by Sonia Daly-Finley, Director, Institutional Nursing Service 

Under the auspices of the Ministry of Education, Health and Welfare, construction of The Joseph Nathaniel France (JNF) General Hospital began in March of 1966 and was expected to be completed in September 1967. The master plan for the Hospital was prepared by Sir John Weekes of Llewellyn Partners, United Kingdom. The facility was built by Clarence Johnson Construction Company Limited of Antigua while the Architect, Mr. Colin Laird, of Trinidad visited and gave advice. Also, Mr. L.G. Felipes, Managing Director of the British Engineering Manufacturing Alliance, visited on a monthly basis from his base in Trinidad. Additionally, Mr. R. Joseph, Inspector or Clerk of Works for the Public Works Department, St. Kitts, supervised the work on the Hospital.

The Hospital was built on lands belonging to Buckley’s Estate at a cost of $2.2 million (E.C); this included the cost of the land. While under construction, His Excellency Mr Fred Phillips, C.V.O., Minister of Education Health and Welfare – Mr. Fitzroy Bryant along with members of the Health Planning Committee for St. Kitts, paid a visit to the site on March 11, 1967. At that time, the members of the Health Planning Committee were:

• Permanent Secretary, Min. of Education, Health and Welfare - Mr Anthony Rebeiro
• Principal Assistant Secretary - Mr Maurice Woods
• Chief Medical Officer - Dr. J. O’Keefe
• Medical Superintendent, Cunningham Hospital - Dr Cuthbert Sebastian
• Representative of the British Medical Association (Local Branch) - Dr Arthur Lake, O.B.E

During a thirty (30) minute guided tour by Mr. R. Joseph, Clerk of Works, they visited the twenty-four (24) bed Maternity Block, the twelve (12) bed Private Ward, Xray and Theatre. At that time, it was felt that the estimated date of completion, late September 1967 was achievable. Upon leaving the construction site of the new hospital, the gentlemen visited the Cunningham Hospital where they pondered the best use of the facility after the transfer.

The new facility was officially handed over to the Government on October 28, 1967. The Hospital was commissioned for use on December 14, 1967.

At the opening ceremony on December 14^th were local Ministers of Government, visitors from overseas and Miss May Stevens, the former Matron of the Cunningham Hospital. Addresses on this auspicious occasion were delivered by:

• The Governor - Sir Fred Phillips
• The Premier – Mr. Robert Llewellyn Bradshaw
• The Deputy Premier - Mr. Caleb Paul Southwell
• Minister of Education, Health and Welfare – Mr. Fitzroy Bryant
• Chief Medical Officer – Dr. J. O’Keefe

The vote of thanks was given by Dr. Cuthbert Sebastian who was then the Medical Superintendent. Mr. Anthony Rebeiro, Permanent Secretary, Ministry of Education, performed the duties of Master of Ceremonies.

In his speech, Premier Bradshaw said that the “Hospital belongs to the people of the entire State. It was financed by grants not only from overseas but from the Sugar Stabilization Fund and the Sugar Industry.”

The Hospital was named after Mr Joseph Nathaniel France, a Minister who was without portfolio at that time and who was formerly the Minister of Social Services. It was the intention to occupy the hospital in January 1968. However, removal of the patients and equipment from the Cunningham Hospital began on March 04, 1968 and was completed during that week. The new Hospital, The JNF General Hospital, did not begin services to the public until Sunday, March 10, 1968. The JNF General Hospital replaced the Cunningham Hospital which was in existence from 1848.

The JNF General Hospital which opened with one hundred and six (164) beds was said to have “top class facilities for a hospital of its size.” The new features included:

• The Maternity Unit which was the “finest to be found anywhere” and it was said to be four (4) times the one at the Cunningham Hospital. Attached to it was a proper Labour Suite with two (2) delivery rooms and an Operating Theatre.
• The Surgical Theatre was said to be very modern.
• The Surgical Ward was intended to have an Intensive Care Unit.
• The Casualty and Out-patient Department was designed to offer better organised service.
• The kitchen was said to be one of the finest and contained “acme in equipment.” Allowance was made for a cafeteria service.
• The laundry was said to be excellent and was “a first in modern electrical equipment.”
• The Central Sterile Supplies Department (CSSD) was “a completely new concept in this State”. It was expected that everything to be sterilised would have been done in CSSD and then distributed to the Wards and other departments. 

At that time, persons who were receiving an income of $3,000.00 per annum or over were expected to pay hospital fees while those receiving less than $3,000.00 per annum were eligible for free medical care in “free beds” at the hospital. The fee structure was as follows:

• Private Ward
  • Single-bed room with wash basin - $ 5.00
  • Two-bed room - $ 3.00
• Medical and Surgical Blocks
  • Single-bed room - $ 2.00
  • Four-bed room - $0.50
• Maternity Block
  • Single-bed room with bath, lavatory and air-conditioning - $10.00
  • Single-bed room with bath and lavatory - $ 8.50
  • Single-bed room with wash basin and air-conditioning - $ 6.00
  • Four-bed room - $ 1.00
• Children’s Block
  • Single-bed room - $ 3.00
  • Two-bed room - $ 2.00

All patients who were covered by medical insurance were automatically considered fee paying patients. Non-residents were classified as fee paying patients. Fee paying patients were charged a Theatre fee for operations and were expected to meet the cost of expensive drugs. Outpatients, except those who were entitled to free medical attention, were expected to pay fees for Xray and laboratory services.

In an effort to lend support to the staff and patients at the new hospital, fifteen (15) women met and established a voluntary organization called ‘Friends of the Hospital’. The first meeting was convened on Wednesday, March 13, 1968, at the Nurses’ Classroom, at The JNF General Hospital. The women were:

• Mrs. O. Audain
• Mrs. R. L. Bradshaw
• Mrs. W. DuBuisson
• Mrs. A. M. Edwards, M.B.E
• Mrs. E. Glasgow
• Mrs E. Jacobs
• Mrs. L. Kassab
• Mrs. A. Osborne
• Mrs. L. Richardson
• Mrs. S. Sebastian
• Mrs. C.A.P. Southwell
• Mrs. G.O. Ward
• Mrs G.E. Warner
• Mrs. F.T. Williams

Mrs. DuBuisson, wife of the Chairman of the Board of Directors of the St. Kitts Sugar Factory, was elected as the Honorary Chairman while Mrs. Audain was elected chairman. Mrs Glasgow was elected Secretary and Mrs. Kassab Treasurer.

It was decided that the primary functions of the group would be social work and fund raising for the hospital. As part of the fund raising exercise, a “Shop on Wheels” was introduced. The trolley was donated by the Sugar Factory.

The Honorary Chairman, Mrs. DuBuisson, had shown great interest in the Cunningham Hospital for many years. In fact, she was a member of the managing committee of the St. Thomas Hospital, London, England, for thirty (30) years. It was therefore planned to establish linkages with similar groups in the United Kingdom.

Shortly after the Hospital was opened, Mrs. DuBuisson presented the Matron, Mrs. Louisy Walwyn, with a cheque for 50 (pounds) to help with the furnishing of the Nurses’ Lounge at the new Hospital. Dr. Charles Jong of Taylor’s Site also made a donation of a cheque for $100.00 to The JNF General Hospital[1].

In 1998, following the devastation of The JNF General Hospital by Hurricane George, rebuilding of the Hospital, on the same site, began in phases. Phases I and II of the new structure was erected at the front or southern end of the old structure. The Paediatric Wing was built as a United Agencies for International Development Hurricane George Project 2001. It was commissioned on March 18, 2002. The other Units, with the exception of the Private Ward were commissioned on January 30, 2003. The Private Ward was completed and commissioned on February 23, 2004.

From the vantage point of the JNF General Hospital, secondary health care delivery has made significant strides over the years, especially during the last two (2) decades. The service has seen the inclusion of:

• The Emergency Medical Services
• Formal Quality Improvement Strategies
• Formal Neonatal Care
• Formal Intensive/Critical Care Service
• Twenty-four (24) hour coverage by Medical Officers at the Accident and Emergency Department
• Asthma Care
• Haemo and Peritoneal Dialysis
• Admission and Discharge Planning
• Improved Ophthalmology Services
• Endoscopic Services
• Computerized Tomography (CT Scan)
• Magnetic Resonance Imaging (MRI)
• Specialized Orthopaedic Services
• Plastic/Reconstruction Surgery
• Counselling Services
• Foot Care Services
• Pain Management Services
• Oncology Services
• Vascular Surgery
• Full Implementation of the Services of the Central Sterilizing and Supplies Department
• In-service Education programmes to facilitate formal ongoing training for all health care providers

As we stand at the threshold over the fiftieth anniversary, we anticipate further expansion of the health care services to include basic cardiology and advanced vascular surgical interventions. We also envisage that the majority of the Junior Nurses will enter the system as Degreed nursing personnel and that the Emergency Medical Technicians will be trained at the intermediate level.

As Chair of the Fiftieth Anniversary Planning Committee, I extend gratitude to the committee members for the unswerving support in the planning and execution of the celebratory activities. I also extend gratitude to all other members of staff who assisted in the planning and execution of the activities. Profound gratitude is extended to the Honourable Wendy Phipps who encouraged and guided the process.

Profound gratitude is extended to all health care providers; we thank you for your service to mankind. To our pioneers, those who have paved the way for the present generation of health care providers, we are also profoundly grateful to you. We thank you for your support, foresight and guidance.

And, to the Almighty, we are grateful that he has brought us thus far. May He continue to bestow us with the wisdom and strength to meet the health care needs of our people as we endeavour to live up to our motto, “People First, Quality Always.”