History of geriatric medicine in the UK: birth of the BGS
Trevor Howell was originally a general practitioner whose interest in elderly medicine was stimulated after he became responsible for the Chelsea pensioners. He was appointed consultant physician at Battersea and subsequently opened one of the first geriatric units there. In 1947 he called a meeting to bring together physicians and an orthopaedic surgeon (Lionel Cosin), who all had a special interest in older people. They had skills in rehabilitation, incontinence management, and domiciliary assessment.
People present at the inaugural meeting of the Medical Society for the Care of the Elderly (later the British Geriatrics Society):
Lord Amulree: member of the Ministry for Health. First president of the British Geriatrics Society, a position held for 25 years. He developed the geriatric unit at St Pancras Hospital in London.
Eric Brooke: physician superintendent at St Helier’s Hospital, Carshalton, and later consultant geriatrician, Southampton. Originator of domiciliary assessment and pioneer of outpatient rehabilitation.
Alfred Mitchell: physician superintendent of St John’s Hospital, London.
Lawrence Sturdee: senior medical officer at the Ministry for Health who chaired the first meeting. Major interest in public assistance institutions.
Thomas Wilson: deputy superintendent of St John’s Hospital. First treasurer of the British Geriatrics Society and became the first consultant geriatrician (in Cornwall) appointed to the NHS.
Other attendees were: George Adams, Lionel Cosin, Trevor Howell and Marjory Warren.
The meeting was the first of the Medical Society for the Care of the Elderly. Nascher’s term “geriatrics” was revived in 1959, when the society was renamed the British Geriatrics Society to emphasise the scientific basis of elderly medicine.
This meeting was to begin a revolution in the delivery of elderly care services. These pioneers persuaded the Minister of Health to appoint more geriatricians as part of the hospital consultant expansion of the new NHS. Following Marjory Warren’s example, frail or disabled patients were to be under the care of a geriatrician and comprehensively assessed by an interdisciplinary team. Those who recovered were discharged home; those who were frail but did not require 24 hour nursing care went to long stay annexes. Patients previously thought to be “senile” or disabled were reassessed, and often found to have modifiable organic disease; many could be rehabilitated. As older patients returned home, there was more space on the wards, which were repainted and upgraded.
Article authored by: A Barton, G Mulley
Extract courtesy of the Postgrad Med J2003; 79:229-234 doi:10.1136/pmj.79.930.229