Guest Editorial > Dark Corners of the NHS No 23: Normansfield Hospital
Dark Corners of the NHS No 23: Normansfield Hospital | BE
Shining a light on this dark corner of NHS history, our Special Correspondent illuminates so many issues that resonate today. This story needs to be read by everyone connected with the health service, from front line staff to members of the Board.
On the evening of 4th May 1976 some nursing members of the trade union COHSE held an informal meeting at Normansfield Hospital in Teddington, London. The hospital cared for over 200 patients with a learning difficulty of varying ages and differing degrees of handicap. The nurses were angry that the Health Authority had ignored their grievances against one of the consultant psychiatrists Dr Terence Lawlor. The following morning they went on strike with a view to persuading the Regional Health Authority to suspend Dr Lawlor. Pickets were deployed at the main gates. Patients were cared for by a skeleton staff and some volunteers, but the cover was well below danger levels. At 10.00 am even the skeleton staff were withdrawn for a while leaving only clerical and other staff to care for the patients. Later in the day Dr Lawlor was suspended from duty and by mid-afternoon the nursing staff were back on their wards.
The BMA responded furiously to a senior doctor being suspended after complaints by what they described as militant trade unionists.
Normansfield had a long and distinguished history having been founded in 1868 by Dr Langdon-Down after whom the Down syndrome was named. When he died in 1898 his son took over and his family members continued to manage the hospital right through to 1970 in the capacity of either medical director or member of the Board.
Dr Lawler who was then appointed as Consultant Psychiatrist, not Medical Director, in a determined break with tradition, proved to be a difficult man. Whenever something went wrong in other hospitals he demanded wholly disproportionate responses. He severely restricted patient outings after reading a newspaper report that a visitor to a nearby safari park had been badly mauled by a lion. His conduct was reviewed by three wise men as early as 1972 when they wondered about his mental health. His conduct was subsequently reviewed by an independent psychiatrist who found no foundation for this and Dr Lawlor returned to his duties. He displayed an intensive dislike and distrust of nurses.
Dr Lawlor declined to give evidence to the RHA inquiry that followed the strike action and as a consequence a public Inquiry followed, chaired by Michael Sherrard QC. [Cmd 7357]. The Inquiry found that the quality of life of patients had deteriorated as a consequence of a failure by the doctors, nurses and administrators to work together. Hostility between Dr. Lawlor and almost everybody else was the principle cause. The Health Authorities should have intervened much earlier than they did. They had also ignored warnings from external sources that “the nursing staff at Normansfield had lost their way”, that morale was low and the hospital was in a poor state of repair. Many of the problems grew worse as they were ignored.
The Inquiry found that Dr Lawlor had made the very worst of an already poor situation. He was hypercritical of the nurses and adopted and enforced an obsessively protective attitude towards patients whose lives he needlessly and harmfully restricted. He was fettered by his fear of personal censure and of being held responsible for any and every occurrence. His intolerant, abusive and tyrannical regime drove new staff away. The local administrator was frightened of him and lacked initiative and drive. The Area and Regional Authorities should have intervened. They “watched the nettle grow but were not prepared either to grasp it at an early stage and to root it out or take other steps thereby weakening the prospects for healthy growth “. Only the Community Health Council, who had worked hard on exposing the problems at the hospital, emerged from the Inquiry with any credit. COHSE was roundly criticised for a strike that should not have taken place as its officials had broken the union’s own rules, misled the rank and file of their membership and then blamed the nurses. The regional secretary had fomented the idea of militant strike action.
The Inquiry recommended that Dr. Lawlor should be sacked and never allowed to work in the NHS again. The same harsh judgement applied to a number of senior nurses and administrators.
The members of the NHS Boards involved at both Area and Regional levels were left with a message that applies today:
The “ duty of the members goes well beyond what happens in the Board room .They have a responsibility to satisfy themselves personally that the standards of care and the living and working conditions provided in their name are not merely adequate but are the best that can be provided with the resources at their command.”
The hospital closed in 1997.
Earlier stories in the Dark Corners series can be found in Guest Editorial or here: