Orthopaedics and the Northern Ireland Council for Orthopaedic Development (NICOD).

IT could be said that orthopaedics started as a speciality in Northern Ireland on Monday 11 March 1940. It started in the Senate Committee Room of the Queen's University at a meeting between Sir David Lindsay Keir, who was Vice-Chancellor, Mr (later Sir) Samuel Irwin from the Royal Victoria Hospital, Mr H.P. Hall from the 'Union' or Belfast City Hospital, and Mr Maurice Lavery from the Mater Hospital. This and subsequent events are recorded in the Minute Books of NICOD,' which is one of the oldest and largest voluntary organisations in Northern Ireland. NICOD currently runs the Balmoral Work Centre, which is a sheltered workshop for the disabled, and three hostels for the disabled. In the past, it started Mitchell House School, the therapy services at Fleming Fulton School, Parkanaur Training Centre for the disabled, the Advice Clinics for disabled children, and numerous research projects. The name 'Northern Ireland Council for Orthopaedic Development' is too long to be handled by the average tongue, yet the acronym 'NICOD', by which it is commonly known, hides the origin of the organisation. In 1937, the newly created Lord Nuffield Fund for Cripples allocated £26,000 to Northern Ireland.2 It engaged the Central Council for the Care of Cripples to survey the needs within Northern Ireland, and in late 1938 a Miss Hill visited the Province. She was probably shocked, for the health of the Province was not good.3 Tuberculosis was rampant, accounting for half the deaths between the ages of 15 and 25, and there were many tuberculous bones and joints. There were poliomyelitis epidemics every four years. Rickets was common, and the infant mortality rate was higher in 1940 that it was in 1920. In Belfast, the medical services were in confusion, being divided between the Poor Law Medical Service, the Government, and the Belfast Corporation. There were rumblings about the Belfast Corporation Tuberculosis Committee, which was suspended soon afterwards because of mismanagement and corruption, and gave way to the very successful Northern Ireland Tuberculosis Authority. Miss Hill presented her report to the Lord Nuffield Fund for Cripples, and was authorised to approach Sir David Lindsay Keir, who as Vice Chancellor was a man of influence, and he convened that meeting of surgeons who had an interest in orthopaedics on that day in March 1940. The broad aims of Miss Hill's report were 'to further provision of facilities for the early discovery and prompt and efficient treatment of those who would otherwise become cripples', and 'to organise schemes for the treatment, education, training, employment and general welfare of cripples'. More specific proposals aimed at the establishment of orthopaedics as a speciality by the setting up of a Department of Orthopaedics at the Queen's University, the provisions of a long-stay orthopaedic hospital, and the starting of orthopaedic clinics throughout the Province.