A HISTORY OF THE ROYAL COLLEGE

OF GENERAL PRACTITIONERS

Frontispiece HRH The Prince Philip, Duke of Edinburgh, KG, KT, OM, GBE, Patron of the College and President 1972

& A HISTORY

OF THE ROYAL COLLEGE OF GENERAL

PRACTITIONERS

The First 25 Years

Edited by John Fry

OBE, MD, FRCS, FRCGP

Lord Hunt of Fawley CBE, DM (Oxon), FRCp, FRCS, FRCGp, FRACGP

and R.J. F. H. Pinsent

OBE, MD, Hon.FRCGP

MT~LIMITED International Medical Publishers

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British Library Cataloguing in Publication Data

A History of the Royal College of General Practitioners. 1. Royal College of General Practitioners-History I. Fry, John, 19-- II. Hunt of Fawley, John Henderson Hunt, Baron III. Pinsent, R.J.F.H. 610' .6'042 R729.5.G4

Published in the USA by MTP Press

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Library oj Congress Cataloging in Publication Data Main entry under title:

A History of the Royal College of General Practitioners.

Bibliography: p. Includes index. 1. Royal College of General Practitioners-History.

I. Fry, John, 1922- . II. Hunt of Fawley, John Henderson Hunt, Lord. III. Pinsent, R.J.F.H. (Robert John Francis Homfray) [DNLM: 1. Societies, Medical­History-Great Britain. WB 1 FAI R81 R35.R473R68 1982 610' .6'041 82-18643

ISBN-13: 978-94-011-5917-3 e-ISBN-13: 978-94-011-5915-9 DOl: 10.1007/978-94-011-5915-9

Copyright © 1983 Royal College of General Practitioners

Soft cover reprint of the hardcover 1 st 1983

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any

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Phototypesetting by Georgia Origination, Liverpool

CONTENTS

FOREWORD

John P. Horder, President, 1980-82 ix

PROLOGUE

Sir Theodore Fox, William A. R. Thomson, Hugh Clegg Xl

II

III

PAST ATTEMPTS TO FOUND A 'COLLEGE OF GENERAL

PRACTITIONERS' ONE AND A HALF CENTURIES AGO

John H. Hunt

EVENTS LEADING UP TO THE FORMATION OF THE STEERING

COMMITTEE

John H. Hunt

THE WORK OF THE STEERING COMMITTEE, AND THE BIRTH

OF THE COLLEGE

Geoffrey O. Barber, John H. Hunt and A. Talbot Rogers

IV THE COLLEGE'S FIRST YEAR AND THE WORK OF THE

FOUNDATION COUNCIL

Geoffrey O. Barber, John H. Hunt, A. Talbot Rogers and

7

17

Richard Scott 31

V PRESIDENTS AND CHAIRMEN OF COUNCIL OF THE COLLEGE

DURING ITS FIRST TWENTY-FIVE YEARS

John H. Hunt 37

VI REGIONAL FACULTIES AND REGIONAL COUNCILS IN THE

UNITED KINGDOM AND EIRE

Sylvia G. DeL. Chapman, John H. Hunt and Andrew Smith 59

v

Scottish Council William S. Gardner, John M. Henderson and Richard Scott 63

Welsh Council John H. Owen 67 Irish Council James S. McCormick, John E. McKnight and

Noel D. Wright 71

VII UNDERGRADUATE EDUCATION

James D. E. Knox and Andrew Smith 75

VIII POSTGRADUATE EDUCATION AND VOCATIONAL TRAINING

Part I: 1953-1965 George SWift 85 Part II: 1965-1977 Donald Irvine 95

IX THE MEDICAL RECORDING SERVICE AND THE MEDICAL

AUDIOVISUAL LIBRARY

John and Valerie Graves 103

X STANDARDS

The Criteria Committee William S. Gardner 111 The Board of Censors John F. Burdon, John Fry and

William S. Gardner 115 The Examination Committee John F. Burdon, John Fry

and William S. Gardner 119 The Examination John Fry and John H. Walker 122

XI THE COLLEGE AND RESEARCH

XII

R.J.F.H. Pinsent and G. Ian Watson 131 THE RESEARCH, EDUCATION AND SCIENTIFIC FOUNDATIONS

Ekke V. Kuenssberg 145

PRACTICE ORGANISATION, EQUIPMENT AND PREMISES

George S. Adams and Michael Drury 149

XIII COLLEGE PUBLICATIONS

The Annual Reports John F. Burdon The College Journal Denis J. Pereira Gray Other College Publications Denis J. Pereira Gray Faculty Publications John F. Burdon

VI

159 160 168 171

XIV THE LIBRARY, MUSEUM AND ARCHIVES Part I: The Library Michael J. Linnett and Margaret

Hammond 173 Part II: The Museum Peter Thomas 176 Part III: The Archives John Horder and Alastair Murray

Scott

XV HEADQUARTERS, STAFF AND ADMINISTRATION John H. Hunt (1952-77) and James Wood (1971-77)

XVI COLLEGE FINANCE AND ApPEAL Stuart J. Carne and Ancrum Evans

XVII AWARDS AND ETHICAL COMMITTEES Annis C. Gillie, John H. Hunt and Basil C. S. Slater

XVIII INCORPORATION, ROYAL PREFIX AND THE ROYAL CHARTER

178

181

193

199

John Mayo 205

XIX INSIGNIA AND THE COLLEGE GRACE The Insignia Annis C. Gillie The College Grace George E. Reindorp

XX RELATIONS WITH OTHER BODIES Part I Sir George Godber Part II Ekke V. Kuenssberg

XXI THE COLLEGE OVERSEAS Overseas Regional Faculties John H. Hunt, John A. R.

215 221

223 227

Lawson and Ian R. McWhinney 231 Overseas Councils: The Australian Council W. A. Conolly and H. Stuart

Patterson 232 The New Zealand Council C. L. E. L. Sheppard 236 The South African Council F. E. Hofmeyr 239

XXII THE FUTURE Part I John Fry and Gordon McLachlan Part II Sir George Godber

VB

243 249

ApPENDICES

1. Honorary Fellows; 2. Honorary Chaplain; 3. Honorary Secretaries of Council; 4. Honorary Treasurers of the College; 5. James Mackenzie Lecturers; 6. William Pickles Lecturers; 7. Foundation Council Awards; 8. George Abercrombie Awards; 9. Fraser Rose Gold Medallists; 10. John Hunt Fellow; 11. Honorary Registrar; 12. Administrative Secretaries; 13. College Solicitors; 14. College Auditors; 15. College Publications

SUBJECT INDEX

viii

255

263

FOREWORD

John P. Horder, President, 1980-82

The first 30 years of the College have been an exciting experience for those most closely involved. Some have already passed on, but this account has been written soon enough for many of the actors to be historians. Future members of the College will be grateful to them for what they have written, as well as for what they did as a remarkably determined and harmonious team.

Students of twentieth century medicine in this country will also be grateful for a first-hand account of the development of an institution which has been closely associated with, and partly responsible for, important changes in medical care and education.

Those who read these pages may wonder how the builders of this young College could have found time to do much general practice. They did. The three editors of this history, which covers 25 years, and the general practitioner members of the Steering Committee all ran large practices, in which they worked very hard throughout that time. Most of their work for the College was done during off-duty hours, weekends and holidays. The College could not have developed as it did, had they not been personally concerned with the practical problems and needs of clinical medicine. This is also true of many of the contributors.

It is impossible to mention everyone who deserves credit. The editors hope that they may be forgiven for any serious omissions.

I want to thank both the editors and the contributors; in doing so, I know that I shall be joined by all those Fellows, Members and Associates whom for the time being I am proud to represent.

Especial thanks are due to Janet Smith, who typed all the drafts of the book with persistent goodwill. Very particular thanks are also due to Mr Robert Clark and others without whose generosity this book might never have been published.

JOHN P. HORDER, CBE, MD, FRCP, PRCGP

IX

Sir Theodore Fox

Editor of The Lancet 1944-1964

In 1952 general practice was in decline. Though many family doctors were working as well as ever, most were losing heart.

An Australian had been shocked by what he saw of British practice l ;

and two indigenous authorities had rejected the explanation that all its faults came from the National Health Service2 •

The truth was that, as the centre of gravity of Medicine shifted towards the hospital, practitioners had become less confident in their role. Some even accepted the view that they were second-class doctors, whose only important duty was to recognize serious conditions and refer these to their first-class colleagues.

This was quite wrong. Most medical care is given in the surgery or the home; and how it is given matters very much to very many. Nor is it easily given well. The efficient care of complex human beings in their natural state and natural habitat calls for more than a medical social worker or the subsidiary member of a specialist team.

To be good alike at primary care, continuing care, and terminal care demands high qualities. And in some ways the task grows harder as knowledge increases. The doctor in continuous personal charge of his patient - who may have diseases in several specialties - has to be very well informed if he is to know both what can be done and what should be done.

Partly the College was founded to make a claim. If physicians, surgeons, and gynaecologists needed colleges, there was no less reason for general practitioners to have one. For their work - when done well - was of no less consequence. But, all too plainly, this work was not being done well enough: so a second object of the College was to examine the practitioner's changing functions and help him to perform them better. To this end the new body brought together a remarkable group of people. If their study of

xi

trammg, qualifications, postgraduate education and research had not proved so conspicuously useful, it would not have been copied and continued in similar colleges overseas.

Inevitably, some of the best doctors remain aloof, feeling no need for corporate recognition or support. But they too have gained because the status of general practice is rising. At a sad time in British Medicine, it is cheering to see that general practice is getting excellent recruits. Never again shall we hear those lamentable words: 'I'm only a GP'; for the labour in the College vineyard has not been in vain.

William A. R. Thomson

Editor o/The Practitioner 1944-1972

The tragedy of general practice in the early days of the National Health Service was that it lacked leadership. Those in authority in the planning and initiation of the Service - that is, the Ministry of Health and the Royal Colleges of Physicians, Surgeons and Obstetricians and Gynaecologists -knew comparatively lictle of family medicine. The British Medical Association, alas, adopted such an abrasive attitude toward the new service that it antagonized the Minister of Health responsible for the Service as it came into being.

The result was that the first quinquennium of the Service witnessed a demoralization of general practice that augured ill for the future. Political propaganda about 'free treatment' unleashed an utterly artificial demand that converted many a doctor's surgery into something resembling a bear garden. Unfortunately, both politicians and doctors were blinkered: the former by enthusiasm for party gain; the latter by equal enthusiasm for their own branch of the profession.

The concept of medicine as a healing art was overlooked, the co­operation essential to success became crude confrontation in the market­place, and what should have been a partnership in service to the community became a running battle in which some personalities assumed a disturbingly ominous influence. As a result the old men of general practice dreamt dreams of retirement, while the young ones saw visions of emigrating or transferring to some other branch of medicine.

It was as general practice reached this nadir that the concept of the College of General Practitioners was launched, based, in the words of the Report of the Steering Committee, on the belief that general practitioners are 'essential to the heart and soul of medicine' and, as I expressed it in The Practitioner at the time, that 'an active and progressive College of General Practitioners would safeguard the future of general practice as an integral

xii

part of the medical services of the country that offers a satisfying life's work to men of culture, understanding and integrity'3.

This undoubtedly it has done. As in the pre-NHS days, general practice is now attracting those young men and women who have entered medicine in order to serve their fellow-citizens, who have the holistic outlook on life, and who have the innate curiosity of good naturalists such as Gilbert White, upon which they can build that intimate knowledge of the patient, his family and his environment, which is the basis of 'good general practice'. Largely as a result of its efforts over the last quarter of a century, the College has enabled general practice to find itself for many as the most satisfying branch of medicine - not a specialty, but the foundation stone of medical practice, and for this it deserves the thanks of all who look upon Medicine as the greatest profession of all.

Hugh Clegg

Editor of the British Medical 10urna11946-1965

A leading article in the British Medical Journal on December 20 1952, discussing general practice in relation to the growth of specialization and special departments, suggested that general practitioners had been brought to a parting of the ways. It said:

Unless something is done to reorient his training, undergraduate and graduate, to medicine as it is today - more exact and exacting, more of an applied science than an empirical art - the general practitioner risks becoming what Gerald Horner called 'a mere medical shopwalker'. It is clear that the moving spirits behind the College of General Practitioners have decided to meet the challenge of the times, and not too soon. Those who care for the welfare of medicine will thank them for their enterprise and foresight, and urge them forward along the path they have courageously taken4 •

References

1. Collings, J. S. (1950). General practice in England today. Lancet, i, 555-585 2. Lewis, R. and Maude, A. (1952). Professional People. London: Phoenix House Ltd. 3. College of General Practitioners (1953). Steering Committee's Report. Practitioner,

170, Supp!. 4. British Medical Journal (1952). The College of General Practitioners, ii, 1344-1345

Xlll