National Health Act 1946

The end of the war was followed rapidly by the National Health Act in 1946, which transformed the structure and funding of health services. The new Northwest Regional Hospital Board grouped together the MREH, MRI, St. Mary's Hospital, the Dental and Foot Hospitals, which in 1948 became The United Manchester Hospitals.

Further pressure on space, especially for the University and Orthoptic departments, led to the purchase in 1956 of Lister House, on Nelson Street. This initially became the base of the University Department, also housing orthoptic beds, consulting space and staff accommodation, later evolving in the 1970s into a glaucoma unit of 20 beds, with hospital library and offices. During the 1960s and 1970s, the Manchester Royal Eye Hospital was the busiest provincial eye hospital in the country, and of the 300 consultant ophthalmologists in England in 1965, some 50 had been trained there. The Orthoptic School was opened in 1965, rapidly achieving national recognition.

Lister House

Lister House is shown here later, in 1975, with the stylish cars of the staff at the time. Some five years later, this author commenced his long relationship with MREH as an elective medical student, at which time the hospital had just under 200 inpatient beds, for 7 consultant surgeons. The succeeding 23 years have been typified by political change and organisational turmoil, accompanying the spiralling costs of healthcare, in association with breathtaking advances in the technology of ophthalmological medicine and surgery.

In 1974 the new Manchester Area Health Authority amalgamated the United Manchester Hospitals with a wide range of community services and health centres with the aim of rationalising primary and secondary care. In 1983 the Griffiths report demanded managerial restructuring, so that at MREH as at all other hospitals, consensus management by the triumvirate of Senior Consultant, Matron and Hospital Secretary, disappeared to be replaced by a General Manager. Further organisational change included the purchaser/provider split and the creation of Healthcare Trusts; MREH became a part of the enlarged Central Manchester and Manchester Children's Hospitals NHS Trust (thankfully shortened to CMMC!) in 2001, and foundation trust status was gained in 2009. Manchester Royal Eye Hospital is now a part of the Central Manchester University Hopsitals Foundation Trust, amongst the largest hospital sites in the UK and providing education for the clinical students of Manchester University, which houses the largest medical school in the UK.

In 1987 the Chair of Ophthalmology was reconstituted after lying fallow for 14 years, and Professor David McLeod was its occupant. His arrival was followed not only by the reinvigoration of both laboratory and clinical research (later reflected by the appointment of two Wellcome Trust Senior Research Fellows, then the only senior ophthalmological fellows in the UK) but by major improvements to postgraduate education at MREH. Research and academic activity remain at the forefront of MREH, and this has been recognised by the appointments of several professors as leaders in both clinical and research ophthalmology (including ophthalmic genetics): currently Professors Bishop, Black, Henson, Lloyd and Stanga.

Following the creation of the National Health Service in 1948, all buildings, originally created and kept by public donation, were effectively nationalised; at this point, investment in upkeep and development by evolution, virtually ceased, and the declining state of the buildings became an increasing problem. Lister House, initially declared unfit for habitation in the 1960s, was eventually vacated and demolished as late as 1995. The main hospital building was unsuitable for redevelopment and of declining state; inventive refurbishment permitted adaptation during the 1980s and 1990s, facilitated by the declining need for inpatient beds as new surgical techniques permitted shorter inpatient stays and some day-case surgery. The outpatient building became similarly unsatisfactory despite cosmetic alteration. It was clear that the buildings of both MREH and MRI were rapidly becoming unsustainable and a large-scale rebuild was planned. The Strategic Outline Case for a new building was made in 1996.  The immensely complex and expensive new build, requiring Private Finance Initiative funding and ultimately including new hospitals for the Mental Health Trust and the Manchester Children's Hospitals, would be created on the same island site, requiring the continuing provision of all services during the building process. Fortunately the Eye Hospital was able to remain in its Oxford Road premises during this time. The new building was occupied in 2009, 13 years after the initial application to rebuild.