Dr John Harrison
I started work in Rowlands Castle in 1987 as part of my GP training scheme. The background to me working in Rowlands Castle started very early on with wanting to become a GP from the age of around 10. ‘Why?’ people would ask me – this is still an impossible question to answer. Schooling was at the Brighton, Hove and Sussex Grammar school. From there I went to Leeds University to study Medicine.
Once qualified I worked in hospitals in Yorkshire and Humberside doing a variety of jobs; Medicine, General surgery, Accident and Emergency, orthopaedics, infectious diseases, Obstetrics and Gynaecology. At this time, I did give some consideration to Orthopaedics as a career choice, and as many know, my fascination with bones and sports injuries persisted through my GP career.
By now I had spent some years ‘up north‘, and had also developed some strong ties with the area having met my future wife Gill whilst I was still a medical student. Gill was a student nurse training in Leeds – home for her was Bury in Lancashire. I was missing the south coast, its weather and the sea. It was decision time as to where to do my year’s GP training. We decided to try and move south. At that time general practice was an extremely popular choice for Doctors and training places were highly contested, especially when trying to move areas. Fortunately, my interview technique worked and in 1987 I was offered a year’s GP training contract at Rowlands Castle Surgery. In those days Dr’s Ashworth and Drew were the partners – the surgery was situated in the building between what is now the Castle Stores and the Hardware store. Gill, who by this time had become my wife, moved down a few months ahead of me as she had secured a job on the neurological unit in what was then known as Southampton General Hospital. We bought our first house and lived in Emsworth.
Training for General Practice
I commenced as a GP trainee in August 1987. Dr Ashworth was in the process of retiring and his new partner was to start work in the practice a week after my arrival. Having settled into the area and discovering what a lovely community it was with the South Downs and the Solent so close by, it seemed I had missed a golden opportunity to work long term in Rowlands Castle. I started exploring long term partnerships close by. Then, somewhat surprisingly, the new partner announced his departure – it appeared that general practice was perhaps not what he wanted to do. This was very fortuitous for me. So, I applied for the partnership along with several others and was lucky enough to be successful at interview. This was the start of a long and happy career.
Life in Rowlands Castle
I was now a partner! I was suddenly discovering the additional responsibilities – decisions were now very firmly my problem! In those days, while we were responsible for a small list of under 3000 people, work wasn’t too pressured. In those days we were responsible 24 hours/7 days a week which meant being on call alternate days and weekends. As it was before mobile phones, this made simple tasks difficult. By default, my wife Gill, became the telephone answer service. This was additionally challenging for her as she worked shifts.
By this time, however, she had secured a job closer to home as Sister in the intensive care unit at Queen Alexandra Hospital.
d the arrival of our first child – doing visits was now even more interesting! Then on weekend visits my daughter was sometimes involved in coming on house calls – medical bag in one hand, daughter in car seat in the other. Maybe this early exposure to patients explains her decision also to qualify as a doctor?
The arrival of our practice mobile phone helped – It was the size of two house-bricks. But there were a few complaints from some patients about the cost of calling the doctor, despite the improvement in being able to speak promptly to him. Sometimes you just can’t win!! Maybe it’s something the NHS may reintroduce as an improvement as the cost of the call was a deterrent to some of the more minor ailment patients!
The mobile phone arrived around the same time as our second child! This time a son. I remember pushing the pram round with the phone in the basket at the bottom of the pram! At the time is was very liberating to be able to leave the house and the land line whilst ‘on call’. Because we were on call 24/7 it was a pre-requisite that you lived close to the practice, and by this time we had moved to a bigger house in Horndean, right on the edge of our area.
I was trying not to mix work and social life, but with a young family and by moving to a new estate, I found my new neighbours converting to become new patients – an unexpected ‘bonus!’ This wasn’t such a problem as I had perhaps originally anticipated, so when my enlarging family needed a larger house, I had no concerns moving into the village. We moved in, and our third child – another son – was born in 1995. The interesting thing here though, was that when I was in the consulting room I could often ask patients how they were – with a response of ‘I’m fine’, but crossing the road to the hardware store the reply could be ‘those tablets you gave me doctor!’ I’m not best known for my ability to remember names let alone what new tablets I may have started patients on, so this response always made me chuckle to myself! Even more interesting is when a patient starts a consultation whilst I have a beer in my hand at the pub amongst friends on a Friday evening!
As the practice at that time was still small, additional work was necessary. Within weeks of starting as a partner, a job in fracture clinic at QA Hospital became available and my orthopaedic career restarted! Having another role was beneficial generally. Doing a GP surgery is very isolating as there is rarely discussion with other clinicians when consulting. In my hospital role there was continual interaction making my working week much more interesting, and of course gaining additional clinical skills to the benefit of the practice’s patients.
The theme of other roles continued throughout my career with the following roles coming and going over the years:
- Vasectomy surgeon
- Local medical committee member
- Advisor to the then Portsmouth Health authority for Audit, a role to lead the local practices to improve quality
- GP member representing small practices for the local drug formulary
- Responsible for setting up/taking the GP lead for the Portsmouth area – – GP lead orthopaedic outpatients, which cut waiting lists dramatically for upper limb orthopaedic access to Queen Alexandra Hospital
- Director of the local GP Alliance, allowing local practices as a large organisation to bid for and run services that individually we were too small to organise and run.
Over the years I have been very lucky to work with a great team, and it is to this that I ascribe the smooth running and efficient service that the practice has delivered over the years. The fantastic teams of receptionists, nurses and administrative team slowly changed and grew over the years. Our receptionist team we have always kept small and compact as patients like a familiar face, with numbers increasing from three to four over the years. When I first started, we had just appointed our first part-time practice nurse – Sister Isobel Jones – a very rare skill in those days, later increasing to two nurses to give full time nursing. The administrative team saw the biggest changes, again initially a part time manager, this increasing to full time, with two part time assistants who also helped with ensuring the phones were answered promptly. Doctor numbers remained constant with two partners and a part time lady doctor, though the work pressures increased significantly over the years, along with the hours worked.
NHS ‘Changes and Challenges’
It has to be said that life would be boring without them! When I started, the practice had one computer, and little knowledge of what to use it for. All major illnesses were on a card-based system so there was no easy way to find how well we were doing in any area. As the trainee doctor, I made it my job to get some simple health data on it so that we had knowledge of the percentage of ladies with up to date smears, for example. This was more challenging than it would appear as the computer was guarded by a ‘dragon’ receptionist! We were an early adopter of many technological developments, from being the first to have a fax machine – so early we had no hospitals to fax – to being very early adopters of computerised records, so much so that, again, we had some 8 years after we had abandoned hand writing consultations. The NHS visit the surgery and certify us able to record consultations electronically.
Medicine similarly has changed significantly; home births with the GP attending still occurred – it has been lovely in some of these deliveries to see them more recently, marry and have children of their own. Minor surgery was for a significantly larger list of procedures than is now allowed.
As we were a rural area the practice was a dispensing practice. This was a great asset to village patients, but the vagaries of the NHS meant that patients near a pharmacy were not allowed to use the facility. Running the pharmacy in addition to the practice was an additional challenge.
Over the 30 years from 1987, the practice population has increased from 2900 to 4300. We moved to our current location non The Green in December 1990. In 2010 we opened the attached pharmacy. This again required a change in working practice. We now had the additional benefit of a pharmacist who rapidly became another source of advice to our patients both for medicine queries and for minor ailments.
Preparing for the Future
With my children now all grown up and two of them living abroad, it seemed a good time for me to increase my family-time as we now had to start travelling to Australia and Oslo to visit them! Although I have loved looking after my patients and have many as friends, I was also starting to feel more and more despondent with the persistent changing NHS politics. So, in 2018 I made the decision to stop clinical practice.
I am still involved with medicine, doing a small amount of work undertaking other GP’s appraisal (this is part of the revalidation system for doctors), and holding regular conversations with my daughter and her boyfriend, both of whom are currently training in local hospitals.
Though I have hung up my stethoscope and no longer do any clinical practice, I have recently taken up a ‘clinical lead’ role in a large inner-city practice helping them respond to change and improving efficiencies to their care provision.
Looking back over the last 31 years of working as a GP in the village, I consider myself very lucky and privileged to have both lived and worked in such a lovely area within such a wonderful community. Gill and I have no plans to move out of the village and I look forward to meeting my ex-patients.
I would like to think that Dr Brendon Hayes and his team, along with Nemesh and Kinali in the pharmacy, will continue to build on these years and, together, can enjoy the same experience and success that working in this great community has given to me.
Editorial: This article was written by Dr Harrison who retains the copyright. It was first included on the RCHC website in November 2019.