Page last updated at 09:35 GMT, Monday, 30 June 2008 10:35 UK

How doctors worked before the NHS

The boys' ward at Craig-y-Nos Castle, near Abercrave
TB hospitals have closed as the pattern of disease has changed

Eldryd Parry was 17 when the NHS was created but he already knew more than most what it would take to be a doctor.

Both his parents were GPs in Cardiff and before 1948 was out the young Parry was at Cambridge studying medicine.

Now Professor Parry OBE, the 77-year-old medical scientist's career includes 25 years in Africa where he was dean of several medical schools.

His working life began at Cardiff Royal Infirmary, in the city where he had accompanied his parents on home visits.

He saw general practice first-hand throughout the war and in the immediate years after the war and, from 1951, experienced the delivery of health care from inside the NHS shortly after its launch.

He said: "General practice then was free from state interference and it was left to the integrity and good will of the practitioners to look after their patients.

"Our dining room was the waiting room. We only used it as a dining room at weekends.

Prof Eldryd Parry OBE. Photo: Nick Treharne/Cardiff University
He didn't send bills to patients who couldn't pay. If a person couldn't pay, he'd say 'I know they're in difficulties, he won't have the bill'
Prof Eldryd Parry on his father, a GP in the 1930s

"They didn't have a practice manager, they managed everything themselves. We had a qualified dispenser who made up the medicines at home.

"My mother would go out on home visits after the evening surgery to give morphine to patients with terminal cancer so they could go through the night.

"I would accompany her to different parts of Cardiff. I know the streets of Cardiff like a map. We'd go to the grand houses in Marine Parade in Penarth and to hovels in Bute Street.

"The people in Bute Street didn't get a bill. When my father died, at his funeral or soon after, one of his patients said I would have become a rich young man if he had sent out all his bills.

"He didn't send bills to patients who couldn't pay. If a person couldn't pay, he'd say 'I know they're in difficulties, he won't have the bill'.

'Severe pneumonia'

"I saw the sort of general practice that that had been historic in Britain. It was an attitude of service, not of financial gain.

"My parents made money but there was nothing spare. They had been practitioners in the 30s, a pretty difficult time.

"They didn't protest at the coming of the NHS. They didn't regard their professional work as under threat. It has changed a lot since then as government has become more controlling.

"My father kept up to date. He took a number of medial journals and read them. He spoke of a change in patterns of disease which he had noticed even before the introduction of penicillin.

"He saw much less severe pneumonia than he had seen when he was a young doctor after the First World War.

"There has been a changing pattern of disease over the life of the NHS. The infections which carried people off, pneumonia, tuberculosis, were common in south Wales.

'The body'

"When I was a medical student I went to a children's hospital in Merthyr Tydfil and one on the outskirts of Cardiff to see children with what we called rheumatic fever, classically associated with poor living conditions. Those hospitals closed long ago.

"That is almost certainly not so much to do with health care as changing patterns of living and a wealthier society. We saw patients coming much later with diseases than perhaps they may do now.

"We know much more now about how the body works but we knew a great deal then, certainly enough to do a lot.

"Medicine inevitably changes. It will be different in 20 years time than it is now."

The healthcare system in Wales
25 Jun 08 |  Topics
The NHS - an easy birth?
25 Jun 08 |  Health


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