Book Review

Abstract

Peter K Leaver The History of Moorfields Eye Hospital: Forty Years On Volume III 348 pages RSM Press , Abingdon, Oxon , 2004 ISBN 185315 580 2 Price: £30.00 Moorfields Eye Hospital in London celebrated its bicentenary in 2005. It is a remarkable institution; it serves London on an everyday basis, provides consultative care nationwide and has served as a prominent global leader in ophthalmology for two centuries. However, at the same time it has managed to maintain its reputation for being friendly and accessible; it is a place that is easy and comfortable to visit. Previous histories of Moorfields were written by Treacher Collin (1929) and Frank Law (1975). The third volume, Forty Years On, published in 2004, is written by Dr Peter K. Leaver, a long-serving consultant in vitreoretinal surgery at Moorfields. During those 40 years enormous changes have taken place at Moorfields. In 1967 the hospital discharged 7400 patients from 345 beds; in 2000 it discharged 14 300 from 80 beds. There were 18 consultants employed at the hospital in the early 1960s; today there are more than 60 members of consulting staff. Attitudes have also changed: in the 1960s, writes Leaver, ‘consultants often behaved like gods, while hospital matrons were usually queenly figures’. The central message of the book for all of us who work in ophthalmology concerns not simply how patient care has evolved at Moorfields, but how the doctors at the hospital have led the major changes all the way! Many members of staff have been involved, but key players such as Professor Barrie R. Jones, Dr Noel Rice, Dr Robert Cooling and house governor John Atwill had the foresight, knowledge and energy that kept their thinking ahead of that of politicians and bureaucrats. There used to be two Moorfields hospitals in London, one on City Road and the other at High Holborn. There was also an academic institute at Judd Street. These were all united in one place, in 1988 and 1991, at City Road Hospital. At the time merging hospitals was not a popular practice; Moorfields was ahead of its time. It also took a lot of courage to transform the hospital from an ‘esoteric centre of excellence’ (and provider of tertiary care) into a centre of ophthalmic primary care for London. However, it is because of this that Moorfields Eye Hospital has survived as an independent and expanding institution, with an international paediatric eye centre now in preparation and opening next year. The research carried out at the Institute of Ophthalmology has scored consistently highly in international ratings since 1990. This book is divided into four parts. The first gives a general account of the development of the hospital. Part two contains a more detailed description of the clinical, nursing and clinical support services, describing each subspecialty in turn. Part three represents academe, divided into medical education and research. Finally, part four describes the organization of Moorfields, its management and administration, finance, fabric and infrastructure and the Moorfields Alumni Association. Peter Leaver's description of events is lively. His text is never dull and his accounts of the political battles fought convey the excitement of the times: you want to know how it all ends! The text is comprehensive and understandable, even for readers who do not know much about health politics in the UK. I enjoyed this book. Leaver writes a very readable text and his account is authenticated by the fact that he was there when it all happened. The book is flavoured with interesting and amusing anecdotes about everyday life in the hospital and illustrated with good colour photographs that depict longstanding doctors and support staff alike.