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Tales of the Village: A Doctor Comes to Pucklechurch
Though Pucklechurch had long had visiting physicians, it wasn’t until 1966 that the village got its own live-in doctor. Dr Graham Winbolt joined the practice that served Pucklechurch, Wick, Marshfield, and Colerne in 1965 and moved to Pucklechurch the following year. Hundreds of new houses were going up and the village needed its own doctor as the patient register rapidly grew from 400 to 2,400.
Originally from Liverpool, young Graham attended Cambridge and then did his medical training at St George's Hospital Medical School in London. After qualifying, the junior doctor went to King Edward VII Hospital in Windsor. In 1959, however, Dr Winbolt was called for national service, and into the Royal Army Medical Corps he went. He didn’t move far: he became the medical officer for one of the Foot Guards barracks in Windsor, where he served for a year while the Irish Guards were in residence. His next post was Pirbright, at the Foot Guards’ training establishment. Because he was having trouble paying his debts on the 25 shillings a day he earned on a two-year basic contract, Dr Winbolt decided to change to a three-year short-service contract, which paid a whopping 40 shillings (£2) a day. “So in the end, I spent three years with Her Majesty's Foot Guards, and a great privilege it was,” says Dr Winbolt.
In 1962, in the waning days of his Army service, Dr Winbolt again found himself at King Edward VII Hospital for a training course. It was there he crossed paths with a young Dutch radiographer called Reineke. Less than a year later, they were married.
 The young couple moved to Barnstaple, Devon, where Dr Winbolt gained a year’s experience as Senior House Officer (SHO) in obstetrics. When that ended, he became a trainee in a practice in Barnstaple. “It was huge,” remembers Dr Winbolt. “It had about 14,000 patients, and they were spread out over a vast area, so you could spend a whole afternoon doing visits. You drove for miles.” While the trainee doctor was learning to deliver babies in Barnstaple, the Winbolts themselves had their first child, a son.
In 1965, Dr Winbolt joined the practice run by Doctors Henry Eastes and John Wilks in Marshfield, though he soon moved to Pucklechurch to help develop the surgery in the growing village. The Winbolts moved into a 400-year-old house on Castle Road which was owned by the practice, though at that time surgeries were held in the Miners’ Hut. “We did a surgery in the ladies’ lavatory… Well, in the anteroom, not actually in the loo,” explains Dr Winbolt.
The Winbolts bought the house from the practice and took out a huge loan to extend the house and turn the stables into a surgery -- the same surgery we have today. “Everybody told me I was mad,” says Dr Winbolt, “The accountant said so, the bank manager said so, the architect said so. So I thought this must be the right thing to do. By the time we finished the development, it was about twice the cost of the original house. It was a heck of a lot of money." In the spirit of supporting local people and the local economy, most of the building work was done by patients of the practice. Having the surgery next door to his house was a big advantage for a village doctor. "You could always nip in here and get the medical records if you had a night visit, for example," says Dr Winbolt.
The stables become the surgery - 1966
“The practice was actually quite successful because it did everything. Not only did we run the surgeries, we did our own night cover, weekend cover, Christmas cover and all the rest of it. We also did all the obstetrics, all the baby inoculations, all the child care, dispensing… everything. It was marvellous, but it was very hard work. You'd start at 8.30 in the morning and you'd be lucky if you finished by 8.30 at night. And then of course there'd be the night calls, of which there were very few in those days, apart from the obstetrics. We were delivering about two babies a week here, either at home or in one of the local maternity hospitals. The throughput was enormous. We used to cope with it, apart from the emergencies, when we could call on the local hospitals.
“When I came here, it was a much smaller practice [than Barnstaple]… the distances were reduced, so you didn't spend all your time sitting in a car. In those days, the number of visits you had to make was considerable because not everyone had a motorcar, so patients couldn't come to you. There's scarcely a house around here that I haven't been in. The number of home visits gradually reduced. It's a great shame, really, because, whilst it was time-consuming, you did really understand a hell of a lot more about your patients if you saw them at home. But it wasn't time-efficient.
“It was proper medicine we practised here -- hands-on proper medicine. I felt we were a bit under-valued though. If we did minor surgery, which I used to do in a fairly big way here, the going rate under the National Health was £6. At the same time, the consultants in Bath were changing about £200.
"The basic concept of the NHS was a sound one. The trouble is that science crept in. People developed all sorts of new techniques. The way the NHS was run this was bound to happen. Everybody was pushing forward with new ideas. When we started, the idea of a hip replacement was fanciful -- the operation didn’t exist. Now it does, of course, but it takes time and it takes money. You've got knee replacements; you've got shoulder replacements; you've got all sorts of new techniques -- but they all cost money and they all take time. You could argue that the NHS is a victim of its own success. But it was a sound concept -- you could get on with the work without worrying if anybody could afford it or not. Anything that anybody needed they could have. Then the waiting lists got longer. It left a heck of a lot of responsibility on the shoulders of the GP -- how hard you pushed it. It's aggravating for people who really need something to have to sit and wait for so long. Waiting times used to be quite modest. People's expectations were not that high, nor was the threat of legal action against you. Now people know that anything is possible. And the lawyer looking over your shoulder certainly made a difference. People were, on the whole, very grateful for what you could do, which was considerably more limited than it is now. The bureaucracy also crept in -- targets and such. You could see the change gradually take place, but it's accelerated in the past few years. Doctors should do what they're good at. They are good at seeing patients, not filling in forms.
"Reineke was fantastically important. She worked for me for basically nothing. If I was out, she'd answer the phone. When I first started in this practice, we had no assistants at all. We didn't have any receptionists or anything like that. Now there are 15 or 16 of them [across the whole practice]. But in those days the wives of the partners did all that. They were absolutely crucial. We couldn't have run the practice without them."
The practice grew along with the village and changed with the times. At first the surgeries were handled on a first-come, first-served basis: people just queued up to see the doctor. When surgeries went over to an appointment system, some people complained.  "The surgery was abuzz -- everybody was talking to everybody else -- a bit like the post office is today, " says Dr Winbolt. "There aren't many places left where you actually meet everybody else and twitter. Even the pubs have changed. People were far more community-orientated then."
Dr Winbolt looks back on his career as being rewarding but stressful. "I remember at the end of a somewhat fraught day there was a patient I thought I ought to just pop in and see for five minutes. I was a bit tense and tired. She was a funny old lady… her husband had died about a year or two before… and she was still grieving a bit. I was in a hurry, but she said 'Doc, you look tired. You just sit right down and have a cup of tea.' And then she just twittered away, and it was like poetry to sit in this little old cottage and listen. It was just marvellous."
"I always used to go and see patients who had just delivered, at home or maybe at the local hospital. We made a habit of visiting several times in the 14 days before the health visitors took over," says Dr Winbolt. The practice received £15 for a patient's obstetric care, which included the antenatal care, the delivery, and the postnatal care. "Obstetrics was quite entertaining. It is of course a happy time for most people, but if you think about what could actually go wrong, it's an extremely anxious time. The £15 from the NHS wasn't a lot. Even in those days it was a disgrace."
On one occasion, Dr Winbolt was finishing up his visits late in the evening and called in to see one of the local farmers. " It was winter and they were lambing. I walked in to see him standing there amongst these lambs, and he looked just like Jesus Christ," he remembers fondly, "There was far more active farming in those days. It was very much a rural community. The village was occupied by villagers. It's changed now. It's full of commuters. It was different then. Our relationship with our patients was closer."
One of Dr Winbolt's more dramatic emergency calls was to the bell tower of Abson Church. "There was this chap who was up in the tower when he had a cerebrovascular accident [stroke]. I nearly had one myself going up the staircase to get to him. In the end, we had the fire brigade and the fire chief up there too, and the patient was lowered from the top of the church tower down to the ground level in a breaches' boy. He was conscious during all this. I'm pleased to say he survived and lived for many happy years afterwards. That was quite an afternoon's exercise!"
Because home visits were so much a part of a GP's job, weather played a part in determining some of the practice's policies. "We used to have real winters in those days. I always remember coming back from a visit and there was snow on the ground -- this was in my first year -- I was trying to get back to Pucklechurch from Marshfield. The road was absolutely hopeless. I managed to get my car stuck in the snow about a mile from the pub at Cold Ashton. I couldn't move my car any farther, so I thought the only thing to do was get out and walk. So I walked along the road, the A46, and I must confess I was damned glad to see that pub. I thought I was going to die," recalls Dr Winbolt. "I phoned up Henry and he came and rescued me. He was absolutely furious that I got bogged down. He had a four-wheel drive vehicle. Quite soon after, it became a rule in the practice that we all had to have four-wheel drive vehicles. It used to be quite exciting at times. There were times when you just couldn’t get there."
After they moved to Pucklechurch, the Winbolts had two more children, a daughter and another son. They raised their family in the village and sent them to an independent school in Bath. "We had the privilege of living in this nice old house. This village is particularly magic. It's a hugely active village -- there's an enormous amount going on. I remember our number two son winning a prize for his radishes on one occasion. Now that's a village. It was a wonderful, wonderful life… absolutely brilliant. I couldn't have wished for better."
In 1998, Dr Winbolt retired from the practice. He now devotes much of his time to disposing of an electronics collection acquired over the course of 30 years. "The children aren't that interested, and this stuff would be a burden to Reineke if I dropped dead," explains Dr Winbolt. His large assortment of early radios, communication systems, radar systems, and navigational systems includes some rare and important pieces, and many are going to the Imperial War Museum at Duxford and to museums in Europe, Australia, and New Zealand. "It's been great fun," he says. "Now it takes up a huge amount of time. I certainly couldn't afford to work anymore -- there just wouldn't be time. How I managed to put the collection together in the first place, while working and having just a few weekends and half a day a week off, I don't know. Looking back on it, it was a wise thing to do. If I hadn't devoted myself to it with such passion, there would be an awful lot of stuff missing, and it was a very important part of our history."
A village doctor gets to know a lot of people, and Dr Winbolt runs into his ex-patients all the time. "Going around Sainsbury's takes me ages because ex-patients are either loading the shelves or I meet them doing their own shopping. And I was over in Doynton a few weeks ago where a friend of mine was staying the night in a B&B. The lady who owned the establishment turned up, saw me, and said I had delivered her daughter. It wasn't a straightforward birth, so we heard all the hairy stories."
Dr Winbolt now looks back on his life with contentment. "It's been a hugely satisfying life. The pressure was quite a lot at times, but thinking back on it now, it was what I always really wanted to do. This is a super village… super people… super life. That sums it up, really. I hope I can survive for a few more years to enjoy what is now a wonderful life."
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