LMITransactions&Report2014-15

Liverpool Medical Institution

Transactions and Report 2014 /15

Conferences I Exhibitions I Medical Library I Membership I Lecture Programme

LMI Transactions and Report 2014 - 2015

Order of Contents 2
3
Frontispiece, Mr Max McCormick 4
List of SMC Members 5
List of MEC Members 6
The Liverpool Medical Institution Staff
Editorial 8
Inaugural Address of the President 11
Held on Thursday 16th October 2014 15
Henry Cohen Memorial Lecture
Annual Healthcare Service 16
Minutes of the Ordinary Meetings of the 176th Session 52
including details of social events and Admission of Life Members 54
Edith Cavell – WWI Heroine 57
Retired Members’ Group 59
Report of Council 60
Report of the Honorary Librarian 65
Obituary Notices 66
Members Joined since last Transactions 67
Auditor’s Report 68
List of Presidents
Charitable Donations

Cover Illustrations

Upper Row, Left to Right:
1. LMI members and guests dining after Professor TM Jones’ lecture in November 2014
2. LMI manager Sam Pickup tries on a WWI helmet during the military medicine exhibition October 2014
3. 208 Field Hospital personnel in modern and WWI uniform outside a simulated WWI trench October 2014
4. Professor Richard Ramsden posing in his kilt before speaking at the Annual Dinner on February 2015
5. LMI librarian Adrienne Mayers admiring Capt. Noel Chavasse’s sword with Dame Lorna Muirhead, October 2014

Lower Row, Left to Right:
1. A visitor and a volunteer inspect the prototype cast for Liverpool Heroes Memorial on display at LMI during the military medicine exhibition October 2014
2. 208 Field Hospital personnel giving a lecture on living conditions and medicine in the trenches
3. Students at a Clinical Skills teaching session held at the LMI in November 2014
4. Macmillan mascot at the Macmillan World’s Biggest Coffee Morning event at the LMI in September 2014
5. Year 12 students attending a surgical skills taster session at Broadgreen Hospital during the Year 12 Medical Conference, December 2014

Liverpool Medical Institution

Registered Charity No: 210112

Transactions
and Report

The Institution book plate, reproduced on the front cover, was designed and engraved by Stephen
Gooden, C.B.E., R.A.
The basis of the design is the staff and serpent of Asklepios, bearing the date when the Library was
opened to the profession in Liverpool and neighbourhood.
On the shield is the emblem of Liverpool and it is supported by two fleams or lancets of a design
once used for blood-letting.
The Institution crest, reproduced above, can be seen in the library, the lecture theatre and as a
mosaic in the main hall. It also shows the Staff and Serpent, with the opening words of the
Aphorisms of Hippocrates:

(Life is short, and Art long; the crisis fleeting; experience
perilous and decision difficult).
Trans. FRANCIS ADAMS

114 Mount Pleasant, Liverpool L3 5SR
Telephone: 0151-709 9125 Fax: 0151-707 2810
Email: [email protected] Web Address: www.lmi.org.uk Twitter: @LMI114

1

LMI Transactions and Report 2014 - 2015

Mr. Max McCormick
President 2014-15

2

LMI Transactions and Report 2014 - 2015

Strategic Management Council (SMC) 2014-2015

Chairman:
A SWIFT

President:
M McCORMICK

President-Elect:
G LAMONT

Treasurer: Secretary: Librarian:
A ELLIS A McCORMICK A LARNER

D ANTONIA Members of SMC: A McCORMICK
L DE COSSART M McCORMICK
E DJABATEY R FARQUHARSON
N GILMOUR S SHEARD
A ELLIS W KENYON A SWIFT
S EVANS A LARNER
G LAMONT

Auditors:
BAKER TILLY

David Antonia Linda de Cossart Edwin Djabatey Anthony Ellis Susan Evans

Roy Farquharson Nigel Gilmour William Kenyon Andrew Larner Graham Lamont

Austin McCormick Max McCormick Sally Sheard Andrew Swift

3

LMI Transactions and Report 2014 - 2015

Membership and Education Committee (MEC) 2014-2015

President:
M McCORMICK

President-Elect:
G LAMONT

Vice Presidents:
V JHA J CURTIS

Treasurer: Secretary: Librarian:
A ELLIS A McCORMICK A LARNER

Members of MEC:

J CURTIS G LAMONT
P D O DAVIES A LARNER
L DE COSSART A McCORMICK
A ELLIS M McCORMICK
R C EVANS I RYLAND
V JHA

Additional Honorary Officers:
Secretary of Ordinary Meetings: VACANT

Editor of Transactions: R C EVANS
(Assistant Editors: N R CLITHEROW, SHARON HUNT AND LYNNE SMITH)

John Curtis Peter Davies Linda de Cossart Anthony Ellis Richard Evans

Vikram Jha Graham Lamont Andrew Larner Austin McCormick Max McCormick

Ida Ryland Samantha Dolan Peter Skellorn

4

LMI Transactions and Report 2014 - 2015

The Staff of the Liverpool Medical Institution

Sue Curbishley Samantha Pickup (Manager) Audrey Roberts (Admin) Jim Penwill (Finance Officer) Sharon Hunt (Admin)
(Library Assistant)

Tom Spearitt (Security) Lynne Smith (Admin) Joyce Williams (Bar) Karen Alsop Adrienne Mayers (Librarian)

(Finance Manager & Project Manager)

Other Team Members

Deborah & Dennis Holden Mark Ross Jeremy Blades
(Catering) (AV Technician) (AV Technician)

Anna Reid Sarah Adams Christopher Mayers
(RCGP Mersey Faculty) (RCGP Mersey Faculty) (RCP Mersey Regional Office)

5

LMI Transactions and Report 2014 - 2015

Editorial

It was a rather exciting Tour-de-France this year with British rider Chris Froome
winning the maillot jaune. Controversies that embroiled Chris Froome perhaps seem
to have arisen from our historical relationship with our neighbour across la manche.
It was also remarkable seeing Chris Froome’s story on television and the way in which
he lived across the inherent borders that are still present in South Africa.

It was the use of modern technology that enabled me to catch snippets of Le tour on
my i-Phone, connected to the now widely available hospital Wi-Fi system, even in our
small community unit. After a long slog through a busy clinic, it was a relief that I
was able to finish the day early just after 3pm, so that I could catch up with family
before my wife started notorious Saturday night duty. Like most other days of the
week, we continue to hunt for time together to be with our 1 year-old daughter.

That evening I took the opportunity to look at my wife’s paediatric rota which was remarkably over-complicated,
but not surprising given the current difficulties with recruitment of doctors. This led me to think about the
problems that we still have, some increasingly so, in borders across medicine. I find it quite difficult as someone
who had such a broad training in general medicine to see that specialities appear to be not only metaphorically
segregated but also geographically.

I am currently in practice on the other side of our own regional border named after King Offa. I notice how
relationships have changed in medicine across the North West now that the rotations from Liverpool and
elsewhere are significantly diminished. One gets the feeling that any mention of migration locally seems to
have a response almost akin to that suffered by poor Edith Cavell [see the feature article in this Transactions].

In the LMI, I find it interesting to see how many people cross the corridors to attend meetings other than their
own speciality. I admit on occasions my only reason is often to have a necessary biscuit after a long journey.
When I was a student my flat mates and I decided to see if we could manage to eat for free for two weeks by
attending clinical meetings alone! Thankfully I shared a flat with students from other medical schools across
London, so we had a wide variety from which to choose. We succeeded in attending, learning and eating
breakfast, lunch and dinner in some of the most wide-ranging speciality meetings one can imagine. I am pretty
sure that, apart from the fact that this enabled me to have enough energy to cycle in and out of Central London,
I learned plenty. I do remember, however, a lecture on child psychiatry being beyond my comprehension, not
withstanding it started at 6am.

I have recently been asked to take over the Merseyside and North Wales Association of Physicians meetings,
which have lapsed for some time now (making note of the fact that the acronym of MANSWOP is not only
incorrect but potentially disappointing).

I find it challenging to work out how to try and recruit new members to this group, combining common interest
and enthusiasm about medicine across boarders, particularly when the old connections of training fellows are
slowly disappearing. It almost feels rather akin to the still delayed stability of the French fusion reactor.

Perhaps I will have to go back to the attraction that worked when I was a student: “let food be thy medicine and
medicine be thy food”

Mangez bien!

Richard Evans

6

LMI Transactions and Report 2014 - 2015
7

LMI Transactions and Report 2014 - 2015

‘The Missing Chapter’

The Inaugural Address of the 176th Session of the Liverpool Medical Institution
Thursday 16th October 2014
By: The President - Mr Max S McCormick

Prof Linda de Cossart and Mr Max McCormick

Introduction Cup. He was a shipwright and worked on the building
of the Titanic. Having achieved success in the 11-plus,
Members, colleagues and guests; first of all I would I entered Methodist College Belfast, a large mixed
like to thank you all for attending tonight and giving school of almost 2,000 people with two prep schools
me the honour of being your President for this 176th and fairly large sporting grounds. Achieving some
session. Thanks especially to the management success in sports activities, mainly in cricket, I managed
committee for putting their faith in me to do this. to achieve sufficient ‘A levels’ to enter medical school.
The choice of medical school was not straightforward
My talk will cover various aspects of my schooling, in that had I chosen Queen’s University Belfast, I would
training and passage through Medical School, Junior have had an offer from them and nowhere else. As it
Doctor training, Senior Doctor training and finally this was I chose Edinburgh, Liverpool and various others
appointment. The title of my talk ‘The Missing and ended up without an offer. Eventually Liverpool
Chapter’ relates to my work as a Consultant Surgeon, agreed to interview me and after a short meeting
whose main interests are in training new doctors and with the then Dean, Jack Leggate, an offer was made.
senior doctors as apprentices and hopefully making a The grades were achieved and I entered medical
difference to my trainees as to how they practise school in 1968. I really enjoyed medical school in all
medicine. aspects, academic, social and artistic, taking part in
many activities including being President of the
Born in Belfast to George and Jessie, my background Medical Students’ Society in 1971-72. Marriage and a
was fairly humble. I attended State primary school young family commenced shortly after this. Early jobs
and subsequently Methodist College Belfast, a State as a House Officer and Senior House Officer in
grammar school. There was a strong history of Whiston were followed by periods of plastic surgery,
working with ships and indeed my grandfather won gynaecology and eventually time in the
many trophies building model yachts sailed at a local demonstrating room, time well spent to obtain
reservoir. We still retain one cup, larger than the FA primary FRCS.

8

LMI Transactions and Report 2014 - 2015

It was at this point I entered training in ENT as an SHO my thoughts in relation to management.
under the guidance of Philip Stell. Six months into this
training I was able to get a Registrar’s post in Oxford It is accepted by all of us that today’s trainees are not
at the Radcliffe Infirmary (the old Radcliffe in the as experienced as their predecessors. We now
centre of town) working with Bernard Coleman, Bill produce emergency safe surgeons and only with
Lund and Andrew Freeland. This was a great time for fellowships and subspecialisation post CCST
my academic career working with likeminded accreditation would a specialist be regarded as fully
individuals, both my level and senior to me, and also trained. This of course means that the general
the 3 Consultants with a tertiary referral practice. training that I gained has now devolved into otology,
Having obtained my Fellowship in Surgery I was able rhinology, head and neck cancer, facial plastics,
to then take advantage of an offer of a Registrar’s paediatric ENT and audiology i.e. the same sort of
post in the Groote Schuur Hospital, Cape Town, under subspecialisation which has happened in General
the guidance of Professor Sean Sellers. This was a very Surgery.
productive period of my life where I was able to utilise
what knowledge I had along with some surgical skills A lot of the conditions covered in otolaryngology are
but under good tutorship and supervision. On not surgical at all and need to be managed in the
completion of this contract and following a three clinic for example tinnitus and dizziness.
month locum in Bulawayo to cover expenses, I
returned initially to Oxford and subsequently to a Surgery, like virtually everything in medicine, is
Senior Registrar’s job in Liverpool. In January 1986 I individualised to each patient, but the same steps
commenced my full time post as a Consultant must be included in each case. This of course is learnt
Otolaryngologist, with sessions both at the Royal by repeated practice in a similar way to the same basic
Liverpool and Arrowe Park Hospitals. It was at this golf swing being used for every shot but then adapted
point that I noticed that the Royal Liverpool Hospital to special circumstances.
building was eleven stories high and the length of two
football pitches i.e. exactly the same dimensions as the I do feel however that the surgical training needs
Titanic. focus and guidance in particular areas, and I
understand that the undergraduate medical
Subsequently I dropped my sessions at Arrowe Park curriculum is being altered to provide some more
and took up sessions at Alder Hey Children’s Hospital. focus and guidance in this respect.
During this time I had worked with approximately 20
Consultant colleagues from whom I learnt a lot about I was fortunate in that I was able to travel to South
surgery, patient management, differing health care Africa and subsequently Zimbabwe using my medical
systems and it gave me an ability to analyse and assess degree almost as a passport. I would recommend this
treatment modalities. to any trainee as a method of broadening your
outlook on life and experiencing different values in
The Missing Chapter healthcare systems.

As indicated earlier, this is the bit of all textbooks The “Whenwees”
which is missing i.e. how to interpret facts and
translate them into patient management. Most of this A displaced group of ex-pats from Rhodesia are often
can only be taught by the bedside or in theatre or in referred to as The “Whenwees”, due to the way that
relaxed frank discussion. I don’t think there is when they meet to discuss the good old days it nearly
anything didactic in this method of teaching: always starts with ‘when we …’. Perhaps I feel a little
textbooks are full of facts and whilst accurate, are like that on looking back at my career, and asking
themselves pretty lifeless. It is the job of the surgical what in fact was wrong with selection and
tutor to enable trainees to elicit and recognise competition? What is the benefit that the
physical signs and then with all the other relevant introduction of university fees has given apart from
details relating to a patient, formulate a management shifting the burden of debt from the State to the
strategy and a plan for treatment. I have estimated student? What was wrong with providing the
that I have perhaps worked with almost 300 trainees underprivileged and underfunded student with a
in my 29-year surgical career and hope that many of student grant as opposed to encouraging to take out
these have been influenced in a positive way about even more loans on top of the university fees?

9

LMI Transactions and Report 2014 - 2015

The NHS Acknowledgements

I work in a system where there appears to be I would like to thank all those that have supported me
continual change and it certainly feels like a top-down in my career and particularly the State education
managed structure. Not only is there continual system, the NHS for supporting my apprenticeship,
change in management, there are continual changes friends who have shared my professional
in ideas, often at the behest of politicians, with development and other providers of opportunities.
nothing longer than a short to medium term
management plan. As clinicians, we often feel Finally I would like to thank my wife, Siobhan, who
disenfranchised offering advice about management. has been an unerring supporter whether it be pushing
I have often wondered whether the NHS might from behind, supporting me by my side or indeed
benefit from a similar structure to the Bank of leading from the front. We have shared this passage
England, who have an independent Board which through medical school, junior doctor, senior doctor
makes recommendations to the Government. and now entering the twilight of my career, I am still
very glad of her presence.

10

LMI Transactions and Report 2014 - 2015

The Henry Cohen History of Medicine Lecture

Delivered on Thursday 30th October 2014

By Professor Mark Harrison, Professor of the History of Medicine and Director of the
Wellcome Unit for the History of Medicine at Oxford University

‘Britain’s Medical War: Health and Medicine in the British Army, 1914-18’

Prof Vikram Jha, Prof Mark Harrison & Mr Max McCormick

In some ways, World War I represented a turning point brought in casualties from the battlefield and they
in medical care during conflict. In major wars up until then passed down a chain from regimental aid post to
then, more soldiers had died of disease than from collecting post, dressing station, casualty clearing
battle injuries. The disease:combat fatality ratio had station and hospital. Long ambulance trains ferried
been 5:1 in the Crimean and American Civil Wars and the wounded to the hospitals, hospital ships carried
2:1 in the South African War. Compare this to the wounded over the Channel and hospital trains were
ratios in WWI and WWII which were 0.7:1 and 0.1:1 available on both sides of the Channel.
respectively and the contrast is clear. However, when
hospital admissions were included as well as deaths,
there were major variations in the disease:combat
ratio in different theatres.

Professor Harrison set out to examine the explanations
for these differences in 3 WWI theatres. Among British
and Empire forces on the Western Front in France and
Flanders, 56% of deaths and hospital admissions were
‘non-battle’, in the Dardanelles this figure was 68%
and in Mesopotamia (modern Iraq) 91%.

In all theatres, 85-90% of non-battle casualties were A convoy of Red Cross Ford Ambulances (built to order
from disease. On the Western Front, where battle lines of the French Relief Fund) en route from Liverpool to
were relatively static for much of the war, the numbers London. The convoy reached the Metropolis without
were enormous and a vast ‘medical machine’ was mishap, proceeding via Lichfield, Coventry and St
established. Over 5.5 million were admitted to Albans.
hospital, 183,454 died of wounds and disease, almost
3 million returned to duty in theatre and 2.3 million Ford Times September 1915.
were evacuated out of the theatre. Stretcher bearers

11

LMI Transactions and Report 2014 - 2015

generated lack of supplies and prolonged casualty
evacuation to base facilities, with the added risk of
interruption by enemy action. Casualty evacuation
was more difficult during advances or retreats.
Operations also generated new varieties of medical
problems such as shell-shock and gas poisoning on the
Western Front. There was little shell-shock in
Mesopotamia. Relationships with the local population
could be hostile in Mesopotamia and it was always
important to negotiate with the locals.

Geographical factors played a major role. The With the rising tide of nationhood in the British Empire
prevalence of diseases such as typhoid in the local it was important that Imperial troops were seen to be
civilian population and in animal reservoirs would treated fairly. On each side of the conflict, nations
influence the likelihood of infecting the soldiers. accused each other of poor treatment of prisoners.
There were problems of heat stroke in the Dardanelles
and Mesopotamia, and of frost bite in France. The Relationships between commanding officers and
terrain in France was flat and there was a pre-existing medical officers was crucial. The Medical Act of 1858
infrastructure of roads and railways, although increased the professionalisation of medicine and the
flooding, wind, snow and ice could be problems. Royal Army Medical Corps was founded in 1898, giving
medical officers the same ranks as the rest of the army.
Casualties in the Dardanelles were evacuated under However, relations remained strained in the later part
fire to poorly-organised medical facilities. Although of the Victorian era. In the Boer War the senior
these improved compared with the second wave of commanders such as Lord Roberts and Sir Garnet
landings, there was no space in the bridgeheads and a Wolseley had a poor opinion of medical officers and
lack of resources for anything like what was available this view appeared to pass down the chain of
on the Western Front. In Mesopotamia there were no command. There was a great gulf between combatant
railways and few roads. Transport was by horse- or officers and medical officers and operational plans
donkey-drawn vehicles over very long distances, until were drawn up without consultation with medical
a river could be reached. officers. Advice on water purification, sanitation and
rations was ignored, resulting in 8000 deaths from
typhoid. Consequently public support for the war
declined.

To some extent, technology played a part in ironing After the Boer War, lessons were learnt. There was
out the differences between the 3 theatres. In better training of commanding officers in the
particular, immunisation against typhoid and tetanus importance of hygiene and sanitation. It was thought
was available in all 3 areas, but immunisation against that better Japanese medical services had contributed
cholera was only 50% effective. Each theatre to their victory in the Russo-Japanese War. The
presented its own unique challenges, but the efficiency and status of the army medical services were
difficulties remained greatest outside Europe. built up by Lieutenant General Sir Alfred Keogh, who
Geographical difficulties could be partly overcome was Director General 1904-1910 and 1914-1918. He
given sufficient planning and resources. worked well with Lieutenant General Sir Arthur
Sloggett who was in charge of medical services on the
Operational factors always played a major role. For Western Front. Although the rapid expansion of the
the medical services, the relatively static theatre on the army diluted knowledge and caused a relative lack of
Western Front carried major advantages, allowing training, every effort was made to overcome this. The
facilities to be built up over a period. Combined High Command on the Western Front was acutely
operations such as in the Dardanelles added problems, aware of the connection between good medical
with poor communications and rivalry between the services and morale and the need to provide good
army and navy. When warfare was more widespread, facilities to get soldiers back to their units as soon as
such as in Mesopotamia, the extended lines of possible.
communication stretching over thousands of miles

12

LMI Transactions and Report 2014 - 2015

In the Dardanelles, the situation was quite different.
General Sir Ian Hamilton excluded the senior medical
staff from his Headquarters before and during the
campaign. The senior medical officer, Colonel Keble,
was not provided with a boat to take him ashore and
was thus confined to his ship. Estimates of the number
of casualties and the means of evacuating them were
unrealistic and there was poor coordination between
commanding officers and medical officers. The navy
was poorly equipped for amphibious operation and its
ships poorly equipped to deal with casualties. Facilities
and attitudes improved with the second wave of
landings but always lagged behind those on the
Western Front.

Mesopotamia was largely the responsibility of the Scrutiny of events by war reporters was surprisingly less
Indian Army, with its culture of deference to authority. important in informing the population at home than
Medical officers were excluded from Lt. Gen. Sir John the return of casualties, visits by dignitaries and
Nixon’s HQ and little thought was given to logistics or politicians and the presence of civilian volunteers and
sanitation. The campaign was very poorly resourced experts in the army. The sister of Sir John French, head
until the handover to control by the War Office in of the British Expeditionary Force in 1914, was a VAD
1916. General Nixon would withhold information nurse who had no hesitation in informing influential
from the Viceroy in Delhi and the Viceroy would friends at home of any deficiencies she came across.
withhold information from London. The distances Sir Frederick Treves on the other hand was guilty of
were enormous and casualty evacuation was held up concealing evidence both in the Boer War and in WWI.
by lack of boats. Nixon was eventually replaced by Lt The High Command was acutely conscious of the need
Gen Sir Frederick Maude in 1916 and there was a slow to maintain public support at home.
but steady improvement. Less deferential civilian
doctors who had volunteered to serve such as Colonel
Sir Victor Horsley1 also played a role in improving
facilities. Horsley unfortunately died in Mesopotamia
in 1916. Apart from the first period of the war in 1914,
the Western Front was well resourced medically. The
Dardanelles theatre was under-resourced but things
improved with the second wave of landings.

Hospital ship No. 1, bearing sick and wounded from Kut, In conclusion, the differences between the three
coming alongside the bank of Tigris at the British lines theatres of war were not simply due to geographical
at Flalhiyah. or operational factors. In general, sanitary and
medical conditions improved even in unpromising
conditions and the main reasons for this were external
scrutiny, better resources and better relationships
between commanding officers and medical officers.
The need for manpower economy and the morale of
troops and families stimulated improvements in the
medical arrangements. The medical and sanitary
advances which were occurring at home diminished

13







LMI Transactions and Report 2014 - 2015

He continued with a slide showing the photographs quickly, within a month of the first letter. In 2012, 800
of the medical members of the Council of the GMC. doctors were referred here and eventually 216 went
He invited the audience to name those in the to full panel hearings with a further one hundred
photographs. Not many could be named. He then doctors agreeing 'undertakings' related to the
showed photographs of the lay members of Council complaint. Panel hearings were 208 down from
and again few if any could be identified. He pointed previous year and there were 55 erasures and 64
out Dame Suzie Leather, former head of the Charity suspensions.
Commission who is now a lay member of the Council.
He reminded us that not only were these people Professor Narula continued, saying that until late 2013
responsible for overseeing the annual GMC spend of he was chief of neurosciences (ENT, Maxillo-Facial,
100 million pounds but were also our leaders in Head and Neck and Neuro) at Imperial and responsible
medical regulation. for nearly 100 consultants. The following two case-
studies illustrated what happens to individual
Fitness to Practice practitioners when things go wrong.

Professor Narula went on to say that as a practising Case Study One: Doctor has an affair with his
doctor, you may one day receive a letter from the secretary.
GMC, and as time goes on the number of people
receiving these will go up. He asked if any in the A respected surgeon, who was under Narula's care as
audience had received one. None had. Currently he a manager, received a letter from the GMC with the
said, each year about 1 in 25 will receive such a letter. criticism that he had taken advantage of a woman
It is probably the most awful heart sink moment in a colleague, started an affair with her and then dumped
doctor's professional career. her.

The letter will inform you of the complainant and you As the chief of the department Narula had received
will be asked to fill in the form to include all the places all the paper work and having read it, felt the GMC
that you have ever worked. The name of the complaint was without foundation.
complainant may be a very disgruntled patient and
well known to you. The GMC will follow this up by The surgeon told Professor Narula his version of the
writing to every medical institution at which you have story. He had had an affair and this had broken down
worked asking 'Is any thing known about this doctor?’ when he had declared to his lover that he was not
The chief of that organisation will have to consider going to divorce his wife. The investigation of the
their position when they reply. case uncovered the fact that during this affair the
surgeon had done two things which caused concern:
There are about 250,000 doctors on the register and in a) he had arranged for the lover to have an MRI scan
2012 there were 10,000 such complaints (4%). This of her knee at the hospital at which they both
figure has gone up by almost 20% on the previous worked, and b) he wrote her a prescription, for a drug
year and by 50% on the previous five years. Following she was already prescribed by her GP (thyroxine) as
review of the complaint 6000 will be dismissed but the there had been a delay in getting it from the GP. The
rest will trigger some sort of investigation. That GMC wrote demanding that he appear before them
translates into investigations being instituted by the within the next thirty days. A date was set.
GMC on 4000 doctors in one year. Approximately 60%
of these are likely to undergo a fuller investigation. Professor Narula said that he was so concerned about
This is an enormous workload, but perhaps more this doctor that he had visions of him getting onto a
worryingly it is a chance for sensationalists and railway station platform and throwing himself under
journalists to misuse the statistics and predict that in a train at Manchester Piccadilly on the way to the
time every doctor will be investigated. All of this hearing. He took a day off and went with him to the
neatly missing the fact this already causes huge pain hearing.
and agony to doctors and their families, in some cases
destroying careers of innocent doctors. The legal costs for the doctor for that day amounted
to £15,000. Narula said that he imagined that the
If the complaint is not dismissed, you may be called to GMC would have been paying a similar amount for
the Interim Orders panel. This will happen very their barrister. The final deliberation of the GMC was

17

LMI Transactions and Report 2014 - 2015

that there was no risk to the public, no action to take processes of feedback from patients and doctors. The
and no reason to proceed. However, it took just under main thrust of this process was to prevent another
two years before the letter saying this arrived on desk Shipman. But, our speaker went on to say, we all
of the surgeon. During that time his revalidation date know Shipman's patients loved him so, even as a mass
was due and because the GMC file was still open, the murderer, he was unlikely to be picked up by this new
Revalidation Responsible Officer at the Trust could not process. There was majority agreement for this from
action his revalidation process. the audience.

Case Study Two We are now in year two of the era of Revalidation. A
phased process has been introduced and it is
A consultant surgeon in his mid sixties, nationally and anticipated that all doctors in practice will have been
internationally well known, received a GMC letter. revalidated by March 2016. There is still much
The complainant was the private hospital at which he sceptism abroad in the profession about the process
worked and where he had complained that the and some believe that if approximately five per cent
facilities fell short of the required standards. The of doctors refused to engage, the whole system would
complaint indicated 10 cases where his practice had collapse.
been found wanting and threatened the safe care of
patients. Our speaker went on to say that the underpinning to
Revalidation is annual appraisal. The annual appraisal
Within 9 to 10 months of receiving this letter all of the process is meant to review the evidence of your
criticisms raised had been dismissed. However, 18 practice as a doctor and the evidence to support the
months later he got another letter from the GMC quality of that practice both in private practice and
saying it was now going to a fitness to practise NHS practice. It is meant to be both formative and
hearing. The ultimate outcome of this hearing was summative in supporting the continuing professional
that there was no case to answer. The effect on this development of you, the doctor. “In my experience”,
man's life has been considerable both personally and said our speaker, “I have been appraised since 2003
professionally as a practising surgeon as well as to his but never been asked about my private practice.”
family.
The process of appraisal is that the doctor submits a
Our speaker went on to say that the Medical portfolio of evidence in line with the four domains of
Protection Society have said that 93% of doctors who the GMC standards for Knowledge Skills and
go through fitness to practise processes report severe Performance; Safety and Quality; Communications,
anxiety and stress. Whistle-blowing brings with it Partnership and Team work and Maintaining Trust.
considerable personal risks. Nowadays this is an electronic repository, which can
be supplemented at the time of appraisal by paper
Revalidation records and evidence. Following a successful appraisal
meeting, a summary is agreed by appraiser and
Professor Narula changed to the subject of Medical appraisee and a professional development plan (PDP)
Revalidation. He said that in the early 2000s the GMC is drawn up and this will form the framework for the
was all set to institute new and improved next appraisal. Our speaker went on to say that there
recertification processes and procedures for doctors in is a requirement in the portfolio for Reflection. He
medical practice in the United Kingdom. However, admitted that he was not sure what this was really
Dame Janet Smith, the High Court judge who chaired about and that many felt the same way.
the Shipman enquiry, heavily criticised the ideas
behind these proposals in her third and final report. One of the key things for appraisal, he offered, is the
Many lawyers criticised her for going outside of her inclusion of national registry data about outcomes for
remit in the enquiry by making these comments but index surgical operations. This is particularly true for
her intervention led to a revisiting by the GMC of this surgeons. He said with considerable feeling that he
whole process. had resisted the recent desire by government for
publication of such data before individual clinicians
Thus a whole new bureaucracy was designed to had had time to see their own results. He went on:
respond to the criticism but in fact the only real
difference that came forth was the introduction of “There are in my opinion a whole lot of potential and

18

LMI Transactions and Report 2014 - 2015

real risks of poorly collected data. The Team and the Many of these things suggest, he said, that the GMC
environment of surgical procedures plays a huge role has many unanswered questions. Medical
and is often not accounted for within the data and the practitioners especially outside of London need to
reported results are often to the detriment of an remain vigilant and be able to voice critique on what
individual until things are investigated in more the GMC and government is doing in particular taking
detail.” note of the many unregulated healthcare providers
on the high street.
He continued by saying that the electronic portfolio
systems are awful and there are many companies Professor Narula concluded with some amusing videos
learning how to construct the database 'on the job' that in a comic and ironic way emphasised some of
and making money out of healthcare providers in these points. He finished by thanking the LMI for
doing so. As the King's Fund has said “it [appraisal] inviting to him to speak and he paid warm tribute to
will become a box ticking exercise because you have to his wife for putting up with him and his mad working
have ticked the boxes to be allowed to proceed”. The ways. As a final point he offered the caption defining
well-meaning purposes of doing these things have the difference between complete and finished:
been lost in this awful process. The system is unlikely
to pick up those doing locums and in independent “If you marry the right person your life is complete if
practice who may fall short of the standards. you marry the wrong person your life is finished, but
if you marry the right person and get caught with the
This bureaucratic monster has been set up by the wrong person you are completely finished.”
Department of Health and the GMC. Locum and
retired doctors have problems in ensuring that they The audience responded with applause and there was
can account for their practice and remediation for the usual time for questions. The meeting concluded
those falling short of the standards is also very with supper.
difficult. He said his experience of managing such
processes left him very concerned about how Linda de Cossart CBE
meaningful remediation could be achieved.
Remediation is a massive problem he said because
many complaints fall into the domain of psychological
problems and few in managerial positions have the
range of skills to respond to this.

He went on to say that the GMC has commissioned a
report from Collaboration for Education and Research
Assessment in Plymouth. He explained that he was of
the opinion that it will find that the profession is
spending a lot of energy and money on ticking boxes
and not getting on with the job in hand. There is
other unfinished business: there is no quality
assurance of the appraisal system between Healthcare
Trusts and this will lead to inconsistencies if and when
doctors move between Trusts.

19

LMI Transactions and Report 2014 - 2015

Minutes of the Second Ordinary Meeting

Held on Tuesday 18th November 2014

Joint Meeting with Liverpool Medical History Society
The Tenth Annual History of Medicine Medical Students’ Prize Evening

Back (left to right): Dr Nick Beeching, Mr Max McCormick, Dr Stephen Kenny, and Dr Christopher Evans
Middle (left to right): Shane D’Souza, Alexander Boone,

Professor Sally Sheard, Dr Susan Evans and Dr Peter Dangerfield
Front (left to right): Kitty Worthing, Siân Elsby and Sophie Gealy-Evans

Kitty Worthing - Winner Laing and his ideas before finally looking at the extent
‘Crazy to be sane - whatever happened to RD Laing?’ to which Laing's ideas are in fact an influence on
modern day attitudes to defining and treating mental
R D Laing was a well-known figure in the 1960s both illness - an influence which it argues can be seen in,
in the medical community and amongst sections of the for example, the 'user movement' and in the
wider public. He became an important, and for a popularity of 'self-help' groups. I will conclude that
while, influential figure in redefining and treating although much of Laing's work lacked scientific
mental illness - in particular Schizophrenia. However validity, his contribution to making 'madness'
his ideas and influence were apparently short-lived. comprehensible and encouraging people to consider
Given criticisms of the style of psychiatric diagnosis mental illness from an empathic and humanistic point
currently employed, this presentation examines of view is of great value to contemporary medical
different historical constructions of mental illness and practice and wider society. It also highlights that there
how it is treated. Opposition to psychiatry has taken is a lack of historical analysis concerning the anti-
many forms, all of which could not be covered by this psychiatry movement; especially in regards to its
presentation. Therefore I have chosen to focus on demise.
outlining the ideas of RD Laing and the 'anti-
psychiatry movement' and to consider the Shane D'Souza - Second Place
contribution that he, and they, made to the ‘Gertrude Elion and Her Drug Discoveries’
understanding and treatment of mental illness. Firstly
I will reflect upon the attitudes and treatments Gertrude Elion made significant discoveries of drugs
prevalent in the 1950s and ‘60s and the critique of in the treatment of leukaemia, herpes and anti-
these made by Laing and others. I will then examine rejection drugs for kidney transplants. Her hard work,
some of the possible reasons for the backlash against commitment and attitude led to revolutionary

20

LMI Transactions and Report 2014 - 2015

developments in the medical world, for which she was gained Paracelsus much notoriety. His actions
awarded the 1988 Nobel Prize in Physiology or ultimately led to his exile. Paracelsus argued that the
Medicine. Not only did Gertrude Elion work on drugs body operated as a chemical system subject to internal
to fight HIV and malaria, she remains an inspirational and external influences. This premise led Paracelsus
figure and a role model of a woman who persevered to introduce chemical substances into medicine.
in science at a time when there was unfair Mercury, for example, was used for the treatment of
discrimination towards women in science. Syphilis. Paracelsus is therefore often termed the
‘Father of Toxicology’.
During the presentation, I discuss the knowledge and
ideas presented before Gertrude’s discoveries, and I propose to discuss the modern day relevance of
how her discoveries have since changed the ideologies Paracelsus and also Paracelsian theory in terms of its
in drug treatment since up to the modern day. I medical, philosophical, socio-political and religious
consider previous ideologies of male dominance in connotations. I hope to convey the pugnacious
science and how Gertrude Elion acted as a temperament of the man and define exactly how he
distinguishing example as someone who has broken defied medicine in his day!
these barriers.

The presentation discusses her background, career Siân Elsby - Runner-Up
struggles, women in STEM; science pre-1954 (specifics ‘Medical Ethics and the Third Reich’
regarding knowledge on Malaria/Leukaemia/Anti-
rejection medicines); science post-1954 (the above The atrocities perpetrated during World War II are
topics and how Elion’s contribution has affected well documented. The Nazi eugenics movement
modern day medicine); the way forward in Medicine. persecuted ‘sub-human’ non-Aryans: labelled as
'genetically unfit', these people were rounded into
Alexander Boone - Third Place concentration camps and routinely sterilized, used as
‘The Exile of Paracelsus’ subjects in human experimentation, and killed. The
scale was unprecedented: after war broke out in
‘The art of healing comes from nature, not from the September 1939, so-called 'mercy deaths' became
physician. Therefore the physician must start from commonplace at mental hospitals - between January
nature, with an open mind’ – Paracelsus. 1940 and September 1942, some 70,723 mental
patients were gassed. The total number of Jews
In 1526, Philippus Aureolus Theophrastus Bombastus murdered during the war is estimated to be between
von Hohenheim, otherwise known as ‘Paracelsus’, was 5.5 and 6 million.
appointed Professor of Medicine at the University of
Basel, Switzerland. In 1538 he was exiled from Basel Much of this torture was given pseudo-scientific
and died just three years later in Austria. justification and perpetrated by willing medical
professionals. When war ended in 1945, one of the
Paracelsus is commonly regarded as one of the most Allies' priorities was bringing war criminals to justice.
influential medical scientists of the Renaissance era. Between December 1946 and August 1947, a trial was
His methods revolutionised medicine in early modern held in Nuremberg - commonly called 'The Doctors'
Europe. Paracelsus rejected the ancient texts from key Trial', the defendants included twenty medical doctors
authorities such as Galen and Celsus and insisted upon and three Nazi officials accused of human
using observations of nature to guide his own medical experimentation and mass murder under the guise of
practice. He specifically rejected Galen’s claim that euthanasia. A defence offered by many was that no
health and disease were controlled by the ‘four ethical guidelines governing human experimentation
humours’. Paracelsus encouraged the study of nature existed at the time - so no laws were breached.
and pioneered an experimental approach. He also
believed in the existence of gnomes, spirits and fairies. The Nuremberg Trials gave rise to the Nuremberg
Code in 1947 - it was 'a catalogue of ten principles
Public burning of books by Ibn Sina and Galen, which would protect the rights of experimental
inviting non-academics and lay-people to his lectures subjects and other vulnerable groups in the future’.
and rejecting much of university-taught medicine This led to the Declaration of Geneva in 1948, which
shaped the Declaration of Helsinki in 1964 - a set of

21









LMI Transactions and Report 2014 - 2015

infection whilst a small percentage (<5%) will develop alternative treatments which will maintain the current
a persistent infective state and an even smaller favourable survival outcomes whilst reducing the
percentage will go on to develop OPSCC. Why this long-term consequences of treatment on swallowing.
happens and why the incidence has increased in the Employing some gory images and video clips of how
last 3-4 decades is also unclear. Paradoxically, whilst to access and remove the tumours from the
these tumours present with apparently adverse oropharynx, data showing the effectiveness of
clinico-pathological features – multiple enlarged neck transoral laser microsurgery (TLM) in achieving this
lymph nodes with a high prevalence of extracapsular aim were presented.
spread - they are more responsive to treatment than
HPV negative cancers. However, conventional Both talks finished well ahead of schedule and left
treatments are associated with significant long term ample time for an intrigued and lively audience to ask
adverse effects on swallowing, to the extent that 15- lots of pertinent questions.
20% of treated patients will require feeding through
an enterostomy tube for the rest of their life. C O’Mahony
Therefore, much research effort is directed to finding

26

LMI Transactions and Report 2014 - 2015

Minutes of the Fifth Ordinary Meeting

Held on Thursday 8th January 2015

Joint Meeting with the Liverpool Society of Anaesthetists

‘Improving Outcome for High Risk Surgery’
Prof Rupert Pearse, Royal London Hospital

Mr M McCormick, Prof R Pearse and Dr E Forrest

Professor Pearse opened his talk by declaring two of anastomotic leaks. Therefore these major surgical
conflicts of interest; firstly he believed that surgical complications had reduced in incidence. However the
outcomes can improve and secondly, despite having medical conditions with which patients present had
trained as an anaesthetist, he no longer gives changed. Those with significantly greater
anaesthetics. He quoted the paper by Weiser T.G. et al1 comorbidities were now undergoing major surgery for
which estimated that there were 234 million major which, in the past, they would be deemed unsuitable.
surgical procedures worldwide each year. The mortality Finally the perioperative care of these patients was
rate for all this surgery is not known. If 1% of patients becoming increasingly important with the recognition
could be prevented from dying as a result of surgery, and early treatment of worsening medical conditions
this would result in 2.3 million avoidable deaths each becoming vital. He looked at the consequences of
year. He then showed a slide demonstrating the anaesthesia and surgery where an inevitable
international variation in adjusted mortality risk in consequence, such as wound inflammation, develops
comparison with the UK. It appeared that northern into a wound infection: a complication. This could also
European and in particular Scandinavian countries had be respiratory impairment becoming a pneumonia,
the best results with eastern and southern European immobility resulting in pulmonary embolism and
countries having the worst. He looked at the work of organ dysfunction becoming acute kidney injury. This
Ghaferi2 which showed that although surgical death was far more likely in the increasingly frail and
rates vary widely across hospitals, the rate of comorbid population undergoing surgery.
complications seems to be similar.
Professor Pearse spoke about his vision of
To understand post-operative complications, Professor perioperative medicine, of which there are many
Pearse thought that you had to consider three things. definitions. He offered one which was the prevention
Firstly the surgery, which technically had greatly and treatment of harm resulting from the tissue injury
improved, for example, with significantly lower rates of surgery (and anaesthesia). He thought that the

27

LMI Transactions and Report 2014 - 2015

battle for safety in anaesthesia had now been largely surgery and showed a paper by Khuri et al6 which
won and thought that is was time to take this further demonstrated those with either pulmonary or wound
outside the operating theatre. He discussed pre- complications had a significantly lower 5 and 10 year
operative assessment which tried to predict patients survival after surgery. This was again demonstrated for
who may have poor surgical outcomes. He highlighted acute kidney injury after cardiac surgery7. Acute
cardiopulmonary exercise testing, one area in which he kidney injury was a key cause of chronic kidney disease
was currently researching. He quoted a paper by as a result of loss of nephrons during each episode. He
Musallam K et al3 which highlighted the incremental reminded the audience that the serum creatinine
risk of anaemia with other comorbidities such as actually falls after surgery and therefore if it is raised,
cardiac disease, COPD, renal impairment, all being this is evidence of a much bigger injury than a rise
associated with a higher mortality. Therefore, as associated with no surgery. Finally, he thought that
Shander A et al4 had highlighted, perioperative patient anaesthetists should see some patients in post-
blood management is vital for good outcomes. This operative clinics because they tend to be better at
includes optimising haemopoiesis, minimising blood looking at the whole patient rather than just the
loss and bleeding and the improvement of tolerance outcome of surgery. They can then refer patients to
of anaemia. He wondered how many of us have been relevant specialists if organ dysfunction has worsened
presented with a patient on the day of surgery who as a result of these surgical episodes.
had been inadequately optimised but we all felt the
pressure to continue. Almost always we manage to Professor Pearse thought that surgery could often be a
get the patient through anaesthesia and surgery but sentinel event with this being the first contact that
the real problems seem to start a couple of days many patients will have with a doctor. This can lead to
afterwards where inevitable consequences often the unmasking of many co-morbidities which often
become complications. Therefore individualised care need to be treated prior to surgery and anaesthesia.
must be the aim of pre-operative assessment. He highlighted a number of quality improvement
initiatives, such as the publication of performance data
Professor Pearse then looked at the surgical event and for individual surgeons and the way that cardiological
highlighted the importance of checklists and the services have been reorganised over the last 10 years
variable use of the WHO checklist across Europe. He showing a major improvement in 30 day survival
spoke about other factors that may help to improve following STEMI. He spoke about the EPOCH trial
outcomes such as minimally invasive cardiac output (Enhanced Perioperative Care for High Risk Patients)
measurements and the use of epidural anaesthesia. He which is a project to implement an integrated care
thought that these were very important and pathway for patients scheduled for emergency
anaesthetists in general were not very good at laparotomy. He described how healthcare can learn
highlighting the necessity of putting their case across lessons from other industries and highlighted the way
strongly for pieces of equipment or better nursing that the building of Crossrail in central London had
care. changed building culture to greatly improve the safety
of workers on the project.
Professor Pearse discussed events occurring early after
surgery and reminded the audience that acute organ Finally he thought that the Royal College of
injury can be a cause of long-term harm. This can Anaesthetists should be renamed that Royal College of
include acute lung injury, sepsis-related myocardial Perioperative Medicine and reminded the audience
injury and loss of muscle function. He quoted a paper that the College was soon to roll out its initiative in this
Squadrone V et al5 which showed that the early use of area.
CPAP (Continuous Positive Airway Pressure) for the
treatment of post-operative hypoxaemia can 1 Lancet 2008;372:139-44
significantly reduce post-operative respiratory 2 NEJM 2009;361:1368-75
complications. He also highlighted the association 3 Lancet 2011;378:1396-407
between post-operative troponin levels and mortality. 4 BJA 2012;109:55-68
Post-operative rises in troponin were associated with 5 JAMA 2005:293;589-95
a much higher mortality than similarly raised levels 6 Ann Surg 2005:242;326-343
found in patients admitted through A&E. 7 Hobson C et al, Circulation 2009:119;2444

Professor Pearse went on to look at events later after Ewen Forrest

28

LMI Transactions and Report 2014 - 2015

Minutes of the Sixth Ordinary Meeting

Held on Thursday 22nd January 2015

‘What I’ve Learnt from Cleveland’
Dr G P Wyatt, The James Cook University Hospital, Department of Paediatrics,
Middlesborough

Dr G Wyatt and Mr M McCormick

The meeting started with the President of LMI, Mr Dilatation’. The first wave of admissions of children
Max McCormick, introducing our guest speaker Dr G P was in May 1987. In all some 121 children were taken
Wyatt who was in fact a Liverpool Medical Graduate. into temporary local authority care. This led to
He had graduated in 1973 the same year as our widespread media coverage and the local MP Stuart
President and several other LMI members. Bell made a statement in the House of Commons.

Dr Wyatt was one of the two paediatricians involved The Tory government set up an inquiry under Lord
in the 1980s child abuse scandal in Cleveland. He gave Justice (Elizabeth) Butler-Sloss which sat for a year and
a very emotional and somewhat disturbing account of published its report in 1988. Dr Wyatt pointed out
his involvement in the matter. Indeed he told us that that at NO time did the inquiry look into the accuracy
it was the first time in the ensuing 17 years that he of the doctors’ diagnoses.
had spoken openly in public about it.
Dr Wyatt gave evidence to the inquiry in December
He summed up his talk in his first slide. “After 1987. He returned to work in March 1988 with a
Discovery comes Discredit, then Discipline, then restriction on his practice which he described as a loss
Discussion, then Delay, then Denial, then Damage, of his clinical freedom. Points about this were raised
then Defiance, then Dismissal.” by members of the audience.

Dr Wyatt used the Cleveland report to illustrate his The two paediatricians were accused of compromising
talk and went through it in fine detail. He was a the work of social workers and demands for action
newly appointed consultant paediatrician in 1987 and were made in July 1988. Dr Wyatt read an extract
wanted to improve his knowledge of managing sexual from the minutes of a meeting held at The Royal
abuse in children. He therefore discussed the topic Society of Medicine at which Lord Justice Butler-Sloss
with his colleague Dr Marietta Higgs. One of the was asked whether the inquiry should have
clinical signs they relied upon was ‘Reflex Anal considered the individual cases to see if abuse had

29

LMI Transactions and Report 2014 - 2015

occurred. He also pointed out that there was NO Dr Wyatt made the point that he was not reported to
recommendation of a restriction of clinical practice the GMC by his employers at any time. He felt that if
made in the Cleveland Report. Despite this he was that had happened he would have been subject to
sent a letter about disciplinary action on 18th October regular review but would not have had to endure the
1988 and his severe reprimand was made public! 20 year restriction on his clinical practice that the RHA
had imposed. Did that restriction amount to a breach
At this point Dr Wyatt donned a striped prison hat and of his human rights?
vest! He then told us that it was later found that there
was no wide scale error of diagnosis made by Drs His contract was eventually terminated in 2010. He
Wyatt and Higgs and a significant number of the then undertook forensic training and he is now
children were subsequently found to be victims of working as an independent expert writing reports and
serious abuse. He said their accuracy of diagnosis was assisting the courts by giving evidence.
70-75% which is as high if not higher than other
branches of medicine! The meeting concluded with a lively question and
answer session between Dr Wyatt and the audience.
In December 1988 the Regional Health Authority It was quite clear to all who attended that Dr Wyatt
issued the following to Dr Wyatt: had been through a very traumatic emotional ride
- a severe reprimand throughout the whole of the Cleveland affair and that
- a warning as to his future conduct it still affected him deeply. He was thanked by Dr J
- a restriction of clinical freedom in that he would Tappin on behalf of the members for sharing his
have no further involvement in child abuse matters. experiences with us.

John Dorgan

30

LMI Transactions and Report 2014 - 2015

Minutes of the Seventh Ordinary Meeting

Held on Thursday 29th January 2015

Joint Meeting with Merseyside Medico-Legal Society

‘Contemporary Themes in Whistle-blowing’
Dr Peter Wilmshurst, Consultant Cardiologist & Ethicist, University of North Staffs

Mr N Gilmour, Mr M McCormick, Dr P Wilmshurst and Dr C Evans

Over sixty members and guests attended the lecture and special leave offered to whistleblowers had cost
given by Dr Peter Wilmshurst, a retired cardiologist the NHS millions of pounds.
from Shrewsbury who formerley worked in Stoke at
the North Staffordshire Hospitals, recently rebranded A special area of concern was research fraud in which
after the mid Staffs debacle. The meeting was opened multinational companies attempted to influence
by our President, Mr Max McCormick, who noted that results and findings of individual doctors, who in turn
whistle-blowing was following a series of related came under intense pressure from high ranking
topics concerning the GMC. Dr Wilmshurst was colleagues, Trust managers and, shockingly, academic
introduced by HH Judge Nigel Gilmour, a past institutions and their heads of departments.
president of the MMLS, deputising for Miss Wendy
Owen who was ill. Dr Wilmshurst related the long saga of a doctor who
had fabricated results, was awarded academic
We were told that in general, whistleblowers were distinction, subsequently admonished by the GMC,
treated worse than those about whom they then re-employed, dismissed as clinically dangerous,
complained. Dr Wilmshurst cited the former Bristol only to be appointed as a consultant elsewhere. He
anaesthetist, who, following the Bristol Kennedy then went on to be awarded Fellowships of Royal
enquiry had been obliged to seek employment in Colleges, and unbelievably, a national clinical
Australia, only to be invited back to the UK to deliver excellence award. Most recently, and utterly
a prestigious lecture to the Royal College of astonishingly, he was awarded a national honour in
Anaesthetists some fifteen years later. High profile recognition of patient safety.
cases involving doctors, radiographers and nurses who
had been the subject of professional and physical By now the audience would have believed almost
intimidation by managers were discussed in clinical anything about the "Club Culture" influencing
detail and included Baby P, gagging clauses, duty of decisions of regulators and that similar double
candour and child protection issues. Such suspensions standards affected the judiciary.

31

LMI Transactions and Report 2014 - 2015

In vigorous discussion Dr Wilmshurst highlighted the Our president gave the vote of thanks and members
international parallels in Europe, America as well as left the institution into the freezing snowy conditions
the third world and the low probity ranking of the UK. bewildered after learning of such a catalogue of cases.

Chris Evans

32

LMI Transactions and Report 2014 - 2015

Minutes of the Eighth Ordinary Meeting

Held on Thursday 5th February 2015

Joint Meeting with the Institute of Physics

‘Stimulating the Parts that Other Treatments Can’t Reach: The Use of Functional
Electrical Stimulation in Neurological Rehabilitation’
Professor Ian Swain, Clinical Director, Odstock Medical Limited. Professor of Clinical
Engineering, Bournemouth University

Dr H Stockdale, Prof I Swain and Mr M McCormick

Professor Swain studied Electronic Engineering at (ii) The setting up of a commercial company in
Southampton University and went on to complete a conjunction with the NHS Trust to manufacture and
PhD at the same institution. He was, until the end of market the devices used in FES.
2014, the Director of Clinical Science and Engineering
at Salisbury NHS Foundation Trust, a role which he (iii) Clinical results for the application of FES to patients
combined with that of Clinical Director of Odstock with neurological disorders. At the end of his talk, he
Medical Limited (OML) and Professor of Clinical gave examples of other clinical uses of FES.
Engineering at Bournemouth University. He continues
in his role with OML as well as his Chair at (i) The basis of FES and its history in Salisbury
Bournemouth.
Stimulating muscles with electrical currents has a long
Professor Swain’s talk concentrated on three aspects of history. The ancient Greeks used the technique on
his work: torpedo fish by rubbing amber (clearly, not knowing
what was happening) through to the work of Volta
(i) The basis of Functional Electrical Stimulation (FES) and Galvani in the 1790s who demonstrated muscle
and its history in Salisbury. He outlined the clinical uses contraction when starting and stopping electrical
of FES in patients with Dropped Foot due to upper current. More recent work involved the development
motor neuron lesions (pointing out that FES was not of external and implanted pacemakers in the 1950s.
indicated in the rehabilitation of patients with The essential point of the application is to apply an
Dropped Foot due to lower motor neurone damage). active electrode to send a current through a nerve
which causes adjacent muscle contraction with the

33



LMI Transactions and Report 2014 - 2015

He also commented on the opinion of the National In conclusion, Professor Swain stated that FES enables:
Institute for Health and Care Excellence (NICE) which (i) a significant increase in walking speed, (ii) clinically
considered the treatment of Dropped Foot using manageable changes in a patient’s functional walking
electrical stimulation (www.nice.org.uk/IPG278) and category, (iii) a significant reduction in the effort of
which supported the use of FES for patients with walking, (iv) a significant reduction in fear of falling,
Dropped Foot of central neurological origin. and (v) a greater likelihood of achieving personal
goals.
He also briefly reported on the use of FES to improve
hand function, orthopaedic muscle strengthening, At the end of Professor Swain’s presentation, Mr
spasticity reduction and facial stimulation among other McCormick invited questions and Professor Swain
clinical applications. responded to several questions from the audience.

To indicate the level of workload by staff and the Dr Harold Stockdale (IOP Branch member and IOP link
commitment required for the patients, he gave details to the LMI) thanked Professor Swain for this
of the standard treatment packages, namely: entertaining and informative talk. That the question
session lasted for twenty minutes (and had to be
For walking stimulation: ended because of time constraints!) in itself indicated
- Initial assessment the degree of interest generated by the talk. The
- Set up audience showed its appreciation of Professor Swain’s
- Follow up at: 2 set ups in the first week; 6 weeks; 3 talk in the usual manner.
months; 6 months; thence annually.
Dr H Stockdale
For upper limb and facial:
- Initial assessment
- Set up
- Follow up at: 2 weeks; 6 weeks; 10 weeks; 18 weeks
and 26 weeks.

35

LMI Transactions and Report 2014 - 2015

Minutes of the Ninth Ordinary Meeting

Held on Thursday 12th February 2015

‘Reasons Why Average Life Expectancy is Set to Fall in Developed Countries’
Professor C Vyvyan Howard, Nano Systems Biology, Centre for Molecular Bioscience,
University of Ulster

Mr M McCormick and Prof C V Howard

Prof Howard started by saying that the possibility of use but there are numerous chemicals in the food we
falls in life expectancy was topical at the moment in eat, in our drinks and even possibly in our clothes.
view of the ‘epidemic’ of obesity, diabetes and cancer These chemicals cross the placenta and may have a
and displayed graphs which confirmed the increase in huge effect later in life causing, at least in part, the
these conditions in recent years. He then suggested conditions mentioned above.
that there might be a common thread linking them.
Prof Howard then discussed the increase in cancer in
The average person’s body contains hundreds of children and young adults which he suggested may be
chemicals in minute quantities none of which was in due to the effect of chemicals in utero. We must be
existence sixty years ago. There are persistent more aware of this and strenuous efforts must be
chemical pollutants which, when recognised, may be made to identify possible chemical pollutants.
banned; e.g. DDT. There are also transient chemicals,
rapidly eliminated, previously thought to be safe A lively discussion took place involving many
which are now regarded as toxic even in miniscule comments and questions, after which we proceeded
amounts. to supper terrified at the prospect of ingesting all the
dangerous chemicals in the seemingly innocent food
An example of a dangerous chemical in plastic bottles put before us.
used for a long time is Bisphenol A. This predisposes
to obesity, reduces sperm count and stimulates R S Ahearn
production of prostate cancer cells. It is no longer in

36

LMI Transactions and Report 2014 - 2015

Annual Dinner

Held on Thursday 19th February 2015

Guest Speaker: Professor Richard Ramsden, Department of Ear Nose and Throat
Surgery, Manchester Royal Infirmary

Mr M McCormick, Dame L Muirhead Prof R Ramsden Prof R Ramsden
and Lord Mayor Erica Kemp and Mr M McCormick

At the well attended Annual Dinner of the Liverpool Professor Ramsden had obtained MRC funding for his
Medical Institution, the President, Mr Max McCormick, research, and when it was shown to be successful,
introduced Professor Richard Ramsden, Emeritus other departments in the United Kingdom started to
Professor of Otorhinolaryngology, who, as a offer the technique.
consultant and then professor at Manchester, had
pioneered the development of cochlear implant A further Australian development had been made by
surgery in the United Kingdom, for which he was W Gibson in the 1990s, who showed that deafness
awarded the MBE in 2014. could be diagnosed in infants, and where suitable,
they could be offered cochlear surgery so that their
Professor Ramsden is a Scot. He graduated from St deafness could be cured in childhood and they could
Andrews in 1968 and was drawn to the speciality of receive mainstream education.
ENT whilst a house officer in Scotland. He was a
registrar and senior registrar at the Royal National The Manchester Cochlear Implant Programme,
Throat Nose and Ear Hospital, London, and was established in 1988, was recognised as the leading
appointed Consultant in ENT surgery at the centre of research in its field in the UK. The
Manchester Royal Infirmary in 1977. procedures are now available to patients in centres
throughout the United Kingdom. For Professor
This was an auspicious time for treatment of cochlear Ramsden, these developments are an example of the
disease. In Australia, in the 1980s, Graham Clarke NHS working at its best. A discovery was made, the
pioneered the use of multi-channelled cochlear United Kingdom research had been funded by the
implants that allowed the treatment of cochlear MRC, and a technique, initially available only at a few
deafness. Professor Ramsden learned of the centres, had been developed so that it is now widely
technique and developed the use of cochlear implants available to NHS patients, improving their quality of
in his department in Manchester. It was a technique life immeasurably.
which could cure cochlear deafness but it was very
complicated and expensive. Professor Ramsden concluded by inviting us to toast
the health of the Liverpool Medical Institution.
The early treatments cost between £15,000 and
£20,000 each. John Sprigge

37

LMI Transactions and Report 2014 - 2015

Minutes of the Tenth Ordinary Meeting

Held on Thursday 5th March 2015

Joint Meeting with Manchester Medical Society (held at MANDEC)

‘Public Health from the Front Line’
Professor John Ashton, CBE
President, Faculty of Public Health Medicine, UK

Prof J Ashton

Professor Ashton was introduced by the Liverpool about his involvements in many of the controversial
Medical Institution President, Max McCormick. He areas about which he speaks.
gave a brief pen picture of his career.
Professor Ashton began his talk by going through
John Ashton was a scholar at Quarry Bank High School some of his earlier career building moments and
in Liverpool and Newcastle University Medical School. influences and then discussed his early involvement
He then did postgraduate training at the London with controversial programmes. He was involved in
School of Hygiene and Tropical Medicine. managing the high incidence of teenage pregnancy
in the Liverpool population. He also worked on the
He became a Lecturer and Professor of Public Health in introduction of a controversial syringe exchange
Southampton and subsequently the London School of programme seen by many traditionalists as an
Hygiene and Tropical Medicine and University of encouragement to drug taking but ultimately
Liverpool Medical School. He was a Regional Director acknowledged as saving more lives than many other
of Public Health for North West England for thirteen health initiatives by helping prevent the spread of HIV
years and the Director of Public Health County and hepatitis.
Medical Officer for six years.
John spoke emotively about his attendance at the
He was appointed President of the Faculty of Public Hillsborough football disaster and his part in
Health, a position he holds until 2016. managing casualties and his subsequent statements
and assistance to the Court in clarifying the sequence
John’s approach to public health is acknowledged by of events.
many to be radical and he himself remains outspoken
about his positions and we looked forward to hearing He then went on to talk about the establishment of

38

LMI Transactions and Report 2014 - 2015

the Liverpool Public Health Observatory which has His wide ranging talk covered other areas, including
subsequently expanded into a network monitoring conversations with Bill Clinton and other dignitaries
the effects of health policy on the public. engaged in the health of the nation.

He spoke stridently about the introduction of John Ashton’s talk was indeed a tour de force about
Foundation Trusts - he felt this was a change which his view of public health as being health of the public
was a step too far, and it had contributed to his as opposed to the traditional view of public health, a
resignation as the Medical Director in Liverpool. form of catechism of behaviour by health bodies.

He described his appointment as President of the The LMI offers its grateful thanks to Manchester
Faculty of Public Health Medicine from 2013 to date Medical Society for their customary hospitality in
and outlined some of the areas where he is involved extending a warm welcome and an excellent venue to
including age of consent, the scrapping of warm visiting guests and speakers.
homes, the healthy people fund and more noticeably
his involvement in the active management of those Max McCormick
terminally ill.

39

LMI Transactions and Report 2014 - 2015

Minutes of the Eleventh Ordinary Meeting

Held on Thursday 12th March 2015

Joint Meeting with the BMA

‘Where Next for the NHS?’
Dr David Wrigley, GP, Carnforth

Mr M McCormick, Dr D Wrigley and Dr P Dangerfield

Dr Wrigley is a GP in Carnforth, north Lancashire. He today, with millions treated by 147,000 doctors and
sits on the British Medical Association UK Council and 371,000 nurses. It was also noted that there are some
the BMA General Practice Committee and also a 36,000 managers employed in the Service.
member of the Medical Practitioners Union. He is a
member of the Labour party. He is also a For the population as a whole, the UK has 2.8 doctors
spokesperson for Keep Our NHS Public – a non per 1000 patients compared with Germany 4.0 or
partisan campaigning group that seeks to bring about France 3.0, so is relatively under doctored. The NHS
an NHS that is publicly funded, publicly provided and copes with 15.1m hospital admissions per year. To
publicly accountable. He has written numerous meet the demand, Medical Schools Intake has risen to
articles and spoken widely on the marketisation of the 6262 in 2012. Overall, life expectancy varies in the
English NHS and contributed to the 2013 book ‘NHS country, but is still lowest in areas of denser
SOS’. A new book has just been published that he has population. Comparing the life expectancy to health
co-authored with Dr Jacky Davis and John Lister titled spending per capita, David noted that the USA spends
‘NHS for Sale – myths, lies and deceptions’. more on health care but overall has a lower life
expectancy.
While he is a graduate of Sheffield Medical School, he
did apply to Liverpool but was rejected and eventually In the launch of the NHS in 1948, the Evening
entered medicine as a mature student through Standard proclaimed “Free for all at a cost of £152m”.
clearing! This is not so likely to happen today! Every household got a leaflet about the new service
explaining that “….everyone can use it for free, but it
In opening his talk, David introduced the audience to is not a charity so be responsible in its use. You are
some key statistics related to the NHS, noting the paying through your taxes…” There were charges for
colossal rise in costs from £33.5b in 1997 to £113b Spectacles though.

40

LMI Transactions and Report 2014 - 2015

The political consensus in England in the 1990s from life expectancies and infant mortality.
supported the concept of a market, and this was
introduced by the Conservatives in 1991. BMA As a case study, David noted that a North Carolina
opposed the plans and were highly critical but were man got arrested for theft of $1 so he could get free
effectively frozen out of discussion. health care, demonstrating a situation of desperation.

Following this new NHS structure, the parties such as Changes to the structure of NHS came from legislation
New Labour, with Blair, Milburn and Stevens, were pro in Parliament, setting up Strategic Health Authorities
market. So were the Liberals with the Orange Book in with Primary Care Trusts and NHS Trusts in the 1990s.
2004 and the latest legislation is very much more pro- The current 2013 structure is highly complex with
market, yet the devolved nations oppose it. Other different bodies.
aspects of the new NHS include private contribution
through Labour’s PFI scheme. Milburn signed the Dr Wrigley asserted that there were numerous myths
concordat 2000 due to waiting lists and Labour put circulating about the NHS. The first is that it is
more money in to the NHS, thus allowing private unaffordable. However, he pointed out that as a
hospitals to treat NHS patients. A purchaser/provider percentage of GDP, the cost is actually stable, running
split was introduced together with new contracts. at about 30% up to 2007. David Nicholson, in 2008,
Patient choice was seen as helpful but did not mean met McKinsey secretly and a £20b cost saving
more providers in the market. Payment by results also challenge was introduced. Cuts from the budget of
meant increased competition to get income by getting NHS quality, innovation, productivity and prevention
more work into the day. Any willing provider policy challenges were viewed from a position of surplus in
and the new Trusts allowed hospitals to be more in 2001. The politicians are not very open and honest
charge of their income. either in their pronouncements. Spending was
increased during 1970 to 2010 but the Coalition is
However, patient budgets have not really taken off, presently only keeping income just above inflation.
even though the concept was supposed to give more
to a patient to look after their care. These changes PFI keeps debt off the Government’s balance sheet but
were backed by provision of new insurance schemes gives big returns to the private sector. It was
to offer a policy to cope if your money ran out. introduced by Labour under Tony Blair, and now has
costs of £180m per year. The deals are rock solid,
Current policies have introduced the CCGs, choice is government backed and can be traded on the open
creating competition and plurality of provision market. Deals are being sold overseas as they are seen
allowing more choice. as a very good investment deal. £12.2 billion could be
£17.4 billion if Government borrowed the money on
A 2010 Select Committee looked at the the markets, but the real cost is actually more like £80
purchaser/provider split and concluded it offered no billion. Interestingly, NHS logo guidelines allow
real benefit. private companies use the NHS logo, as it is seen as
safe. In context of public opinion, YouGov polls
The Commonwealth Fund looked at health care looked at NHS, Rail, Energy and Mail and showed they
systems and found the NHS produced the best results were felt best in national ownership.
compared with the rest of the world. For world
health, comparing life expectancy with cost, showed The Health and Social Care Act was opposed by all the
highest cost in USA with the UK performing very well medical Colleges, Midwives and the BMA but was
in spite of every negative comment made about it. nonetheless adopted. The view is widely held that the
present NHS reforms are the worst mistake by this
Effectively, this demonstrated a market failure in Coalition Government. The speaker also pointed out
practice in the USA. The USA system is a $2.3 trillion that there were links between MPs who often ended
medical industrial complex but there are 50m people up working for the private sector, giving rise to the
uninsured, and 62% personal bankrupts due to health ‘Revolving doors’ concept.
care costs. ObamaCare came up against the lobby of
industry opposition, using phrases like “socialised The speaker then gave a number of quotes, including:
health care” and “look at the mess of the UK NHS”. “In the future the NHS will be a state insurance
The pressure for change was of course poor outcomes provider not a state deliverer…” and “…NHS will not

41

LMI Transactions and Report 2014 - 2015

exist is 5 years…”, quoting Oliver Letwin. Dr Wrigley concluded by saying “Power to the
people!” A range of questions were raised from the
The talk then considered the new concept of floor.
Manchester devolution. The Treasury deal, signed
with councils in Manchester, covers 1.7 million people. Issues discussed included the merits of a national
The deal was secretive and there was no consultation service for providing healthcare as opposed to private
whatsoever with anyone. The devolved budget is £6 provisions – namely that a national service is joined up
billion, to cover health and social care. There are and talks to itself, and private provisions are risky,
mixed feelings about the plans but it is clear that inconsistent and driven by profitability, with the profit
Government will not be involved. Is this the end of not necessarily being re-invested in the health service.
the NHS with the new MHS? Is the money enough to Market contracting is complex, bureaucratic and
sustain the service demands? Dr Wrigley noted that secretive, covered by commercial confidentiality. The
social care alone is a significant cost and members of role of CCGs was further explored, with some noting
the audience raised the point that this move might that CCGs could be very difficult to access from a
risk a blurring between health care and social support. doctor’s perspective, and lack of transparency and
consultation could lead to inappropriate decision
On a positive note, this devolution takes healthcare making and poor direction for patients.
away from Government into the powers of the local
population. However, is it undermining Labour The group pondered the future for education and
signing up with Labour councils? training, which is not covered by the private sectors
and is something the NHS does quite well. Where
After the election, the outcome is uncertain. Health training has suffered following a takeover, such as in
policy differs between the contenders but the Nottingham, consultants have resigned in protest!
Conservatives will continue the same way. Labour will However, social reform is also needed to achieve
repeal some of the Health and Social Care Act, such as anything.
market mechanisms, giving us the NHS first option.
Monitor will go and Health and Well-being Boards will Some regretted the trend of disappearing GP
be run with local councils. partnerships, and the emergence of short term APMS
contracts which offer little security, and would have
LibDems will continue as before while the Greens have liked to have seen more action from the BMA and GPs
a policy making the NHS entirely publicly provided. to help keep partnerships alive. Also, patients
The SNP are anti-market anti-PFI, anti-Trident and favoured continuity and would not get it out-with a
UKIP are difficult to assess. partnership agreement.

In concluding, the speaker raised the issues for the The conversation turned to the role of managerial
election and what can be done in the lead up to it. He staff and whether it was justifiable to say there was
encouraged the audience to talk to MPs about the an over-provision of managers in the NHS. It was
NHS and health policies and write to local papers as it noted that more are needed as complexity develops,
can have an impact. The BMA is campaigning to try to with the appointment of supporting staff, and the
get political interference away from the NHS. But it figures bear this out. The NHS is efficient for its size,
was also noted that the Lobbying Act is effectively a and the number of managers is relatively low.
way to stop anyone campaigning on government
policy and is effectively a gagging bill. The vote of thanks was given by the President, who
alluded to the excellent content and illuminating
The Pollock Roderick NHS reinstatement bill is laid delivery.
before parliament and it will be interesting to see
where this leads to. 38 degrees and Keep NHS Public Peter Dangerfield
are active as well.

42



LMI Transactions and Report 2014 - 2015

Admission of Life Members

The following members were admitted to Life Membership of the Institution at the
Celebration and Admission of Life Members on Thursday 11th December 2014.
Three Public Orators presented these citations.

Back row (left to right): Mr A McCormick, Mr C Faux, Dr W Taylor, Dr J Ridyard, Mr P Rostron and Dr C Evans
Front row (left to right): Dr J Seager, Mr G McLoughlin, Mr M McCormick, Dr E Preston and Mr J Drakeley

EILEEN MARY BELL (in absentia) She regards her greatest achievement was “just to
qualify at all” at a time when many women struggled
Eileen Bell is a retired to enter medical school and especially to qualify in
Consultant Psychiatrist. She psychiatry which she felt at the time was somewhat of
now lives in Abergele in a Cinderella specialty.
retirement.
She continues to be interested in ornithology and
She initially trained as photography.
a pharmacist at Leeds
University then did her pre- Max McCormick
clinicals at the College of
Surgeons in Dublin and JOHN RICHARD CLAYDEN (in absentia)
qualified from the Royal Free
Hospital School of Medicine in 1963. John Clayden is a retired
General Practitioner and
After house jobs in London and New York, she came to lives in Holmfirth, West
Liverpool and trained in psychiatry in various hospitals Yorkshire. He was educated
including Walton, Rainhill, Newsham and Winwick. in Royds Hall Grammar
She eventually took a medical assistant post at Rainhill School, Huddersfield and
and later became a Consultant at Rainhill. qualified from Liverpool
Medical School in 1969.

In 1977 she moved to Moss Side Hospital which He also shared digs with
subsequently became Ashworth Hospital. She retired John Drakeley.
in 1992.

44

LMI Transactions and Report 2014 - 2015

After house jobs and SHO job in obstetrics and seven grandchildren. John has a big interest in
gynaecology he entered general practice in ornithology and wildlife photography and is still
Huddersfield in 1971. He moved to a single handed involved with various clubs including the Brandreth
dispensing practice in Holmfirth in 1980 and then into Club and the Harlech Club for cardiothoracic surgeons.
partnership in 1993. He retired from full-time practice
in 2007 but continued working as a locum. He regards his greatest achievement as playing a
significant role in training surgeons in the USA,
An enthusiastic trainer, he has been involved with over Europe and Malaysia.
seventy GP trainees. Unfortunately the demands of
revalidation meant that he was no longer able to Max McCormick
continue working and retired fully in May 2014.
JAMES CHRISTOPHER FAUX

He is married to Marie and has two children and two Chris Faux and I were
grandchildren. interviewed for entry to the
Liverpool Medical School
His outside interests include music, theatre, drawing consecutively in the autumn
and painting and he has travelled extensively in the of 1957. I was the last of the
Caribbean. E's and he was the first of
the F's.
Max McCormick

MICHAEL JOHN DRAKELEY This tall, elegant blond
Adonis told me in the
John was educated at the waiting room, that he
King Edward VI School attended Fettes College, sang in the choir, played in
Nuneaton and graduated an undefeated rugby 15 and had even met the Queen
from Liverpool Medical and Prince Philip when the Royals were choosing a
School in 1963. He was school for Prince Charles. His father was a GP-
involved in the general gynaecologist from Bolton. To say that I was
surgical rotation training intimidated was an understatement.
scheme at its inception in
Liverpool and this included Chris didn't tell me that his A level choices were for
time on the Chest Unit at mechanical engineering rather than the human
Broadgreen Hospital. variety, so it was perhaps foreseeable that it would be
ten years later before he graduated. In that decade
He did a Fellowship in Aukland for twelve months and Faux had been a spectacular President of MSS and a
thereafter trained in cardiothoracic surgery and medical school legend, in the manner of Richard
obtained a Consultant post in 1977 until his Gordon's ‘Doctor in the House’.
retirement in October 2003.
As an aspiring orthopaedic surgeon, his mechanical
John was Regional Specialty Advisor for cardiothoracic engineering based postgraduate career was meteoric,
surgery and Programme Director for higher surgical such that in ten years he was appointed as a
training and an examiner for the Intercollegiate Consultant Orthopaedic Surgeon to Preston and
Board. Chorley hospitals. By then he had passed first time
and for the first time an examination - FRCS and whilst
Although originally qualified FRCS in Edinburgh he training on the Manchester rotation had worked for
was awarded an Honorary English Fellowship in 1998 John Charnley at Wrightington.
for his contribution to education.
In Preston, he revolutionised orthopaedic services,
John’s medical legacy continues with Andrew, who is waiting lists and trauma and fracture clinics, and
now in charge of the John Hewitt IVF Unit at the appreciated the stimulus of teaching medical students,
Liverpool Women’s Hospital. with whom he had a natural affinity. Private practice
also included being MO to Preston Grasshoppers
He and his wife Irene, a marriage of 44 years, have Rugby Club and British Leyland trucks and busses.

45

LMI Transactions and Report 2014 - 2015

When Charnley died in 1982, Chris became a trustee of children, Claire, Anthony and Terence.
the trust bearing Charnley's name and subsequently
its chairman for which he edited essays "After He obtained Fellowships from the Edinburgh and
Charnley" for the Robert Jones Series. London Colleges and then obtained senior jobs
working with Professor Robert Shields and Robert
Later he returned to work at Wrightington Sells and then senior registrar with John McFarland.
performing hip and knee revision surgery until he
suffered a mild heart attack in 2003, described by his He was a vascular Fellow in Boston and Harvard for
wife Patti as “his first attention seeking illness”, several years and obtained an MD and MS.
causing Chris to stop water skiing and surgery.
He was appointed as Consultant Vascular Surgeon at
He and Patti, a Consultant Radiologist, have three the Royal Liverpool Hospital, initially working with
children, none medical, and seven grandchildren. Raymond Helsby until he retired in 1980 and then
Faux continues to encourage research on behalf of the Gerry was in single-handed practice providing vascular
trust and nowadays he is a rugby spectator but services to the hospital.
regrettably continues to enjoy gun sports.
In 1999 following cardiac surgery, he retired from the
In conclusion Mr President, our honorary member’s NHS but then studied law and became a medically
successful career was only interrupted by a decade at qualified judge working with the Criminal Injuries
medical school where he enjoyed himself and met his Compensation Tribunal Board. He also undertook
wife. I have the honour to present James Christopher medico-legal work.
Faux for Life Membership of our Institution.
When Pope John Paul visited Liverpool in 1982, he was
Chris Evans volunteered by his colleagues to be the on-call
surgeon for papal emergencies. Six months after the
GERARD ANTHONY McLOUGHLIN visit Bishop Vincent Malone rang his doorbell. As a
token of gratitude the Pope had sent a medal. Gerry
Gerry is a retired vascular believes this is the only time a vascular surgeon has
surgeon who worked at the been awarded a papal medal sent by a Bishop.
Royal Liverpool Hospital.
Outside of medicine and family, his interests are
He was born in the Scottish French language and literature and rugby union. As
borders and exiled from well as playing rugby until aged 40 he was the
Newcastle by German Liverpool Club doctor for about twenty years. He has
bombers. His mother’s left directions that he is to be buried in his Liverpool
family was from Scotland, Rugby Club jersey.
his father’s from the west of
Ireland. Both had settled in Max McCormick
Newcastle Upon Tyne. Six months after Gerry was
born, his Father was tragically killed in action in Sicily. ELIZABETH MARY PRESTON
His Mother trained to become a school teacher to
support their only child. The eldest of five girls, Dr
Elizabeth Preston was
He boarded at Austin Friars School Carlisle and studied always busy as a child, a
Classics. Inspired by the school’s GP he studied sciences habit she continued into
and entered medical school. In 1966 he qualified from her career. She was
Durham Medical School with a First Class medical educated at The Alice
honors degree. House jobs in Newcastle were Ottley School for Girls,
followed by registrar jobs in general surgery, initially Worcester, which since she
on the Brewer and Helsby firm at the Liverpool Royal has left has amalgamated
Infirmary. with the adjacent boys
school and a gate has been
In 1971 he married Liz McSweeney and he has three inserted into the 30ft wall - no doubt since she left it
was felt the wall wasn’t necessary. She completed her

46

LMI Transactions and Report 2014 - 2015

medical degree here in Liverpool and after house jobs John’s father was a Methodist minister from the
worked in most of the hospitals in Liverpool, as they Yorkshire dales where John went to primary school
were then, as an anaesthetic trainee. This included prior to attending Rydal in the welsh hills. As an
learning to give open ether from Dr J Beddard. outstanding A level student he went to Cambridge
and graduated in natural sciences before joining the
She was appointed as a Consultant in Anaesthesia Liverpool Medical School from where he graduated in
including Neuroanaesthesia at Walton and Fazakerley 1968.
Hospitals in 1975, later renamed Aintree University
Hospitals. Her medical career was notable for the His straightforward, conscientious and sympathetic
multiple times she had to change her roles and approach to his professional career was rapidly
responsibilities as she worked between the Walton rewarded with MRCP and an MD from the Broadgreen
site and Fazakerley - something we may all be about Chest Unit where he utilised the radioactive Xenon
to go through again as talks of merging hospitals and apparatus to study regional lung function in a variety
service reconfiguration abound. of medical and musculoskeletal disorders under the
direction of Colin Ogilvie.
She will be remembered as a medical leader in
Liverpool, firstly as Clinical Director in anaesthesia and As a medical registrar he had a year out, not in the
latterly as Medical Director for ten years (longer than USA or Europe, but in Nigeria as a lecturer in medicine
most survive in that position) including six months as at the Ahmadu Bello University Hospital in Zaria. This
acting Chief Executive of Aintree Hospital. established his love of Africa, where he has returned
several times. He has crossed the Sahara desert and
Outside medicine, as a school girl she competed very climbed Kilimanjaro to cite but two of many revisits.
successfully at national level in show jumping and
three day eventing, a skill she taught her children. Her John’s hobbies are extensive; choral music - he was a
son Nick is a Consultant in Anaesthesia in Bristol founder member of the Renaissance Music Group of
Southmead Hospital and her daughter Caroline has Liverpool - fell walking unsurprisingly, cycling, travel
degrees in both Business and Law. She has two especially railways as a latter day Bradshaw rather
grandchildren and one more on the way. than a Portillo, squash and gardening.

Like many in the medical profession she met her John was appointed as Consultant General Physician
husband at work. Tim, who is known to many of you, to Whiston Hospital where he enjoyed all medical
was a registrar for Mr James Cosbie Ross when they disciplines and started undergraduate teaching
met at the lunch table. 46 years later they are still rounds in the manner of his mentor. A dedicated full
enjoying lunch together, thanks partly to Tim’s present time physician he developed lung function and
early in their marriage of a 72 edition Cordon Bleu bronchoscopy services as well as cardiac measurement
cookery course. and the CCU.

Austin McCormick When aged 46, this self titled unreconstructed
bachelor married Joyce, a Care of the Elderly
JOHN BOLTON RIDYARD Physician, with immediate results such that there are
two sons, both now junior doctors. John’s latest baby
John Ridyard and I first met is their border terrier.
at the Royal Southern
Hospital, when John was Mr President, I have the honour of presenting to you
the new house physician for Life Membership of this Institution, John Bolton
and I the medical registrar Ridyard, a resolute trustworthy Yorkshire physician
on Dr Gerard Sanderson’s who is best described by the phrase “what you see and
Firm. The apprenticeship hear is what you get”.
was to influence both our
careers as regards a Chris Evans
physicianly ethos, student
and junior staff welfare and
training, as well as team work based on the firm
structure.

47

LMI Transactions and Report 2014 - 2015

PETER KENNETH MAKIN ROSTRON paediatric immunology and allergy and he was a
Consultant Paediatrician at Arrowe Park Hospital
Peter grew up in Southport Wirral, where he became the Clinical Director for
where his father was a GP Paediatrics.
and was educated at King
George V School. A keen One of his happiest achievements at that time was to
athlete he represented the move some aspects of paediatric care out of the
school at rugby and hospital environment into the community. This
captained the cricket team involved further developing the Hospital at Home
and informs me he once ran team and setting up a day ward so that more children
100 yards in 10.2 seconds. could be treated at home with their families. This he
achieved not without some political skill in convincing
He qualified from Liverpool Medical School in 1967. local politicians of the need to close a children’s ward
After demonstrating anatomy for a year, he started on to make this happen. Now in a well earned
his career then had a year out as a ship’s surgeon with retirement with his wife Liz, he enjoys electrical
P & O circumnavigating the globe. things, languages and growing things you can eat.

He returned to Liverpool, completed his rotational He is most welcome as a Life Member at the LMI, an
training in orthopaedics and was appointed as a Institution his father was President of in 1973 (the year
General Orthopaedic Surgeon at Whiston and St of my birth).
Helens in 1979, with particular interest in paediatric
orthopaedics. He provided his expertise to St Helens Austin McCormick
and Widnes rugby league clubs as well as Everton for
over twenty years. WILLIAM (BILL) TAYLOR

He is married to his wife Christine and has three William Taylor, known
daughters and five grandchildren.
when he worked in the
He resigned from the Health Service in 1995 but
continued in practice until 2007 and still does some Royal’s pathology
medico-legal work.
department as “the nice Bill
He is a keen golfer, captained Birkdale in 1998 and
presented Mark O’Meara with the Claret Jug in 1998. Taylor”, graduated from

When not playing golf, he plays bridge, watches birds Liverpool Medical School in
and looks after hens and a few sheep on his farm in
Ormskirk. 1969. He had been

Max McCormick educated at the Liverpool

JOHN SEAGER Collegiate School and his

Dr John Seager was educated house jobs were at the
at Malvern College before
coming to Liverpool for his David Lewis Northern
medical degree. He specialised
in paediatrics, training first in Hospital. It was here that his mind was turned in the
Liverpool, then at Great
Ormond Street Hospital, The direction of pathology and he was inspired by Dr
Institute of Child Health and
University Hospital Wales in Winston Evans. He was unwilling to give up direct
Cardiff. His interests included
contact with patients so soon after qualifying, but a

year as an SHO in obstetrics at the Liverpool Maternity

Hospital, passing the DObst RCOG examination,

confirmed his view that pathology was the career for

him. As a trainee, Bill recalls the great influence of

such icons as Alan Cruickshank, Charles St Hill, David

Weatherall and Alan Percival.

As a lecturer then senior lecturer in the University
Department of Pathology his interest in pulmonary
pathology was shaped by Donald Heath and in
gastroenterology by Alan Cruickshank.

48