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BMJ. 2007 June 16; 334(7606): 1279.
PMCID: PMC1892508

William Bingham

William (“Bill”) Bingham qualified at Queen's University, Belfast, in 1941 and, after accelerated six-month posts on the house at the Royal Victoria Hospital (RVH), he joined the Royal Naval Volunteer Reserve (RNVR) and served on rescue ships with the North Atlantic convoys. These were small ships, often converted coastal packets, which were certainly not designed for the Atlantic and which steamed behind the convoys with the task of picking up survivors from torpedoed ships so that the merchantmen and their escorts did not have to stop. The naval surgeon provided resuscitation and medical care to survivors and delivered any other medical care required to the ships' crews in the convoy, sometimes having to cross between ships in whalers in high seas. But because the rescue ships had to heave to to pick up survivors, they made easy targets for the German U-boats and the attrition rate was high, most being sunk. Bill Bingham was lucky to survive. He saw subsequent service with Combined Operations and commanded his own landing craft, converted into a mini-operating theatre, in which he participated in landings on the Dutch coast when Field Marshal Montgomery was attempting to stop the Wehrmacht from escaping across the Scheldt in the winter of 1944. After subsequent service in a destroyer, he ended the war as principal medical officer for the Mediterranean Fleet aboard HMS Orion where other Queen's men in the Fleet, including Jack Pinkerton, served under his command. He was demobilised in 1946.

Back in Northern Ireland, after a spell in general practice in Bangor, he recalled the training in resuscitation (for the dreadfully injured, burnt, and hypothermic seamen in the North Atlantic) he had received from Dr (later Professor) Alec Forrester in Glasgow, when his ship was refitting, and he decided on a career in anaesthetics, being appointed to Lurgan and Portadown Hospital in 1948. He had never intended to stay in Lurgan for more than a few years but, because of the death of a colleague, the mental ill health of another, and the suspension and subsequent resignation of yet another, the Northern Ireland Hospitals Authority asked him to remain to steady the ship—in the end he stayed for 13 years. During all of this time he was the only anaesthetist in Lurgan and, initially, had to cover Banbridge Hospital as well as the maternity hospitals in Portadown and Armagh and, occasionally, Daisy Hill Hospital in Newry and the County Hospital in Omagh. This meant that he was permanently on call for 13 years without respite—unimaginable today.

During his time in Lurgan, in the days when the British Medical Association (BMA) was a proper association and not yet acting as a trades union, he succeeded in getting agreement for the amalgamation of the Armagh and Down divisions of the BMA and was the first chairman of the new combined division. He was one of the principal proponents for the building of the new Craigavon Hospital, eventually constructed after he had left, but he liked to say that the final agreement in principle was reached in his garden.

Bill Bingham was the first specialist anaesthetist appointed outside Belfast, and he trained up several young men there who subsequently became distinguished anaesthetists. In Lurgan at the time there was no paediatrician and, because he had undertaken his MD in paediatrics, he was involved in the management of the children in the hospital for some years. Nutrition in the population around Lough Neagh was poor in those days and the caesarean section rate was high owing to cephalopelvic disproportion. The anaesthetic arrangements in obstetrics were very basic in the 1950s, and he decided to develop a more rational and scientific approach, which he described in a seminal paper in 1957—balanced anaesthesia for caesarean section. This paper was widely referenced and the method described became the standard of care around the world; indeed, the paper was selected as one of the most significant anaesthetic papers in the preceding 50 years and was republished in Anaesthesia a few years ago.

Cases of tetanus in Lurgan had, previously, been managed by the surgeon, but in 1950 when he was on sick leave the management fell to Bill. The first case was inextremis with opisthotonus, and he decided that the best course of action would be to paralyse the boy and ventilate him. This was before the advent of ventilators so a rota was drawn up of the housemen and other staff, among whom was R C (Bob) Gray, to continue the “bagging” over several days. The boy survived and 12 further cases were managed in a similar way. Word reached Belfast and the professor of surgery, Harold Rodgers, asked him to talk at the RVH. The hospitals authority established a committee consisting of the professor of medicine, Graham Bull, the professor of therapeutics, Owen Wade, and Bill Bingham to draw up a plan for a respiratory failure intensive care unit at the RVH. This took some time in materialising but did eventually open with Bob Gray as its director. It is interesting to observe that this approach was two years in advance of similar management in Copenhagen, when Bjorn Ibsen, another anaesthetist, also ventilated cases of poliomyelitis with bulbar palsy and received international acclaim for so doing. The polio pandemic of the early 1950s also affected Northern Ireland, and cases in Lurgan were managed in this way before being transferred to Purdysburn. Thus Bill Bingham was the originator of respiratory intensive care in Ulster.

On returning to Belfast in 1961, he was involved in the commissioning of the new Ulster Hospital the following year. He modernised obstetric anaesthetic practice at the Royal Maternity Hospital, including neonatal resuscitation, and played his part in establishing the neonatal intensive care unit at the Ulster Hospital. Anaesthetists in the Royal at that time were not keen on anaesthetising elderly patients in need of emergency orthopaedic surgery. Bill Bingham was prepared to do so, and indeed previously had written a paper on operability in the aged. The orthopaedic department was grateful for this assistance and, for many years, he undertook a Saturday morning list with them and helped them out at other times. When Terence Kennedy developed an interest in surgery for the removal of phaeochromocytomas, he worked out a scheme for cardiovascular control in these difficult cases and published it in Anaesthesia with Jimmy Elliott and Morrell Lyons.

He built up a substantial anaesthetic private practice, the largest in the province according to BUPA at the time, but decided when he was 55 years old to give it up and concentrate on other professional activities. As treasurer of the Ulster Medical Society he was responsible for selling off the Whitla Institute, adjacent to RBAI, which had been willed to the society by Sir William. Its maintenance was becoming a financial burden to the society, but many of the senior medical men in Belfast were opposed to its sale and it took considerable tenacity to gain approval for its disposal. Later, he was vice president of the society. He was an examiner for the final FFARCSI at the Royal College of Surgeons in Dublin for 10 years, became chairman of staff at the Royal Maternity Hospital and at the Ulster Hospital in its centenary year. With one of the early reorganisations of the health service, piloted in Northern Ireland in1974 before being introduced in England, he became the first chairman of the medical advisory committee of the area health authority (Eastern Area Board). He and the public health physician who acted as his assistant, Dr Harry McNeilly, produced a number of documents and plans, including the Bingham report on the future of maternity services in Belfast.

Bill Bingham was a man of his generation; he, like more than 70% of the profession, had voted against the establishment of the NHS (for honourable reasons) but, when the scheme was railroaded through by Aneurin Bevan, he and his contemporaries accepted the fait accompli and worked extremely hard for it and well beyond the call of duty. They didn't expect thanks and didn't receive any from their political masters who took any credit going, but they felt that the practice of medicine was a privilege and acted accordingly. He was loyal to his family, to his colleagues and friends, to his hospitals, and to his college. He was pleased that three of his children followed him into a career in medicine, although, sadly, one of his sons predeceased him.

Notes

Former consultant anaesthetist Royal Victoria and Maternity Hospitals, Ulster Hospital, Belfast (b 31 May 1916; q Queen's University, Belfast, 1941; MD, FFARCSI, FRCA), died from bronchopneumonia on 21 March 2007.


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