"A hospital is where you need a bit of comfort," believes Pam

Natasha Lewer

Shaker and mover

By Natasha Lewer

Scholarship girl

Pam Hibbs was born in 1935 and brought up in Kent, Wiltshire and Hampshire. An academic high-achiever, she knew early on that she wanted to go into nursing, and at the age of twelve applied to St Bartholomew’s Hospital, or Barts as it is more commonly known. The matron there told her to come back in a few years, when she had finished her education. After completing school, followed by a short spell as a cadet nurse at Southampton Eye Hospital, Pam went to Barts to do her training, going on to work in the intensive care wards at St Mary’s Hospital and as a health visitor in rural Berkshire. She subsequently returned to Barts to be a ward sister and nursing officer, while also working as a night superintendent at St Leonard’s Hospital.  

A terrible state

Pam was in her late thirties, and very experienced in leading and managing nurses, when she was asked if she would go to Hackney Hospital for six months in order to help shake up and turn around what was then a neglected and failing institution. There had been public criticism of Hackney Hospital and the care that was received there. There was a shortage of trained, skilled staff; the equipment was outdated and shoddy, and the buildings were in a bad way. The nursing school had been threatened with closure, and local people were calling for a public enquiry: “To see a hospital in that state was terrible,” Pam recalls; “I was pretty shocked.”  

Pam was not keen to leave work that she loved at Barts, but she was told firmly that she was the right person for the job, and should go.  

Sweeping change

It was the hot summer of 1976. On her first day Pam got the wards swept and scrubbed and the linen changed, to get rid of the terrible smell that pervaded the place, and then took a good look at what she could do to help make things better. She took on the role of reformer with enthusiasm, and proceeded to introduce changes and innovations that always had the welfare and comfort of her patients at heart. "It was time to put the patients first," she recalls. By the time six months had passed, Pam had “got engrossed” and had no thoughts of leaving.

Apple blossom outings

Care of the elderly was one of her “passionate interests”, and improving their quality of life was one of her priorities. She applied for a grant from the Mercers, and with the money she employed a social secretary to organise trips and treats that would give them something to look forward to. There were outings at Christmas to see the lights in Regent Street, in the spring to see the blossoms in the Kent apple-orchards, and in the summer to the seaside. Back in the hospital, there were tea parties and art classes.

With the grant from the Mercers, Pam also set up a ground-breaking research project into pressure sores. She had been shocked, on arriving at Hackney Hospital, to find that the incidence of hospital-acquired pressure sores was as high as 25%. She was determined to find out why they were so widespread and what could be done to improve the situation. The project was a great success, and by the time she retired in 1997, the incidence rate had been reduced to less than 2%.  

New clothes

Before Pam arrived, the hospital had been run by a manager who took pride in his ability to save money. Pam liked to do the opposite: to spend money, for the good of her patients. “They’re your patients, and you get the best for them,” she believed. Pam bought new beds and chairs for the wards, and new clothes for the elderly patients – which they could choose for themselves – to replace their institutional garb. For the first time patients had lockers to store individual possessions in. She bought a Coke machine and a fish tank for the Accident and Emergency department, and borrowed pictures from Hackney Library to put on the walls. She would have liked to have given them a garden, preferably with a duckpond – somewhere to sit in the sunshine – but there was limited open space at Hackney Hospital, and at this time no greenery at all.  

Plans were already underway to close the hospital down and move its departments elsewhere. Pam agreed that it was a good idea to move to a new site, to get away from its workhouse associations with degradation and poverty and to make a new start. But she felt strongly that the move was no excuse to allow the hospital to deteriorate further, and that it was vital to maintain high standards. She believed that “If you make an effort – if it’s clean and neat and tidy, with good working equipment – then you notice a big difference in people’s behaviour.”

Out on strike

It was hard work, and often Pam would find herself called out of bed and driving to the hospital in the middle of the night to sort out a problem. She remembers a fight in A&E that culminated in the police arresting everyone on the scene, staff and patients alike. At one time the hospital was affected by industrial action, when catering staff, porters and laundry workers all went out on strike. Pam was determined to keep the hospital running and the patients clean and fed, even if this meant working the laundry machine herself and buying fish and chips all round. She was adamant that the nurses would not walk out and abandon their patients, despite being denounced on a striker’s banner as a “bullying nurse manager”. 

But though she might be firm with the nurses in her charge, she was always a soft touch when it came to patients. “I didn’t see the point of strictness,” she says; “I got worked up about infection, but not about rules.”  

Police and thieves

Hackney Hospital had an informality about it – particularly after the staidness of Barts – and also a sense that anything could happen. “There was a different thing happening every day,” remembers Pam. “It was a unique environment, so different from anything before.” She recalls the psychiatric patients, “wandering around all over the place, always causing problems.” She remembers villains, incidents involving the police, and petty thieves – her eyes sparkling, she tells a story about a time when they ran short of patient gowns, until one of her staff found them for sale in Ridley Road market, at a pound each, with Hackney Hospital clearly stitched inside. But above all she recalls the “delightful, funny, entertaining” patients, the extremely likeable staff, and the strong sense of the hospital both as a community, and also rooted in the local community. She thought it "was such an interesting place to be."

The next move

Local people, and their local needs, were of primary importance to Pam. When the plans began to be drawn up for the new Homerton Hospital – which superseded Hackney Hospital – she played an instrumental part in its design. A team was set up in 1978, including architects and representatives from the Department of Health, to decide how it would be organised and what it would look like. One of the things Pam did was to contact a “wonderful group” of old people in the area, who came into the hospital to talk to patients about their likes and dislikes. They found that elderly patients hated being shunted off to the day room every day, with its incessant television and tedium; they wanted to be part of the life of the ward, to be able to see what was happening and who was going in and out of the door. They also wanted room around their beds for mobility aids. Pam made sure that the new designs for the Homerton took their wants and needs into account.  

Clearing the clutter

Homerton has the bright wards and spacious feel that Pam aimed for: “It’s an attractive place,” she says, “though not perfect.” She never got her duck pond and landscaped garden for the patients, but on the whole, she believes, “it works well, and the community likes it too.” When the time came to move in to the new, state-of-the-art hospital, Pam was there to mastermind the changeover and prevent the nurses from "taking their old clutter with them." She believed that this was a new beginning, and that the staff would have to learn to work differently now.

Pam was based at Hackney Hospital for eight years, until 1982, at which point she became Chief Nurse of the Hackney Group of Hospitals, based at Barts. In 1993 she was asked to be Chief Nurse of Barts and the Royal London Hospitals. She found it quite a wrench to leave Hackney completely, after being rooted in the borough for so long, but was confident that she was leaving behind a wonderful team of nurses whose professionalism and enthusiasm she had helped to develop.

Buckingham Palace

In 1986 Pam received an OBE for her work with old people at Hackney Hospital, and ten years later she returned to Buckingham Palace to receive a CBE for her subsequent work at Barts and the Royal London.

Pushing the boat out

Although she retired from the NHS in 1997, Pam is still very involved in healthcare, in particular the areas of palliative care and the care of the elderly. Since retirement, she has worked in the prison service, helping to improve healthcare for prisoners; she has sat on Fitness to Practice panels with the General Medical Council; and she has been involved in enquiries about failing hospitals. She has been a trustee and chair of the charity Counsel and Care, which gives advice to older people and their carers throughout the UK. And she is still intimately connected with Hackney, where she is chair of the board of governors of St Joseph’s Hospice, and a trustee of Hackney Parochial Charities.

“There was a lot of pushing the boat out in Hackney, a lot of new things going on,” she recalls, of her time at Hackney Hospital.  “It was a great time, when I felt anything was possible.”  

Click here to listen to Pam Hibbs talking about her experiences at Hackney Hospital.