Stepping up the pace

In the final part of The Journal's feature series marking the 100th anniversary of Newcastle's Royal Victoria Infirmary, Hannah Davies finds out what the future holds.

In the final part of The Journal's feature series marking the 100th anniversary of Newcastle's Royal Victoria Infirmary, Hannah Davies finds out what the future holds.

Medicine has developed at a phenomenal rate over the past century - a trend which looks set to continue apace. From stem cell research to face transplants, Sir Miles Irving, chairman of the Newcastle Hospital's Trust, speaks on what we can expect from the future of medicine at the RVI.

"It is amazing to think when I started my career around 50 years ago there was so little that we could do for patients.

"There were no dialysis machines for kidney failure, no effective joint replacements, no heart transplantation, no pacemakers and very few effective drugs.

"In the future the same rapid pace of change we have seen over the last half century will continue to happen, but at an even greater pace.

"We can confidently predict that many of the chronic diseases which are currently difficult to treat, such as diabetes, arthritis and coeliac disease, will respond to new drugs and other novel types of treatment.

"An example of the sort of amazing treatments that will develop can already be seen today, where we are witnessing patients bed-bound from the severest form of rheumatoid arthritis, gaining such relief from novel drugs they are able to walk within a few hours. Of course, many such treatments are at the experimental stage of their development and are very expensive, but they give us a glimpse of what is possible.

"In our Centre for Life here in Newcastle, scientists are producing stem cells with the potential for treatment. Red blood cells are already being produced which in time may come to replace the need for blood transfusions as we know them.

"Stem cells capable of producing insulin will be used in treating diabetes, and the scientists in the Centre for Life are already looking at individual cells that are contracting spontaneously like a heart cell.

"Elsewhere in the world, scientists are grafting such cells on to scaffoldings with the aim of producing a heart-like structure.

"There will also be massive advances in the field of implantable electronic devices, similar to the pacemaker technology currently used to maintain and regularise heartbeats.

"I foresee such technology being used to re-stimulate nerve cells that have been damaged by disease or injury. Within the last few weeks, doctors in the USA have announced the development of an effective treatment for migraine using focused magnetism applied externally to the skull.

"In the field of surgery, many current operations will become obsolete. Surgery for many cancers will no longer be necessary as new drugs and other treatments are developed.

"Already, here in Newcastle, our radiologists have been leading the way in treating aneurysms of blood vessels in the brain by blocking them off using fine tubes inserted through blood vessels in the groin, thus removing the need for brain surgery other than in a few very difficult cases.

"On the other hand, many diseases for which, currently there is no effective treatment will become manageable by new surgical procedures. This will be especially true in injured patients and those with degenerative diseases.

"The consequences of the advances described above will be profound. There is no doubt that many patients who currently need hospital treatment will be able to have their diseases managed at home.

"However, as technological treatments become more advanced, doctors, nurses and other therapists working in hospitals will have to become more specialised and work in large teams in large hospital centres.

"There is no doubt the RVI and the Freeman will create such centres.

"The challenge for the medical profession will be the new illnesses and ailments that are already coming into being. Infectious diseases will become more prominent as the number of people in the world rises.

"There will also be an increase in the number of degenerative diseases as people live longer. Organ transplantation will be more widely used, as the technology and drug treatment becomes more effective, and will spread to other structures, as we are currently seeing in the case of face transplants.

"As our society becomes more violent, we will see an increase in the number of people who will need treatment for injury, and unless we can control the downward spiral of alcohol abuse and drug usage, we will have to cope with their medical consequences.

"Add to this the unpredictable diseases which are bound to arise and we can see that the RVI and the Freeman, with their new facilities, will not be short of work in the future. The world- class doctors and scientists who work in our universities and hospitals will be well equipped to look after the people of the North-East."

* Share your memories of the RVI with The Journal. Call Hannah Davies on (0191) 204-3309

* For more information read 100 years of the RVI 1906 - 2006 which costs £10, or £15 with postage, and is available from Centenary Office, Peacock Hall General Office, RVI, Newcastle, NE1 4LP.

Distinguished career

Name: Sir Miles Irving

Age: 71

Family: Wife Lady Patricia Irving, 65, with whom he has four children, three of them doctors.

Career: Sir Miles trained as a doctor at Liverpool University, graduating in 1959. He has worked all over the country and abroad, including two years in Sydney, Australia. He worked briefly at Newcastle General Hospital in the 1960s as part of his training where he met his anaesthetist wife. He spent the majority of his career at Manchester University where he was Professor of Surgery, working at the Hope Hospital, Salford, specialising in gastroenterology. He retired to Newcastle in 1998 to become chairman of the Newcastle Hospitals NHS Trust.

History of the RVI

* Foundation stone laid on June 20, 1900.

* Officially opened by King Edward VII on July 11, 1906.

* First major addition built by the government towards the end of the First World War for the care of wounded soldiers. These buildings were demolished in 1979 and 1994 to make way for a new catering block.

* In the 1930s there were more additions; a large extension to the nursing home and an orthopedic block.

* Dental Hospital and School opened in 1978 followed by the Medical School in 1985.

* Leazes Wing block opened in 1992.

* In 1996 the Claremont Wing opened to ophthalmic patients who had been in temporary accommodation for 50 years.

* The Sir James Spence Institute for Child Health completed in 1994.

* Currently the RVI is undergoing its biggest single change since 1906 with many of the original Edwardian buildings being demolished. Most of the new state-of-the-art RVI is set for completion in 2008. Everything should be finished by 2013.

New developments

RVI

Children's hospital

* Neurosciences centre

* Accident and Emergency services

* Trauma centre

* Operating theatre

* Critical care

* Infectious diseases unit

* Dermatology

* Outpatient clinics

* Ambulatory care

Freeman Hospital

* Cancer and renal services centre

* New multi-storey car park

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