....co-pioneer of geriatric orthopaedics in Hastings

The development of geriatric-orthopaedics, the system of interdisciplinary care of older people with hip fractures, was revolutionary in its time.

It was pioneered in Hastings by Bobby Irvine in collaboration with the orthopaedic surgeon, Michael Devas. It was to become the benchmark for the care of older patients with hip fractures. The principle of interdisciplinary care driven by regular meetings of senior specialists, of which this initiative was the first major example, has also provided the inspiration for developments in other areas of care, notably cancer services.

On Dr Irvine’s arrival in Hastings, he had 300 patients under his personal care, in four hospitals. Many of these patients would not have been expected to leave hospital. Many years later, he pointed out with justified pride, that one of the younger, “chronic sick” patients he had inherited had not only been discharged to live independently in the community, but was subsequently employed as a porter by the hospital in which he had been a patient. This well exemplified the complete change in society’s attitudes towards the disabled in general, and older people in particular - from paternalism to a striving for dignity and independence. This change had depended on pioneers from the 1940s, notably Marjory Warren, but was underpinned by the geriatricians of Bobby Irvine’s generation.

Bobby’s great successes in Hastings were built around collaborations borne of his generosity, ebullience and sheer stature, both physical and personal. He had an uplifting presence. It was perhaps important that he and Michael Devas were appointed around the same time, but it says much for the personalities and innovative flair of both men that they were quick to appreciate the advantages, to both their services, of joint working. This is now so much the norm, particularly in such areas as cancer care, that it is hard to remember that in 1959, when Drs Irvine and Devas started geriatric-orthopaedics, such collaborations were anathema to many. By his enthusiasm and commitment, Bobby Irvine championed multi-professional interdisciplinary care. Nurses of all grades were encouraged and enabled to contribute to the assessments of his patients at a time when nursing and medical hierarchies tended to be very separate.

Hastings had one of the first geriatric day hospitals. Again, it is easy to forget that the early day hospitals pioneered approaches to inter-disciplinary rehabilitation between medical, nursing and therapy professions that are now taken for granted. It says much that in remembering the revolution in geriatric nursing practice that occurred during his career, Bobby particularly singled out the importance of removing the restrictions to visiting times in elderly care wards.

Under Bobby Irvine’s leadership, the unit in Hastings became both nationally and internationally recognised. Prof Ian Philp, now DOH National Director for Older People’s Services, came from Scotland to work with Dr Irvine at an early stage in his specialist training, and two academic units in New Zealand are led by men who came to spend formative years in Hastings.

Stuart Bruce
Consultant : Hastings Hospital