This extract is taken from "The History of BAUS" by John Blandy and JP Williams.
At the outbreak of the Second World War in 1939 every surgeon who could be spared went off to the services but, very soon, the casualties of the Blitz obliged the Navy to return Howard Hanley and others back to civilian life, where there was no time to stand on ceremony or to keep to any narrow specialty. Throughout the war, plans were being made for a National Health Service.
Fortunately there were a few men with imagination and vision, and it was their action which led to the foundation of BAUS and the formation of the Institute of Urology
It might be thought somewhat curious that there had been no previous British Association for the urologists: after all the French Urological Association had been founded as early as 1896 with Félix Guyon as first President and the Belgian Association in 1901, the year that an Association of Urology was founded in New York, which became the American Urological Association in 1902.
An International Association of Urology had been started in 1907, with its first meeting in Paris in 1908 and the second in London in 1911 with Hurry Fenwick (left) as its President. After the war this became the Société Internationale d'Urologie (SIU) and Hurry Fenwick was President of Honour
One factor in the tardy formation of BAUS, certainly so far as London and the South of England was concerned, was that a perfectly good organisation was already in existence - the Royal Society of Medicine. The long-standing Medico-Chirurgical Society was formed in 1805 as a breakaway from the Medical Society of London. The leading lights were Blizard, Abernethy, Astley Cooper and James Yelloly; the new society flourished and received a Royal Charter in 1834 as The Royal Medical and Chirurgical Society of London. In 1907 it merged with other smaller specialist societies, whose separate independence was guaranteed with the status of a "Section" within the larger entity, renamed The Royal Society of Medicine.
One of the reasons why there seemed no need for a new association for urologists may have been their strong influence in the RSM, whose second President was Sir Henry Morris, the-pioneer of renal surgery. Another stronger reason was the English opposition to subspecialisation within Surgery.
The Section of Urology of the Royal Society of Medicine held its first meeting on 17 March 1920 with Sir Peter Freyer as its first President. Freyer pointed out that the decision to establish a separate section of urology, rather than a subsection of Surgery, marked "a distinct and healthy advance in the attitude of the surgical world in England, and particularly in London, which till recently had looked askance at the idea of Urology being a distinct specialty, though this specialty had long been recognised in, I may say, every other country".
The British Journal of Urology was founded in 1929 with Winsbury White and Frank Kidd, of St Paul's Hospital, as editors. Its first issue carried a message of goodwill from Hurry Fenwick. It was to wait 20 years before becoming the official organ of the BAUS in 1949.
In the words of Leslie Pyrah:
" It is difficult to say who initiated the idea that an Association of Urologists should be formed in Great Britain but it was probably Mr R Ogier Ward of St Peter's Hospital, London ".
While serving overseas during the War, Ogier Ward (pictured right) had taken part in discussions on the Government White Paper on a National Health Service, and became concerned that there was no organisation in Britain to speak for Urology, although the other specialties had representation. Sir Alfred Webb-Johnson (President of the Royal College of Surgeons of England) and Sir Ernest Rock Carling (adviser to the Ministry of Health) advised him to set up an Association of Urologists to speak on the Consultants' Advisory Committee and compile a survey of urological requirements for the new NHS.
So it was that, on 11 December 1944, seven men met at Eric Riches’ house 22 Weymouth Street London: F Loughnane, Terence Millin, Clifford Morson, Eric Riches, R H O B Robinson, Ogier Ward and Winsbury White. They agreed to write to 29 surgeons who were known to be doing urology almost exclusively, suggesting:
" that an Association of Urologists be considered. The object of such an Association would be to promote the general interests of the practice of urology. In the immediate future one of its most important functions would be to represent to those responsible for the development of the medical services of the country, the ideals of urology and advise them as to what is necessary in order that a satisfactory service may be ensured .”
A circular letter was send to 29 consultant surgeons known to interested in urology. 27 replied, all but two were in favour and even these were open to persuasion. There was a second exploratory meeting on 22 January 1945 and a larger meeting was organised for those to whom the circular letter had been sent as well as the Editorial Committee of the British Journal of Urology. Sir Alfred Webb-Johnson, President of the College, (pictured left) was asked to take the Chair.
This inaugural meeting was held in the Royal College of Surgeons of England on 17 March 1945. Thirty seven members were present. Webb-Johnson opened the meeting: Ogier Ward was elected President of the new Association and Webb-Johnson handed over the chair. Eric Riches (pictured below right) was the first Honorary Secretary.
Webb-Johnson offered the new Association a home at the Royal College of Surgeons and placed the facilities of the Joint Secretariat at their disposal at an initial rent for the remainder of the year of £35, later to be raised to £50 per annum.
A motion was proposed by Eric Riches and seconded by Clifford Morson that:
"This meeting approves of the proposal to form a British Association of Urologists (or other title)".
The motion was carried unanimously. It was then decided that the actual title of the new Association would be: " The British Association of Urological Surgeons (Home and Overseas " and that its object would be:- " To promote a high standard in the practice of urology”
Membership of BAUS would be confined to those engaged in the practice of Urological Surgery. There would be three classes of members, Honorary Members, Members, and Associate Members. Those present at the meeting, and those who had been invited to attend, would be invited to become Foundation Members. Those present were asked to submit additional names of those they considered should have been invited to the meeting. Suitable candidates from the Dominions should be invited to become Overseas Members.
There was to be an Annual General Meeting, close in time to the meeting of the RSM Section of Urology. The Officers of the Association (to be elected annually, the first ones for two years) would be President, Vice-President, Honorary Secretary, Honorary Treasurer and Honorary Editorial Secretary. The Council would have eight other ordinary members, two of whom should retire each year and be ineligible for re-election for one year.
The first Officers and Members of Council of BAUS were:
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- R Ogier Ward (right of photo) - President
- Bernard Ward - Vice President
- E W Riches (left of photo) - Honorary Secretary
- John Everidge - Treasurer
- H P Winsbury White - Editorial Secretary
Members of Council were:
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- AW Adams
- David Band
- Arthur Jacobs
- JB Macalpine
- Terence Millin
- Clifford Morson
- RHOB Robinson
- Charles Wells
It was agreed that the first Annual Meeting would be on 29 June 1945. Except for the first, the Annual Meetings would be in two parts, business and scientific. The first meeting of the new Council of BAUS was on 17 March 1945 at 22 Weymouth Street. It was agreed that the British Journal of Urology would be the official organ of the Association, that the annual subscription for Full Members would be three guineas and for Associate members, two guineas - both to include the annual subscription to the Journal of £1 5s 0d.
Full Membership would be limited to those who had given proof of scientific ability and practical experience in Urological Surgery; they would have to be sponsored by two full members. Certain selected members from overseas would be invited to become Full Members. Associate Members would be junior surgeons working in a Department of Urology, or other surgeons who were making a special study of Urology. The first Honorary Members were:
- Sir Alfred Webb-Johnson (Middlesex Hospital)
- Sir Girling Ball (St Bartholomews Hospital)
- Cyril Nitch (St Thomas's Hospital)
- Sir Hugh Lett (The LondonHospital
- Henry Wade (Edinburgh Royal Infirmary)
- Ralph Thompson (Guy's Hospital)
The second meeting of Council was on 3 May 1945, at which a further list of Honorary Members was agreed:
- Sir Charles Ball
- Surgeon Rear-Admiral Gordon Gordon-Taylor
- Professor George Grey Turner
- Surgeon Rear-Admiral RJ Willan
Letters were received from the President of the Royal College of Surgeons, the Director General of Emergency Medical Services, Sir Francis Fraser, and Mr RJ Silverton, of Sydney Australia - with congratulations on the formation of BAUS. Another 27 foundation members were elected as well as 14 Associate Members.
The first Annual Meeting was held on 29 June 1945 at the Royal College of Surgeons. Ogier Ward presided at a dinner, after which 38 members attended the business meeting. Professor Bernard Fey of Paris was invited to become an Honorary Member.
From the very beginning Ogier Ward addressed the two most urgent needs of Urology in the face of the impending NHS: manpower and training:
- how many Urologists were needed?
- how should they be trained?
These two questions have continued to occupy BAUS ever since.
A subcommittee was set up to address this question and by April 1946 had sent the draft of its Urological Survey to the Ministry of Health. This Urological Survey of Britain emphasised three 'General Considerations': that urology was highly developed and expensive from the point of view of equipment: that specially trained nursing was necessary and that many patients needed medical care. It recommended that, in the new Health Service:
" Important Hospitals (must) contain Urological Departments, and that the staffs of certain smaller hospitals include surgeons competent to render the correct immediate treatment for any urgent cases, and to decide that subsequent transfer to the fully equipped and staffed Urological Department will presently be necessary ".
Urological departments were to have their own beds. The survey went on (two years before the inception of the NHS) to envisage University Centres, Area Group Hospitals, Area Hospitals and sub-Area Hospitals — the concept of the spoke and wheel. One tactical concession was made to the-prevailing views on subspecialisation within Surgery: it was thought:
"not essential that a urologist should be engaged solely in urology, but all surgeons who are to be entitled to call themselves Urologists should be competent, in the opinion of their colleagues, to have charge of a Urological Department."
The plan went on to envisage Professors of Urology in certain University Centres.
From the outset the Royal College of Surgeons sought the views of the new Association on the training of Consultants in Urology. A second sub-committee was set up in March 1946 which recom-mended that special training in urology would be needed in addition to training in General Surgery at Registrar status.
Both these documents were discussed and ratified at the Annual Meeting of BAUS in June 1946.
At the end of the 2nd World War the-British Postgraduate Medical Federation, under its Director Sir Francis Fraser, was given the task of coordinating postgraduate work and training. There was obviously a need for Urology to have a voice in the Universities as well as in the coming NHS.
It was another stroke of imagination, again owing much to Ogier Ward, which brought St Peter's and St Paul's together. Thanks to Ogier Ward, John Sandrey and Alec Badenoch at St Peter's, and Winsbury-White and Howard Hanley at St Paul's, St Peter's and St Paul's joined forces in the Institute of Urology, which was at first housed in 10 Henrietta Street, opposite St Peter's.
The more far-sighted idea of setting up University Professorial units was less successful. Personal chairs were awarded from time to time; to Pyrah in Leeds (1956), Shackman at Hammersmith (1961), Blandy in the London Hospital (1968), Swinney in Newcastle (1969), Mitchell in Bristol (1970), Blacklock in Manchester (1985), Peeling in Newport (1990), Mundy at the Institute of Urology (1992) and Kirk in Glasgow (1995). But none of them were established and, so far, none of these chairs has survived the retirement of the nominee.
Two established chairs have been held by urologists, but these were both Chairs in Surgery — Geoffrey Chisholm in Edinburgh (1977) and David Neal in Newcastle (1992). BAUS repeatedly wrote to the University Grants Committee, urging the establishment of Chairs in Urology, but the University Grants Committee perversely took the line that Urology was a post-graduate subject and that everything an undergraduate needed to know about surgery could be taught by a general surgeon.
The Coat of Arms was presented to the Association by Her Royal Highness, The Duchess of Gloucester on 29 June 1994.
It was devised by York Herald of The College of Arms and was based largely on the President's badge. Many features of the badge are retained in the Coat of Arms such as the ship (now changed to a heraldic 'Lymphad') and the two dolphins (now altered to their heraldic versions and in the 'urinant' position). A new feature was the crest which consists of the crossed keys of St Peter entwined by a golden serpent. The supporters are, on the left, St Peter and, on the right, Hippocrates with the rod of Aesculapius. They are standing on a grassy compartment from which grow sweet peas.
Other features of the Coat of Arms include the shield (which is taken to represent the bladder), the sun in the upper left hand corner which is the emblem of Apollo (the god of medicine) and the golden sea which represents the urine.
The motto (Vis unita fortior) translates as "United strength is stronger". It is also the motto of the city of Stoke-on-Trent.