice from Combe Down Surgery. From then on, the house stayed in the hands of the same family. When Ann Sumsion died, it passed to her daughter, Eleanor Eliza Annie Smith (b. 1887), who died on 12th December 1969, leaving it to her daughter, Doris Amy Smith (1911 – 1993), from whose estate, upon her death, the house was bought by the Combe Down Practice in 1994.

It had been rented for 96 years by a succession of doctors who, in their turn, had cared unceasingly for the folk on ‘The Down’ and its outlying villages, to make the practice what it is today, well established, well respected and thriving!

Up to this point, I have attempted to authenticate facts as best I can and will continue to do so, although from here on, I can vouch for absolutely nothing told to me by elderly patients with whom I have spent many interesting hours. However, I am sure that their reminiscences and anecdotes, true or not, make fascinating reading!

So, in 1898 we find Dr Cyril Morris (1866 – 1939) living and working in Combe Down House, along with his frail and slightly ‘strange’ wife, who had a ‘live in’ companion, presumably to look after her.

Patients used to wait in the ‘second on the right’ room down the hall (now the nurses room) before going further down towards the back of the house to a small room on the right (now lost within the redesigned building), for their consultation. Dr Morris, of course, prescribed and mixed all his own medicines on the premises.

In the beginning, he attended most of his house calls in a pony and trap until he eventually bought a ‘new fangled’ ‘Standard‘ car with two outside wheel brakes!

There is a record of the rent being paid for Combe Down House in 1924 as £55 per annum. Whether Dr Morris died or retired, we do not know, but in 1929 the Combe Down House tenant was Dr Warren Morris (1901 – 1966), son of Cyril, the proud owner of a Ford V8 motor car.

Warren married a nurse from St Martin’s Hospital, who, by all accounts, was quite beautiful!

They had one son, William (Bill). Young Bill went to Prior Park College but sadly died suddenly from meningitis when he was 15 -16 years old. Unfortunately, many relevant records were destroyed at the school in the terrible fire in 1991.

I should imagine their home life was none too happy, as rumour had it that the boy was sadly neglected and always around the village. Mrs Morris apparently ran up large bills at the Hadley Arms and was also often seen at the Empire Bar at the Empire Hotel, as it was then, which was the ‘in’ place to socialise, particularly during the war.

No doubt the early death of the lad exacerbated all their problems.

Although Dr Morris Jnr was, as his father before him, a hard working, well liked doctor, it soon became apparent and common knowledge that not only had he a drink problem but he was also addicted to Morphine, no doubt by self prescribing for a ‘simple complaint’ but the combination eventually took control of his life.

I was told that he had been ‘struck off’ but I went to great lengths to enquire of the BMA and GMC as to the validity of that claim, and no record was found to substantiate any such thing! It’s a pity it’s too late to save that little bit of his reputation.

However, a patient I spoke to remembers him falling asleep in her armchair. Not liking to wake him, he slept on for several hours. I fear this was attributed to his ‘problem’, although to be charitable, he could have been up all night!

Another more unfortunate incident occurred when he was unable to attend a complicated home delivery. The Nurse’s Association, who at that time controlled the midwives, refused to let their nurses attend further home births with Dr Morris.

When the war started, he joined the Navy and looked after the wounded, both in ships and on shore, leaving the practice in the hands of neighbouring doctors. During that time, he was paying £65 per annum for Combe Down House.

He also held the post of Medical Officer for Monkton Combe School from 1925-35. Sadly, after he eventually left the practice and moved away, the poor man was thought to have committed suicide.

In the early 1940’s, Dr Charles Hagenbach (1901 – 1993) came to Combe Down and presumably, as was the custom in those days, bought the practice from Dr Warren Morris. These early dates are somewhat sketchy as the letters from Hagenbach’s daughters think it was 1940 when the family moved there, although the last entry in the Medical Register still records Dr Morris as living in Combe Down House in 1942. Maybe this was why when Dr Hagenbach, his wife Barbara and the three children, Paul, Helen and Frieda from his first marriage (later to be joined by another little girl, Barbara) arrived, they lived at ‘Glencaple’, North Road (now known as ‘Della Rosa’) only later moving into Combe Down House.

During this time, the war was still on and in 1941, Dr Hagenbach was called up as a Captain in the RAMC in India, and, I think, a Dr Phillips from a neighbouring practice kept the Combe Down patients ticking over until Dr Hagenbach returned home after VE Day in 1945.

Dr Hagenbach and daughters bringing in the potato crop grown on the side lawn

Dr Hagenbach and daughters bringing in the potato crop grown on the side lawn

Olga Henning-Lee, long hours, (8 till 8), long suffering and long time receptionist with Barbara Hagenbach

Olga Henning-Lee, long hours, (8 till 8), long suffering and long time receptionist with Barbara Hagenbach

Throwing himself back into General Practice, he found himself extremely busy, running a cottage hospital as well, so he took on an assistant called Reeves.

Dr Hagenbach’s predecessor, Dr Morris, had also staffed a branch surgery in Odd Down. It was in a house called ‘Homelea’, No 498 Wellsway. The left hand side of a pair of semi-detached houses – the other being ‘Craven’, No 494.

When Dr Morris left, Dr Hagenbach took over as tenant. When ‘Craven’ next door came up for sale, Dr Hagenbach bought it, installing his branch surgery at the back of the house where it is to this day.

The shop in the front was at one time a sweet shop, an electricians and finally (in Hagenbach’s day) a chemist shop ran by a pharmacist called Tom Palmer.

He stayed there for a few years before buying Suttons, the coalman’s premises at Noad’s Corner, where he built an extension for a new chemists, which still functions as such today.

In addition to the Odd Down shop, Tom Palmer also owned and ran the chemist shop at Isabella Place in Combe Down village. He was a well loved, kindly man whom people used to trust and consult before being advised by him that they really needed to see a doctor – in fact, many called him Dr Palmer, but he must have saved the practice a lot of work. Tom eventually sold the Combe Down shop to GK Chemists, who sold to Lloyds, who then moved from those premises in 1996 to their present one in Combe Down House.

A rather macabre story I heard about Tom’s predecessor whose chemist shop at that time was in Brunswick Place, Combe Road, a house with steps leading up to the front door, which enabled one to look down into the basement, where one day he took his own life by hanging.

The local children took a daring delight in leaning over the handrails to look into the basement and were fascinated and frightened by the tale.

In the early 1950’s, Dr Robert Lane Walmsley (1909 – 1982) and his family moved into Ashlands, Church Road and joined Hagenbach in the practice. This came as a great relief to share the ever increasing work load.

Reeves, who was presumably still an assistant with Dr Hagenbach, left, and set up practically next door in Hansford Square, although his speciality was Psychotherapy. When he later died, there was apparently great panic and concern amongst his patients world-wide, wanting to know what had happened to all his records and notes. (What had they all to hide?)

Dr Walmsley, his wife Margaret and their three children, Charles, Anthony and Jane, then moved into a ‘three cottages into one’ house, rather grandly called Tucking Mill Manor.

His most enduring legacy (but not for much longer I fear, with the onset of computers) are his notes in the patients’ files, all written in green ink!

Craven, the small branch surgery in Odd Down

Craven, the small branch surgery in Odd Down

A word about Craven!

Craven, the small branch surgery in Odd Down, has for nearly fifty years held afternoon sessions most days of the week. Old-fashioned, basic, cramped and shabby for many years, it has fulfilled an enormous need in the community by giving patients the opportunity to just turn up without an appointment - this is probably the only one of its kind left in Bath.

The need for its continuing existence has been discussed often in the past, as it was not particularly popular with most doctors, who found the surgeries extra long and tiring with a seemingly endless stream of patients.

However, in this day and age of fierce competition between practices to gain new patients, dear old Craven has, by its very existence, ensured that by possession (of territory) being nine points of the law, it is a very powerful force in keeping other hungry Bath practices at bay!

In 1949, Dr David Stewart joined Hagenbach and Walmsley. A small shy rather dour Scot with a perspicacious nature he retains to this day, (as shown when he charmingly but flatly refused to provide a photograph or summary of his life!).

Apparently, once, when asked by a receptionist when he returned from a home delivery “was it a boy or a girl?” The laconic reply was ‘one or the other’!

David married his wife Sheila (who was also a qualified doctor) late in life. Their only daughter, Margaret, was born in Bristol Maternity Hospital, delivered by Dr David Carr, who, unbeknown by both parties at the time, was later to become David Stewart’s partner in Combe Down.

Margaret Stewart carried on the family tradition and also became a doctor.

When trying to extract information from Dr Stewart, he modestly said all he was any good at was finding golf balls! I’m sure his patients would have argued with that!

Two years later, in 1951, the practice was busy and thriving enough to take on another partner. With about 150 applications for every job at that time, Dr Rowton Old (1921 – 1981) was the lucky man!

He joined the practice in July 1951, married his sweetheart, Pamela, in October and they moved into the flat over the surgery in Combe Down House.

The Hagenbachs moved into Tor View on Combe Road, a house occupied at present by Dr and Mrs Peters (now retired from the Pulteney Street practice). Apparently, Mrs Hagenbach travelled extensively, and there remains a cupboard under the stairs in the hall, with a line of large air holes in the top of the door, where she kept a bush baby, presumably acquired on one of her trips!

Around 1950 Foxhill Estate was built, bringing hopes of new patients and the subsequent wealth they would engender! Unfortunately, the patients didn’t come to Combe Down House, the other Bath doctors with whom they were still registered, continued to serve them. This left Drs Hagenbach, Walmsley,Stewart and Old still working very long hours in a pretty poorly paid practice. At this time the rent was £80 p.a. and the house was insured for £4,000.

In 1958, Dr Hagenbach retired.

Dr Charles Hagenbach

Dr Charles Hagenbach

Dr Charles Hagenbach qualified at St George’s, London. One of four brothers, he came from Cornwall, where his family owned the village of Porthleven. A quietly spoken, friendly man, he joined the practice from another village in Cornwall, called Townsend, where he was in practice before the tragic death of his first wife. Many years later, he was laid to rest with her and by a strange twist of fate, Rowton Old, one of his partners from Combe Down. He loved to fish in Prior Park lake and always described himself as a country doctor, having a keen and knowledgeable interest in animals and nature. He worked eighteen years in the Combe Down Practice.

Unable to carry on with only three partners, the vacant post was advertised and Dr Alexander Neill (1925 – 2013), amongst others, applied for the post.

Dr Neill was unlucky, for a young man called Barry Crane got the job. He stayed for a year, rapidly coming to the conclusion that the ill-paid post constituted a bad career move. So off he went!

The three remaining partners hastily looked through their files and found Dr Neill’s application. By this time, Dr Walmsley was becoming unwell with an unpromising prognosis, so ‘Sandy’ Neill joined the practice, moving into the Combe Down House flat with Sheila his wife, herself a doctor, and their two little girls, Rowena and Fiona.

Dr Walmsley retired in 1963.

Dr Robert Lane Walmsley

Dr Robert Lane Walmsley

Dr Robert Lane Walmsley, qualified in 1925 MRCS Eng, LRCP 1936, LMSSA. He specialised in anaesthetics. He and Dr Hagenbach often worked together, operating in the surgery and in patients’ homes. He was very interested in local politics and was Finance Officer and Councillor for Bathavon in the mid 1950’s and was responsible for a million pound budget. (How ever did he find the time?) He was also a Governor at Combe Down Primary School. He retired to Aylesbury, having worked for approximately 10 to 12 years in the practice.

At that time, in 1963, the practice had 3,000 patients at £15 capitation p.a. Dr Neill felt that the practice would not support a fourth partner again, but was overruled by his other two partners, so in 1964 Dr David Carr became the new junior partner joining Old, Stewart and Neill. With him, came his wife Jackie and their baby son Stephen, They subsequently had two more children, Sally and Matthew.

After the ups and downs of the previous four years, the Combe Down practice settled down, still not producing a great deal of money, but continuing with a demanding workload.

At this stage, Dr Old, a very conscientious GP, who had been suffering from blood pressure problems, decided that general practice was becoming too stressful, so in 1965, he and his family returned to his beloved Cornwall, where he became a school medical officer.

Dr Rowton Old

Dr Rowton Old

Dr Rowton Old, qualified in Bristol in 1949, worked in a practice in Bedminster, before joining Combe Down. He left to become a school medical officer in Penzance, becoming senior medical officer for the western area of Cornwall. He was also elected a founder member of the Faculty of Community Medicine. A quiet, kindly man, he loved reading, fly fishing and walking his beloved Cornish cliffs. He worked fourteen years in the practice.

Dr David Carr and his family, who had been living in various rented cottages in Monkton Combe, bought Rowton’s house, ‘Tamarisk ‘ in Stonehouse Lane, where they still live today.

Dr Old’s replacement had been found in the form of Dr Jack Turner (1930 – 2002), who had qualified later in medicine than most, having already led an eventful life in the S.B.S. (Special Boat Service) and selling real estate.

He arrived in 1965, bringing with him his wife Ann (1939 – 2006), herself a qualified doctor, and their baby daughter Sophie. They later had two more children, Edward and Jessica. They also started life in Combe Down in the surgery flat, which the Neill’s had vacated when they moved to Midford and eventually Southstoke. The same year, 1965 Dr David Stewart retired.

Dr David John Stewart qualified in Glasgow in 1944 MB, ChB, LM Rotunola 1957. He was a ships medical officer before becoming a GP and often took his holidays working on cruise ships. He was Clinical Medical Officer for Bath Health District and Clinical Assistant, Orthopaedics. He went into Schools Medicine, after retiring from general practice. Although a very private man, (hence no photograph!), he is a keen golfer and plays regularly. He worked for sixteen years in the practice.

Although the practice was very popular and busy, the money it generated was still a relatively small amount to support four doctors and their families, so it was decided not to replace David Stewart. This meant that some reorganising and stream-lining was necessary.

An appointment system for patients was introduced – the first in Bath. This was noted and watched by other practices and before long, this became common practise for them all! Another first was having a social worker actually attached to the practice.

The three partners continued their busy lifestyle until one cold and rainy day in October 1967, David Carr read out a ‘locum wanted’ advertisement for a 6 month period in Montserrat, British West Indies, starting in June the following year. This sounded too inviting for Drs Neill, Carr and Turner, who decided two months each of Caribbean sun would brighten their lives.

They sent a reply on the 21st October, outlining their hopeful plan. Months went by, they had all given up hope and almost forgotten about it.

A phone call from Montserrat on the 12th February suddenly confirmed that they had the job! Panic ensued! Anne Turner was now pregnant with her third child. She and Jack thought it would be too difficult to go under the circumstances, so it was decided that David and Jackie Carr would go first for three months, with Sandy and Sheila Neill and family following for two months.

This adventure proved a great success and breathed new life into the partners, if not the practice!

The next year, 1969, Bath University was completed sufficiently for them to require medical cover, and the Combe Down practice was appointed for the following two years until, eventually, the University became large enough to justify their own medical officer. Another first for the Combe Down Practice.

The flat over the surgery continued to be let to various people after the Turner family moved to Church Road and in 1970, Dr Carr’s parents moved in on a permanent basis, becoming unofficial caretakers of the property, only moving out in 1996 after 26 years, when the old house was being renovated after the extension had been built.

In 1973/4 Dr David Carr decided to become a GP Trainer. As there had been no trainees in Bath for the previous 12 years, the ‘powers that be’ had to convene a committee made up from other GPs in the city, to examine Dr Carr to decide whether it was appropriate for him to take on trainees. He was successful, and Dr Roger Rolls was the first of many (the practice still continues this tradition) and is now the Senior Partner in the Pulteney Street Practice, one of the largest in the city.

In 1977, the practice felt there was a need for a separate Family Planning Clinic, so Dr Anne Turner, the wife of Jack Turner, was asked if she would organise and conduct a session once a fortnight. The practice was still pleading poverty, so for nine months (a meaningful time period!) she provided her services free. Find a professional who would do that today! After about a year, the clinics were held weekly. Dr Turner was put on the payroll!

The number of patients and the workload were increasing, so in 1979, Dr Christina Kennaway, Hungarian by birth, trained and qualified in Cape Town S.A., joined the practice in a half-time capacity.

By 1984, it had become increasingly necessary to employ an administrator known as the Practice Manager, David Wright, an ex R.A.F. Wing Commander, was the first. His job was mainly to organise the non-medical staff, and to see that the new claims system for payment of services i.e. cervical smears, vaccinations etc. were met and targets achieved to maximise Income.

This new post of Practice Manager reduced considerably the business responsibilities for the doctors.

Doctor swap

Doctor swap

Another opportunity to work abroad came in 1988, when Dr Kennaway responded to a letter from an English GP working in Adelaide, South Australia. His parents and brother lived in Bath and he wanted to swap jobs for a year with a local GP, so that his Australian wife and their children could meet and spend time with his family. The idea was mooted amongst the partners and finally it was decided that Drs Kennaway and Carr would share the job and work six months each. It involved an enormous amount of organising. All houses and cars were swapped and the accountants, both in Australia and England nearly blew a fuse trying to work out salaries, tax and insurance. It was an interesting experiment, although difficult and frustrating in such a country, never visited before, convincing oneself that one was not on holiday, but there to work!

To make the swap financially possible, Dr Kennaway had to become a full – time partner (and the first female partner in the practice).

In 1990 Dr Sandy Neill retired as he had reached the age of 65, retiring time, under partnership rules.

Dr Alexander (Sandy) Neill

Dr Alexander (Sandy) Neill

Dr Alexander (Sandy) Neill, graduated from the Royal London Hospital in 1950. and then completed his National Service in the RAF, mainly in Malaya. He became one of the first trainees in General Practice but returned to hospital work, where he met his future wife. After their marriage they worked briefly in estate medicine in Malaya but returned to the UK, where, after many jobs as locums, they eventually came to Combe Down. He was Secretary of the Bath Medical Committee and later held most of the offices in the local BMA Branch. He was the first part-time medical officer to Bath University and set up the University Medical Service and also became the Clinical Assistant with care of Mental Handicap for the Bath Health District. He worked for 31 years in the practice.

When Dr Neill joined the practice in 1960, he bought into his share of Craven, the branch surgery. Likewise, when Drs Carr and Turner became partners they did the same.

At the time of Dr Neill’s retirement, the property was paid for and jointly owned between the three doctors, so when he retired, he wished to cash in his share. It was , therefore, decided to sell Craven.

The hairdressers, who had been renting the front part of the building, bought the house and their landlords of many years now became their tenants, and the branch surgery carried on as usual.

Dr Neill (standing) remaining partners, Drs Turner, Snowise, Kennaway and Carr

Dr Neill (standing) remaining partners, Drs Turner, Snowise, Kennaway and Carr

Dr Neill’s retirement coincided with the Government’s infamous Patient’s Charter. (A good move on Sandy’s part!) Basically, the idea was to expose the small minority of doctors who were abusing the system, albeit at the expense of the conscientious and hard working majority.

Now the GPs had to prove that they were doing the work they were being paid for, i.e. by monitoring each patient over the age of 75 years, every year, and reaching set targets – or no pay!

It gave access and authority to people to challenge their GPs and made it easier to change their doctors and encouraged them to complain. Not entirely a bad thing in itself, but rather an insult to the vast majority of doctors who cared and did their best for their patients. It has generally increased demand and expectancy and the attitude of ‘I pays me money, I knows me rights’ ! All this, of course, meant a huge increase in bureaucratic paperwork, making less time available to the very people they were trying to help!

Dr Neill’s replacement was Dr Neil Snowise, Oxford trained, who, with his wife, Kathy, a nurse, and their two children, Thomas and Laura came to Combe Down from a practice and partnership in the Midlands.

Dr Neil Snowise, of the Combe Down surgery, collects the new ECG machine from Dr Richard Venables, of the British Heart Foundation

Dr Neil Snowise, of the Combe Down surgery, collects the new ECG machine from Dr Richard Venables, of the British Heart Foundation

Periodically, over the last 50 years, the doctors at Combe Down House had tried to buy the property from its owner, Mrs Doris Smith, to no avail. The rent paid at this time was £7,000 p.a.

Doctors get more money

Doctors get more money

In November 1993, two events happened within weeks of each other, which were to change the face of the Combe Down practice for ever.

The first was the news that their ageing landlady had died and the house was to be sold.

The second was the offer of an improvement grant in October 1993, that had to be spent by March 1994 or be lost. This was to the value of £50,000 for rebuilding or new building.

A decision had to be made quickly.

The grant was no good unless the practice owned the property.

What a fortunate coincidence! But was four months long enough to value the building, raise money for the mortgage (£100,000), find an architect to draw up plans for the extension, have the plans passed by the planning committee, survey the mines under the house and garden, find a builder and progress quickly enough to present receipts for materials etc. to the Local Health Authority?

The stress levels fell off the top of the chart but eventually everything was achieved and the work started in the spring of 1994.

The previous November when the news broke and decisions were being made to buy and build, ill-health, and the thought of the forthcoming upheaval, forced Dr Turner into unwilling early retirement.

Dr John (Jack) Ferens Turner

Dr John (Jack) Ferens Turner

Dr John (Jack) Ferens Turner. After finishing his education at Bryanston School he gained a place at Cambridge University to read Classics, but, with National Service to complete, this was not taken up.  After trying work in Land Agency and the family clothing business, he joined the 21st Special Air Service Regiment (Artists’ Rifles) TA as a canoeist and climber. He attended evening classes and NE Essex Technical College and finally went to St Thomas’ Medical School, where he qualified in 1962, marrying Anne, a fellow medical student in the same year. He joined the Combe Down practice in 1965. In the mid-eighties he renewed contact with former T.A. friends and spent regular challenging holidays mountain climbing, walking, skiing and sailing. He worked for 20 years in the practice.

At the same time decisions were having to be made concerning the property, the practice was just beginning to get to grips with going ‘Fundholding

As the name suggests, this was a Government dictate to encourage general practice to be responsible for their own budgets. The scheme was designed to make general practices the purchasers and local hospital services the providers.

Fundholding was offered to the larger general practices first (1st wave) which were generously funded. According to patient list size, practices were invited to be 2nd wave, 3rd wave etc. fundholders. Combe Down practice was 4th wave, by which time, the Government, through the Area Health Authority had become considerably more mean with the budgets offered.

The whole ethos of general practice has become money orientated and the partners have to sit in judgement as to who receives what treatment to remain within the budget figure. This also applies to prescription costs, making some patients a financial hazard to practices and therefore unwelcome.

However, it has made hospital charges more competitive as GPs are able to shop around for the best deals and in so doing, increase the standards of hospital health care and outpatient services e.g. X-ray and physiotherapy etc.

After Dr Turner retired in November 1993, Dr Imogen Batterham, who graduated from King’s College Hospital, joined the practice, making for the first time an equal male/female partnership.

After Christmas that year, volunteers were called in to move the entire office and nerve centre and all the consulting rooms from the old house to the new extension. The response was wonderful, everybody turned up to help, many dragging husbands and partners in tow.

The Combe Down Surgery ‘in-house catering services’ swung into action and it turned into a big happy working party.

All the patients’ files were removed from their old-fashioned cabinets, which since the beginning of time had firmly kept the males and females apart! Emancipation prevailed and families were united at last in their smart new (but wrongly put together, whoops! – had to call the little man in!) filing drawers.

The same month of the big move, saw the opening of the Bath Primary Care Centre, providing out-of-hours care for patients. This involved practices joining a co-operative instead of looking after just their own patients.

The Combe Down practice opted out of joining initially, wanting to continue giving a personal service, but after a year of resistance, the practice decided to join the scheme on a six months trial. It continues to be so.

Opening of Bath Primary Care Centre

Opening of Bath Primary Care Centre

The 1st May 1996 saw the Grand Opening of the new surgery. The Mayor of Bath, Councillor Margaret Feeny, performed the task of ‘cutting the bandage’.

Past and present doctors, hospital specialists, guests and employees of the practice celebrated the result of two years hard work during the change over, and looked to the continuing success of the practice.

Not long after the opening, Lloyds Chemists moved into part of the old house, tailor made to their requirements. They had approached the practice two years previously, when the alterations to the surgery became common knowledge, suggesting they move their dispensing services from their shop in the village. They would be responsible for the shop fittings and pay rent to the practice. This has proved successful and very convenient for patients and doctors alike.

Drug sales at Combe Down

Drug sales at Combe Down

After holding regular weekly Family Planning clinics, Dr Anne Turner retired in the spring of 1997, exactly 20 years to the day she first started. Although never a partner, she holds a unique place in the history of the practice.

Dr Anne Curtis Turner

Dr Anne Curtis Turner

Dr Anne Curtis Turner graduated from St Thomas’ Medical Hospital School in 1962 and married ‘Jack’ Turner three weeks after qualifying. Came to Combe Down with husband and baby Sophie in 1965. Worked in Bath Clinic specialising in Family Planning. Started Family Planning Clinic in Combe Down House in 1977. Clinical Assistant in Family Planning at St Martin’s Hospital (Wessex). Regional Advisor in Family Planning training. Elected to Council of National Association of Family Planning Doctors (the next year this became the Faculty of Family Planning and Reproductive Health Care of which she became a Foundation Member). Part-time Medical Officer for the Committee on Safety of Medicines plus six years at Bath Clinic with Well-Woman Screening. After retiring in 1997, has new post of Under Gardener and enjoys tennis and music.

In the same spring of 1997, Dr David Carr reached his 60th birthday. He decided to work till the end of Prior Park College school year before retiring. He had been their medical officer for 20 years.

Dr David Wilfred Rowland Carr

Dr David Wilfred Rowland Carr

Dr David Wilfred Rowland Carr qualified at Bristol in 1961. He was born in Coventry, he moved around a great deal, due to the blitz, ending up at Nunney near Frome in Somerset, He was Head Boy at Frome Grammar School where he met his future wife Jackie. A past Clinical Assistant in general medicine and cardiology, currently Divisional Surgeon to St John’s Ambulance Brigade, Bath. Medical Officer to Bath Race Course and the Bath Casualty Union, honorary doctor to Percy Boys Club , Combe Down Rugby Club. An entertaining after dinner speaker, with a wicked sense of humour, he spent ten very active and enjoyable years in Bath Round Table, where he was Chairman in 1973/74. Hobbies are, walking, music/singing, gardening and collecting Victorian mangles. His own heartfelt quote; “I may not know the answer, but please don’t accuse me of not caring”  To date, the longest serving partner, 33 years in the practice.

To be continued…

© Jackie Carr 1997