Dr Thelma Bates OBE
As well as being a determined clinical oncologist who helped to establish one of the first hospital-based palliative care units in Britain, Thelma was also one of Princess Alice Hospice’s founders.
When Thelma Bates told friends and colleagues she was going to start an end-of-life care unit at St Thomas’ Hospital in London, where she worked as a clinical oncologist, they tried to persuade her that the move would damage her reputation. Palliative care was considered the “soft option” in oncology, where the emphasis was on cure and prolongation of life.
With high cancer death rates in the 1970s, care of the dying was routine in oncology. Thelma never turned a blind eye to terminally ill patients: she was passionate to help them and when she discovered that they were often more comfortable at Cicely Saunders’s hospice in south London, she wanted to know more. She visited St Christopher’s, forging close links with the staff, and eventually became their oncologist, offering palliative radiotherapy and chemotherapy.
Thelma wanted to bring hospice style care to hospital patients and was convinced that a roaming multidisciplinary advisory team at St Thomas’ could do this. She ignored well meaning colleagues who said palliative care was a “soft option” that would ruin her career.
“I took no notice,” said Thelma, and in December 1977 she welcomed her first patient at the clinic, which helped to develop gentle palliative radiotherapy or chemotherapy to relieve symptoms in patients with a limited life expectancy.
A decade earlier she had been appointed the first female clinical consultant at St Thomas’, specialising in the treatment of breast cancer.
“It came as a surprise to find that patients were so much more comfortable and content in a hospice setting,” she recalled. “It was obvious that there were clinical skills that I lacked. The more I learnt, the more I understood that these skills were lacking. Something needed to be done.”
In 1977 she travelled to New York to observe an experimental palliative care unit at Mount Sinai Hospital in Manhattan, which was run by Roman Catholic nuns. She returned to England to campaign for funds to start the clinic at St Thomas’ with four others: a nurse, a social worker, the hospital chaplain and the oncology registrar.
Within six months they were able to discharge so many patients that an outpatient clinic and a home care service, which provided pain management, were established. The system was replicated in hospitals across Britain.
After buying land near her home in Esher, Surrey, in 1985, Bates also established the Princess Alice Hospice, a purpose-built unit of which she was clinical trustee and chairwoman of the clinical strategy committee. Today the hospice cares for more than 500 patients.
When Thelma was six she broke her arm and “fell in love” with the smell of the hospital. “I wanted to know what was happening behind those closed screens,” she recalled. “And I was absolutely certain that this was where I wanted to be — not as a nurse, but as a doctor.”
At the age of 16, however, she was accepted to study medicine at Birmingham University. Upon qualifying in 1952 she persuaded a shipping company to give her a job as the ship’s surgeon on a one-way voyage to New Zealand, where she worked as a GP.
After a brief return home she spent six months sailing around the South Pacific on a yacht called Arthur Rogers. In Tahiti she was asked to dinner with the prince of the island; local people nicknamed her “Puke” (pronounced “pookie”), meaning “little island” in Polynesian.
Eventually settling in Tasmania, she gained a medical degree at the region’s only cancer centre, in the Launceston General Hospital, later running the radiotherapy and oncology departments. She was attracted to oncology, she said, because it gave her more time to spend with her daughter, Annie. She had met and married Mills Bates, an ear, nose and throat surgeon from England with whom she lived in a traditional farmhouse, with a tin roof and a veranda.
When she was six weeks pregnant, Thelma took three tablets of Distaval, also known as thalidomide, to help her to sleep. A fortnight before Annie was born she received a letter from the health authorities warning her — as a doctor, not a mother — about the newly reported dangers of the drug, which resulted in at least 10,000 birth deformities or infant deaths worldwide.
“It said all women who’d taken it were likely to give birth to ‘foetal monsters’,” she recalled in an interview with The Sunday Times in 2016. “I saw Annie the moment she was born, and she wasn’t a foetal monster, she was very sweet, very pretty, with little chicken wings instead of arms — to me, she looked like an angel.”
Thelma was “determined” that her daughter would enjoy a normal life, and though she regretted time away from Annie — her job was so demanding that often they spent Christmas Day at the hospital — she never felt guilt about taking the pills. “My mum taught me to accept myself completely,” Annie wrote in the same article. “It was the rest of the world that had a problem.”
Annie, a wildlife film-maker, survives her along with Richard, a yacht captain. Charlie, another son, died in a house fire in 1991. She and Mills divorced in 1963.
In the late 1960s, Thelma returned to England, where she got a job in the radiotherapy and oncology departments at St Thomas’ Hospital, and after taking a postgraduate degree, became a consultant clinical oncologist in 1967.
By the time she left the hospital in 1991, a quiet revolution had taken place in the way in which patients with incurable cancer, and other terminal illnesses, were cared for.
Dr Thelma Bates OBE, FRCR, oncologist and palliative care pioneer, was born on August 18, 1929. She died on June 10, 2023, aged 93
Information from The Times Obituary 14 July 2023 and the BMJ 9 August 2023.