Sixty or seventy years ago, poor country families were often forced to rely on the amateur health care offered by the untrained and unpaid village 'nurse' rather than go to the doctor when somebody fell ill.
But although calling the doctor was an expensive business, there were ways in which ordinary people could afford the occasional professional care, and this week, our series on Health looks at the role of the village doctor, his place in the local community and the variety of services he had to give, from dentist to dispenser of medicines.
Although regarded with great affection and esteem, the country doctor was not well paid, largely because few people could afford to pay him and bills were often never presented, or never paid:
"We owed a bill of £5 and my husband went and did his gardening and worked it off. They sent you very little bills in - my mother used to say, 'How much do I owe you, Doctor?' and he said, 'Now then, I'll make the rich pay for the poor', and he never sent them a bill.
Some families paid two shillings a month into a club fund to pay for the doctor:
"The doctors were really poor - well, you see they didn't get much at two shillings a month off a family, did they? I know I used to collect it for the old doctor and it was only 28/- to 30/- a month I could give him."
Before the National Health Service provided free medicine for all,many people subscribed to organisations like the Oddfellows to pay for their medical bills, and to help provide a small income during times of sickness; there was no sick pay in those days. And if a doctor was needed, he usually visited the patient rather than the other way round:
"The doctors were different to what they are now, if there was anybody really ill, they would come and see them, it wasn't the policy to take sick people on stretchers and in wheelchairs to them. They used to come and see you in those days, at home. They seemed to like moving about and they always thought it their duty to do so, I think. People who were ill were really ill. And what happened was, you see, in those days, most people were in a Friendly Society - some were in the Sons of Temperance, some were in the Oddfellows, some would perhaps be in the Foresters and Hearts of Oak. That's why Friendly Societies got so strong, because people were totally dependent for sickness on them; there was not a lot of places you got your wages made up and it was something of a calamity, it was really bad if anyone was off ill any length of time. There was no DHSS propping you up much; you just got your sick pay for so many weeks, but you could get permanently sick. But that augmented the sick pay, you see, what you got off the Friendly Society and also against doctor's bills. Most of the old family doctors had a system whereby the wife - if she didn't work, and she wouldn't work where there was children, and the children were covered by a private card, you paid so much a month. I used to go and pay it to the doctor's. I donT know whether they chopped it up to make it easy, whether it was a month or every six weeks, so many shillings you took, and it was an insurance against if you were ill, and you got free treatment. And we were always on that, and m'father was in the Friendly Society and that's how people carried on. They had to do something, they had to have some safeguard to take the sting out of illness, and that's how people existed."
Country doctors had to deal with every sort of emergency, in addition to making up their own medicines and dispensing them, carrying out simple operations, pulling teeth, removing tonsils, and even sewing the odd finger end back on after an accident at the sawmill:
"The doctor would do everything in the medical world, everything to do with the body. You took it home with you, the bottle of medicine, you didn't get a prescription. You got it from the doctor there and then. And they used to come round more to you, and they almost always came two days after without asking, where you wouldn't get that today, would you?...also the doctor used to pull your teeth out as well. I can remember going along once, it was a bit slack, I was stood up there, and he said "Sit down there" and he pulled it out there and then. He didn't put anything in it first, was I glad to get out of there!"
If you missed the visiting dentist, the Ambleside doctor pulled teeth on a Wednesday afternoon at a shilling a time:
"If you had toothache you had a mustard plaster put on, then you had to walk all the way to Ambleside and it was a shilling just to get your tooth out, just pull your tooth out! And they make such a fuss today. My grand daughter came in - I said, 'What's one tooth? I had seventeen out all at once!"
The doctor's working life revolved around his house, where surgeries were held two or three times a day, and where his long-suffering wife worked day and night as receptionist, first aider and telephonist. Most small country practices were single-handed, and the doctor was on call all day and every day, including weekends, with perhaps only one half day off a week. Holidays were few and far between:
"It was a frightful business getting a holiday. We were allotted a fortnight a year, and as for weekends, they didn't start until after the last War - before that it was Wednesday afternoon, from lunch until we came back, and very often when we came back, things were waiting for us. The great thing was to get away and fish somewhere or do something quietly on the mountains where you couldn't be caught up with messages."
"The practice was in our house, of course. It was a fulltime job, I mean, when you had to fill in forms, I didn't sign myself 'housewife', I signed myself 'doctor's wife' because we were on duty all the time. We never emptied the house, we always had somebody on duty. Telephone, reception, connecting with him when he'd taken his list and gone off up one valley, he'd have to contact us before he left that valley in case there was something urgent had come up and you got at him through the telephone exchanges because they were manned by people who'd say, 'Oh yes, wanting Doctor? Well, he's just gone across to Mrs Robinson - would you like me to fetch him?'
"They dealt with many more emergencies. They did the little things, the stitching up, the setting of things, they had their own X-Rays in Windermere, and a great deal more accident treatments were done on the spot. They would go out to these things. They went out to everything."
There were different coloured bottles of medicine sometimes, depending on whether you were a private patient, or on the 'panel'; but whatever the colour or content, it usually did the trick:
"The only thing with the Oddfellows was that when you sent to see a doctor,he asked you if you were on the panel or a private patient. And when you said you were on the panel, he didn't give you the same medicine as what he did if you were a private patient. You got cheaper medicine. In fact, when they're talking about the Health Service now and making these drugs a lot cheaper, they want to go back to those days when the doctors gave cheap medicine and all you got when you think about it, if you had an upset tummy or anything like that, you got a bottle and it was coloured water. And that was the psychological thing it had on you. You supped that and you thought - 'By gum, I feel better!' And that's why you thought such a lot of your doctors in those days. You looked up to them same as you did your clergyman, your policeman. It was different altogether."