Seacroft Hospital Leeds in the Seventies -recollections of a paediatric house officer

Dr Disampathy Subesinghe with Dr Jim Littlewood

In the 1970s Seacroft Hospital was the premier children’s hospital in Leeds. The much smaller paediatric medical unit at the Leeds General Infirmary was divided between Professor Craig’s university department and Dr Eric Allibone the NHS consultant paediatrician.

Seacroft Hospital is situated 4 miles east of the city centre on the main A64 York Road dual carriageway and until recently was  operated by the Leeds Teaching Hospitals NHS Trust. Initially the New Mansion Hall Estate was purchased from Edward Waud in 1898. In 1898 a smallpox isolation hospital was opened on the site, building continued (figure) and Seacroft Hospital was completed in 1904 as an isolation hospital for people with infectious diseases – particularly scarlet fever and small pox.   

By the entrance is a local landmark, a clock tower (Grade II listed building built by E.T. Hall with the clock by Potts & Sons) (figure) which is also a water tower, holding 28000 gallons of water. In 2017 the hospital is now a major centre for ambulatory care services. In June 2006 the Seacroft Specialist Rehabilitation Centrep opened there. The hospital also has renal dialysis facilities.

Although a “House of Recovery” (figure) for people with infectious diseases existed in Leeds from 1802, first in  Vicar Lane and then in Beckett Street.   Andrew Robinson of the Yorkshire Post reported in 2004 the by 1893 a decision was taken to put up a temporary smallpox hospital at Seacroft and a severe  outbreak of typhus led to a tented hospital going up in 1897. Records show that 1898 saw the first permanent accommodation open at Seacroft. Sixty-six beds were for scarlet fever patients. ‘B’ ward was opened for 30 smallpox sufferers. A decision was taken, also in 1898, to build a new hospital for scarlet fever, diphtheria and enteric fever, and a separate hospital for smallpox – which led to the purchase of the Killingbeck estate. 

The big event came in 1904 with the opening of hospitals at Seacroft and Killingbeck at a cost of £250,000 and £75,000 respectively. Eventually at Seacroft, accommodation was provided for 482 patients (240 scarlet fever, 60 diphtheria, 104 enteric fever, 48 isolation and 30 convalescence). At Killingbeck there were 238 beds for smallpox. 

The unusually large size of the hospital site and its rather curious layout, with ward blocks located well away from each other separated by long corridors, is explained by this past use for treating patients with infectious conditions (figure).

After the Second World War, medical advances lessened the need for so many infectious disease beds, and the use of the hospital gradually changed. In more recent times a number of modern buildings housing specialised departments have been concentrated at the hospital site as will be described below.

Killingbeck Hospital Leeds

On the opposites side of the dual carriage way was Killingbeck Hospital (figure) where patients with respiratory diseases were treated under the care of Drs. Gordon Edwards, David Charley and John  Templeman. In 1914 the foundations of the present Killingbeck Hospital were built. The Killingbeck Hall Estate had been sold by Mrs. Meynell Ingram in December 1898. Killingbeck Hall, then known as Webster House was in occupation by the Gregg family from the 1500’s and subsequently by other families before Mrs. Meynell.

So Killingbeck Hospital opened in 1904 to deal with cases of smallpox. From 1913, it became known as Killingbeck Municipal Sanatorium  and specialised in cases of tuberculosis. The buildings were extended again in 1936. Eventually Killingbeck was to become a successful treatment centre for heart and lung diseases, until it was closed in 1997 following a gradual closure process stating in 1993. Killingbeck Hall had been demolished in 1978.  

Killingbeck Hospital History & Heritage murals are displayed in the Jubilee Wing of the Leeds General Infirmary.  The permanent retrospective exhibition of Killingbeck Hospital is made up of 4 landscape and 3 portrait panels (Hospital Art Studio. tony@hospitaartstudio.co.uk)

In the Seventies Killingbeck and the General Infirmary were the two  major centres in Leeds for cardiac investigations. 

The paediatric  cardiology department was headed by Dr. Olive Scott (1924-2007) (figure) who had moved to Leeds in 1961 when her husband James Scott was appointed Professor of Obstetrics at the University. In 1966 she  was appointed as consultant paediatric cardiologist at Killingbeck – the first such appointment in the UK. Thereafter she had a very distinguished career being the first in the UK to perform a balloon atrial septostomy; also she was the first in 1976 to establish non-invasive cardiac diagnosis through echocardiography at Killingbeck. With her husband James she did important research on congenital heart block.  

Olive Scott’s consultant colleague, Fergus McCartney (1940-2005), was appointed in 1969 when only 29 years old following his return from postgraduate study in the USA.  With Olive Scott as his mentor they together built an excellent small department, incorporating the necessary surgical experience through the collaboration of Philip Deverall, appointed as paediatric cardiac surgeon in 1970. 

When the opportunity arose, in 1975, to take the newly created chair of paediatric cardiology at Great Ormond Street, Fergus was  ideally positioned to assume the role of academic leader.  He was replaced at Killingbeck by Dr. Gordon Williams.  In 1978 Philip Deverall took up an appointment at Guys Hospital in London and Mr Duncan Walker took his place as cardiothoracic surgeon.

Duncan Walker (figure) founded the Children’s Heart Surgery Fund in 1988 when he was a heart surgeon at Killingbeck Hospital. Thanks to his fundraising efforts, in 1990 Duncan was given the accolade of Yorkshireman of the Year. Since 1988, Children’s Heart Surgery Fund has awarded over £6 million in grants to the heart unit, its patients and their families. Between 1999 and 2002, Children’s Heart Surgery Fund awarded £250,000 to Leeds University’s Department of Mechanical Engineering. Unfortunately Duncan was not an easy personality and retired early in 1997 after various disputes with colleagues and the hospital authorities.  The University Physiology department, headed by Professor Lyndon and a Senior lecturer Dr. Tissa Kappagoda (1943-2015) both had a major input into the investigative work at Killingbeck.
During the Seventies the two hospitals, Seacroft and Killingbeck, were closely linked and shared the same telephone exchange located in the porter’s lodge at the main entrance to Seacroft. For the general paediatricians working in Seacroft, to have Philip Deverall, a paediatric cardio-thoracic surgeon, close by at Killingbeck was a major advantage when a child required a bronchoscopy (this was before the days of fibreoptic bronchoscopy).  

There was also collaboration between the general paediatricians and Dr. Olive Scott who would send occasional non-thriving infants to Dr Littlewood if their problems did not appear to be entirely cardiovascular.  For example, she referred a failing-to-thrive infant which we diagnosed as having the very rare Bartter’s syndrome.  Also Dr. Scott referred an occasional infant with a known congenital heart lesion but where she did not consider the heart problem accounted for the poor weight gain; where she suspected another cause. Eventually six such infants were found, on investigation including jejunal biopsy, to also have coeliac disease. All responded well to a gluten free diet.

Littlewood JM. Lee MR. Meadow SR. Treatment of childhood Bartter’s syndrome with indomethacin. Lancet 1976; 2(7989):795.                                                                 

Congdon PJ. Fiddler GI. Littlewood JM. Scott O. Coeliac disease associated with congenital heart disease. Arch Dis Child 1982; 57(1):78-9.     

Other major specialities at Seacroft included infectious diseases – the original role of the hospital – and Ear Nose and Throat surgery. Eventually during the decade Paediatric Oncology (Prof. Cliff Bailey) and Paediatric Disability Centre (Dr. Grace Woods) were based at the hospital.  The Regional Blood Transfusion service and the Public Health Virology Laboratory were also based at Seacroft.    

BUILDINGS

The three storied administration block at the front of the hospital (figure) overlooked the tall ivy-covered clock tower. On the ground floor of the building were the offices of the administrators.  Mr. Brown (an ex.RAF fighter pilot from WW2) a delightful man, was the secretary of the Leeds B Group of hospitals (made up of Seacroft, Killingbeck and St George’s Hospital Rothwell). The hospital secretary Mr. Haigh (who during the decade was succeeded by Dennis Mulligan) was supported by Miss Joyce Cartwright.  Together with Mr. Lenehan, the group treasurer, Miss Ellison and her deputy Miss Buckley, these officers ran the hospital with admirable efficiency.   

At the other end of the ground floor of the administrative building was the doctors’ common room and adding it the dining room, with its long table, where consultants often joined junior staff for lunch, seven by the amiable and always helpful “dinner ladies” Mary and Joyce.    On the first floor, directly above the dining room was the matron’s flat. The board room was to the centre the first floor and at the other end were some of the rooms for the resident doctors, while on the top floor were the remainder of the doctors’ rooms.

There were two other there storied buildings – the Maids’ Home and the Nurse’s Home symmetrically situated on either side of the corridor leading from the rear of the administration block. Towards the back of the nurses home was the smallish Recreation Hall – used the the doctors for their parties, by other staff and also by the volunteer  “Friends of Seacroft” groups for fund raising activities.  

 LABORATORIES 

Near the second small entrance to the hospital from the Bridle Path by the side of which was the Public Health Virology and Bacteriology Laboratories in a single story building. Dr Peter Hambling was head of Virology and Dr. George Gibson head of Bacteriology. This second entrance was used mostly by Blood Transfusion Service (BTS) vehicles.     

Derrick Tovey

The BTS and Haematology services were headed by Dr. Derek Tovey, Dr. Mano Rajah and Dr. Angela Robinson – the latter being the paediatric haematologist.  Dr Derrick Tovey (1926- ) (figure) was  Director of the Yorkshire Region Transfusion Centre (1966–88) and Chairman of the Anti-D Working Party, Department of Health and Social Security (~1980–88).  Later at a Welcome Witness Seminar convened in 2003, Angela Robinson later commented “Dr Derrick Tovey did the first proper antenatal rhesus prophylaxis trials. Twenty years ago he started it, and 20 years on they have now decided nationally that it’s a good thing to do. That very early work was done by Derrick in the Yorkshire trials”.  

Angela Robinson later became Director of the National Blood Transfusion services. Jim Airth was the senior technician at their laboratory.

Although the Biochemistry Department was based at St James Hospital, two senior technicians, Alan Steel and David Goddard, were based at Seacroft. From the early Sixties Alan Steel provided a very reliable sweat test service for Seacroft and many other hospitals in the Leeds area for many years.

THE WARDS

There were 14 wards  at Seacroft which were alphabetically named. They were all long single story buildings with high ceilings, set widely apart from each other. They were connected by a series of  long corridors – initially only roofed but later with side walls.

ENT SURGERY                

The 3 ENT wards A, B and D were close to one another. B was a children’s ward, but part of it was an operating theatre and was part of D ward.  The two ENT surgeons were Mr. Peter Mills (1925-1977) and Mr. Arun Ghandi.  Dr. Subesinghe’s late wife was the ENT SHO when Mr Mills passed away suddenly and his senior registrar Iain Frazer was appointed to the post. The other senior registrars who worked there in the early Seventies became consultants in the region – David Commerford  (Bradford), David Hanson (LGI), and Mr. Hehazi (Wakefield) part from Julian Upton who moved south and David Wilcox who migrated to Australia. Although there were no acute surgical services in the hospital, when a child with croup seemed in danger of obstructing the ENT staff were ready to help and this was much appreciated by the paediatricians. Many acute paediatric problems were admitted to Seacroft and  it was a rather lonely place when a child with croup and severe stridor was admitted during the night. 

PAEDIATRIC SURGERY

Geoff Smiddy

Non-urgent paedaitric surgery was carried out in the theatre of D ward by visiting surgeons Mr Geoff Smiddy, (1922-2003) (figure) a general surgeon who did some paedaitric surgery and Mr Bob Williams a urologist who also operated on many  children there.  There was no resident anaesthetist and hence no non-elective  surgery was performed.

John Beck

The first paedaitric surgeon to be appointed in Leeds was a South African Mr John Beck (figure) in 1972/3 and he worked at the LGI. John was a very pleasant man who came to the UK when increasingly appalled but the situation in South Africa.  For the first ten years, with his anaesthetist Laurie Gardener, he worked single handed to develop paediatric surgery in the region.  He was greatly respected by local paediatricians although somewhat resented by some Leeds surgeons who had previously performed all the paedaitric surgery prior to his arrival in Leeds.

INFECTIOUS DISEASES

The two infectious disease consultant were Dr. John Stevenson and Dr. Herbert Pullen; they also cared for patients with general medical problems; between them they had access to seven wards. X ward was a “cubicalised” ward for adults with infections conditions. Y ward was for female general medical patients. Sisters Comfort and Pat Cook were in charge of these two wards. 

Ward VW was a combined adult and children’s ward for patients with “uncertain” skin rashes.  All the infants were nursed in T Ward (Sister Kennedy) and H Ward (Sister Allenby) and J Ward (Sister Grundy) were ID wards for older children. Sister Palfreyman was in charge of U ward, the adult male medical ward.

From February 1973 to August 1975 Dr. Subesinghe worked as SHO in the ID unit. The unit had two senior registrars, a medical assistant and 4 SHOs. The two senior registrars Drs. Ghosh and Nanda moved on to Middlesborough and Hull respectively as consultants. Roy Nicholas was the medical assistant.

Each morning all the ID medical staff met with the two consultants win a room joining the library in the education block, when the SHO on duty gave a resume of the admissions of the previous night. After discussing any particular problems we would disperse to our respective wards.  The ID unit as a whole was a happy unit to work in. Both Dr. Stevenson and Dr. Pullen took a paternalistic interest in the welfare of their junior doctors and were always approachable. The paediatricians had a good working relationship with the consultants and staff of the ID department. Dr. Stevenson was a highly respected physician and a good friend of paediatricians and always very helpful to them. He later played a significant role in the development of the adult cystic fibrosis unit at Seacroft.

PAEDIATRICS

There were seven visiting consultant paediatricians in the  Seventies. Those employed by the university were Professor Dick Smithells (1924-2002) shared P ward with his University colleagues, Dr. Roy Meadow (nephrologist), and Dr. John Buckler (endocrinologist). Dr Meadow’s two senior registrars were Dr. Trevor Brockelbank (later paediatric nephrologist St James’s University Hospital) and Dr. Tim Chambers (later consultant in Bris

Dick Smithells moved from Liverpool in 1968 to the chair of Paediatrics in Leeds. Of major importance was his research into possible links between poor nutrition, such as vitamin deficiency, and malformations of the spine and brain such as spina bifida. Shortly after his arrival in Leeds he established a laboratory to study the effects of drugs and nutrition on the early development of the embryo and foetus. He subsequently  demonstrated the importance of vitamin supplements in the prevention of these conditions. Eventually in 1991 the MRC concluded  folic acid supplementation should be provided for those  with a previously affected pregnancy and that “public health measures should be taken to ensure that the diet of all women who bear children contains an adequate amount of folic acid”.

For his research on the role of folic acid in preventing neural tube defects Smithells was awarded the James Spence Gold Medal by the British Paediatric Association in 1992 (figure) and, in 2000, the International Research Award of the Joseph P Kennedy Foundation.

Roy Meadow (figure) had a distinguished career but a sad conclusion as he became increasingly involved in medico-legal work. In 1968 he was awarded the Donald Paterson Prize of the British Paediatric Association for a study of the effects on parents of having a child in hospital. In 1977 he described Munchausen Syndrome by Proxy. In 1980 he was awarded the chair of paediatrics at St James’s University Hospital and later became involved in the formation of the Royal College of Paediatrics and Child Health becoming the first President in 1998 for which he received a knighthood. 

Sadly his reputation was severely damaged after his appearances as an expert witness for the prosecution in several trials where his expert evidence played a crucial part in wrongful convictions for murder. After a variety of legal battles, in 2009, Roy Meadow relinquished his registration with the GMC and thus became unlicensed to practice medicine ensuring he would no longer be answerable to the GMC should any further concerns be raised regarding any previous professional actions.

Dr. Ian Forsythe had F Ward to himself. He was a dour Ulster-man and already an experienced consultant paediatrician when appointed. His special interest was neurology but he was essentially a general paediatrician who had previously worked in Belfast. He was appointed on Dr. Eric Allibone’s retirement in 1970. His two registrars in the early seventies, David Haigh and Peter Congdon (1944-1987) (figure), were to become Dr. Littlewood’s Senior Registrars a couple of years later. David moved on to Bradford.  Peter, after a very productive time with Dr. Littlewood when he was involved in a number of publications, became the first specialist neonatologist at the Leeds general Infirmary. Sadly, within a few years of his appointment, he died from oesophageal cancer  in 1987; the neonatal unit at the LGI is named after him.

The clinical service for sick newborns which Peter Congdon established, was used with gratitude by paediatricians throughout the Yorkshire region and beyond. He contributed a high degree of technical expertise, a great sense of personal responsibility, and a constant awareness of the emotional strains which sick newborns impose upon parents and staff alike.    

Jim Sarsfield

Dr Patrick Clarke and Dr Michael Buchanan shared N Ward .  “Paddy” Clarke, as he was known, had moved to  Harrogate from Belfast in 1969 with his family; he had a weekly consultant session in Leeds. His wife Pat still lives in Harrogate where she is a gardening expert and grandmother of eight children.

Dr. Jim Sarsfield (figure), then a lecturer with Prof Smithells, worked with them and other consultants at Seacroft. He eventually succeeded Paddy Clarke as consultant paediatrician in Harrogate. Jim died prematurely of carcinoma of the pancreas

Dr Buchanan’s special interest was childhood non-accidental injury and child abuse. Indeed he was one of the pioneers in bringing these problems to the attention of colleagues. His protégées Drs Jayne Wynne and Chris Hobbs became national experts in this field.  Sister China was their ward sister.

G WARD

in 1972 Dr. James Littlewood had access to only one half of G ward. The other half was reserved for children with cancer (mainly leukaemia) managed by Dr. Katie Howarth who migrated to America later that year; subsequently Dr. Cliff Bailey was appointed as the  first full time paediatric oncologist.

This author (Dr. Subesinghe) was SHO to Dr. Littlewood for a year from February 1972 and again for a further year from February 1977. 

Dr. Littlewood was widely regarded as the best general paediatrician in the Yorkshire Region. He was an excellent clinician, a quite brilliant and inspirational teacher and meticulous researcher. He has published extensively. His clinical interests in the early 70’s included urinary infections in neonates young children, gastroenterology, asthma, paedaitric allergy and cystic fibrosis. He was later to become a world authority in cystic fibrosis and in 1995 was honoured by Her Majesty Queen Elizabeth with an OBE.   

Throughout his career he instilled in all the staff the importance and value of urine examination. It was the SHO’s responsibility to record in the notes the results of the chemical and microscopic examination of the patient’s urine. 

In addition to his Senior Registrar there was a part time Clinical Assistant, Dr Avril Crollick who eventually performed the majority of the jejunal biopsies and also trained the registrars in the technique as well.  Dr Sydney Smith the radiologist was a great help in siting the biopsy capsules.

Jim Littlewood’s Senior Registrars during my time, who were later appointed consultants in the Yorkshire Region, were Drs. Neil Boyle Boyle (Huddersfield and later Guernsey), Bill Arrowsmith (Doncaster), John Davies (Grimsby), John Alexander (Pontefract), David Haigh (Bradford) and Peter Congdon (Leeds). Philip Lloyd-Jones moved away from Yorkshire and my first SR Phoebe Edwards took up a career in general practice in Leeds.

The ward sisters in 1972 were Karen Roberts and Joan Raphael. My co-SHO Dr. Dhia Al Obeidi an Iraqi from Basra was very knowledgeable; he returned home a few years later and I often think of him in the light of what has gone on in his war torn country.

When I rejoined the hospital staff in 1977 Dr. Littlewood had sole use of the refurbished G ward which now had several additional cubicles. The ward sister was Margaret Sproat. My co-SHO was Sarah Haughey – now a senior partner in general practice in Islington, North London. It so happened that Sarah and I were both fans of the popular TV series “The Rise and Fall of Reginald Perrin”, as indeed (we later found out) was Dr. Littlewood. Sometimes on ward rounds he would have us in fits of laughter by giving a very good imitation of the character “CJ”.

Dr. Littlewood’s outpatients (figures) were held at both Seacroft (right figure) and on the first floor of Chancellor Wing at St James’s hospital (left figure). Sister Moriarty was  the very efficient and friendly sister in the Seacroft outpatients.

His secretary Christine Silburn (figure) had been with him since she left secretarial college as a teenager in the late 60’s and remained his secretary until he retired in 1997, moving to St James with the paediatrics in 1980. She attended all his clinics and took notes and the letter that he dictated after each consultation. In 2019, now a Grandma, she is about to retire as the Senior Administrator of the Regional Paediatric Cystic Fibrosis Unit at the Leeds General infirmary!

CLINICAL MEETINGS

In the 70’s clinical meetings were held at lunch times every  Thursday in the Education Block. The library, lecture room and offices of the ID consultants and their secretaries were located here. Paediatric consultants from hospitals in the region along with their juniors attended regularly and presented cases of clinical interest. They gathered in the library for a sandwich lunch prior to the meeting which started at 1 pm.

Regular attenders were Drs. Henderson and Robinson (York), Rajan (Dewsbury), Charles Livingstone (Wakefield), Arthurton and Roberts (Bradford), David Morgan (Airedale), and the two ID consultants. Occasionally paediatricians from Halifax and Huddersfield and the cardiologists from across the road would attend.  Dr. Sydney Smith would be at hand to give an opinion on all matters radiological. Dr. Eric Allibone, a well-respected retired Leeds consultant then well into his 80’s, was also a regular attender.

CHILD DEVELOPMENT CENTRE

The Child Development Centre (CDC) was set up at Seacroft in the early 70’s by the first consultant Dr. Grace Woods, an expert on cerebral palsy. A second consultant, Dr. S H (Ted) Roussounis was appointed around 1977. When the CDC moved from Seacroft to St James’s in 1980 Dr. Woods retired.

TRANSFER OF PAEDIATRICS OUT OF SEACROFT

A debate had already begun in the mid-70’s about the future of paediatrics in the city i.e. where services should based. Some consultants believed Seacroft could be developed as specialist children’s hospital with A&E and surgical services. There already existed well established paediatric ID and ENT departments and the excellent paediatric cardiology service across the road, not forgetting the hospital’s picturesque setting and the ease of travel particularly by public transport.  Others made a case for moving paediatrics to either or both of the two main hospital LGI and St James’s with their well established A&E and acute surgical services. Several letters were written to the local newspapers by the general public as well as the medical fraternity arguing the pros and cons.

Eventually paediatrics did move out of Seacroft to both main hospitals in 1980 where the subspecialties were divided. This led to a second chair of paediatrics being established at St James’s to which Dr. Roy Meadow was appointed.

THE DECLINE OF SEACROFT AS A PAEDIATRIC HOSPITAL

The decline of Seacroft as an in-patient facility for children was inevitable following the transfer of paediatrics. Seacroft now has several functions as an out-patient facility providing a range of services including an extensive outpatients for the Leeds Regional Adult Cystic Fibrosis Centre.   

So Seacroft and the staff who worked there have played a major part in providing paediatric services for Leeds and the Yorkshire region. It particular, it is interesting that the first Cystic Fibrosis clinic in the Leeds region was started in the Seacroft outpatients in 1977/8 as a monthly clinic by Dr. Littlewood with the help of Sister Moriarty,  the outpatient sister, Miss Jenkins the physiotherapist and the paediatric dietitian. This was the start of the Leeds Regional Cystic Fibrosis service which today (2018) is one of the largestu in the country.

In another place (www.jimlittlewood.com) Dr Littlewood has discussed in detail how this occurred and the numerous people and circumstances that helped this development. For example how, in the late Seventies, this small monthly paediatric outpatient clinic for babies with CF represented the start of one of the UK’s major CF centres with a national and international reputation. By 2015 the number of children and adults with CF attending the paediatric and adult Leeds CF centres (228 children & 437 adults – total 665) was exceeded only by the number attending those at the Royal Brompton in London (335 & 671 – total 1006) and marginally by those attending the Manchester clinics (323 & 426 – total 749).

As we write (in 2019) a significant part of the Seacroft site has been designated for much needed new housing developments. However a number of medical services will remain including the Regional Adult Cystic Fibrosis outpatient services for the 437 adults with CF who are cared for by the unit.