Long and winding road
As the NHS celebrates its 60th birthday this year, it’s worth pausing to reflect on how our own organisation has grown and developed alongside it. HefmA President Bill Murray offers his thoughts
Looking back to the start of the NHS in 1948, one cannot but marvel at the changes that have taken place. Then the life expectancy of a male was about 70, today you can expect another 10 or more years on that, and many are now living to over 100.
Medical technology has obviously played a major role in these improvements, but do not underestimate the role the Estate and its staff have played.
When I was asked to write this short piece about the genesis of HefmA, I wondered if there was much of a history to it. But on listing the organisations that had gone before, I soon realised that I had belonged to all of them.
The memories came flooding back recalling many fine colleagues who had worked so hard and given so much to improving the physical environment for patients and staff.
My recollection of exact dates is rather dim so apologies in advance for any errors, it’s a start. Seriously, though, all such information should be catalogued properly, with correct dates, titles, list of chairmen etc. I am happy to edit all this if individuals will write to me with more details. It can then go on the HefmA web site and be updated as time goes on.
My first recollection of a national association was with the National Association of Group Engineers. I was 28 and I believe I was the youngest group engineer in the UK. The Northern Region was silly enough to vote me in as its national representative.
Once a month off I would go to the meetings at 40 Eastbourne Terrace, Paddington, home of the four London Regional Health Authorities. The year was 1968. I have no idea when the association started, but life was slow in those days and little changed year on year, so it must have started between 1947 and 1965. Does anybody know?
At this time many of those employed as group engineers (one of the three chief officers at Hospital Management Committee level) were ex-chief marine engineers and like me many were also responsible for building and surveying as well as engineering. Some committees employed a separate building supervisor.
Then, in 1974, came the first of the NHS reorganisations. Out went Hospital Management Committees and in came Area Health Authorities, much larger organisations headed on the estates side by an area works officer. This reorganisation, from an estates viewpoint, brought together for the first time the disciplines of architecture, engineering and surveying under a team of chartered people.
Many group engineers gained promotion to these posts, I was one, and we made sure the old Group Engineers Association formed the core of a new National Area Works Officers Association. They, too, met regularly at 40 Eastbourne Terrace, (we ad found a good pub for a ploughman’s lunch – how times have changed). ABBA won the Eurovision song contest and were top of the hit parade with Waterloo.
The engineers were in the majority, but only just, with architects and surveyors making up the other member disciplines.
These were exciting times, with the birth of the major hospital building programme. Regional Health Authorities employed very large numbers of design staff, as many as 250 per region. Getting hold of capital was not so much of a problem, but getting the proper running costs for these new high tech hospitals was, hence later a backlog of maintenance problems, (we did tell them!) Again, I spent I think two years as its national chairman
Just eight years later and guess what? Yes, another reorganisation. It’s now 1982 and the 1974 version was thought to be a failure, with confusion between the Area Health Authority and its District based management teams. It may have been the right decision for general management, but it was disastrous for estates.
Marvin Gaye was in the hit parade with Sexual Healing, rather appropriate for the NHS.
As usual, estates people were adaptable, they collectively took a deep breath and moved on. The Area Works Officer Association changed to The National Association of Chief Works Officers at District Health Authorities - nice snappy title? I found myself as its first National Chairman.
And yes, we continued to meet in London at Eastbourne Terrace and formed very strong relationships with the Department of Health. The task was to press ahead with replacing old and outdated buildings and start to establish a proper primary care system that worked with the hospitals, not fighting each other.
Great work was achieved over these years, with departmental data sheets and other documentation and standards becoming the envy of the world.
In 1988 we saw the emergence of hospital trusts with all their new autonomy. I joined the excitement of this new world and became the chief executive of South Tees NHS Trust, a major tertiary centre in the north of England, sadly moving away from directly managing the estate. The DWO Association widened its remit to embrace the new movement, inviting directors of estates from each trust to join.
At this time thoughts were turning to new ways of running and maintaining the estate. In the US many were merging all the disciplines associated with the physical environment into one organisation called ‘facilities’.
The leading figure in introducing this concept into the NHS was Ceri Davies, later to become Professor of Facilities Management at Reading University. Ceri was then at the Department of Health and worked hard to establish the facilities management philosophy into our service.
At South Tees we were happy to pilot these new ideas and Andy Collingwood, an old friend and my director of estates, became an enthusiastic advocate, later becoming one of the first chairmen of HefmA.
So catering, laundry, cleaning, portering, telephonists etc joining all the other building and engineering disciplines. Only the PFI initiative a little later modified some of these unifying ideas.
Over the years we saw the emergence of the ‘patient-led environment’ and ‘putting the patient first’ and it was estates and facilities that took the lead in this new approach to quality.
And so Hefma was born. Although it is worth noting that also during this time span the Institute of Health Engineering and Estate Management (IHEEM) and the Regional Engineers Group were also very active and working with and alongside the associations I have discussed above.
And now here we are in 2008 at the 60th Anniversary of the NHS.
Having been an active member of all the other national associations I now find myself president of HefmA, which for me is the final link with all those other associations and which I feel qualifies me to comment on how the present team lines up.
I can say without any hesitation they hold the baton well. Those that have already passed though its predecessor organisations would, I am sure, be very content and happy with how it has developed and is developing.
Under the chairmanship of Kevin Oxley and all its members it is in good hands and enhancing the estate for patients, carers, staff and the general public.
The challenges for facilities staff in the future are greater than ever.
Public expectations are rightly very demanding, technological complexity is developing exponentially and so much of healthcare today is reliant on the physical environment.
So well done all you estates people both past and present and good luck for the future. You have a proud tradition of service to follow.
