Charles Raymond Gill, FRCP
Walton on Thames, United Kingdom

Spring 2014

Sealing of the Bank of England Charter (1694)
Lady Jane Lindsay

The Bank of England is a venerable institution, founded in 1694 to act as the government's banker. By the time of the Gordon Riots of 1780, it had evolved into somewhat of a fortress, a military guard being added to prevent the rioters from breaching its walls. Also for security reasons, the number of persons coming and going was reduced, and many activities such as cleaning, painting, and repairs began to be carried out in-house. 

In 1809 a Mr. Vaux was appointed Bank Medical Officer at £75 for one year, which was to include his services as well as medicines for clerks, porters, and labourers.  His main job was to screen for infectious disease, most likely tuberculosis, which was rampant at the time. But after his death in 1820 the Committee of the Treasury felt that the appointment of a new medical person was unnecessary.

In 1839, however, another Medical Officer was appointed, Mr Alfred Smee, surgeon, chemist, and polymath. Graduating from Kings College and St. Bartholomew Hospital in 1840, he became surgeon general to the Bank of England in 1841, and in that year was elected for his research to the prestigious Royal Society. A keen horticulturist, he acquired a family home at 7 Finsbury Circus, about 600 yards from the Bank, renowned for its plane trees and allergic rhinitis. He was active in public health, encouraging the safe disposal of sewage and effluent.

Because of security concerns, Mr Smee’s family also had to live in the fortress-like premises of the bank, in a flat that included a small laboratory where he invented a cell, or battery, made from plates of zinc, silver, and platinum, that with the addition of sulphuric acid produced a steady electric current. The device became popular for electroplating small objects in metal, usually copper. The bank adopted his technology in 1853 for easily producing bank notes, as the traditional finely engraved steel plates became worn too quickly. His other innovation, in 1842, was the development of long lasting black ink. He was also interested in actuarial science, founding the Gresham Life Assurance and Accident Company, also acting as its Medical Officer, and encouraging the use of accurate mortality tables for risk assessment.

In 1764 some members of staff established the Widows Fund, continued after 1831 as the Bank Annuity Society, a voluntary association which everyone was encouraged to join to make provision for dependants if the breadwinner were to die. This evolved over time into the Bank Provident Society with a guarantee of 4% interest on the amount paid by the premiums. In July 1857 candidates for bank clerkship were required to insure their lives with the Society for the sum of £200, a considerable amount in those days.

The result of this was that the directors of the bank decided to appoint a salaried doctor. Until that time Alfred Smee had been paid on an ad-hoc basis and was required to examine men proposing to insure their lives with the Bank Provident Society. In 1843 Smee was paid £100, with gratuities of £100 and £50 for services rendered in 1845. This gradually rose to £250 by 1875, with added expenses of £25 for visits to Manchester and Liverpool, and an extra gratuity of £50 for unusual sickness among the staff. Several other Medical Officer appointments followed: Herbert Davies in 1877, John Kingdon in 1885, and  Arthur Templar Davies in 1906. The annual salary rose gradually to £450, the duties expanding to examining the staff of the bank and later also that of the printing works. 

What were the duties of these Medical Officers? The only record is from January 1877 and I quote the document in full, slightly edited. It is clear from the didactic style that it comes from another era:

  1. In general the function of the Medical Officer is to advise the authorities on the action he considers should, in the interests of the Bank, to be taken in all matters referred to him.
  2. In particular he is required:
    1. To attend at the Head Office of the Bank daily, Monday to Friday, not later than 10 am.  and for as long as he is required, normally between 11.30 am and 12 noon.
    2. To be prepared to come to the Bank, if possible at any time in an emergency.
    3. To give notice to the Chief of Establishments, now Human Resources, in good time…when unable to attend at the Bank and to make alternative arrangements satisfactory to the Bank in the case of absence to meet the cost of a locum at his own expense.
    4. Except as regards the Staff of The Bank of England Printing Works [They have their own Medical Officer], to examine –
      1. All candidates for the Bank's service, both clerical and non-clerical, and all candidates for appointment to the Permanent Staff, the standard of fitness required is that of a first-class life, as required for insurance purposes, and to report to the Chief of Establishments upon their fitness or otherwise.
    5. To examine persons in the service who may be referred to him and to report to the Chief of Establishments as to: 
      1. their state of health
      2. their fitness or otherwise for duty
      3. their need for Sick Leave of absence, and
      4. to give his opinion, in specific cases, of mental and physical fitness for retention in the Service.
    6. To examine and report upon candidates for life assurance-Bank Provident Society and Widows' Annuity Fund.
    7. To visit members of the Staff in their own homes if requested by the Chief of Establishments to do so and to submit a report on their state of health [Expenses to be reimbursed by the Bank].
    8. When required, to consider and advise upon medical certificates submitted by members of the Staff and upon the question of quarantine.
    9. To advise upon the incidence of epidemics and as to any special measures which should be observed by the Bank and by the Staff.
    10. To communicate on behalf of the Bank with other members of the medical profession and with hospitals, etc. about the health of members of the Staff and to deal with incoming medical correspondence in conjunction with the Chief of Establishments.
    11. To give professional advice on any other matters when asked to do so.  

Arthur Philip Gibbons, a keen golfer and tennis player, was Medical Officer from 1929 to 1937. He was a very distinguished doctor, as he was a Yeoman, really an apprentice, of the Worshipful Society of Apothecaries Hall. He was elected to the Friendly Medical Society in 1902, to the Court of Assistants at the Apothecaries Hall in 1930 and became Master in 1936, the greatest accolade of all. Indeed, the Bank presented the Society a silver cup to commemorate his Mastership. The Society of Apothecaries is close to the Bank in Black Friars Lane, EC4 and survived World War Two, each Master has a stained glass `Coat of Arms` in the Great hall and is worth a visit.  He also had a busy professional life as a police surgeon in the City of London for about twenty five years as he attended them for accident, illness and admission medicals, which were rigorous in terms of height, physique and suitable, qualifications.

Gibbons was followed in 1937 by his deputy Donald Craig Norris, a surgeon and barrister-at-law, who in 1943 wrote an excellent article in The Practitioner on malingering. In 1954 he was asked if disease could be spread by handling bank notes, as a member of staff complained. This was duly investigated and found no spread of disease was discovered, simple hand hygiene being recommended. Dr Norris thought about occupational as distinct from clinical health, a novel concept in a bank when there were few physicians with such a background other than in heavy industry.

In 1957 Ian Douglas MacDonald became Bank Medical Officer, serving with distinction until his retirement in 1977, when I took his place. He was a good clinician and a delightful partner—having served as a ship's doctor during World War Two, joined a medical practice in the City of London, practiced as Medical Officer for the British Red Cross Society and the Royal Exchange Assurance Company (now AXA), and presided as president of the Assurance Medical Society. As Bank Medical Officer he had to deal with the health problems of a staff of about 5000. He had three full-time nursing staff and pioneered early forms of health screening, likely influenced by his interest in life insurance. Starting with blood pressure, height/weight ratios, and urinalysis, he arranged in 1967 for a consultant gynaecologist to have a clinic once a month to encourage female staff to have cervical smear tests to prevent cervical cancer—quite a heretical concept in a workplace environment!

During my near twenty-five years as Medical Officer the bank saw the introduction of computers, the near "scare-mongering" problems with "emanations" from them, forcing the pregnant to wear lead-lined aprons and accompanying the rise and fall of repetitive strain injury. On one occasion, during an outbreak of intense skin irritation on the legs of persons in one area of work, there were rumours that tiny fragments of copper wiring had been left on the carpet when the computers were installed. I had to obtain the help of an occupational dermatologist, who spent a morning with patients to prove that this was routine atopic eczema, psoriasis, dry, asteatotic eczema, and other harmless but troublesome conditions.

We also established a first-class dental service, which has proved very popular, and expanded the health screening service further to include routine blood tests and access to consultant specialist advice and treatment. Eventually on-site physiotherapy, a safety officer, and an ergonomist completed the picture. Certainly the rise of training in the proper use of computers, posture, font size, chair height, visual checks in case glasses were needed, as they always would be, and natural breaks in the work seem normal today.  Shortly after my arrival the bank took over all the catering duties, hygiene, and food handling regulations—rendering important the reporting of food related sickness. The City of London in my early days had a Medical Officer of Health because the Port of London was a very large enterprise, and imported disease was always a possibility. I used to invite him to see our facilities, which in the mid-eighties were the most up-to-date in the catering world.

Gradually, occupational health rose in importance and the duties of the Medical Officer encompassed these, such as manual handling of gold bars which were numbered and kept in the vaults, not only for Britain but also for many overseas central banks. Needless to say, lifting a bar weighing 12.7 kg might quite often be required —"Doctor my back is sore!"— buried in the orderly way as shown in the film of James Bond in "Goldfinger" and the gold in Fort Knox.

When I retired in 2000 the Medical Officer role was split into clinical and occupational medicine. By then the staff of the bank was about half its post-war size. It has been a fascinating period, many things are covered by the Official Secrets Act which I had to sign every three months and still remain locked away, including my own file as I am the last of the original-style Bank Medical Officers.  From them I inherited a fascination for actuarial risk, sharing with my predecessors an all-embracing interest in the world of life and disability insurance.

References

Bank of England Archive. Many thanks to Sarah Millard and her staff.
Dictionary of National Biography, Oxford, and The Royal Society Library Collection for data on Alfred Smee.
The Archive of the Worshipful Society of Apothecaries for data on Dr Gibbons.


CHARLES Raymond GILL, FRCP, MRCGP, AFOM, FAMS, served as Deputy Medical Officer of the Bank of England from 1970 to 1977, when he became Chief Bank Medical Officer. After graduating from Charing Cross Hospital, London University in 1966, he was a full time hospital doctor, then joined Drs. MacDonald and Derrick Harris in private practice, thus returning to his old teaching hospital Charing Cross Hospital on a part-time basis in general medicine, working sequentially in gastroenterology, endocrinology and respiratory medicine with a big geriatric component. He was asked to stay on at the Bank of England by the Governor Eddie, later Lord George, and left five years later as a part time medical advisor. He was president of the Assurance Medical Society and of the International Committee of Life Assurance Medicine, and board member of the American Academy of Insurance Medicine.