IN 1950s Glasgow, an argument over a fish supper led to life-threatening injuries for one hardened criminal.

Dr Roy Miller, now 86, was a young medic training at Glasgow Royal Infirmary long before Accident and Emergency became a standalone department when he encountered the grisly consequences for himself.

"As a medical student you were allowed to do things that you can't do now," he said. "I haunted the casualty departments and I was allowed to do simple stitching and bandaging. I learned quite a lot in my own time.

"As there were no Accident and Emergency units in the hospitals, each surgical or medical unit had to take a 24-hour spell running the casualty department.

"They would come in with a great variety [of ailments]. One I remember was a safe-blower who mistimed his bomb to go off and blew off both hands and half his face. We admitted him to the ward, stopped his bleeding, put a drip up, sedated him, and we were all tired so we left him in peace.

"In the morning, on my way to breakfast, I saw that the Daily Express had 'Surgeons Fight All Night to Save Life of...' whoever. And this was one of the worst rascals you ever came across.

"What had happened was he was refused service in a fish and chip shop, so he found his bomb, went to the back door of the fish and chip shop, tried to tear off the netting that was protecting the window, but took too long so the bomb went off in his hand.

"He was seen in the streets thereafter begging with no hands and half his face away saying he was 'war wounded'."

HeraldScotland: Dr Roy Miller

Dr Miller began studying medicine at Glasgow University in 1950, just two years after the NHS was formed. His class of 200 had just 30 women and competition for entry was fierce.

"Of about every eight to ten applicants, only one was admitted," he said.

When he first began hospital-based training, three years into his studying, the NHS was a mix of general hospitals and separate, specialist hospitals: eye hospitals, maternity hospitals, mental hospitals, and fever hospitals for infectious diseases such as polio and smallpox.

Glasgow was also ringed by sanatoriums for tuberculosis, which accounted for 6.2 per cent of all deaths in Scotland in 1948.

HeraldScotland: Mass chest X-ray in Glasgow in the 1950s

Dr Miller said: "There were a great number of sanatoriums. Men with pulmonary tuberculosis lived practically out in the open under red blankets on verandas and, because TB was so rife, Glasgow ran a mass miniature radiography screen which picked up so many tuberculosis patients that were unknown.

"And it happened to be coinciding with proper treatment for tuberculosis - streptomycin - so that many people could be cured. Strangely enough, at the beginning of the health service the only beds we were short of were beds for tuberculosis.

"But of course with all these mass vaccinations and immunisations, there was less and less need for fever hospitals so they shrank and shrank until now each major hospital has maybe only one ward which treats infectious diseases."

HeraldScotland: Nye Bevan visits a Glasgow hospital in 1948, accompanied by the 'matron'

Hospitals were also run very differently when Dr Miller embarked on his career.

"The hospitals from day to day were run by the matron and the medical superintendent. The matron was in charge of all female staff. Nurses began their training as young probationers, as teenagers, and over the course of their stay they were taught by hospital teaching departments.

"At the end they were given a badge which was individual to each training hospital and they wore that badge with great pride. They used to say that their particular training hospital was 'the best' in the world.

"The medical superintendent was in charge of all the medical staff, including the pathology department and other specialists.

"He was also in charge of the people that made sure the hospital ticked - the electricians, the storemen. And, of course, the great thing was that the buck stopped with them [the matron and superintendent].

"They would regularly meet together with the hospital oblique secretary to discuss what was going on with the hospital.

"Also the most important maid within the hospital at that time was the ward maid. They competed with one another to see who had the cleanest ward - it was unofficial, but they did it.

"Once a week all the beds were brought into the middle of the ward and the place was cleaned from top to toe and everything put back in place.

"They were a great liaison with the patients. They would communicate with the patients, take messages for them, put bets on for the men, check patients were eating and they could also tell the ward sister quietly about any problems that the patients weren't keen to tell medical staff about.

"They were held in the most high regard."


By the 1970s, ward maids were being phased out as catering was out-sourced, nursing auxiliaries became more common and matrons and medical superintendents - who not only oversaw the running of hospitals, but how to spend their budgets too - were axed as the running of hospitals shifted from medics to an executive team.

"It was taken out of medical hands," said Dr Miller. "The centralised bureaucracy increased and the voice of the doctor has become less and less important."

Dr Miller, who now lives in Cambuslang and is the Honourary Librarian for the Royal College of Physicians and Surgeons Glasgow (RCPSG), retired in 1994 following a career as an ENT (Ear, Nose and Throat) consultant, initially at the Victoria Infirmary in Glasgow and later in Lanarkshire, where he was one of only two ENT consultants covering the region when he took up his first post in 1968.

He went on to head up the ENT Department at Monklands Hospital from 1978 until his retirement.

Dr Miller said the decades brought "tremendous" advances for medicine - but the challenges for the NHS never end.

"In the early days investigation was quite primitive - you had X-ray. But then there was ultrasound, initially for maternity but now ultrasound is used in all sorts of problem cases.

"Cardiac surgery has developed tremendously. Coronary care has evolved tremendously, drugs have improved, we can cure so many things that were incurable.

"MRI and CT scanning - that is tremendous. The general acceptance of how to deal with head injuries. The Glasgow Coma Scale was a wonderful thing, and it's still used after 40 years after it was first propounded."

"But as soon as you get rid of one set of infections, another comes up. We learned to live with venereal disease - syphilis and such like, we had that more or less under control. Then HIV/AIDS appears. Then there's things like Ebola fever.

"It's almost like a half-filled air cushion - you push down one part and the other side comes up. You wonder if you'll ever win, and I don't know that you will."

Asked if he would still choose to be a doctor if he was 18 today, Dr Miller added: "When I was young, the idea of the hours worked or the remuneration did not bother me. You think about those single-handed GPs, the hours they worked were ridiculous. Now of course people will not work those hours.

"Would I be a doctor again? I think I would. It's a great life and the greatest thing about being a doctor is there is an opportunity to follow all sorts of lines of treatment and investigation and career avenues.

"If you don't want to talk to patients you can become a pathologist, look at slides all day, or if you are good at mending things you can become an orthopaedic surgeon.

"Joint replacement is such a great boon to people these days. Before people were just put in a splint and they ended up with a stiff joint and either limped or had a crutch. So much has changed."