LMITransactions&Report2014-15

Liverpool Medical Institut ion 

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 

Frontispiece, Mr Max McCormick 2 

List of SMC Members 3 

List of MEC Members 4 

The Liverpool Medical Institution Staff 5 

Editorial 6 

Inaugural Address of the President 

Held on Thursday 16th October 2014 8 

Henry Cohen Memorial Lecture 11 

Annual Healthcare Service 15 

Minutes of the Ordinary Meetings of the 176th Session 

including details of social events and Admission of Life Members 16 

Edith Cavell – WWI Heroine 52 

Retired Members’ Group 54 

Report of Council 57 

Report of the Honorary Librarian 59 

Obituary Notices 60 

Members Joined since last Transactions 65 

Auditor’s Report 66 

List of Presidents 67 

Charitable Donations 68 

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: admin@lmi.org.uk Web Address: www.lmi.org.uk Twitter: @LMI114 

1


Mr. Max McCormick 

President 2014-15 

2


Strategic Management Council (SMC) 2014-2015 

Chairman: 

A SWIFT 

President: 

M McCORMICK 

President-Elect: 

G LAMONT 

Treasurer: 

A ELLIS 

Secretary: 

A McCORMICK 

Librarian: 

A LARNER 

D ANTONIA 

L DE COSSART 

E DJABATEY 

A ELLIS 

S EVANS 

Members of SMC: 

R FARQUHARSON 

N GILMOUR 

W KENYON 

A LARNER 

G LAMONT 

A McCORMICK 

M McCORMICK 

S SHEARD 

A SWIFT 

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


Membership and Education Committee (MEC) 2014-2015 

President: 

M McCORMICK 

President-Elect: 

G LAMONT 

Vice Presidents: 

V JHA J CURTIS 

Treasurer: 

A ELLIS 

Secretary: 

A McCORMICK 

Librarian: 

A LARNER 

Members of MEC: 

J CURTIS 

P D O DAVIES 

L DE COSSART 

A ELLIS 

R C EVANS 

V JHA 

G LAMONT 

A LARNER 

A McCORMICK 

M McCORMICK 

I RYLAND 

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


The Staff of the Liverpool Medical Institution 

Sue Curbishley 

(Library Assistant) 

Samantha Pickup (Manager) Audrey Roberts (Admin) Jim Penwill (Finance Officer) 

Sharon Hunt (Admin) 

Tom Spearitt (Security) 

Lynne Smith (Admin) 

Joyce Williams (Bar) 

Karen Alsop 

(Finance Manager & Project Manager) 

Adrienne Mayers (Librarian) 

Other Team Members 

Deborah & Dennis Holden 

(Catering) 

Mark Ross 

(AV Technician) 

Jeremy Blades 

(AV Technician) 

Anna Reid 

(RCGP Mersey Faculty) 

Sarah Adams 

(RCGP Mersey Faculty) 

Christopher Mayers 

(RCP Mersey Regional Office) 

5


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

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 

Members, colleagues and guests; first of all I would 

like to thank you all for attending tonight and giving 

me the honour of being your President for this 176th 

session. Thanks especially to the management 

committee for putting their faith in me to do this. 

My talk will cover various aspects of my schooling, 

training and passage through Medical School, Junior 

Doctor training, Senior Doctor training and finally this 

appointment. The title of my talk ‘The Missing 

Chapter’ relates to my work as a Consultant Surgeon, 

whose main interests are in training new doctors and 

senior doctors as apprentices and hopefully making a 

difference to my trainees as to how they practise 

medicine. 

Born in Belfast to George and Jessie, my background 

was fairly humble. I attended State primary school 

and subsequently Methodist College Belfast, a State 

grammar school. There was a strong history of 

working with ships and indeed my grandfather won 

many trophies building model yachts sailed at a local 

reservoir. We still retain one cup, larger than the FA 

Cup. He was a shipwright and worked on the building 

of the Titanic. Having achieved success in the 11-plus, 

I entered Methodist College Belfast, a large mixed 

school of almost 2,000 people with two prep schools 

and fairly large sporting grounds. Achieving some 

success in sports activities, mainly in cricket, I managed 

to achieve sufficient ‘A levels’ to enter medical school. 

The choice of medical school was not straightforward 

in that had I chosen Queen’s University Belfast, I would 

have had an offer from them and nowhere else. As it 

was I chose Edinburgh, Liverpool and various others 

and ended up without an offer. Eventually Liverpool 

agreed to interview me and after a short meeting 

with the then Dean, Jack Leggate, an offer was made. 

The grades were achieved and I entered medical 

school in 1968. I really enjoyed medical school in all 

aspects, academic, social and artistic, taking part in 

many activities including being President of the 

Medical Students’ Society in 1971-72. Marriage and a 

young family commenced shortly after this. Early jobs 

as a House Officer and Senior House Officer in 

Whiston were followed by periods of plastic surgery, 

gynaecology and eventually time in the 

demonstrating room, time well spent to obtain 

primary FRCS. 

8


It was at this point I entered training in ENT as an SHO 

under the guidance of Philip Stell. Six months into this 

training I was able to get a Registrar’s post in Oxford 

at the Radcliffe Infirmary (the old Radcliffe in the 

centre of town) working with Bernard Coleman, Bill 

Lund and Andrew Freeland. This was a great time for 

my academic career working with likeminded 

individuals, both my level and senior to me, and also 

the 3 Consultants with a tertiary referral practice. 

Having obtained my Fellowship in Surgery I was able 

to then take advantage of an offer of a Registrar’s 

post in the Groote Schuur Hospital, Cape Town, under 

the guidance of Professor Sean Sellers. This was a very 

productive period of my life where I was able to utilise 

what knowledge I had along with some surgical skills 

but under good tutorship and supervision. On 

completion of this contract and following a three 

month locum in Bulawayo to cover expenses, I 

returned initially to Oxford and subsequently to a 

Senior Registrar’s job in Liverpool. In January 1986 I 

commenced my full time post as a Consultant 

Otolaryngologist, with sessions both at the Royal 

Liverpool and Arrowe Park Hospitals. It was at this 

point that I noticed that the Royal Liverpool Hospital 

building was eleven stories high and the length of two 

football pitches i.e. exactly the same dimensions as the 

Titanic. 

Subsequently I dropped my sessions at Arrowe Park 

and took up sessions at Alder Hey Children’s Hospital. 

During this time I had worked with approximately 20 

Consultant colleagues from whom I learnt a lot about 

surgery, patient management, differing health care 

systems and it gave me an ability to analyse and assess 

treatment modalities. 

The Missing Chapter 

As indicated earlier, this is the bit of all textbooks 

which is missing i.e. how to interpret facts and 

translate them into patient management. Most of this 

can only be taught by the bedside or in theatre or in 

relaxed frank discussion. I don’t think there is 

anything didactic in this method of teaching: 

textbooks are full of facts and whilst accurate, are 

themselves pretty lifeless. It is the job of the surgical 

tutor to enable trainees to elicit and recognise 

physical signs and then with all the other relevant 

details relating to a patient, formulate a management 

strategy and a plan for treatment. I have estimated 

that I have perhaps worked with almost 300 trainees 

in my 29-year surgical career and hope that many of 

these have been influenced in a positive way about 

my thoughts in relation to management. 

It is accepted by all of us that today’s trainees are not 

as experienced as their predecessors. We now 

produce emergency safe surgeons and only with 

fellowships and subspecialisation post CCST 

accreditation would a specialist be regarded as fully 

trained. This of course means that the general 

training that I gained has now devolved into otology, 

rhinology, head and neck cancer, facial plastics, 

paediatric ENT and audiology i.e. the same sort of 

subspecialisation which has happened in General 

Surgery. 

A lot of the conditions covered in otolaryngology are 

not surgical at all and need to be managed in the 

clinic for example tinnitus and dizziness. 

Surgery, like virtually everything in medicine, is 

individualised to each patient, but the same steps 

must be included in each case. This of course is learnt 

by repeated practice in a similar way to the same basic 

golf swing being used for every shot but then adapted 

to special circumstances. 

I do feel however that the surgical training needs 

focus and guidance in particular areas, and I 

understand that the undergraduate medical 

curriculum is being altered to provide some more 

focus and guidance in this respect. 

I was fortunate in that I was able to travel to South 

Africa and subsequently Zimbabwe using my medical 

degree almost as a passport. I would recommend this 

to any trainee as a method of broadening your 

outlook on life and experiencing different values in 

healthcare systems. 

The “Whenwees” 

A displaced group of ex-pats from Rhodesia are often 

referred to as The “Whenwees”, due to the way that 

when they meet to discuss the good old days it nearly 

always starts with ‘when we …’. Perhaps I feel a little 

like that on looking back at my career, and asking 

what in fact was wrong with selection and 

competition? What is the benefit that the 

introduction of university fees has given apart from 

shifting the burden of debt from the State to the 

student? What was wrong with providing the 

underprivileged and underfunded student with a 

student grant as opposed to encouraging to take out 

even more loans on top of the university fees? 

9


The NHS 

I work in a system where there appears to be 

continual change and it certainly feels like a top-down 

managed structure. Not only is there continual 

change in management, there are continual changes 

in ideas, often at the behest of politicians, with 

nothing longer than a short to medium term 

management plan. As clinicians, we often feel 

disenfranchised offering advice about management. 

I have often wondered whether the NHS might 

benefit from a similar structure to the Bank of 

England, who have an independent Board which 

makes recommendations to the Government. 

Acknowledgements 

I would like to thank all those that have supported me 

in my career and particularly the State education 

system, the NHS for supporting my apprenticeship, 

friends who have shared my professional 

development and other providers of opportunities. 

Finally I would like to thank my wife, Siobhan, who 

has been an unerring supporter whether it be pushing 

from behind, supporting me by my side or indeed 

leading from the front. We have shared this passage 

through medical school, junior doctor, senior doctor 

and now entering the twilight of my career, I am still 

very glad of her presence. 

10


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 

in medical care during conflict. In major wars up until 

then, more soldiers had died of disease than from 

battle injuries. The disease:combat fatality ratio had 

been 5:1 in the Crimean and American Civil Wars and 

2:1 in the South African War. Compare this to the 

ratios in WWI and WWII which were 0.7:1 and 0.1:1 

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. 

brought in casualties from the battlefield and they 

then passed down a chain from regimental aid post to 

collecting post, dressing station, casualty clearing 

station and hospital. Long ambulance trains ferried 

the wounded to the hospitals, hospital ships carried 

wounded over the Channel and hospital trains were 

available on both sides of the Channel. 

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 

from disease. On the Western Front, where battle lines 

were relatively static for much of the war, the numbers 

were enormous and a vast ‘medical machine’ was 

established. Over 5.5 million were admitted to 

hospital, 183,454 died of wounds and disease, almost 

3 million returned to duty in theatre and 2.3 million 

were evacuated out of the theatre. Stretcher bearers 

A convoy of Red Cross Ford Ambulances (built to order 

of the French Relief Fund) en route from Liverpool to 

London. The convoy reached the Metropolis without 

mishap, proceeding via Lichfield, Coventry and St 

Albans. 

Ford Times September 1915. 

11


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 

prevalence of diseases such as typhoid in the local 

civilian population and in animal reservoirs would 

influence the likelihood of infecting the soldiers. 

There were problems of heat stroke in the Dardanelles 

and Mesopotamia, and of frost bite in France. The 

terrain in France was flat and there was a pre-existing 

infrastructure of roads and railways, although 

flooding, wind, snow and ice could be problems. 

Casualties in the Dardanelles were evacuated under 

fire to poorly-organised medical facilities. Although 

these improved compared with the second wave of 

landings, there was no space in the bridgeheads and a 

lack of resources for anything like what was available 

on the Western Front. In Mesopotamia there were no 

railways and few roads. Transport was by horse- or 

donkey-drawn vehicles over very long distances, until 

a river could be reached. 

To some extent, technology played a part in ironing 

out the differences between the 3 theatres. In 

particular, immunisation against typhoid and tetanus 

was available in all 3 areas, but immunisation against 

cholera was only 50% effective. Each theatre 

presented its own unique challenges, but the 

difficulties remained greatest outside Europe. 

Geographical difficulties could be partly overcome 

given sufficient planning and resources. 

Operational factors always played a major role. For 

the medical services, the relatively static theatre on the 

Western Front carried major advantages, allowing 

facilities to be built up over a period. Combined 

operations such as in the Dardanelles added problems, 

with poor communications and rivalry between the 

army and navy. When warfare was more widespread, 

such as in Mesopotamia, the extended lines of 

communication stretching over thousands of miles 

With the rising tide of nationhood in the British Empire 

it was important that Imperial troops were seen to be 

treated fairly. On each side of the conflict, nations 

accused each other of poor treatment of prisoners. 

Relationships between commanding officers and 

medical officers was crucial. The Medical Act of 1858 

increased the professionalisation of medicine and the 

Royal Army Medical Corps was founded in 1898, giving 

medical officers the same ranks as the rest of the army. 

However, relations remained strained in the later part 

of the Victorian era. In the Boer War the senior 

commanders such as Lord Roberts and Sir Garnet 

Wolseley had a poor opinion of medical officers and 

this view appeared to pass down the chain of 

command. There was a great gulf between combatant 

officers and medical officers and operational plans 

were drawn up without consultation with medical 

officers. Advice on water purification, sanitation and 

rations was ignored, resulting in 8000 deaths from 

typhoid. Consequently public support for the war 

declined. 

After the Boer War, lessons were learnt. There was 

better training of commanding officers in the 

importance of hygiene and sanitation. It was thought 

that better Japanese medical services had contributed 

to their victory in the Russo-Japanese War. The 

efficiency and status of the army medical services were 

built up by Lieutenant General Sir Alfred Keogh, who 

was Director General 1904-1910 and 1914-1918. He 

worked well with Lieutenant General Sir Arthur 

Sloggett who was in charge of medical services on the 

Western Front. Although the rapid expansion of the 

army diluted knowledge and caused a relative lack of 

training, every effort was made to overcome this. The 

High Command on the Western Front was acutely 

aware of the connection between good medical 

services and morale and the need to provide good 

facilities to get soldiers back to their units as soon as 

possible. 

12


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 

Indian Army, with its culture of deference to authority. 

Medical officers were excluded from Lt. Gen. Sir John 

Nixon’s HQ and little thought was given to logistics or 

sanitation. The campaign was very poorly resourced 

until the handover to control by the War Office in 

1916. General Nixon would withhold information 

from the Viceroy in Delhi and the Viceroy would 

withhold information from London. The distances 

were enormous and casualty evacuation was held up 

by lack of boats. Nixon was eventually replaced by Lt 

Gen Sir Frederick Maude in 1916 and there was a slow 

but steady improvement. Less deferential civilian 

doctors who had volunteered to serve such as Colonel 

Sir Victor Horsley 1 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. 

Scrutiny of events by war reporters was surprisingly less 

important in informing the population at home than 

the return of casualties, visits by dignitaries and 

politicians and the presence of civilian volunteers and 

experts in the army. The sister of Sir John French, head 

of the British Expeditionary Force in 1914, was a VAD 

nurse who had no hesitation in informing influential 

friends at home of any deficiencies she came across. 

Sir Frederick Treves on the other hand was guilty of 

concealing evidence both in the Boer War and in WWI. 

The High Command was acutely conscious of the need 

to maintain public support at home. 

Hospital ship No. 1, bearing sick and wounded from Kut, 

coming alongside the bank of Tigris at the British lines 

at Flalhiyah. 

In conclusion, the differences between the three 

theatres of war were not simply due to geographical 

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


fatalism in the armed forces and increasing 

democratisation increased politicians’ awareness of 

their responsibilities to the nation. 

During subsequent discussions, Dr John Goldsmith 

pointed out the different stress-related conditions of 

the two world wars in the 20th century: in WWI 

hysterical reactions such as paralysis were common 

while in WWII peptic ulcers were more prominent. Dr 

Sally Sheard asked if soldiers in WWI had ever been 

ordered not to pass on details of conditions as had 

happened with returning Far East Prisoners of War in 

WWII. Professor Harrison had found no evidence of 

this and in any case did not believe that such 

prohibitions would have worked. 

Dr John Rowlands 2 pointed out that two of the 

fourteen medical officers whose names are on the 

LMI’s WWI war memorial took their own lives and 

wondered how common this was. Professor Harrison 

was unable to throw any light on this but considered 

that the combination of unrealistic expectations and 

appalling conditions was very conducive to severe 

mental stress. A further questioner wondered if 

conditions in the enemies’ medical services were any 

different from ours. Professor Harrison thought that 

conditions often depended on how well the war was 

going for them. At the time of any defeat, conditions 

in enemy hospitals would always tend to be poor. 

The meeting closed with a vote of thanks by Professor 

Dangerfield and the reading of the University’s 

formula of dismissal by Professor Jha. 

1 

Professor Sir Victor Horsley’s name is on the WWI Roll of Honour in the entrance hall of the Medical Institution. 

He was a pioneer neurosurgeon, a Fellow of the Royal Society, member of the Pathological Society and Founder 

of the Journal of Pathology. He was elected an Honorary Member of the LMI in 1894. He held many international 

distinctions. He died of heatstroke on active service in Mesopotamia on 16th July, 1916 at the age of 59 and is 

buried in the Commonwealth War Cemetery in Amarah. The Intensive Care Unit in the Walton Centre for 

Neurology and Neurosurgery is named after him. 

2 

Dr Rowlands is the author of a booklet listing the histories of these fourteen medical officers. There is a copy 

in the LMI Library. 

14


Merseyside Annual Healthcare Service 2015 

The Annual Healthcare Service took place at the Liverpool Metropolitan Cathedral in the form of choral evening 

prayer on Sunday, 10th May at 3pm. The speaker was Archbishop Malcolm McMahon and the celebrant Canon 

Tony O’Brien. The Epistle was read by Mr Graham Lamont, President Elect of the Liverpool Medical Institution 

and the Gospel was read by Father Dominic Curran. Also in attendance was Councillor Erica Kemp, Lord Mayor 

of Liverpool. The theme was Child Health to celebrate the opening of the newly built Alder Hey Hospital. 

In his homily, Archbishop Malcolm McMahon spoke of the faith that leads to help as illustrated in the Gospel 

reading. The passage described the healing of the Centurion’s servant and also the healing of Peter’s mother in 

law. He pointed out that it was the faith of the Centurion that essentially supplied the cure that Jesus provided. 

Jesus’s dying opened a path of cure for all for entry in to the Kingdom of Heaven. The suffering of Jesus was of 

value. As the topic of the service was child health, Archbishop McMahon alluded to the faith of the sick child. 

This would often provide resilience, hope and joy and energy to the carers. The heart of a child was the gift of 

love both from the parents and the Father God. Just as in the same way, Jesus restored the Centurion’s servant 

and Peter’s mother in law to perform the task to worship in the service of God. So healing provides us with the 

ability to provide our worship in our daily lives through performing the works that God has given us to do. 

As healthcare workers we would be contributing to God’s healing creation and this was the time to give thanks 

to God for healthcare work. 

The first address was given by Dr Alan Fryer, Geneticist at Alder Hey Hospital. He pointed out that 75% of all 

serious childhood illness came from genetic disorders. It was important for parents that the condition is 

diagnosed so that they would know what to expect and how best to provide support for the suffering child. As 

a Clinician, Dr Fryer said that prayer was important to give him wisdom as he set out on his daily tasks. Prayer 

should not be seen as an alternative therapy but as part of the care plan that God has for all people, who are 

disabled or in any way unwell. The Health Care Service was a time to thank God for the expertise and the science 

of medicine and to pray for the needs of the region. 

The second address was given by Dr Janine Arnott, a Social Scientist working at Alder Hey. She spoke of the need 

to talk to the families directly, helping them through their personal journey of helping a disabled or ill child. It 

was her job to make the journey more positive for the parents. Just the simple actions of a child were important 

in detecting improvements in the abilities. However it was difficult to quantify such things when applying to 

grant-giving bodies to provide funds for further research. She spoke of servant leadership which was the new 

buzzword in the health service. She pointed out that it is over 2000 years old, and initiated by Our Lord himself. 

Followers of Jesus were in the ministry of providing support, care and cure to those who suffered. There was 

no conflict between faith and reason. 

The bidding prayers were composed by Reverend David Williams, Chaplain to Alder Hey Hospital and read by 

Professor Linda de Cossart CBE, Past President of the Liverpool Medical Institution. 

The blessing dismissal was given by Dean Anthony O’Brien. I would like to stress my thanks to all those on the 

Committee and in the Liverpool Metropolitan Cathedral for enabling the service to take place. 

Professor Peter Davies 

Chair, Merseyside Healthcare Service Committee 

15


Minutes of the First Ordinary Meeting 

Held on Thursday 13th November 2014 

‘The GMC in 2014. What Is It (Good) For?’ 

Professor Anthony Narula, FRCS. Treasurer, Royal College of Surgeons (England) 

Mr M McCormick, Prof A Narula and Prof L de Cossart 

The President, Mr Max McCormick welcomed 

Professor Narula to the first ordinary meeting of the 

LMI Academic sessions. Max went on to tell the 

audience that he was delighted that Tony had 

accepted his invitation to Liverpool explaining that 

they had met many years ago as ENT Trainees and 

progressed through their careers contemporaneously. 

Professor Narula was welcomed to the podium with a 

round of applause. 

Professor Narula replied that he was enormously 

pleased to be at the LMI. He offered a short 

biography of himself saying that he had just recently, 

at the age of 59 years, retired from the NHS, he said 

'to avoid bare below the elbows'. He was born in 

South Asia in Burma and came with his family to 

Britain as a refugee. He suggested that he was 

probably the first asylum seeker to speak at the LMI! 

Following school education at a 'Victorian boarding 

school in the South East’ he went on to study medicine 

at Trinity Hall Cambridge and The Middlesex Hospital 

in London. He explained that he managed to 

graduate with a minimum of work but not without a 

concentrated cramming just before examinations! He 

went on to say that he had spent the first twelve years 

of his consultant career working as a busy NHS 

consultant in Leicester. He was called to the lofty 

spires of London to take up a post at St Mary's 

Hospital in London just over ten years ago. 

He began his talk by setting the scene of what is 

regarded as the 'typical consultant' by showing the 

entry of 'Sir Lancelot Spratt' (actor James Robinson 

Justice) into an early NHS hospital in a flurry of action 

and paying little attention to the patients. He went 

on to begin his talk ‘The GMC in 2014. What is it good 

for?’ 

The General Medical Council, he said, was responsible 

for many regulatory functions with respect to 

practising doctors. He showed the complexity of the 

various committees and processes, reassuring us that 

his talk tonight would focus on ‘Fitness to Practise’ 

and ‘Revalidation’ but offering a quote from a well 

respected psychiatric colleague “All of these bodies 

eventually become self-serving”. He proffered that 

the GMC is probably at this point right now. 

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He continued with a slide showing the photographs 

of the medical members of the Council of the GMC. 

He invited the audience to name those in the 

photographs. Not many could be named. He then 

showed photographs of the lay members of Council 

and again few if any could be identified. He pointed 

out Dame Suzie Leather, former head of the Charity 

Commission who is now a lay member of the Council. 

He reminded us that not only were these people 

responsible for overseeing the annual GMC spend of 

100 million pounds but were also our leaders in 

medical regulation. 

Fitness to Practice 

Professor Narula went on to say that as a practising 

doctor, you may one day receive a letter from the 

GMC, and as time goes on the number of people 

receiving these will go up. He asked if any in the 

audience had received one. None had. Currently he 

said, each year about 1 in 25 will receive such a letter. 

It is probably the most awful heart sink moment in a 

doctor's professional career. 

The letter will inform you of the complainant and you 

will be asked to fill in the form to include all the places 

that you have ever worked. The name of the 

complainant may be a very disgruntled patient and 

well known to you. The GMC will follow this up by 

writing to every medical institution at which you have 

worked asking 'Is any thing known about this doctor?’ 

The chief of that organisation will have to consider 

their position when they reply. 

There are about 250,000 doctors on the register and in 

2012 there were 10,000 such complaints (4%). This 

figure has gone up by almost 20% on the previous 

year and by 50% on the previous five years. Following 

review of the complaint 6000 will be dismissed but the 

rest will trigger some sort of investigation. That 

translates into investigations being instituted by the 

GMC on 4000 doctors in one year. Approximately 60% 

of these are likely to undergo a fuller investigation. 

This is an enormous workload, but perhaps more 

worryingly it is a chance for sensationalists and 

journalists to misuse the statistics and predict that in 

time every doctor will be investigated. All of this 

neatly missing the fact this already causes huge pain 

and agony to doctors and their families, in some cases 

destroying careers of innocent doctors. 

If the complaint is not dismissed, you may be called to 

the Interim Orders panel. This will happen very 

quickly, within a month of the first letter. In 2012, 800 

doctors were referred here and eventually 216 went 

to full panel hearings with a further one hundred 

doctors agreeing 'undertakings' related to the 

complaint. Panel hearings were 208 down from 

previous year and there were 55 erasures and 64 

suspensions. 

Professor Narula continued, saying that until late 2013 

he was chief of neurosciences (ENT, Maxillo-Facial, 

Head and Neck and Neuro) at Imperial and responsible 

for nearly 100 consultants. The following two casestudies 

illustrated what happens to individual 

practitioners when things go wrong. 

Case Study One: Doctor has an affair with his 

secretary. 

A respected surgeon, who was under Narula's care as 

a manager, received a letter from the GMC with the 

criticism that he had taken advantage of a woman 

colleague, started an affair with her and then dumped 

her. 

As the chief of the department Narula had received 

all the paper work and having read it, felt the GMC 

complaint was without foundation. 

The surgeon told Professor Narula his version of the 

story. He had had an affair and this had broken down 

when he had declared to his lover that he was not 

going to divorce his wife. The investigation of the 

case uncovered the fact that during this affair the 

surgeon had done two things which caused concern: 

a) he had arranged for the lover to have an MRI scan 

of her knee at the hospital at which they both 

worked, and b) he wrote her a prescription, for a drug 

she was already prescribed by her GP (thyroxine) as 

there had been a delay in getting it from the GP. The 

GMC wrote demanding that he appear before them 

within the next thirty days. A date was set. 

Professor Narula said that he was so concerned about 

this doctor that he had visions of him getting onto a 

railway station platform and throwing himself under 

a train at Manchester Piccadilly on the way to the 

hearing. He took a day off and went with him to the 

hearing. 

The legal costs for the doctor for that day amounted 

to £15,000. Narula said that he imagined that the 

GMC would have been paying a similar amount for 

their barrister. The final deliberation of the GMC was 

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that there was no risk to the public, no action to take 

and no reason to proceed. However, it took just under 

two years before the letter saying this arrived on desk 

of the surgeon. During that time his revalidation date 

was due and because the GMC file was still open, the 

Revalidation Responsible Officer at the Trust could not 

action his revalidation process. 

Case Study Two 

A consultant surgeon in his mid sixties, nationally and 

internationally well known, received a GMC letter. 

The complainant was the private hospital at which he 

worked and where he had complained that the 

facilities fell short of the required standards. The 

complaint indicated 10 cases where his practice had 

been found wanting and threatened the safe care of 

patients. 

Within 9 to 10 months of receiving this letter all of the 

criticisms raised had been dismissed. However, 18 

months later he got another letter from the GMC 

saying it was now going to a fitness to practise 

hearing. The ultimate outcome of this hearing was 

that there was no case to answer. The effect on this 

man's life has been considerable both personally and 

professionally as a practising surgeon as well as to his 

family. 

Our speaker went on to say that the Medical 

Protection Society have said that 93% of doctors who 

go through fitness to practise processes report severe 

anxiety and stress. Whistle-blowing brings with it 

considerable personal risks. 

Revalidation 

Professor Narula changed to the subject of Medical 

Revalidation. He said that in the early 2000s the GMC 

was all set to institute new and improved 

recertification processes and procedures for doctors in 

medical practice in the United Kingdom. However, 

Dame Janet Smith, the High Court judge who chaired 

the Shipman enquiry, heavily criticised the ideas 

behind these proposals in her third and final report. 

Many lawyers criticised her for going outside of her 

remit in the enquiry by making these comments but 

her intervention led to a revisiting by the GMC of this 

whole process. 

Thus a whole new bureaucracy was designed to 

respond to the criticism but in fact the only real 

difference that came forth was the introduction of 

processes of feedback from patients and doctors. The 

main thrust of this process was to prevent another 

Shipman. But, our speaker went on to say, we all 

know Shipman's patients loved him so, even as a mass 

murderer, he was unlikely to be picked up by this new 

process. There was majority agreement for this from 

the audience. 

We are now in year two of the era of Revalidation. A 

phased process has been introduced and it is 

anticipated that all doctors in practice will have been 

revalidated by March 2016. There is still much 

sceptism abroad in the profession about the process 

and some believe that if approximately five per cent 

of doctors refused to engage, the whole system would 

collapse. 

Our speaker went on to say that the underpinning to 

Revalidation is annual appraisal. The annual appraisal 

process is meant to review the evidence of your 

practice as a doctor and the evidence to support the 

quality of that practice both in private practice and 

NHS practice. It is meant to be both formative and 

summative in supporting the continuing professional 

development of you, the doctor. “In my experience”, 

said our speaker, “I have been appraised since 2003 

but never been asked about my private practice.” 

The process of appraisal is that the doctor submits a 

portfolio of evidence in line with the four domains of 

the GMC standards for Knowledge Skills and 

Performance; Safety and Quality; Communications, 

Partnership and Team work and Maintaining Trust. 

Nowadays this is an electronic repository, which can 

be supplemented at the time of appraisal by paper 

records and evidence. Following a successful appraisal 

meeting, a summary is agreed by appraiser and 

appraisee and a professional development plan (PDP) 

is drawn up and this will form the framework for the 

next appraisal. Our speaker went on to say that there 

is a requirement in the portfolio for Reflection. He 

admitted that he was not sure what this was really 

about and that many felt the same way. 

One of the key things for appraisal, he offered, is the 

inclusion of national registry data about outcomes for 

index surgical operations. This is particularly true for 

surgeons. He said with considerable feeling that he 

had resisted the recent desire by government for 

publication of such data before individual clinicians 

had had time to see their own results. He went on: 

“There are in my opinion a whole lot of potential and 

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real risks of poorly collected data. The Team and the 

environment of surgical procedures plays a huge role 

and is often not accounted for within the data and the 

reported results are often to the detriment of an 

individual until things are investigated in more 

detail.” 

He continued by saying that the electronic portfolio 

systems are awful and there are many companies 

learning how to construct the database 'on the job' 

and making money out of healthcare providers in 

doing so. As the King's Fund has said “it [appraisal] 

will become a box ticking exercise because you have to 

have ticked the boxes to be allowed to proceed”. The 

well-meaning purposes of doing these things have 

been lost in this awful process. The system is unlikely 

to pick up those doing locums and in independent 

practice who may fall short of the standards. 

This bureaucratic monster has been set up by the 

Department of Health and the GMC. Locum and 

retired doctors have problems in ensuring that they 

can account for their practice and remediation for 

those falling short of the standards is also very 

difficult. He said his experience of managing such 

processes left him very concerned about how 

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. 

Many of these things suggest, he said, that the GMC 

has many unanswered questions. Medical 

practitioners especially outside of London need to 

remain vigilant and be able to voice critique on what 

the GMC and government is doing in particular taking 

note of the many unregulated healthcare providers 

on the high street. 

Professor Narula concluded with some amusing videos 

that in a comic and ironic way emphasised some of 

these points. He finished by thanking the LMI for 

inviting to him to speak and he paid warm tribute to 

his wife for putting up with him and his mad working 

ways. As a final point he offered the caption defining 

the difference between complete and finished: 

“If you marry the right person your life is complete if 

you marry the wrong person your life is finished, but 

if you marry the right person and get caught with the 

wrong person you are completely finished.” 

The audience responded with applause and there was 

the usual time for questions. The meeting concluded 

with supper. 

Linda de Cossart CBE 

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


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 

‘Crazy to be sane - whatever happened to RD Laing?’ 

R D Laing was a well-known figure in the 1960s both 

in the medical community and amongst sections of the 

wider public. He became an important, and for a 

while, influential figure in redefining and treating 

mental illness - in particular Schizophrenia. However 

his ideas and influence were apparently short-lived. 

Given criticisms of the style of psychiatric diagnosis 

currently employed, this presentation examines 

different historical constructions of mental illness and 

how it is treated. Opposition to psychiatry has taken 

many forms, all of which could not be covered by this 

presentation. Therefore I have chosen to focus on 

outlining the ideas of RD Laing and the 'antipsychiatry 

movement' and to consider the 

contribution that he, and they, made to the 

understanding and treatment of mental illness. Firstly 

I will reflect upon the attitudes and treatments 

prevalent in the 1950s and ‘60s and the critique of 

these made by Laing and others. I will then examine 

some of the possible reasons for the backlash against 

Laing and his ideas before finally looking at the extent 

to which Laing's ideas are in fact an influence on 

modern day attitudes to defining and treating mental 

illness - an influence which it argues can be seen in, 

for example, the 'user movement' and in the 

popularity of 'self-help' groups. I will conclude that 

although much of Laing's work lacked scientific 

validity, his contribution to making 'madness' 

comprehensible and encouraging people to consider 

mental illness from an empathic and humanistic point 

of view is of great value to contemporary medical 

practice and wider society. It also highlights that there 

is a lack of historical analysis concerning the antipsychiatry 

movement; especially in regards to its 

demise. 

Shane D'Souza - Second Place 

‘Gertrude Elion and Her Drug Discoveries’ 

Gertrude Elion made significant discoveries of drugs 

in the treatment of leukaemia, herpes and antirejection 

drugs for kidney transplants. Her hard work, 

commitment and attitude led to revolutionary 

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developments in the medical world, for which she was 

awarded the 1988 Nobel Prize in Physiology or 

Medicine. Not only did Gertrude Elion work on drugs 

to fight HIV and malaria, she remains an inspirational 

figure and a role model of a woman who persevered 

in science at a time when there was unfair 

discrimination towards women in science. 

During the presentation, I discuss the knowledge and 

ideas presented before Gertrude’s discoveries, and 

how her discoveries have since changed the ideologies 

in drug treatment since up to the modern day. I 

consider previous ideologies of male dominance in 

science and how Gertrude Elion acted as a 

distinguishing example as someone who has broken 

these barriers. 

The presentation discusses her background, career 

struggles, women in STEM; science pre-1954 (specifics 

regarding knowledge on Malaria/Leukaemia/Antirejection 

medicines); science post-1954 (the above 

topics and how Elion’s contribution has affected 

modern day medicine); the way forward in Medicine. 

Alexander Boone - Third Place 

‘The Exile of Paracelsus’ 

‘The art of healing comes from nature, not from the 

physician. Therefore the physician must start from 

nature, with an open mind’ – Paracelsus. 

In 1526, Philippus Aureolus Theophrastus Bombastus 

von Hohenheim, otherwise known as ‘Paracelsus’, was 

appointed Professor of Medicine at the University of 

Basel, Switzerland. In 1538 he was exiled from Basel 

and died just three years later in Austria. 

Paracelsus is commonly regarded as one of the most 

influential medical scientists of the Renaissance era. 

His methods revolutionised medicine in early modern 

Europe. Paracelsus rejected the ancient texts from key 

authorities such as Galen and Celsus and insisted upon 

using observations of nature to guide his own medical 

practice. He specifically rejected Galen’s claim that 

health and disease were controlled by the ‘four 

humours’. Paracelsus encouraged the study of nature 

and pioneered an experimental approach. He also 

believed in the existence of gnomes, spirits and fairies. 

Public burning of books by Ibn Sina and Galen, 

inviting non-academics and lay-people to his lectures 

and rejecting much of university-taught medicine 

gained Paracelsus much notoriety. His actions 

ultimately led to his exile. Paracelsus argued that the 

body operated as a chemical system subject to internal 

and external influences. This premise led Paracelsus 

to introduce chemical substances into medicine. 

Mercury, for example, was used for the treatment of 

Syphilis. Paracelsus is therefore often termed the 

‘Father of Toxicology’. 

I propose to discuss the modern day relevance of 

Paracelsus and also Paracelsian theory in terms of its 

medical, philosophical, socio-political and religious 

connotations. I hope to convey the pugnacious 

temperament of the man and define exactly how he 

defied medicine in his day! 

Siân Elsby - Runner-Up 

‘Medical Ethics and the Third Reich’ 

The atrocities perpetrated during World War II are 

well documented. The Nazi eugenics movement 

persecuted ‘sub-human’ non-Aryans: labelled as 

'genetically unfit', these people were rounded into 

concentration camps and routinely sterilized, used as 

subjects in human experimentation, and killed. The 

scale was unprecedented: after war broke out in 

September 1939, so-called 'mercy deaths' became 

commonplace at mental hospitals - between January 

1940 and September 1942, some 70,723 mental 

patients were gassed. The total number of Jews 

murdered during the war is estimated to be between 

5.5 and 6 million. 

Much of this torture was given pseudo-scientific 

justification and perpetrated by willing medical 

professionals. When war ended in 1945, one of the 

Allies' priorities was bringing war criminals to justice. 

Between December 1946 and August 1947, a trial was 

held in Nuremberg - commonly called 'The Doctors' 

Trial', the defendants included twenty medical doctors 

and three Nazi officials accused of human 

experimentation and mass murder under the guise of 

euthanasia. A defence offered by many was that no 

ethical guidelines governing human experimentation 

existed at the time - so no laws were breached. 

The Nuremberg Trials gave rise to the Nuremberg 

Code in 1947 - it was 'a catalogue of ten principles 

which would protect the rights of experimental 

subjects and other vulnerable groups in the future’. 

This led to the Declaration of Geneva in 1948, which 

shaped the Declaration of Helsinki in 1964 - a set of 

21


ethical principles regarding human experimentation 

developed for the medical community by the World 

Medical Association. 

The presentation will seek to inform the audience 

about what led to the Nuremberg Trials - and invite 

them to reflect on whether it is unethical to use 

information gained from Nazi experiments, or if to 

ignore it would mean millions of people ‘died for 

nothing’. 

Sophie Gealy-Evans - Runner-Up 

‘Anaesthesia in the First World War’ 

Anaesthetics is now considered an essential part of 

medicine, but in 1914 it was a game of trial and error. 

The First World War was a brutal massacre of life, for 

which both soldiers and medical professionals were 

severely unprepared. There was a sudden 

advancement in anaesthetic techniques in this period 

(1914-1918), during which a massive need for pain 

relief and emergency treatment resulted in the 

established role of the anaesthetist. Out of the 

desperation came innovative new ways to deal with 

casualties and poor facilities. 

I believe there were three key elements that were 

outcomes of the harsh conditions of war - the role of 

the anaesthetist, the development of anaesthetic 

agents and their administration and the better 

understanding of the physiology behind them. In this 

presentation, I would like first to give some 

background on what was already known about 

anaesthetics at the time, and then consider how each 

of these three aspects developed, and why the War 

was so integral in their progression. 

On the year of its centenary, it is especially important 

that we recall how this war shaped and moulded 

these three elements, and I will consider how the 

setting of World War I was both a catalyst, and 

limiting factor, to the advancements of anaesthetics, 

which shaped the course of new advancements. It 

should be remembered whilst looking at new 

developments in the war zone that these must be fully 

explored and adapted to civilian life, away from the 

limitations of combat, so that positives can be taken 

from the horrific situations from where they came. I 

believe it is a topical subject, and an educational way 

to pay respect to those who died during the First 

World War. 

22


Minutes of the Third Ordinary Meeting 


‘Catheter Ablation for Cardiac Arrhythmias: What’s New?’ 

Dr Dhiraj Gupta, Consultant Cardiologist and Electrophysiologist, 

Liverpool Heart and Chest Hospital 

‘Device Therapy for Heart Failure’ 

Dr Richard Snowdon, Consultant Cardiologist and Electrophysiologist, 

Liverpool Heart and Chest Hospital 

The President introduced Dr Dhiraj Gupta and Dr 

Richard Snowdon from the Liverpool Heart and Chest 

Hospital. In his introduction he reflected on his own 

memories of cardiology and how things have changed 

in the intervening years. 

Dr Gupta introduced his subject of arrhythmia 

ablation, explaining that the Liverpool Heart and 

Chest Hospital served a population of 2.8 million and 

carried out around 1200 procedures per year. The 

ablation of cardiac arrhythmias relies on mapping the 

focus generating the arrhythmia and then delivering 

either heat or cold to that area. Intravascular 

catheters are able to locate the focus of the 

generation of the arrhythmia to deliver an electrical 

burn and to measure the temperature, or as an 

alternative, to deliver cold. The technique may be 

used to treat supraventricular tachycardias, atrial 

flutter, Wolff-Parkinson-White syndrome and re-entry 

tachycardias, atrial fibrillation being increasingly 

common. Paroxysmal atrial fibrillation is the most 

common arrhythmia treated, and untreated can result 

in serious disability with shortness of breath and 

stroke, symptomatic spells and may reduce life 

expectancy significantly. 

In around 2000 it had been determined by intracardiac 

electrical mapping that the commonest position was 

around the origins of the pulmonary veins and 

creating a circular scar around this area had an 80% 

success rate in suppression of such arrhythmias. A cryo 

generating balloon was also very effective and could 

reduce the symptomatic rate by 80-90%. In the last 

decade of the 20th century, a surgical approach had 

been adopted using basket electrodes in the atrium 

to map arrhythmia origins followed by surgical 

burning. This technique sometimes involved 2 or 3 

procedures but had an 80% success rate. The ability to 

carry out this procedure by intracardiac catheter had 

now superseded the surgical approach. The 

procedures were not without some complications, but 

these were increasingly uncommon with increasing 

experience. Bleeding from the catheter entry site, 

usually in the groin, tamponade from perforation and 

the accumulation of intrapericardial fluid were not 

unknown but were increasingly uncommon, 

particularly with the advent of ultrasound guidance 

to determine accurately the catheter position. 

Subsequently pulmonary vein stenosis at the site of 

the scar was not unknown but rare. 

The starting point for consideration of catheter 

ablation of arrhythmias was the failure of drug antiarrhythmic 

treatment. There is now approximately 

ten years’ experience of catheter ablation with good 

long term results gradually accumulating. 

Dr Richard Snowdon discussed recent advances in 

implanted devices, in particular, pacemakers 

for the treatment of heart block and bradicardias, 

for the termination of tachyarrhythmias and 

resynchronisation of atrial and ventricular 

23


components of cardiac output to improve heart 

failure. Most devices were battery operated with 

leads to the appropriate areas of the heart. The leads 

were able to sense cardiac electrical impulses and 

deliver an appropriate electrical stimulation. 

The majority of pacemakers inserted are dual chamber 

with leads to both atria and ventricle. Single chamber 

pacing is occasionally indicated in the atrium for sinus 

node dysfunction with normal atrio-ventricular 

conduction or ventricular pacing only for ventricular 

rate control resistant atrial fibrillation. Cardiac 

function is best maximised by efficient synchronised 

atrial and ventricular activity. The existence of an 

intraventricular bundle branch block results in 

dysfunctional ventricular activity, in particular a left 

bundle branch block gives rise to a dysfunctional left 

ventricular contraction. In the past, pacing of the 

right ventricle mimicked a left bundle branch block 

and subsequent inefficient activity. This could be 

overcome by pacing the posterolateral wall via the 

coronary sinus requiring a 3 lead pacemaker. 

Ventricular tachycardia or ventricular fibrillation is 

amongst the commonest cause of sudden cardiac 

death. Modern devices are able to sense ventricular 

tachycardia or ventricular fibrillation to terminate it 

and pace the ventricles. Unfortunately this technique 

does not work for atrial fibrillation. Ventricular shock 

so delivered can be painful but this is a relatively small 

price. Dr Snowdon continued by briefly describing the 

technique involved in the insertion of such devices. 

The heart is approached from the systemic venous side 

and a subcutaneous pocket is developed for the device 

itself. Leads are of either a corkscrew or a grappling 

hook type of end, which engages with the 

trabeculations within the heart. Subcutaneous 

defibrillation devices for ventricular tachycardia or 

ventricular fibrillation have no intracardiac lead. 

Intracardiac leads are continually moving and 

therefore can become broken or moved from the 

implanted position. Such devices will deliver a shock 

to revert VT or VF but can only give rescue pacing. 

Sudden cardiac death is usually of arrhythmic origin. 

Implanted defibrillators do make patients live longer 

but the anxiety about such attacks of VT or VF does 

remain. In the presence of known episodes the risk of 

death in five years, if untreated, is around 50%, and 

the chance of surviving cardiac death outside hospital 

is around 5%. In the presence of a known chance of 

catastrophic arrhythmia implanted defibrillators 

present a significant risk improvement. Life 

expectancy is improved. Inappropriate shocks are 

rare. Battery life of such devices is 5-8 years. 

Indications for such devices are a known arrhythmic 

problem, either familial or acquired with improved 

long term survival following surgery for congenital 

heart disease. Right ventricular failure can also present 

an arrhythmic risk. The long term outcomes for the 

different groups are obviously variable. 

In the investigation of arrhythmias and syncope 

attacks, external monitoring devices have a limited 

use. Implantable loop recorders are capable of 

monitoring for up to three years and usually record a 

7-10 minute cycle overwritten if no event occurs. They 

may be interrogated transcutaneously by telephone 

without the necessity for visiting the monitoring 

centre. 

In recent years there have been significant 

advancements in the scope of the use of such devices. 

The risk of lead failure is now very low, battery life is 

extended considerably and sophisticated electronics 

are capable of sophisticated tasks. Although the 

presence of an implanted device does improve patient 

outlook, it is apparent that not all anxiety from 

knowledge of the underlying condition is removed, 

and patients continue to need significant 

psychological support which at present is ill resourced. 

The President thanked the two speakers from the 

Liverpool Heart and Chest Hospital. 

R Franks 

24


Minutes of the Fourth Ordinary Meeting 


‘The Human Papilloma Virus Epidemic – Sex, Science, Cancers, Vaccines and the Media’ 

Prof T M Jones, Consultant in ENT & Head and Neck Surgery, Aintree University Hospital 

And 

Dr C O’Mahony, Consultant Physician in Sexual Health, Countess of Chester Hospital 

Dr C O’Mahony, Mr M McCormick and Prof T M Jones 

Dr O’Mahony opened with some anecdotes before 

moving on to some startling genital images. Dr 

O’Mahony discussed recent editorials he was involved 

in with the BMJ:- 

i) HPV Vaccination: Reaping the rewards of the 

appliance of Science 

(BMJ 2013;346:f2184 doi: 10.1136/bmj.f2184 

(Published 19 April 2013) 

ii) 

HPV Vaccination: What about the boys? 

BMJ 2014;349:g4783 doi: 10.1136/bmj.g4783 

(Published 29 July 2014) 

HPV causes a wide range of conditions and evidence 

has accumulated over the last 30 years of its oncogenic 

role. From this evening’s point of view it was about 

genital warts, laryngeal papillomas, cervical cancer, 

vulval cancer, vaginal cancer, anal cancer and 

oropharyngeal cancer. 

HPV types 6 and 11 cause anogenital warts, rarely 

oropharyngeal warts and occasionally laryngeal 

papilloma. 

HPV vaccine was considered impossible as people can 

often be infected again with the strain or simply 

develop recurrences. However, Professor Fraser 

working in Melbourne isolated the outer capsid 

protein, L1, for HPV 16 and remarkably these capsids 

self-assembled to create the perfect scientific vaccine, 

ie; a protein coat with absolutely no nucleic material 

inside. This virus-like particle (VLP) looks exactly like 

the real thing so stimulates an immune response 

which is perfect for dealing with the actual agent. 

Also, intramuscular injection of this vaccine produced 

very high antibody levels and immune response to 

HPV of a far greater magnitude than from a real 

infection. Remarkably, these vaccine trials show 100% 

in many of the trials which was a staggering result. 

Two vaccines are available, (i) Cervarix, containing 16 

and 18 the predominant oncogenic types and (ii) 

Gardasil, which contains 6, 11, 16 and 18. SPMD will 

soon produce a nanovalent vaccine containing 

additional oncogenic types. 

Professor Jones then gave an overview of increasing 

incidence of oropharyngeal cancers and, in particular, 

the near epidemic increase in human papillomavirus 

genotype 16 associated oropharyngeal cancers (HPV+ 

OPSCC) seen in the developed world in the last four 

decades. Whilst sexual contact is a pre-requisite for 

developing HPV+ OPSCC, which specific sexual act is 

most relevant is not clear from the data. Whilst the 

vast majority of sexually active individuals will contract 

an HPV infection, the vast majority of us will clear the 

25


infection whilst a small percentage (


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 

conflicts of interest; firstly he believed that surgical 

outcomes can improve and secondly, despite having 

trained as an anaesthetist, he no longer gives 

anaesthetics. He quoted the paper by Weiser T.G. et al 1 

which estimated that there were 234 million major 

surgical procedures worldwide each year. The mortality 

rate for all this surgery is not known. If 1% of patients 

could be prevented from dying as a result of surgery, 

this would result in 2.3 million avoidable deaths each 

year. He then showed a slide demonstrating the 

international variation in adjusted mortality risk in 

comparison with the UK. It appeared that northern 

European and in particular Scandinavian countries had 

the best results with eastern and southern European 

countries having the worst. He looked at the work of 

Ghaferi 2 which showed that although surgical death 

rates vary widely across hospitals, the rate of 

complications seems to be similar. 

To understand post-operative complications, Professor 

Pearse thought that you had to consider three things. 

Firstly the surgery, which technically had greatly 

improved, for example, with significantly lower rates 

of anastomotic leaks. Therefore these major surgical 

complications had reduced in incidence. However the 

medical conditions with which patients present had 

changed. Those with significantly greater 

comorbidities were now undergoing major surgery for 

which, in the past, they would be deemed unsuitable. 

Finally the perioperative care of these patients was 

becoming increasingly important with the recognition 

and early treatment of worsening medical conditions 

becoming vital. He looked at the consequences of 

anaesthesia and surgery where an inevitable 

consequence, such as wound inflammation, develops 

into a wound infection: a complication. This could also 

be respiratory impairment becoming a pneumonia, 

immobility resulting in pulmonary embolism and 

organ dysfunction becoming acute kidney injury. This 

was far more likely in the increasingly frail and 

comorbid population undergoing surgery. 

Professor Pearse spoke about his vision of 

perioperative medicine, of which there are many 

definitions. He offered one which was the prevention 

and treatment of harm resulting from the tissue injury 

of surgery (and anaesthesia). He thought that the 

27


battle for safety in anaesthesia had now been largely 

won and thought that is was time to take this further 

outside the operating theatre. He discussed preoperative 

assessment which tried to predict patients 

who may have poor surgical outcomes. He highlighted 

cardiopulmonary exercise testing, one area in which he 

was currently researching. He quoted a paper by 

Musallam K et al 3 which highlighted the incremental 

risk of anaemia with other comorbidities such as 

cardiac disease, COPD, renal impairment, all being 

associated with a higher mortality. Therefore, as 

Shander A et al 4 had highlighted, perioperative patient 

blood management is vital for good outcomes. This 

includes optimising haemopoiesis, minimising blood 

loss and bleeding and the improvement of tolerance 

of anaemia. He wondered how many of us have been 

presented with a patient on the day of surgery who 

had been inadequately optimised but we all felt the 

pressure to continue. Almost always we manage to 

get the patient through anaesthesia and surgery but 

the real problems seem to start a couple of days 

afterwards where inevitable consequences often 

become complications. Therefore individualised care 

must be the aim of pre-operative assessment. 

Professor Pearse then looked at the surgical event and 

highlighted the importance of checklists and the 

variable use of the WHO checklist across Europe. He 

spoke about other factors that may help to improve 

outcomes such as minimally invasive cardiac output 

measurements and the use of epidural anaesthesia. He 

thought that these were very important and 

anaesthetists in general were not very good at 

highlighting the necessity of putting their case across 

strongly for pieces of equipment or better nursing 

care. 

Professor Pearse discussed events occurring early after 

surgery and reminded the audience that acute organ 

injury can be a cause of long-term harm. This can 

include acute lung injury, sepsis-related myocardial 

injury and loss of muscle function. He quoted a paper 

Squadrone V et al 5 which showed that the early use of 

CPAP (Continuous Positive Airway Pressure) for the 

treatment of post-operative hypoxaemia can 

significantly reduce post-operative respiratory 

complications. He also highlighted the association 

between post-operative troponin levels and mortality. 

Post-operative rises in troponin were associated with 

a much higher mortality than similarly raised levels 

found in patients admitted through A&E. 

Professor Pearse went on to look at events later after 

surgery and showed a paper by Khuri et al 6 which 

demonstrated those with either pulmonary or wound 

complications had a significantly lower 5 and 10 year 

survival after surgery. This was again demonstrated for 

acute kidney injury after cardiac surgery 7 . Acute 

kidney injury was a key cause of chronic kidney disease 

as a result of loss of nephrons during each episode. He 

reminded the audience that the serum creatinine 

actually falls after surgery and therefore if it is raised, 

this is evidence of a much bigger injury than a rise 

associated with no surgery. Finally, he thought that 

anaesthetists should see some patients in postoperative 

clinics because they tend to be better at 

looking at the whole patient rather than just the 

outcome of surgery. They can then refer patients to 

relevant specialists if organ dysfunction has worsened 

as a result of these surgical episodes. 

Professor Pearse thought that surgery could often be a 

sentinel event with this being the first contact that 

many patients will have with a doctor. This can lead to 

the unmasking of many co-morbidities which often 

need to be treated prior to surgery and anaesthesia. 

He highlighted a number of quality improvement 

initiatives, such as the publication of performance data 

for individual surgeons and the way that cardiological 

services have been reorganised over the last 10 years 

showing a major improvement in 30 day survival 

following STEMI. He spoke about the EPOCH trial 

(Enhanced Perioperative Care for High Risk Patients) 

which is a project to implement an integrated care 

pathway for patients scheduled for emergency 

laparotomy. He described how healthcare can learn 

lessons from other industries and highlighted the way 

that the building of Crossrail in central London had 

changed building culture to greatly improve the safety 

of workers on the project. 

Finally he thought that the Royal College of 

Anaesthetists should be renamed that Royal College of 

Perioperative Medicine and reminded the audience 

that the College was soon to roll out its initiative in this 

area. 

1 Lancet 2008;372:139-44 

2 NEJM 2009;361:1368-75 

3 Lancet 2011;378:1396-407 

4 BJA 2012;109:55-68 

5 JAMA 2005:293;589-95 

6 Ann Surg 2005:242;326-343 

7 Hobson C et al, Circulation 2009:119;2444 

Ewen Forrest 

28


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 

Max McCormick, introducing our guest speaker Dr G P 

Wyatt who was in fact a Liverpool Medical Graduate. 

He had graduated in 1973 the same year as our 

President and several other LMI members. 

Dr Wyatt was one of the two paediatricians involved 

in the 1980s child abuse scandal in Cleveland. He gave 

a very emotional and somewhat disturbing account of 

his involvement in the matter. Indeed he told us that 

it was the first time in the ensuing 17 years that he 

had spoken openly in public about it. 

He summed up his talk in his first slide. “After 

Discovery comes Discredit, then Discipline, then 

Discussion, then Delay, then Denial, then Damage, 

then Defiance, then Dismissal.” 

Dr Wyatt used the Cleveland report to illustrate his 

talk and went through it in fine detail. He was a 

newly appointed consultant paediatrician in 1987 and 

wanted to improve his knowledge of managing sexual 

abuse in children. He therefore discussed the topic 

with his colleague Dr Marietta Higgs. One of the 

clinical signs they relied upon was ‘Reflex Anal 

Dilatation’. The first wave of admissions of children 

was in May 1987. In all some 121 children were taken 

into temporary local authority care. This led to 

widespread media coverage and the local MP Stuart 

Bell made a statement in the House of Commons. 

The Tory government set up an inquiry under Lord 

Justice (Elizabeth) Butler-Sloss which sat for a year and 

published its report in 1988. Dr Wyatt pointed out 

that at NO time did the inquiry look into the accuracy 

of the doctors’ diagnoses. 

Dr Wyatt gave evidence to the inquiry in December 

1987. He returned to work in March 1988 with a 

restriction on his practice which he described as a loss 

of his clinical freedom. Points about this were raised 

by members of the audience. 

The two paediatricians were accused of compromising 

the work of social workers and demands for action 

were made in July 1988. Dr Wyatt read an extract 

from the minutes of a meeting held at The Royal 

Society of Medicine at which Lord Justice Butler-Sloss 

was asked whether the inquiry should have 

considered the individual cases to see if abuse had 

29


occurred. He also pointed out that there was NO 

recommendation of a restriction of clinical practice 

made in the Cleveland Report. Despite this he was 

sent a letter about disciplinary action on 18th October 

1988 and his severe reprimand was made public! 

At this point Dr Wyatt donned a striped prison hat and 

vest! He then told us that it was later found that there 

was no wide scale error of diagnosis made by Drs 

Wyatt and Higgs and a significant number of the 

children were subsequently found to be victims of 

serious abuse. He said their accuracy of diagnosis was 

70-75% which is as high if not higher than other 

branches of medicine! 

In December 1988 the Regional Health Authority 

issued the following to Dr Wyatt: 

- a severe reprimand 

- a warning as to his future conduct 

- a restriction of clinical freedom in that he would 

have no further involvement in child abuse matters. 

Dr Wyatt made the point that he was not reported to 

the GMC by his employers at any time. He felt that if 

that had happened he would have been subject to 

regular review but would not have had to endure the 

20 year restriction on his clinical practice that the RHA 

had imposed. Did that restriction amount to a breach 

of his human rights? 

His contract was eventually terminated in 2010. He 

then undertook forensic training and he is now 

working as an independent expert writing reports and 

assisting the courts by giving evidence. 

The meeting concluded with a lively question and 

answer session between Dr Wyatt and the audience. 

It was quite clear to all who attended that Dr Wyatt 

had been through a very traumatic emotional ride 

throughout the whole of the Cleveland affair and that 

it still affected him deeply. He was thanked by Dr J 

Tappin on behalf of the members for sharing his 

experiences with us. 

John Dorgan 

30


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 

given by Dr Peter Wilmshurst, a retired cardiologist 

from Shrewsbury who formerley worked in Stoke at 

the North Staffordshire Hospitals, recently rebranded 

after the mid Staffs debacle. The meeting was opened 

by our President, Mr Max McCormick, who noted that 

whistle-blowing was following a series of related 

topics concerning the GMC. Dr Wilmshurst was 

introduced by HH Judge Nigel Gilmour, a past 

president of the MMLS, deputising for Miss Wendy 

Owen who was ill. 

We were told that in general, whistleblowers were 

treated worse than those about whom they 

complained. Dr Wilmshurst cited the former Bristol 

anaesthetist, who, following the Bristol Kennedy 

enquiry had been obliged to seek employment in 

Australia, only to be invited back to the UK to deliver 

a prestigious lecture to the Royal College of 

Anaesthetists some fifteen years later. High profile 

cases involving doctors, radiographers and nurses who 

had been the subject of professional and physical 

intimidation by managers were discussed in clinical 

detail and included Baby P, gagging clauses, duty of 

candour and child protection issues. Such suspensions 

and special leave offered to whistleblowers had cost 

the NHS millions of pounds. 

A special area of concern was research fraud in which 

multinational companies attempted to influence 

results and findings of individual doctors, who in turn 

came under intense pressure from high ranking 

colleagues, Trust managers and, shockingly, academic 

institutions and their heads of departments. 

Dr Wilmshurst related the long saga of a doctor who 

had fabricated results, was awarded academic 

distinction, subsequently admonished by the GMC, 

then re-employed, dismissed as clinically dangerous, 

only to be appointed as a consultant elsewhere. He 

then went on to be awarded Fellowships of Royal 

Colleges, and unbelievably, a national clinical 

excellence award. Most recently, and utterly 

astonishingly, he was awarded a national honour in 

recognition of patient safety. 

By now the audience would have believed almost 

anything about the "Club Culture" influencing 

decisions of regulators and that similar double 

standards affected the judiciary. 

31


In vigorous discussion Dr Wilmshurst highlighted the 

international parallels in Europe, America as well as 

the third world and the low probity ranking of the UK. 

Our president gave the vote of thanks and members 

left the institution into the freezing snowy conditions 

bewildered after learning of such a catalogue of cases. 

Chris Evans 

32


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 

Southampton University and went on to complete a 

PhD at the same institution. He was, until the end of 

2014, the Director of Clinical Science and Engineering 

at Salisbury NHS Foundation Trust, a role which he 

combined with that of Clinical Director of Odstock 

Medical Limited (OML) and Professor of Clinical 

Engineering at Bournemouth University. He continues 

in his role with OML as well as his Chair at 

Bournemouth. 

Professor Swain’s talk concentrated on three aspects of 

his work: 

(i) The basis of Functional Electrical Stimulation (FES) 

and its history in Salisbury. He outlined the clinical uses 

of FES in patients with Dropped Foot due to upper 

motor neuron lesions (pointing out that FES was not 

indicated in the rehabilitation of patients with 

Dropped Foot due to lower motor neurone damage). 

(ii) The setting up of a commercial company in 

conjunction with the NHS Trust to manufacture and 

market the devices used in FES. 

(iii) Clinical results for the application of FES to patients 

with neurological disorders. At the end of his talk, he 

gave examples of other clinical uses of FES. 

(i) The basis of FES and its history in Salisbury 

Stimulating muscles with electrical currents has a long 

history. The ancient Greeks used the technique on 

torpedo fish by rubbing amber (clearly, not knowing 

what was happening) through to the work of Volta 

and Galvani in the 1790s who demonstrated muscle 

contraction when starting and stopping electrical 

current. More recent work involved the development 

of external and implanted pacemakers in the 1950s. 

The essential point of the application is to apply an 

active electrode to send a current through a nerve 

which causes adjacent muscle contraction with the 

33


current looped to an indifferent electrode. 

FES has a role in the rehabilitation of patients with 

Dropped Foot due to upper motor neurone lesions due 

to stroke, MS, head injury, cerebral palsy, HSP, 

Parkinson’s disease and spinal cord injury (but only 

above T12). FES has no role in the rehabilitation in 

patients with lower motor neurone damage due to 

polio, motor neurone disease, peripheral nerve 

damage, Guillain-Barre syndrome or spinal cord injury 

below T12. 

It was in the 1970s that Nightingale and Glanville set 

up FES research in Southampton and, in 1984, the 

Spinal Unit at Salisbury began work with FES using a 

modified Slendertone machine. The service developed 

and an in-house design for FES was introduced 

culminating in 37 patients with a variety of 

neurological conditions causing a Dropped Foot being 

treated between 1988 & 1992. The FES clinical service 

started in 1992 coinciding with an article in the 

Independent newspaper. 

Initially, all the equipment was made in-house for 

research work. In 1996, the clinical success of FES was 

evident and other centres were asking for the 

equipment so the Salisbury unit started manufacturing 

to a view to commercial development. In 1998, the 

Medical Devices Directive came into force and the 

Salisbury unit applied for ISO 9000 accreditation which 

was granted in October of that year. Patents were 

granted in the UK, US and Canada during the period 

2002 – 2004. 

(ii) The setting up of a commercial company 

It became clear that trying to manufacture and sell 

products from within an NHS Department would be 

fraught with problems. The sales income distorted the 

financial position of the NHS department with issues 

such as income not being ring fenced, money not 

rolling over from one financial year to the next, lack 

of funding for long term investment, not being able 

to advertise and difficulties with overseas accounts 

being just some of the problems. 

However, in 2004, the regulations within the NHS were 

changed to allow NHS 3 Star Trusts to set up spin-off 

companies to capitalise on R&D work carried out 

within these NHS Trusts. A business plan was 

submitted in 2005 and Odstock Medical Limited started 

trading in April, 2006. 

Setting up a spin-off company had its initial problems 

(such as separating the company and NHS budgets, 

seconding staff between the two entities, appointing 

an MD with commercial experience and shareholder 

agreements.) The company was set up successfully 

with 68% owned by the NHS Trust, 18% by Trustees, 

12% by staff and 2% by Bournemouth University. The 

company appointed its first directly appointed 

employee in December 2006 by taking on its Managing 

Director. The company turnover in 2006/07 was £820k. 

OML went from strength to strength such that in 2015, 

3.5 wte NHS staff were seconded to OML, 16.6 staff 

were directly employed by OML, there was a separate 

accounts system established and the company was 

profitable with a projected turnover in 2014/15 of ~ 

£1.8m. 

(iii) Clinical results for the application of FES 

Professor Swain described several clinical cases where 

patients experienced significant improvements in 

walking following the onset of Dropped Foot. Patients 

measured their improvement either in increased 

walking speed or increased walking confidence, often 

accompanied with a significant decrease in fear of 

falling and a consequent increase in stability. Patients 

frequently reported a reduced (self-rated) effort in 

walking. 

As an example, he cited results from a group (n = 144) 

of patients with Dropped Foot following Multiple 

Sclerosis during the period 2008 - 2013. From that set 

of results, 91% of patients were still using FES after 18 

weeks, there was a significant increase in walking 

speed (p


He also commented on the opinion of the National 

Institute for Health and Care Excellence (NICE) which 

considered the treatment of Dropped Foot using 

electrical stimulation (www.nice.org.uk/IPG278) and 

which supported the use of FES for patients with 

Dropped Foot of central neurological origin. 

He also briefly reported on the use of FES to improve 

hand function, orthopaedic muscle strengthening, 

spasticity reduction and facial stimulation among other 

clinical applications. 

To indicate the level of workload by staff and the 

commitment required for the patients, he gave details 

of the standard treatment packages, namely: 

For walking stimulation: 

- Initial assessment 

- Set up 

- Follow up at: 2 set ups in the first week; 6 weeks; 3 

months; 6 months; thence annually. 

For upper limb and facial: 

- Initial assessment 

- Set up 

- Follow up at: 2 weeks; 6 weeks; 10 weeks; 18 weeks 

and 26 weeks. 

In conclusion, Professor Swain stated that FES enables: 

(i) a significant increase in walking speed, (ii) clinically 

manageable changes in a patient’s functional walking 

category, (iii) a significant reduction in the effort of 

walking, (iv) a significant reduction in fear of falling, 

and (v) a greater likelihood of achieving personal 

goals. 

At the end of Professor Swain’s presentation, Mr 

McCormick invited questions and Professor Swain 

responded to several questions from the audience. 

Dr Harold Stockdale (IOP Branch member and IOP link 

to the LMI) thanked Professor Swain for this 

entertaining and informative talk. That the question 

session lasted for twenty minutes (and had to be 

ended because of time constraints!) in itself indicated 

the degree of interest generated by the talk. The 

audience showed its appreciation of Professor Swain’s 

talk in the usual manner. 

Dr H Stockdale 

35


Minutes of the Ninth Ordinary Meeting 


‘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 

falls in life expectancy was topical at the moment in 

view of the ‘epidemic’ of obesity, diabetes and cancer 

and displayed graphs which confirmed the increase in 

these conditions in recent years. He then suggested 

that there might be a common thread linking them. 

The average person’s body contains hundreds of 

chemicals in minute quantities none of which was in 

existence sixty years ago. There are persistent 

chemical pollutants which, when recognised, may be 

banned; e.g. DDT. There are also transient chemicals, 

rapidly eliminated, previously thought to be safe 

which are now regarded as toxic even in miniscule 

amounts. 

An example of a dangerous chemical in plastic bottles 

used for a long time is Bisphenol A. This predisposes 

to obesity, reduces sperm count and stimulates 

production of prostate cancer cells. It is no longer in 

use but there are numerous chemicals in the food we 

eat, in our drinks and even possibly in our clothes. 

These chemicals cross the placenta and may have a 

huge effect later in life causing, at least in part, the 

conditions mentioned above. 

Prof Howard then discussed the increase in cancer in 

children and young adults which he suggested may be 

due to the effect of chemicals in utero. We must be 

more aware of this and strenuous efforts must be 

made to identify possible chemical pollutants. 

A lively discussion took place involving many 

comments and questions, after which we proceeded 

to supper terrified at the prospect of ingesting all the 

dangerous chemicals in the seemingly innocent food 

put before us. 

R S Ahearn 

36


Annual Dinner 


Guest Speaker: Professor Richard Ramsden, Department of Ear Nose and Throat 

Surgery, Manchester Royal Infirmary 

Mr M McCormick, Dame L Muirhead 

and Lord Mayor Erica Kemp 

Prof R Ramsden 

Prof R Ramsden 

and Mr M McCormick 

At the well attended Annual Dinner of the Liverpool 

Medical Institution, the President, Mr Max McCormick, 

introduced Professor Richard Ramsden, Emeritus 

Professor of Otorhinolaryngology, who, as a 

consultant and then professor at Manchester, had 

pioneered the development of cochlear implant 

surgery in the United Kingdom, for which he was 

awarded the MBE in 2014. 

Professor Ramsden is a Scot. He graduated from St 

Andrews in 1968 and was drawn to the speciality of 

ENT whilst a house officer in Scotland. He was a 

registrar and senior registrar at the Royal National 

Throat Nose and Ear Hospital, London, and was 

appointed Consultant in ENT surgery at the 

Manchester Royal Infirmary in 1977. 

This was an auspicious time for treatment of cochlear 

disease. In Australia, in the 1980s, Graham Clarke 

pioneered the use of multi-channelled cochlear 

implants that allowed the treatment of cochlear 

deafness. Professor Ramsden learned of the 

technique and developed the use of cochlear implants 

in his department in Manchester. It was a technique 

which could cure cochlear deafness but it was very 

complicated and expensive. 

The early treatments cost between £15,000 and 

£20,000 each. 

Professor Ramsden had obtained MRC funding for his 

research, and when it was shown to be successful, 

other departments in the United Kingdom started to 

offer the technique. 

A further Australian development had been made by 

W Gibson in the 1990s, who showed that deafness 

could be diagnosed in infants, and where suitable, 

they could be offered cochlear surgery so that their 

deafness could be cured in childhood and they could 

receive mainstream education. 

The Manchester Cochlear Implant Programme, 

established in 1988, was recognised as the leading 

centre of research in its field in the UK. The 

procedures are now available to patients in centres 

throughout the United Kingdom. For Professor 

Ramsden, these developments are an example of the 

NHS working at its best. A discovery was made, the 

United Kingdom research had been funded by the 

MRC, and a technique, initially available only at a few 

centres, had been developed so that it is now widely 

available to NHS patients, improving their quality of 

life immeasurably. 

Professor Ramsden concluded by inviting us to toast 

the health of the Liverpool Medical Institution. 

John Sprigge 

37


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 

Medical Institution President, Max McCormick. He 

gave a brief pen picture of his career. 

John Ashton was a scholar at Quarry Bank High School 

in Liverpool and Newcastle University Medical School. 

He then did postgraduate training at the London 

School of Hygiene and Tropical Medicine. 

He became a Lecturer and Professor of Public Health in 

Southampton and subsequently the London School of 

Hygiene and Tropical Medicine and University of 

Liverpool Medical School. He was a Regional Director 

of Public Health for North West England for thirteen 

years and the Director of Public Health County 

Medical Officer for six years. 

He was appointed President of the Faculty of Public 

Health, a position he holds until 2016. 

John’s approach to public health is acknowledged by 

many to be radical and he himself remains outspoken 

about his positions and we looked forward to hearing 

about his involvements in many of the controversial 

areas about which he speaks. 

Professor Ashton began his talk by going through 

some of his earlier career building moments and 

influences and then discussed his early involvement 

with controversial programmes. He was involved in 

managing the high incidence of teenage pregnancy 

in the Liverpool population. He also worked on the 

introduction of a controversial syringe exchange 

programme seen by many traditionalists as an 

encouragement to drug taking but ultimately 

acknowledged as saving more lives than many other 

health initiatives by helping prevent the spread of HIV 

and hepatitis. 

John spoke emotively about his attendance at the 

Hillsborough football disaster and his part in 

managing casualties and his subsequent statements 

and assistance to the Court in clarifying the sequence 

of events. 

He then went on to talk about the establishment of 

38


the Liverpool Public Health Observatory which has 

subsequently expanded into a network monitoring 

the effects of health policy on the public. 

He spoke stridently about the introduction of 

Foundation Trusts - he felt this was a change which 

was a step too far, and it had contributed to his 

resignation as the Medical Director in Liverpool. 

He described his appointment as President of the 

Faculty of Public Health Medicine from 2013 to date 

and outlined some of the areas where he is involved 

including age of consent, the scrapping of warm 

homes, the healthy people fund and more noticeably 

his involvement in the active management of those 

terminally ill. 

His wide ranging talk covered other areas, including 

conversations with Bill Clinton and other dignitaries 

engaged in the health of the nation. 

John Ashton’s talk was indeed a tour de force about 

his view of public health as being health of the public 

as opposed to the traditional view of public health, a 

form of catechism of behaviour by health bodies. 

The LMI offers its grateful thanks to Manchester 

Medical Society for their customary hospitality in 

extending a warm welcome and an excellent venue to 

visiting guests and speakers. 

Max McCormick 

39


Minutes of the Eleventh Ordinary Meeting 


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 

sits on the British Medical Association UK Council and 

the BMA General Practice Committee and also a 

member of the Medical Practitioners Union. He is a 

member of the Labour party. He is also a 

spokesperson for Keep Our NHS Public – a non 

partisan campaigning group that seeks to bring about 

an NHS that is publicly funded, publicly provided and 

publicly accountable. He has written numerous 

articles and spoken widely on the marketisation of the 

English NHS and contributed to the 2013 book ‘NHS 

SOS’. A new book has just been published that he has 

co-authored with Dr Jacky Davis and John Lister titled 

‘NHS for Sale – myths, lies and deceptions’. 

While he is a graduate of Sheffield Medical School, he 

did apply to Liverpool but was rejected and eventually 

entered medicine as a mature student through 

clearing! This is not so likely to happen today! 

In opening his talk, David introduced the audience to 

some key statistics related to the NHS, noting the 

colossal rise in costs from £33.5b in 1997 to £113b 

today, with millions treated by 147,000 doctors and 

371,000 nurses. It was also noted that there are some 

36,000 managers employed in the Service. 

For the population as a whole, the UK has 2.8 doctors 

per 1000 patients compared with Germany 4.0 or 

France 3.0, so is relatively under doctored. The NHS 

copes with 15.1m hospital admissions per year. To 

meet the demand, Medical Schools Intake has risen to 

6262 in 2012. Overall, life expectancy varies in the 

country, but is still lowest in areas of denser 

population. Comparing the life expectancy to health 

spending per capita, David noted that the USA spends 

more on health care but overall has a lower life 

expectancy. 

In the launch of the NHS in 1948, the Evening 

Standard proclaimed “Free for all at a cost of £152m”. 

Every household got a leaflet about the new service 

explaining that “….everyone can use it for free, but it 

is not a charity so be responsible in its use. You are 

paying through your taxes…” There were charges for 

Spectacles though. 

40


The political consensus in England in the 1990s 

supported the concept of a market, and this was 

introduced by the Conservatives in 1991. BMA 

opposed the plans and were highly critical but were 

effectively frozen out of discussion. 

Following this new NHS structure, the parties such as 

New Labour, with Blair, Milburn and Stevens, were pro 

market. So were the Liberals with the Orange Book in 

2004 and the latest legislation is very much more promarket, 

yet the devolved nations oppose it. Other 

aspects of the new NHS include private contribution 

through Labour’s PFI scheme. Milburn signed the 

concordat 2000 due to waiting lists and Labour put 

more money in to the NHS, thus allowing private 

hospitals to treat NHS patients. A purchaser/provider 

split was introduced together with new contracts. 

Patient choice was seen as helpful but did not mean 

more providers in the market. Payment by results also 

meant increased competition to get income by getting 

more work into the day. Any willing provider policy 

and the new Trusts allowed hospitals to be more in 

charge of their income. 

However, patient budgets have not really taken off, 

even though the concept was supposed to give more 

to a patient to look after their care. These changes 

were backed by provision of new insurance schemes 

to offer a policy to cope if your money ran out. 

Current policies have introduced the CCGs, choice is 

creating competition and plurality of provision 

allowing more choice. 

A 2010 Select Committee looked at the 

purchaser/provider split and concluded it offered no 

real benefit. 

The Commonwealth Fund looked at health care 

systems and found the NHS produced the best results 

compared with the rest of the world. For world 

health, comparing life expectancy with cost, showed 

highest cost in USA with the UK performing very well 

in spite of every negative comment made about it. 

Effectively, this demonstrated a market failure in 

practice in the USA. The USA system is a $2.3 trillion 

medical industrial complex but there are 50m people 

uninsured, and 62% personal bankrupts due to health 

care costs. ObamaCare came up against the lobby of 

industry opposition, using phrases like “socialised 

health care” and “look at the mess of the UK NHS”. 

The pressure for change was of course poor outcomes 

from life expectancies and infant mortality. 

As a case study, David noted that a North Carolina 

man got arrested for theft of $1 so he could get free 

health care, demonstrating a situation of desperation. 

Changes to the structure of NHS came from legislation 

in Parliament, setting up Strategic Health Authorities 

with Primary Care Trusts and NHS Trusts in the 1990s. 

The current 2013 structure is highly complex with 

different bodies. 

Dr Wrigley asserted that there were numerous myths 

circulating about the NHS. The first is that it is 

unaffordable. However, he pointed out that as a 

percentage of GDP, the cost is actually stable, running 

at about 30% up to 2007. David Nicholson, in 2008, 

met McKinsey secretly and a £20b cost saving 

challenge was introduced. Cuts from the budget of 

NHS quality, innovation, productivity and prevention 

challenges were viewed from a position of surplus in 

2001. The politicians are not very open and honest 

either in their pronouncements. Spending was 

increased during 1970 to 2010 but the Coalition is 

presently only keeping income just above inflation. 

PFI keeps debt off the Government’s balance sheet but 

gives big returns to the private sector. It was 

introduced by Labour under Tony Blair, and now has 

costs of £180m per year. The deals are rock solid, 

government backed and can be traded on the open 

market. Deals are being sold overseas as they are seen 

as a very good investment deal. £12.2 billion could be 

£17.4 billion if Government borrowed the money on 

the markets, but the real cost is actually more like £80 

billion. Interestingly, NHS logo guidelines allow 

private companies use the NHS logo, as it is seen as 

safe. In context of public opinion, YouGov polls 

looked at NHS, Rail, Energy and Mail and showed they 

were felt best in national ownership. 

The Health and Social Care Act was opposed by all the 

medical Colleges, Midwives and the BMA but was 

nonetheless adopted. The view is widely held that the 

present NHS reforms are the worst mistake by this 

Coalition Government. The speaker also pointed out 

that there were links between MPs who often ended 

up working for the private sector, giving rise to the 

‘Revolving doors’ concept. 

The speaker then gave a number of quotes, including: 

“In the future the NHS will be a state insurance 

provider not a state deliverer…” and “…NHS will not 

41


exist is 5 years…”, quoting Oliver Letwin. 

The talk then considered the new concept of 

Manchester devolution. The Treasury deal, signed 

with councils in Manchester, covers 1.7 million people. 

The deal was secretive and there was no consultation 

whatsoever with anyone. The devolved budget is £6 

billion, to cover health and social care. There are 

mixed feelings about the plans but it is clear that 

Government will not be involved. Is this the end of 

the NHS with the new MHS? Is the money enough to 

sustain the service demands? Dr Wrigley noted that 

social care alone is a significant cost and members of 

the audience raised the point that this move might 

risk a blurring between health care and social support. 

On a positive note, this devolution takes healthcare 

away from Government into the powers of the local 

population. However, is it undermining Labour 

signing up with Labour councils? 

After the election, the outcome is uncertain. Health 

policy differs between the contenders but the 

Conservatives will continue the same way. Labour will 

repeal some of the Health and Social Care Act, such as 

market mechanisms, giving us the NHS first option. 

Monitor will go and Health and Well-being Boards will 

be run with local councils. 

LibDems will continue as before while the Greens have 

a policy making the NHS entirely publicly provided. 

The SNP are anti-market anti-PFI, anti-Trident and 

UKIP are difficult to assess. 

In concluding, the speaker raised the issues for the 

election and what can be done in the lead up to it. He 

encouraged the audience to talk to MPs about the 

NHS and health policies and write to local papers as it 

can have an impact. The BMA is campaigning to try to 

get political interference away from the NHS. But it 

was also noted that the Lobbying Act is effectively a 

way to stop anyone campaigning on government 

policy and is effectively a gagging bill. 

The Pollock Roderick NHS reinstatement bill is laid 

before parliament and it will be interesting to see 

where this leads to. 38 degrees and Keep NHS Public 

are active as well. 

Dr Wrigley concluded by saying “Power to the 

people!” A range of questions were raised from the 

floor. 

Issues discussed included the merits of a national 

service for providing healthcare as opposed to private 

provisions – namely that a national service is joined up 

and talks to itself, and private provisions are risky, 

inconsistent and driven by profitability, with the profit 

not necessarily being re-invested in the health service. 

Market contracting is complex, bureaucratic and 

secretive, covered by commercial confidentiality. The 

role of CCGs was further explored, with some noting 

that CCGs could be very difficult to access from a 

doctor’s perspective, and lack of transparency and 

consultation could lead to inappropriate decision 

making and poor direction for patients. 

The group pondered the future for education and 

training, which is not covered by the private sectors 

and is something the NHS does quite well. Where 

training has suffered following a takeover, such as in 

Nottingham, consultants have resigned in protest! 

However, social reform is also needed to achieve 

anything. 

Some regretted the trend of disappearing GP 

partnerships, and the emergence of short term APMS 

contracts which offer little security, and would have 

liked to have seen more action from the BMA and GPs 

to help keep partnerships alive. Also, patients 

favoured continuity and would not get it out-with a 

partnership agreement. 

The conversation turned to the role of managerial 

staff and whether it was justifiable to say there was 

an over-provision of managers in the NHS. It was 

noted that more are needed as complexity develops, 

with the appointment of supporting staff, and the 

figures bear this out. The NHS is efficient for its size, 

and the number of managers is relatively low. 

The vote of thanks was given by the President, who 

alluded to the excellent content and illuminating 

delivery. 

Peter Dangerfield 

42


Minutes of the Twelfth Ordinary Meeting 


Joint Meeting with the Athenaeum Club 

‘The Flying Doctor’ 

Dr A A Gilbertson, MD, RAF (retired) 

Sir D Maddison, Dr A A Gilbertson, Dr W Taylor and Mr M McCormick 

Members of the Medical Institution and their guests 

were welcomed to the Athenaeum Club by Sir David 

Maddison who then introduced the speaker for the 

evening, Dr Alfred Anthony Gilbertson (known to us 

as Tony). 

Tony told us that he had attended St Edwards College 

and Liverpool University Medical School, qualifying in 

1956. Although he officially retired from his NHS 

consultant post in anaesthetics and intensive care in 

1997, he continued with research, gaining his MD in 

2013. However, his illustrated talk confined itself to 

the period between his conscription into the RAF in 

October 1959 and his last sorties during the 1st Gulf 

War in 1991. He described how he was initially sent to 

Derbyshire as an MO but after eight months, on the 

closure of that unit he was able to choose his 

subsequent posting; MO to RAF Newton where the 

Nottingham University Air Squadron was based. 

Learning to fly there was the origin of an amazing 

career combining the skills of a pilot and squadron 

leader with those of an anaesthetist (he gained FFA 

FRCS whilst at RAF Wroughton). 

During the five years that he remained in the RAF he 

flew high (taking Canberras to 56,000 feet) and far 

(for a period he was the only anaesthetist at a military 

hospital in Ghana). He regaled us with incidents and 

highlights of this period. 

In September 1964 he left the RAF, but didn’t stop 

flying. He returned to Liverpool, firstly as senior 

registrar then consultant in the Cardiothoracic Unit at 

Broadgreen Hospital. He continued as an Authorised 

Medical Examiner for the Board of Trade, 

relinquishing this in 1981. 

Dr Bill Taylor thanked Tony for his tales of a misspent 

youth and cold-war warrior. The meeting concluded 

with an excellent two course meal enhanced by 

convivial companions from both the Athenaeum and 

Medical Institution. 

Christine Brace 

43


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) 

Eileen Bell is a retired 

Consultant Psychiatrist. She 

now lives in Abergele in 

retirement. 

She initially trained as 

a pharmacist at Leeds 

University then did her preclinicals 

at the College of 

Surgeons in Dublin and 

qualified from the Royal Free 

Hospital School of Medicine in 1963. 

After house jobs in London and New York, she came to 

Liverpool and trained in psychiatry in various hospitals 

including Walton, Rainhill, Newsham and Winwick. 

She eventually took a medical assistant post at Rainhill 

and later became a Consultant at Rainhill. 

In 1977 she moved to Moss Side Hospital which 

subsequently became Ashworth Hospital. She retired 

in 1992. 

She regards her greatest achievement was “just to 

qualify at all” at a time when many women struggled 

to enter medical school and especially to qualify in 

psychiatry which she felt at the time was somewhat of 

a Cinderella specialty. 

She continues to be interested in ornithology and 

photography. 

Max McCormick 

JOHN RICHARD CLAYDEN (in absentia) 

John Clayden is a retired 

General Practitioner and 

lives in Holmfirth, West 

Yorkshire. He was educated 

in Royds Hall Grammar 

School, Huddersfield and 

qualified from Liverpool 

Medical School in 1969. 

He also shared digs with 

John Drakeley. 

44


After house jobs and SHO job in obstetrics and 

gynaecology he entered general practice in 

Huddersfield in 1971. He moved to a single handed 

dispensing practice in Holmfirth in 1980 and then into 

partnership in 1993. He retired from full-time practice 

in 2007 but continued working as a locum. 

An enthusiastic trainer, he has been involved with over 

seventy GP trainees. Unfortunately the demands of 

revalidation meant that he was no longer able to 

continue working and retired fully in May 2014. 

He is married to Marie and has two children and two 

grandchildren. 

His outside interests include music, theatre, drawing 

and painting and he has travelled extensively in the 

Caribbean. 

Max McCormick 

MICHAEL JOHN DRAKELEY 

John was educated at the 

King Edward VI School 

Nuneaton and graduated 

from Liverpool Medical 

School in 1963. He was 

involved in the general 

surgical rotation training 

scheme at its inception in 

Liverpool and this included 

time on the Chest Unit at 

Broadgreen Hospital. 

He did a Fellowship in Aukland for twelve months and 

thereafter trained in cardiothoracic surgery and 

obtained a Consultant post in 1977 until his 

retirement in October 2003. 

John was Regional Specialty Advisor for cardiothoracic 

surgery and Programme Director for higher surgical 

training and an examiner for the Intercollegiate 

Board. 

Although originally qualified FRCS in Edinburgh he 

was awarded an Honorary English Fellowship in 1998 

for his contribution to education. 

John’s medical legacy continues with Andrew, who is 

now in charge of the John Hewitt IVF Unit at the 

Liverpool Women’s Hospital. 

He and his wife Irene, a marriage of 44 years, have 

seven grandchildren. John has a big interest in 

ornithology and wildlife photography and is still 

involved with various clubs including the Brandreth 

Club and the Harlech Club for cardiothoracic surgeons. 

He regards his greatest achievement as playing a 

significant role in training surgeons in the USA, 

Europe and Malaysia. 

Max McCormick 

JAMES CHRISTOPHER FAUX 

Chris Faux and I were 

interviewed for entry to the 

Liverpool Medical School 

consecutively in the autumn 

of 1957. I was the last of the 

E's and he was the first of 

the F's. 

This tall, elegant blond 

Adonis told me in the 

waiting room, that he 

attended Fettes College, sang in the choir, played in 

an undefeated rugby 15 and had even met the Queen 

and Prince Philip when the Royals were choosing a 

school for Prince Charles. His father was a GPgynaecologist 

from Bolton. To say that I was 

intimidated was an understatement. 

Chris didn't tell me that his A level choices were for 

mechanical engineering rather than the human 

variety, so it was perhaps foreseeable that it would be 

ten years later before he graduated. In that decade 

Faux had been a spectacular President of MSS and a 

medical school legend, in the manner of Richard 

Gordon's ‘Doctor in the House’. 

As an aspiring orthopaedic surgeon, his mechanical 

engineering based postgraduate career was meteoric, 

such that in ten years he was appointed as a 

Consultant Orthopaedic Surgeon to Preston and 

Chorley hospitals. By then he had passed first time 

and for the first time an examination - FRCS and whilst 

training on the Manchester rotation had worked for 

John Charnley at Wrightington. 

In Preston, he revolutionised orthopaedic services, 

waiting lists and trauma and fracture clinics, and 

appreciated the stimulus of teaching medical students, 

with whom he had a natural affinity. Private practice 

also included being MO to Preston Grasshoppers 

Rugby Club and British Leyland trucks and busses. 

45


When Charnley died in 1982, Chris became a trustee of 

the trust bearing Charnley's name and subsequently 

its chairman for which he edited essays "After 

Charnley" for the Robert Jones Series. 

Later he returned to work at Wrightington 

performing hip and knee revision surgery until he 

suffered a mild heart attack in 2003, described by his 

wife Patti as “his first attention seeking illness”, 

causing Chris to stop water skiing and surgery. 

He and Patti, a Consultant Radiologist, have three 

children, none medical, and seven grandchildren. 

Faux continues to encourage research on behalf of the 

trust and nowadays he is a rugby spectator but 

regrettably continues to enjoy gun sports. 

In conclusion Mr President, our honorary member’s 

successful career was only interrupted by a decade at 

medical school where he enjoyed himself and met his 

wife. I have the honour to present James Christopher 

Faux for Life Membership of our Institution. 

GERARD ANTHONY McLOUGHLIN 

Chris Evans 

Gerry is a retired vascular 

surgeon who worked at the 

Royal Liverpool Hospital. 

He was born in the Scottish 

borders and exiled from 

Newcastle by German 

bombers. His mother’s 

family was from Scotland, 

his father’s from the west of 

Ireland. Both had settled in 

Newcastle Upon Tyne. Six months after Gerry was 

born, his Father was tragically killed in action in Sicily. 

His Mother trained to become a school teacher to 

support their only child. 

He boarded at Austin Friars School Carlisle and studied 

Classics. Inspired by the school’s GP he studied sciences 

and entered medical school. In 1966 he qualified from 

Durham Medical School with a First Class medical 

honors degree. House jobs in Newcastle were 

followed by registrar jobs in general surgery, initially 

on the Brewer and Helsby firm at the Liverpool Royal 

Infirmary. 

In 1971 he married Liz McSweeney and he has three 

children, Claire, Anthony and Terence. 

He obtained Fellowships from the Edinburgh and 

London Colleges and then obtained senior jobs 

working with Professor Robert Shields and Robert 

Sells and then senior registrar with John McFarland. 

He was a vascular Fellow in Boston and Harvard for 

several years and obtained an MD and MS. 

He was appointed as Consultant Vascular Surgeon at 

the Royal Liverpool Hospital, initially working with 

Raymond Helsby until he retired in 1980 and then 

Gerry was in single-handed practice providing vascular 

services to the hospital. 

In 1999 following cardiac surgery, he retired from the 

NHS but then studied law and became a medically 

qualified judge working with the Criminal Injuries 

Compensation Tribunal Board. He also undertook 

medico-legal work. 

When Pope John Paul visited Liverpool in 1982, he was 

volunteered by his colleagues to be the on-call 

surgeon for papal emergencies. Six months after the 

visit Bishop Vincent Malone rang his doorbell. As a 

token of gratitude the Pope had sent a medal. Gerry 

believes this is the only time a vascular surgeon has 

been awarded a papal medal sent by a Bishop. 

Outside of medicine and family, his interests are 

French language and literature and rugby union. As 

well as playing rugby until aged 40 he was the 

Liverpool Club doctor for about twenty years. He has 

left directions that he is to be buried in his Liverpool 

Rugby Club jersey. 

Max McCormick 

ELIZABETH MARY PRESTON 

The eldest of five girls, Dr 

Elizabeth Preston was 

always busy as a child, a 

habit she continued into 

her career. She was 

educated at The Alice 

Ottley School for Girls, 

Worcester, which since she 

has left has amalgamated 

with the adjacent boys 

school and a gate has been 

inserted into the 30ft wall - no doubt since she left it 

was felt the wall wasn’t necessary. She completed her 

46


medical degree here in Liverpool and after house jobs 

worked in most of the hospitals in Liverpool, as they 

were then, as an anaesthetic trainee. This included 

learning to give open ether from Dr J Beddard. 

She was appointed as a Consultant in Anaesthesia 

including Neuroanaesthesia at Walton and Fazakerley 

Hospitals in 1975, later renamed Aintree University 

Hospitals. Her medical career was notable for the 

multiple times she had to change her roles and 

responsibilities as she worked between the Walton 

site and Fazakerley - something we may all be about 

to go through again as talks of merging hospitals and 

service reconfiguration abound. 

She will be remembered as a medical leader in 

Liverpool, firstly as Clinical Director in anaesthesia and 

latterly as Medical Director for ten years (longer than 

most survive in that position) including six months as 

acting Chief Executive of Aintree Hospital. 

Outside medicine, as a school girl she competed very 

successfully at national level in show jumping and 

three day eventing, a skill she taught her children. Her 

son Nick is a Consultant in Anaesthesia in Bristol 

Southmead Hospital and her daughter Caroline has 

degrees in both Business and Law. She has two 

grandchildren and one more on the way. 

Like many in the medical profession she met her 

husband at work. Tim, who is known to many of you, 

was a registrar for Mr James Cosbie Ross when they 

met at the lunch table. 46 years later they are still 

enjoying lunch together, thanks partly to Tim’s present 

early in their marriage of a 72 edition Cordon Bleu 

cookery course. 


JOHN BOLTON RIDYARD 

John Ridyard and I first met 

at the Royal Southern 

Hospital, when John was 

the new house physician 

and I the medical registrar 

on Dr Gerard Sanderson’s 

Firm. The apprenticeship 

was to influence both our 

careers as regards a 

physicianly ethos, student 

and junior staff welfare and 

training, as well as team work based on the firm 

structure. 

John’s father was a Methodist minister from the 

Yorkshire dales where John went to primary school 

prior to attending Rydal in the welsh hills. As an 

outstanding A level student he went to Cambridge 

and graduated in natural sciences before joining the 

Liverpool Medical School from where he graduated in 

1968. 

His straightforward, conscientious and sympathetic 

approach to his professional career was rapidly 

rewarded with MRCP and an MD from the Broadgreen 

Chest Unit where he utilised the radioactive Xenon 

apparatus to study regional lung function in a variety 

of medical and musculoskeletal disorders under the 

direction of Colin Ogilvie. 

As a medical registrar he had a year out, not in the 

USA or Europe, but in Nigeria as a lecturer in medicine 

at the Ahmadu Bello University Hospital in Zaria. This 

established his love of Africa, where he has returned 

several times. He has crossed the Sahara desert and 

climbed Kilimanjaro to cite but two of many revisits. 

John’s hobbies are extensive; choral music - he was a 

founder member of the Renaissance Music Group of 

Liverpool - fell walking unsurprisingly, cycling, travel 

especially railways as a latter day Bradshaw rather 

than a Portillo, squash and gardening. 

John was appointed as Consultant General Physician 

to Whiston Hospital where he enjoyed all medical 

disciplines and started undergraduate teaching 

rounds in the manner of his mentor. A dedicated full 

time physician he developed lung function and 

bronchoscopy services as well as cardiac measurement 

and the CCU. 

When aged 46, this self titled unreconstructed 

bachelor married Joyce, a Care of the Elderly 

Physician, with immediate results such that there are 

two sons, both now junior doctors. John’s latest baby 

is their border terrier. 

Mr President, I have the honour of presenting to you 

for Life Membership of this Institution, John Bolton 

Ridyard, a resolute trustworthy Yorkshire physician 

who is best described by the phrase “what you see and 

hear is what you get”. 

Chris Evans 

47


PETER KENNETH MAKIN ROSTRON 

Peter grew up in Southport 

where his father was a GP 

and was educated at King 

George V School. A keen 

athlete he represented the 

school at rugby and 

captained the cricket team 

and informs me he once ran 

100 yards in 10.2 seconds. 

He qualified from Liverpool Medical School in 1967. 

After demonstrating anatomy for a year, he started on 

his career then had a year out as a ship’s surgeon with 

P & O circumnavigating the globe. 

He returned to Liverpool, completed his rotational 

training in orthopaedics and was appointed as a 

General Orthopaedic Surgeon at Whiston and St 

Helens in 1979, with particular interest in paediatric 

orthopaedics. He provided his expertise to St Helens 

and Widnes rugby league clubs as well as Everton for 

over twenty years. 

He is married to his wife Christine and has three 

daughters and five grandchildren. 

He resigned from the Health Service in 1995 but 

continued in practice until 2007 and still does some 

medico-legal work. 

He is a keen golfer, captained Birkdale in 1998 and 

presented Mark O’Meara with the Claret Jug in 1998. 

When not playing golf, he plays bridge, watches birds 

and looks after hens and a few sheep on his farm in 

Ormskirk. 

Max McCormick 

JOHN SEAGER 

Dr John Seager was educated 

at Malvern College before 

coming to Liverpool for his 

medical degree. He specialised 

in paediatrics, training first in 

Liverpool, then at Great 

Ormond Street Hospital, The 

Institute of Child Health and 

University Hospital Wales in 

Cardiff. His interests included 

paediatric immunology and allergy and he was a 

Consultant Paediatrician at Arrowe Park Hospital 

Wirral, where he became the Clinical Director for 

Paediatrics. 

One of his happiest achievements at that time was to 

move some aspects of paediatric care out of the 

hospital environment into the community. This 

involved further developing the Hospital at Home 

team and setting up a day ward so that more children 

could be treated at home with their families. This he 

achieved not without some political skill in convincing 

local politicians of the need to close a children’s ward 

to make this happen. Now in a well earned 

retirement with his wife Liz, he enjoys electrical 

things, languages and growing things you can eat. 

He is most welcome as a Life Member at the LMI, an 

Institution his father was President of in 1973 (the year 

of my birth). 


WILLIAM (BILL) TAYLOR 

William Taylor, known 

when he worked in the 

Royal’s pathology 

department as “the nice Bill 

Taylor”, graduated from 

Liverpool Medical School in 

1969. He had been 

educated at the Liverpool 

Collegiate School and his 

house jobs were at the 

David Lewis Northern 

Hospital. It was here that his mind was turned in the 

direction of pathology and he was inspired by Dr 

Winston Evans. He was unwilling to give up direct 

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


In 1983 Bill was appointed to Fazakerley Hospital as a 

Consultant Histopathologist where he provided a 

regional-wide service on resected and biopsied lung 

specimens. With William Kenyon, from the 

Broadgreen Laboratory, he attended the regional 

combined thoracic meetings at Broadgreen Chest Unit 

where their diligent microscopic detailed reports 

spawned many papers for the clinical staff. Believing 

that pathologists should see patients, he did a weekly 

endoscopy list which he regarded as ‘pathology on the 

hoof’. This greatly enhanced understanding and 

cooperation between the gastroenterologists and the 

laboratory. Later in his career he set up and 

singlehandedly ran a service for post mortem 

examinations on maternal deaths in the North West 

and North Wales. Bill also ran the Histology Journal 

Club which never failed to meet over twenty years. 

This attention to detail came to the fore when Dr 

Peter Davies encouraged him to take over the 

editorship of LMI Transactions & Report which he 

upgraded from a 20th Century black and white A5 

publication to a 21st Century glossy A4 journal. Bill 

was President of our Institution in 2009/10 and we 

well recall his erudite address on Thomas Hardy, who 

remains one of his passions. 

Bill married Dr Nancy Gibson, a General Practitioner, 

whom he had met at the Northern Hospital. Sadly she 

died in 2012. They have three children, one of whom 

is a GP in London, and one grandchild. He is now 

embarking on a biography of Sir Cyril Clarke, who 

introduced him to the LMI when Bill was a student on 

his firm at the old Royal Infirmary. When he is not 

writing, he is walking or flying as he holds a private 

pilot’s licence. 

PHILIP NICHOLAS WAKE (in absentia) 

Phil Wake is a retired General 

and Vascular Surgeon. He was 

educated at the Aristotle 

Secondary Modern School, 

Brixton and Norwood Technical 

College, London. He qualified 

from Liverpool Medical School in 

1969. 

Following his training in general surgery and some sub 

specialty training in vascular surgery, he was 

appointed to Warrington and Halton NHS Trust. He 

was Regional Adviser for surgery from 1998 to 2004 

and Chairman of the STEC. He was Clinical Director of 

Surgery at Warrington Hospital from 1993 to 1998 and 

became Medical Director from 2004 to 2008. He has 

also acted as a member of the independent review 

panel and has considerable experience of being a 

medical expert in legal cases. 

He is married to Margaret and has three children, 

Suzanna, an anaesthetist, Peter, a solicitor, and Kate, 

a teacher. He has eight grandchildren. 

He regards his greatest achievement as actually 

getting into medical school from an inner city 

secondary modern school. 

His outside interests include golf, DIY, walking and 

childcare. 

Max McCormick 

Mr President, in the case of Bill Taylor, we are 

admitting to Life Membership of our Institution a 

doctor who has served this Institution well and is an 

earnest seeker of the truth. 

Chris Evans 

49


President’s Guest Lecture 


‘The Attempt to Destroy the NHS’ 

Prof Raymond Tallis, Retired Professor of Gerontology, Manchester and Philosopher 

Mr M McCormick and Prof R Tallis 

The president introduced Professor Tallis by 

welcoming him again to the Institution, Professor 

Tallis having spoken on several occasions to the 

members of the Institution in the past. 

Born in Liverpool in 1946, Raymond Tallis attended 

Liverpool College and obtained an open scholarship 

to Keeble College, Oxford. 

After a degree in animal physiology he completed his 

medical degree in 1970 and then completed his 

training as a Senior Lecturer in Gerontology in 

Liverpool University and thereafter moved to 

Manchester as Professor of Gerontology. 

He has held many prestigious posts as an advisor to 

the Government regarding care of the elderly and 

became well-known for his views on care of the 

elderly and end of life management. He is a humanist, 

atheist and a patron of dignity in dying. 

As well as being an exceptionally clear-thinking orator, 

he commands respect in the philosophical world. 

During his talk he applied his clear thinking to the 

present problem of structural, philosophical and 

financial management of the National Health Service. 

The title of his talk, namely “The Attempt to Destroy 

the NHS” left the audience in no doubt from the 

outset where he stood on the subject of privatisation 

of the National Health Service. He explained that the 

impetus for his developing a deep concern for the 

future of the NHS was the introduction of the Health 

and Social Care Act which was passed in 2012. His 

chagrin at the failure of the BMA to oppose it was 

documented in two books which he contributed called 

‘NHS SOS’ and ‘NHS for sale’. 

He set the scene for the Act by turning to the run up 

to the election of 2010 when Conservative politicians 

made three promises, namely: 1) no cutbacks in 

funding, 2) no hospital closures and 3) no further 

reorganisations. He then proceeded to illustrate the 

duplicity of politicians by demonstrating how they 

reneged on each of these promises. 

Professor Tallis informed the audience that the 

underlying policies of the Health and Social Care Act 

were deliberately hidden by subterfuge and 

propaganda by the propagation of several “myths” to 

50


conceal the true intentions of the then Conservative 

Government, and they were: 1) that the Health and 

Social Care Act was not about privatisation, 2) that 

privatisation was not happening, 3) that privatisation 

was a good thing anyway and 4) that privatisation 

cannot be stopped. These myths were buttressed by 

misinformation that the Health Service was beyond 

repair, that the NHS was about empowerment of 

general practitioners by allowing them to be the 

budget holders and patient choice, and that it was 

about reducing bureaucracy. 

He then provided evidence to refute each of these 

assertions and subsequently to identify those elements 

of the Conservative party and their supporters, some 

of whom were doctors, who were responsible, both 

openly and surreptitiously, for developing and 

railroading this piece of legislation through 

Parliament. He expressed his deep concerns about 

other developments such as the Transatlantic Trade 

and Investment Partnership (TTIP), an agreement 

between the American government and the EU, 

particularly the clause called the Investment States 

Dispute Settlement, which purports to prevent 

governments from interfering in the practice of 

business. 

Professor Tallis followed this up by listing the 

numerous ways in which privatisation would actually 

worsen the National Health Service such as disruption 

of the tendering process, fragmentation of the service, 

and cherry-picking. He gave concrete examples of 

these worrying tendencies. He was particularly 

worried about accountability, teaching, ethical, moral 

and de-professionalisation issues in the private sector. 

In spite of appearances that privatisation was already 

a ‘done deal’, he maintained that it was still possible, 

even at this late stage, to rally sufficient support to 

reverse the Health and Social Care Act, if not 

completely, then at least sections 75 and 165. His 

frustration that the media had not woken up to what 

was happening and the Royal Colleges had not given 

more of a lead surfaced several times. His final 

message was that although the situation looked 

perilous we should continue to fight for the National 

Health Service. 

The President thanked Professor Tallis for his 

stimulating, factual account about the present NHS and 

the effect of the “financial management of the NHS” 

and other matters such as teaching, education and 

quality of patient care which remain dear to most of us. 

Anthony Ellis 

51


WORLD WAR ONE HEROINE 

EDITH CAVELL - EXECUTED FOR TREASON DURING WW1 

Born 4th December 1865, in Swardeston, Norfolk 

Executed on 12th October 1915 in Brussels 

“But this I would say, 

standing as I do in view 

of God and Eternity, I 

realise that patriotism is 

not enough, I must have 

no hatred or bitterness 

toward anyone.” 

Edith Cavell 

It is difficult to tell 

Edith’s story condensed 

into two pages but I 

have endeavoured to portray her heroism and 

devotion to her fellow man. The incredible injustice 

of her execution affected many. The shooting of this 

brave nurse was not forgotten or forgiven and was 

used to sway neutral opinion against Germany and 

eventually helped to bring the U.S.A. into the war. 

Propaganda about her death caused recruiting to 

double for eight weeks after her death was 

announced. 

As a young girl, she was far from being a little saint; 

however it is clear that, as an adult, she held fast to 

her Christian faith. Edith's father was a Church of 

England Vicar and would want to keep a strict 

Sabbath. There was no play on a Sunday; however, 

there was laughter in the family. Edith's father was 

not dour and could easily be tempted to disguise 

himself as a bear and cause the Cavell children to 

shriek with delight. 

Edith was quite an 

accomplished artist. She 

loved drawing and 

painting the natural 

things around her, 

flowers, plants, birds 

and even other 

people enjoying the 

countryside. She would 

sometimes give one of 

her pictures as a gift to a 

villager for a special 

occasion. 

Edith was not just a talented artist; she was also very 

good at French. In 1890, Edith took a governess post 

with the Francois family in Brussels. She stayed here 

for five years and became a firm favourite with the 

family, even though she objected to their jokes about 

Queen Victoria being a prude. She continued to paint 

in her spare time and became fluent in French. 

During her summer breaks she is thought to have 

formed a romantic fondness for her second cousin, 

Eddie. Unfortunately, he had an inherited nervous 

condition he did not think he ought to pass on by 

marrying and having children. Edith did not forget 

him however, and on the day she was executed, she 

wrote in her copy of 'The Imitation of Christ' "With 

love to E. D. Cavell". 

After testing her vocation for a few months at the 

Fountains Fever Hospital, Tooting, Edith (aged 30) was 

accepted for training at the London Hospital under 

Eva Lückes in April 1896. 

In the summer of 1897, an epidemic of typhoid fever 

broke out in Maidstone. Six of Miss Lückes’ nurses 

were seconded to help, including Edith. Of the 1700 

that contracted the disease, only 132 died. Edith 

received the Maidstone Medal for her work here - the 

only medal she was ever to receive from her country. 

In September 1906, Edith went to work for the 

Manchester and Salford Sick Poor and Private Nursing 

Institution as a nurse at one of the Queen's District 

Nursing Homes, in a temporary position for 3 months. 

However, since the Matron, Miss Hall, became ill, she 

filled in as Matron. In a letter dated 12th March 1907, 

she wrote to Miss Lückes at London Hospital, saying 

that it was a heavy responsibility, and she knew little 

of the work of the Queen's District Nurses. She asked 

if there were any trained nurses willing to fill in a 3 

month post for pay of £30 per annum. Edith's work in 

Manchester was commemorated by a splendid brass 

plaque, which was found in a Manchester scrap-yard 

in April 2002. 

In 1907, after a short break, Edith returned to Brussels 

to nurse a child patient of Dr Antoine Depage but he 

soon transferred her to more important work. Dr 

52


Depage wanted to pioneer the training of nurses in 

Belgium along the lines of Florence Nightingale. Until 

now, nuns had been responsible for the care of the 

sick and, however kind and well intentioned, they had 

no training for the work. Edith Cavell, now in her early 

forties, was put in charge of a pioneer training school 

for lay nurses, 'L'Ecole Belge d'Infirmieres Diplomees', 

on the outskirts of Brussels. It was formed out of four 

adjoining houses and opened on October 10th, 1907. 

By August 1914 she was despatching the Dutch and 

German nurses home and impressing on the others 

that their first duty was to care for the wounded 

irrespective of nationality. The clinic became a Red 

Cross Hospital, with German soldiers receiving the 

same attention as Belgian. When Brussels fell, the 

Germans commandeered the Royal Palace for their 

own wounded and 60 English nurses were sent home. 

Edith Cavell and her chief assistant, Miss Wilkins 

remained. At her establishment, Edith sheltered 

British, French and Belgian soldiers, from where they 

were helped to escape to Holland. Edith provided 

refuge for soldiers in her school whilst they waited for 

the necessary documents and guide to get over the 

border. She also provided medical care for any who 

were wounded. Edith's network managed to help 

over 200 Allied soldiers to escape and, thereby, live to 

fight another day. Throughout Belgium, thousands 

were helped by other networks in similar ways. 

Edith’s cell in prison 

Edith was not arrested for espionage, as many people 

believed, but for treason. The Germans discovered 

that she had helped many allies escape and arrested 

her. The Americans argued that she could not be tried 

or executed for treason, because as a British citizen 

she had no allegiance to Germany; however the 

American minister in Belgium was not allowed to 

attend the trial. 

The execution was carried out at dawn by a firing 

squad, on October 12th, 1915, in Brussels. Edith was 

still wearing her nurse's uniform. Until the end of the 

war Edith's body was buried where she was executed 

and then carried from Dover to London in a passenger 

luggage wagon. This same wagon was used for 

carrying the body of the Unknown Soldier some time 

later. Her family wanted her re-interred at Norfolk 

Cathedral and she was re-interred just outside the 

Cathedral in a spot called Life’s Green. 

Account by Reverend H. Stirling Gahan 

on the Execution of Edith Cavell 

On Monday evening, October 11th, I was admitted by 

special passport from the German authorities to the 

prison of St. Gilles, where Miss Edith Cavell had been 

confined for ten weeks. The final sentence had been 

given early that afternoon. To my astonishment and 

relief I found my friend perfectly calm and resigned. 

But this could not lessen the tenderness and intensity 

of feeling on either part during that last interview of 

almost an hour. 

Her first words to me were upon a matter concerning 

herself personally, but the solemn asseveration which 

accompanied them was made expressedly in the light 

of God and eternity. 

She then added that she wished all her friends to 

know that she willingly gave her life for her country, 

and said: "I have no fear nor shrinking; I have seen 

death so often that it is not strange or fearful to me." 

She gave me parting messages for relations and 

friends. She spoke of her soul's needs at the moment 

and she received the assurance of God's Word as only 

the Christian can do. Then I said "Good-by," and she 

smiled and said, "We shall meet again." The German 

military chaplain was with her at the end and 

afterwards gave her Christian burial. He told me: "She 

was brave and bright to the last. She professed her 

Christian faith and that she was glad to die for her 

country." "She died like a heroine." 

Lynne Smith 

Assistant Editor 

53


Retired Members’ Group 

Tuesday 14th October 2014 

The Cheshire Salt Industry and Liverpool Connections 

Gilmour Stubbs, Former MD, NW Cheshire Salt Works 

Ltd 

Gilmour’s family company worked about 8% of the 

huge Cheshire Salt Industry before being subsumed 

into the dominant British Salt Ltd a few years ago. 

Quite apart from producing an essential ingredient 

for industry and food, the huge underground spaces 

of the salt mines are used for safe storage of all 

manner of items except those prone to rust. 

Tuesday 2nd December 2014 

Hidden Gems of Merseyside 

Ian Meadows CBE, DL. High Sheriff of Merseyside 

2013-4. Executive Chairman RS Clare & Co. 

Ian spoke mostly of his family company, RS Clare, who 

manufacture lubricants. The company was founded 

in 1748 and continues to trade robustly in its second 

quarter MILLENIUM! Part of the factory is on the site 

of the former Royal Southern Hospital. This was a 

point of nostalgia for some members. Ian also told us 

some amusing tales arising from his recent tour of 

duty as High Sheriff of Merseyside. 

Tuesday 10th March 2015 

Fracking 

David Millar, MD Heap & Partners, Birkenhead 

David’s family business, Heap & Co. has been trading 

in Birkenhead for almost 150 years. Its main interest 

is in control of fluid at high pressure. Fracking is the 

process of extracting hidden reserves of gas and oil 

from underground stores, previously untapped, using 

water under high pressure. The prospect of a bounty 

of almost unlimited fossil fuel could prompt a second 

industrial revolution. Reserves in the North of 

England are very great. So far, the UK has been 

reluctant to commit to fracking, largely for fear of 

unknown consequences. 

Tuesday 19th May 2015 

SUMMER OUTING 

Visit to Elthorn’s Farm, Burton, Home of Mark & Tass 

Leather 

The weather was kind to our group of about 30 when 

we were welcomed to this glorious house and garden 

by Mark and Tass. Further exploration led us to a trio 

of classic cars on display in the yard, two XK Jaguars 

and an early model Porsche. The crowning glory (for 

the boys at least) was a large shippon laid out with an 

amazingly complex model railway. We were dragged 

away, almost screaming, to a fine lunch at the Red Fox 

pub in Thornton Hough. 

ENVOI 

About a year ago, I said that after ten years I had run 

my course as convenor of these meetings. It was an 

honour and delight to do them. I include a list of the 

meetings we had. I thank our speakers most of whom 

were not doctors and thus relative strangers to the 

LMI. I thank members and their guests who took part. 

I thank the LMI staff for coping with the chaos which 

I often created. 

It is a great joy to me that Chris Evans has agreed to 

take over now. Please give him your full support. 

Austin Carty 

Members who have attended the decade of thrice 

yearly meetings, which Austin has served up for us, 

together with varied summer outings, will be sorry to 

lose his innovative, convivial style and panache. In 

thanking him on behalf of us all and wishing him well, 

I do hope that you will support the programme I am 

arranging, the details of which will be circulated in the 

usual way. I look forward to you joining me at midday 

on October 20th. 

Chris Evans 

54


LMI Retired Members Group 

Meeting Schedule 2005-2015: Convenor A T Carty 

Date Speaker Title 

October 2005 Stanley Owens: Guide dogs for the blind 

December 2005 Sir David Henshaw Cranes over the City 

March 2006 James Carmichael Glyndebourne 

Summer Outing Visit to Rydal Hall and Summerdale House, Cumbria: Sheals Family 

October 2006 Captain Mick Owen Soldiers of the Queen 

December 2006 Michael Groves Fairbridge 

March 2007 Howard Beddow British Canals (part 2) 

Summer Outing Visit to Aintree Racecourse 

October 2007 Bob Muirhead Mechanical Music 

December 2007 Don Menzies Aspects of Midwifery in 19th and 20th centuries 

March 2008 Kit Jackson Investment in Fine Wine 

Summer Outing Visit to Speke Hall 

October 2008 Tony Ensor An Indian Summer in Crime 

December 2008 David Lloyd Footballs for Fun 

March 2009 Arthur Aldcroft Cotton: the Liverpool Connection 

Summer Outing Visit to Bryngwyn Hall, Welshpool 

October 2009 Austin Carty A Favourite of the King 

December 2009 Frank Carlyle Liverpool Unravelled 

March 2010 Nick Wainwright Fascinating Gemstones 

October 2010 Terry Overill ‘Operatunity’ in Retirement 

December 2010 Helen Carty Carving a niche 

March 2011 Elizabeth Steele Liverpool Theatres: History and Present 

May 2011 Simon Marsh Sods I have cut on the Turf 

October 2011 Peter Kennerley What’s so special about Liverpool Cathedral? 

December 2011 Sophia Povey The Reader Organisation 

March 2012 Bruce Gibson Past Imperfect or Future Perfect 

Summer Outing Visit to Hoylake Lifeboat Station 

October 2012 Paul Nolan The Mersey Forester 

December 2012 Iolo Thomas Pole Dancing at the Bar. (River Mersey Pilot Service) 

March 2013 James Carmichael The Arnolfini Portrait 

Summer Outing Ian Tracey Organ Recital at Liverpool Cathedral 

December 2013 Jane Kennedy Policing Merseyside: Partners in Crime 

March 2014 Lesley Dixon PSS in its 94th year 

Summer Outing Visit to the new Central Library, William Brown Street 

October 2014 Gilmour Stubbs The Cheshire Salt Industry: Liverpool Connections December 

2014 Ian Meadows Little Gems of Merseyside 

March 2015 David Millar Fracking 

Summer Outing Visit Mark and Tass Leather’s home: Garden, Model Trains and Classic Cars 

55


56


Report of the Strategic Management Council (SMC): 2014-2015 

This year’s president for the 176th session of the 

Liverpool Medical Institution was Mr Max McCormick. 

He presented a very varied and interesting programme 

that included medical military history, marking the 

centenary of World War I; Whistle Blowing in the NHS; 

personal insights into the Cleveland Scandal from Dr 

Wyatt and a thought-provoking lecture by Professor 

Vyvyan Howard. 

If you were unable to attend, recordings of some of this 

session’s lectures are available for members to view on 

the LMI website at http://www.lmi.org.uk/publicwebcast.aspx. 

Events 

The undoubted highlight of the year was the military 

medicine exhibition organised by the library, 

comparing 1914 and 2014 field medicine, which was a 

great success. The exhibition took place from the 2nd to 

4th October 2014, in partnership with 208 Liverpool 

Field Hospital and in association with Liverpool Medical 

History Society. It is estimated that LMI received 800 

visitors over the duration of the event. 208 Field 

Hospital organised 8 lectures, which were all very well 

received. 

Displays included Captain Noel Chavasse’s sword and 

the last letter he is known to have written, military 

uniforms and a recreated trench in the LMI car park. 

Adrienne, the LMI Librarian, was successful in obtaining 

an Heritage Lottery Fund grant which enabled her to 

employ a co-ordinator, train 18 volunteer guides and 

video the lectures. VIP guests included the Lord 

Lieutenant and the High Sheriff of Merseyside. The 

event received excellent feedback via email and the 

visitors’ book and had strengthened links with 208 Field 

Hospital who were very keen to work with LMI again. 

Members can see the photographs of the event and 

hear recordings of the talks on the LMI’s website. 

LMI was also part of the Alder Hey Centenary 

Exhibition celebrating 100 years of Alder Hey. Alder Hey 

are very interested in working with LMI on future 

projects and events. LMI also opened for Liverpool 

Light Night on the 15th May 2015, to celebrate 

Liverpool’s medical heritage and invite members of the 

public to take a fascinating tour through 250 years of 

medicine. Light Night is an annual cultural event where 

arts places of interest open their doors until late. The 

LMI received an estimated 250 visitors over the 3 hour 

duration. 

The admin team have been working with Liverpool 

Heart and Chest Hospital to share resources for 

improving pathways into medicine for students 

considering applying to study medicine, and widening 

the appeal of the ‘Year 12 Conference’. The variety of 

external conferences hosted during the year include 

the annual LSTM Neurological Infectious Diseases 

conference, the Norman Gibbon Urology Meeting, 

popular five-day ECG training courses and regular 

Essential Stroke and Neuro MRI courses, RSM’s North 

West meeting, the bi-annual Final FRCA exam prep 

course, student case presentations, Liverpool Biennial 

Artists’ Talks and many more. LMI has even played host 

to several paranormal investigation teams who 

explored the building for signs of ghostly activity. 

Membership 

The LMI have negotiated with University of Liverpool 

Libraries an improvement to membership benefits 

whereby walk in access to their library facilities will be 

granted on presentation of an LMI Membership Card, 

which members will have received in their Christmas 

mailing. The LMI has also extended its links with the 

Liverpool Philharmonic with access to exclusive behindthe-scenes 

events for members. 

The Strategic Management Council has discussed 

proposals to share the wealth of clinical experience and 

knowledge among the LMI’s membership by setting up 

a mentoring programme directed at Year 4 and 5 

medical students in the University of Liverpool. 

Students would derive significant benefits from 

forming relationships with experienced clinicians. 

Anyone interested in taking part or wanting more 

information on this scheme or should make themselves 

known to the admin team. 

People 

The Strategic Management Council wish to thank all 

those who help the LMI run on a day-to-day basis. In 

particular this year we would like to thank Mrs Claudia 

Harding-Mackean and Mr Terry Wardle for their efforts 

with the Sixth Form Conference; Dr Tony Ellis for his 

work as Honorary Treasurer; Dr Richard Evans for his 

role as Editor of the LMI Transactions & Report, Dr 

57


Andrew Larner for his work as Honorary Librarian and 

our regular caterers, ‘Real Food’ for their outstanding 

offerings. 

The staff of the Institution, who work tirelessly behind 

the scenes ensuring meetings, lectures and conferences 

run smoothly, are also much appreciated. Karen Alsop 

has joined us from Save the Family, and has worked 

wonders improving the LMI building, planning the 

various projects and since March has been keeping a 

firm hand on the LMI’s finances. Sadly, our stalwart 

Finance Officer, Jim Penwill, retired this year. We wish 

him a wonderful retirement and thank him for his years 

of support. 

Adrienne, Sue, Joy and the many library volunteers 

continue to run a most efficient library and have 

recently completed a complete reclassification of the 

contents. They also ran the extremely popular and wellpublicised 

World War I event over several days that 

attracted local and national attention. We look forward 

to new interest in the LMI and collaborations as a result 

of this project. 

Managing the membership and conferences could not 

be done without the administration team Audrey, 

Lynne, Sam and Sharon. Joyce, who manages the bar, 

wishes to retire at the end of the 2015 session. She has 

worked at the LMI for over 20 years and we wish her 

well, and thank her for her years of service. We also 

thank Tom, who looks after the evening meetings. 

Last but not least, the support of members in these 

challenging economic times is appreciated now more 

than ever, and we love to see members using and 

enjoying the building. 

The Building 

Plans to modernize and develop the building have 

continued this year, and it is an exciting time in the 

development of the LMI. The Gallery, Oak Study and 

Dining Room have been redecorated in tasteful 

heritage red and are looking fantastic. The stonework 

on the Ionic colonnade at the front of the building has 

been cleaned and retouched. The Wi-Fi system has 

been upgraded to provide a better service; members 

and visitors now need only register once and the system 

will remember them next time. 

The antique grandfather clock fondly known as the 

‘Old Doctor’ was featured on the second of two BBC 

Antiques Roadshow episodes filmed out of Liverpool 

Metropolitan Cathedral. A link to the programme can 

be found on the LMI website for those who missed it! 

An eight-week programme to renovate and improve 

the Back Corridor outside the Lecture Theatre, and 

overhaul the windows in the Council Room and Library 

has begun over the summer. The new layout will 

provide a new accessible facility, ladies facilities on the 

ground floor and a larger facility for men. We expect 

this to dramatically improve the appearance and 

functionality of this area for members and visitors to 

the building. We have made a conscious effort to 

choose fittings and décor commensurate with the 

period in which the building was built, and we are 

looking forward to seeing the finished result. 

The Year Ahead 

The incoming President for the 177th Session (2015- 

2016) is Mr Graham Lamont, and we look forward to 

his programme of events, meanwhile Mr Derek Machin 

has been nominated for President of the 178th Session. 

Following the modest success of the initial Trainee 

Programme, a new LMI Junior Doctors Committee has 

been set up to to facilitate long term input from the 

trainees and students themselves and provide a regular 

programme of meetings and events to interest and 

support junior doctors and medical students. 

Representatives from each of the Hospital Trusts have 

agreed to sit on the committee to suggest ideas for 

appropriate and interesting topics and speakers. They 

will then bring the message back to their own hospitals 

and grand rounds, to help LMI engage better with 

junior doctors and promote these evenings. The 

programme will begin in August, with an evening for 

the new F1 doctors about to begin their first preregistration 

year. 

The next stage of material redevelopment, for which 

proposals have already been received from architects, 

involves the ground floor of the 1960s’ extension of the 

LMI (the reception area and ‘Reading Room’). The brief 

is to maximise the space and flexibility the LMI can 

provide for exhibitions and events, whilst providing a 

more welcoming entrance befitting the age and 

heritage of the building. Once more formal plans have 

been shortlisted these concepts will be circulated to 

members. We hope members can join us in looking 

forward to an exciting future. 

Mr Austin McCormick 

Honorary Secretary 

58


Report of the Honorary Librarian 2014-15 

The highlight of the 2014-15 session was the World 

War I commemoration event, Then and Now: Military 

Medicine 1914-2014, in partnership between the LMI 

and 208 Field Hospital (Liverpool) and in association 

with the Liverpool Medical History Society, which took 

place on 2-4 October. It featured a wide range of 

displays, including a 1914 trench re-created in the LMI 

car park, a 1914 Casualty Clearing station and a 2014 

Field Dressing station, lectures on military medicine by 

Army medical personnel, and opportunities to learn 

about Liverpool doctors who contributed to the War 

effort including Noel Godfrey Chavasse, Frances Ivens, 

Mary Birrell Davies and Sir Robert Jones. Much further 

information is accessible on the LMI website at: 

http://www.lmi.org.uk/libraryandarchives/recentexhibi 

tions/thenandnowww1exhib.aspx. The library reclassification 

project is now complete with over 12000 

books barcoded. The next stage is to move the books 

to their new locations in subject, and not author, 

order. Books published between 1900 and the present 

day will be housed in the Library and Library Gallery. 

Small sub projects will be started presently. There are 

collections in the President’s Room and in the Archive 

basement ready to be classified and catalogued. 

The pamphlet records in the electronic Library 

Management System have been checked, and 

corrections and many additions made. It is hoped that 

in due course these pamphlets might be digitised. 

All LMI members should now have an LMI 

membership card which will facilitate access to the 

University of Liverpool libraries. 

The Library fabric has been enhanced with repainting 

of the Gallery, and revision of the blurbs 

accompanying each painting is in progress. 

A number of other events have taken place or are 

scheduled to take place in the Library this year. The 

annual History of Medicine Prize Evening, now a 

fixture in the LMI calendar, was held in November 

2014 and once again proved a popular and enjoyable 

event. 

Liverpool Medical Institution Historic Building Tours, 

run by Library staff, have proved to be immensely 

popular. Compared to the same period in 2014, the 

number of tours has increased by 500%. Tours are 

booked by a wide range of local organisations from 

U3A groups to University of Liverpool. 

On Friday 15 May, selected rooms in the building were 

opened for LightNight. This is Liverpool's one-night 

arts and culture festival taking place annually in May, 

www.lightnightliverpool.co.uk. There was a fabulous 

turnout with the rooms packed with visitors between 

4 and 8pm. On offer were a fruit quiz, historic 

instruments, and modern doctors’ training aids. Many 

thanks are due to Christopher Mayers from the Royal 

College of Physicians for his support, and training us 

to use the equipment. 

On Friday 4 September the building will open again 

in the evening for members of the public, on this 

occasion it will be for Maggie’s Culture Crawl 

www.maggiescentres.org/culturecrawl which will take 

a night-time 10k adventure around Liverpool's most 

fabulous sights (that’s the LMI amongst others!) and 

help the centre support more people with cancer in 

Merseyside. 

To continue working towards becoming an accredited 

museum, several items have been loaned to 

exhibitions in Liverpool. Amputation instruments and 

books circa 1865 are currently on loan to the 

University of Liverpool for their ‘Life and Limb’ 

exhibition in Abercromby Square. An 18th Century 

microscope and several 17th Century books and 

pamphlets are on loan to the University for their 

‘Micrographia’ exhibition, which opened on 12 May 

in the Victoria Gallery. 

In October 2015 an exhibition will open in the Victoria 

Gallery to showcase Independent Libraries in Liverpool 

between 1779 and 1837. This will feature the 

Liverpool Medical Institution Library and the 

Athenaeum Library, the two oldest, still surviving, 

independent libraries in Liverpool. The LMI library is 

the oldest, but both organisations share founding 

members. Special items from both collections will be 

on display until May 2016. This will include an LMI 

clock, ‘The Old Doctor’ which was featured on BBC TV 

Antiques Roadshow on 29 March 2015. 

Dr Andrew Larner 

Honorary Librarian 

59


Obituaries 

Dr MURIEL ANDREWS 

Senior Medical Officer 

Dr Andrews was educated 

at Wigan High School for 

Girls and qualified from 

Liverpool University in 1943. 

From the outset she pursued 

a career in child health, 

initially at the Stanley 

Hospital in Liverpool under 

Miss Nicholson, who kept 

strict order! Subsequently 

she worked at Heswall 

Hospital and at Booth Hall Children's Hospital in 

Manchester. She obtained the Diploma in Child Health 

in 1946 and the Diploma in Public Health in 1947. Dr 

Mary Sheridan, a pioneer of child development, was a 

great source of inspiration. 

Subsequently Muriel became a school medical officer 

in Liverpool. She grew to know families very well and 

helped many to overcome the difficulties of adjusting 

to fathers and sons returning from the war. There 

were many health and social problems to deal with. If 

parents failed to bring their children to appointments, 

Muriel and her team of nurses would go out and find 

them! 

During her time as Senior Clinical Medical Officer, 

Muriel became a founder member of the Faculty of 

Community Medicine in 1972. She worked with Dr 

Pinkerton and Dr Leveson, continuing to pursue her 

interest in child development. 

Fulwood Court, where she was cared for to the end 

with great affection and devotion. She passed away on 

19th November 2014. 

Muriel Andrews, MB ChB Liverpool 1943, DCH England 

1946, DPH Manchester 1947, Residential Medical 

Officer, Monsall Hospital Manchester, House Officer, 

Surgery, Stanley Hospital, Liverpool. 

Dr Ruth Hussey 

Dr ELEANOR MAUD HAMILTON (nee PEARSON) 

Research Fellow, University of Liverpool 

and 

Mr CHARLES JOHN KENNETH HAMILTON (Died: 1980) 

Consultant Gynaecologist 

Eleanor & John on their engagement 

She retired in 1979 and became a school governor, a 

member of the Committee for the Blind, and an 

(honorary) member of the Association for Retired 

Head Teachers! She also continued to support the 

Medical Women's Federation, Liverpool Medical 

Institution, the Soroptimists and the British Federation 

of University Women. She became a skilled 

embroiderer, and pursued her interests in walking and 

natural history. 

Muriel was closely involved in family life and derived 

much pleasure in retirement from her role as a greataunt, 

keeping her skills in developmental assessment 

well-honed on the next generation. 

Her final years were clouded by increasing physical and 

mental frailty and were spent in residential care at 

At the home they had designed and built 

On December 19th 1938, Amy Buller Warden of 

University Hall Liverpool wrote to Eleanor: 

“You already know what great gifts I feel you have to 

bring to your job and your home……..” 

On July 26th 1916, Eleanor was born to William and 

60


Norah Pearson. WWI raged. Her grandparents Moss 

lost a son in battle so Eleanor’s arrival was a great 

comfort. By her own admission Eleanor had undivided 

attention. She repaid this privilege throughout her 

life. Eleanor was proud of her descent from William 

Moss, the Loughborough contractor who built the 

Adelphi Hotel and the entrance to the Mersey Tunnel. 

As an infant, her grandmother, Mayor of 

Loughborough, introduced her to the responsibility of 

duty towards others. Later in life she worked tirelessly 

for others - The Medical Benevolent Society, The 

Marriage Guidance Council, Abbeyfield and as a 

Magistrate on the Liverpool Bench. She sponsored a 

child in Calcutta. 

As a child Eleanor weekly boarded at the Herbert 

Strutt School in Belper. She left aged 16 with a place to 

study Medicine at Liverpool University. As Miss Butler’s 

protégée, Eleanor dined at High Table where she 

conversed with Jung, Adler, Henry Lunn and many 

others, helping her explore ideas and listen to others. 

She qualified in 1938 as a doctor and became a lecturer 

in histology. When she met John Hamilton, he was a 

well qualified young doctor. Colleagues noted that 

something was going on when he lent his precious 

Lagonda to an attractive young student named 

Eleanor. Soon their engagement was a Leicester 

Mercury banner headline reading ‘Lough’bro Student 

Medical Romance’. The couple married on 2nd 

September 1939. 

Next day WWII began and they spent their honeymoon 

in the Palace Hotel Buxton filling sandbags. John 

Hamilton was 1 of 3 gynaecologists and obstetricians 

covering Merseyside. 

His nightly call-outs to burning buildings on the dock 

road left Eleanor holding their babies and putting her 

own brilliant career on hold. The introduction of the 

electron microscope also made a return to her subject 

very difficult. 

John and Eleanor’s great joint creation was a modern 

house overlooking the sea in Blundellsands designed 

by the award winning architect Jo Parker. It featured 

in Ideal Home magazine and was THE ideal home in 

which to enjoy their nine grandchildren. 

As a teenager, Eleanor looped the loop in a friend’s 

Tiger Moth. She won two Henry Lunn bursaries, one to 

the Farne Islands, the second an Hellenic Cruise where 

she mixed with the best scholars of the age and saw 

the classical sites. This academic travel established her 

habit of research and travel diaries. Travel with John 

when he was an external examiner took her to many 

other universities. Family holidays were educational 

and fun. As pioneers with the Caravan Club they 

explored castles, houses and landscapes with their four 

children. In her widowhood Eleanor travelled with her 

great friend Freda Adams on interfaith group visits to 

China, India, The Holy Land and Iona. To the end she 

thanked the surgeon Robin Downie for his skills and 

facilitating – in her own words “30 years’ travel 

without a bag”. 

Her passion for all things Liverpool, which she shared 

with her children and grandchildren, ranged from 

music at the Phil to football at Anfield. Her ashes are 

to be buried next to John in the family grave in 

Liverpool. 

Eleanor Hamilton, MB ChB Liverpool 1939, MRCS 

England, LRCP London 1939, Holt Research Fellow, 

University of Liverpool 1939-40. 

Charles John Kenneth Hamilton. Qualified MRCS, LRCP 

1930, B Chir Cambridge 1931, MB 1933, FRCS Ed 1934, 

MRCOG 1937, FRCOG 1948. Gynaecological Surgeon, 

Walton Hospital. Senior Consultant Surgeon Liverpool 

Maternity Hospital and Women’s Hospital. Clinical 

Lecturer in Obstetrics and Gynaecology, University of 

Liverpool. Life Member LMI 1975. Died 1980. 

Dr JOE LAVELLE 

General Practitioner 

Elspeth Hamilton 

Dr Joseph Owen Lavelle 

("Joe") was born in Liverpool 

in 1931 and educated at St 

Francis Xavier's College. He 

represented the college at 

football and excelled 

academically, his academic 

prowess culminating in the 

award of a place at Oxford 

University to read English. 

However, he had already 

decided upon a career in medicine and declined the 

place at Oxford in favor of a place at Liverpool Medical 

School, which he entered as a first year student in 

1951. Throughout his undergraduate years he was a 

keen supporter of Medical Students Society, his loyalty 

being rewarded by his election to the post of treasurer 

in 1955. 

61


Following graduation in 1957, Joe did his house jobs 

at Broadgreen Hospital where he met a ward sister, 

Cecily Ryan, who later became his wife. On completing 

his pre-registration year, he was conscripted into the 

RAMC in the rank of captain and spent the next two 

years at Catterick Garrison, despite a request for a 

posting overseas. 

After leaving the army, he undertook training for 

general practice before joining a family practice in 

Upton, Wirral in 1963. There he stayed until 1968 when 

he went into partnership with Margaret Baron in 

Rutherford Road, Liverpool 18, where he remained in 

practice until his retirement in 1991, by which time Dr 

Peter Griffiths and Dr Barbara Gaze had joined him. In 

addition to his family practice, Joe was, for many years, 

medical officer for Liverpool University. An Honorary 

Life Member of Liverpool Medical Institution, he was 

also a stalwart member of the Innominate Club. 

Gifted with great clinical skills and deeply 

compassionate, he was admired and greatly respected 

by colleagues and patients alike, many of whom 

attended his funeral service at Bishop Eton Church, 

Liverpool, in April 2015. 

Joe's greatest interests, apart from his family and 

medicine, were music, literature, sport and travel - in 

particular, being conversant in German and French, 

European travel - which he greatly enjoyed with Cecily 

and with Sheila, his second wife. His main sporting 

interests included Everton Football Club, and Woolton 

Golf Club, of which he was a past president and past 

captain, scoring a hole-in-one during his captaincy. 

Predeceased by Cecily and by his daughter, Emma, Joe 

Lavelle is survived by Sheila, his sons, Martin and Peter, 

his stepsons, Jefferson and Jonathan and by his five 

grandchildren. 

Joseph Owen Lavelle. Born 9th November 1931. 

Qualified MB ChB Liverpool 1957. General Practitioner, 

Liverpool. Died 7th April 2015. 

Jim Burns 

Dr CHARLES STEWART McKENDRICK 

Consultant Physician 

Charles Stewart McKendrick 

was born in Warkworth, 

Northumbria, on 21st October 

1919. His father was a banker 

and his mother a milliner; he 

was the first of the family, 

after education at the Quaker 

Bootham School in York, to 

study medicine. 

His pre-clinical training was undertaken at St. John’s 

College, Cambridge and, bucking the custom for 

undertaking clinical training in London, he completed 

his training and graduation in medicine in Liverpool, 

in 1941. His activities at Cambridge were not confined 

to the academic; outraged at the permission given for 

a lecture at his College by Sir Oswald Mosley of the 

British Union of Fascists, he mustered the rugby team 

to bounce Mosley’s Rolls Royce into the River Cam, an 

endeavor apparently demanding all of their combined 

strength. 

Shortly after completing his house jobs, he enlisted in 

the Royal Army Medical Corps, and was later intimately 

involved with major battlefield surgery on the beaches 

of the D-Day landings in 1944, given a scalpel and an 

operating tent next to the senior surgeon, and ordered 

to get on with it. He was subsequently with the 11th 

Armored Division during the relief of the Bergen- 

Belsen concentration camp on 15th April 1945. 

He forever found the horror of finding 60,000 

emaciated prisoners in desperate need of medical 

attention difficult to describe. Attaining the rank of 

Major during the war, he later remained in the 

Territorial Army, retiring from the reserve force as 

Lieutenant-Colonel. 

Dr McKendrick became Consultant Cardiologist to the 

then Regional Cardiac Centre at Sefton General 

Hospital, and later, the father of modern cardiology in 

the City. With the realisation, in the 1960s, that the 

outcomes and survival of patients with acute 

myocardial infarction was improved by managing their 

care in specialised facilities staffed by specifically 

trained and skilled staff, he set up one of the first 

purpose-designed coronary care units in England. 

Allied to this development, the introduction in 1960 of 

coronary angiography by Mason Sones at the 

62


Cleveland Clinic led to the establishment of cardiac 

catheter laboratories in the UK. Under Charles 

McKendrick’s foresight and leadership, Liverpool was 

again in the vanguard of specialised cardiac 

investigation, a development taken forward to the 

highest standards of the day by Norman Coulshed, Ellis 

Epstein and, later, Sandy Harley. 

His third key innovation was the introduction and 

development of the cardiac pacemaker service, initially 

with the cardiothoracic surgeon Ken Waddington and 

general surgeon Wing Turner, evolving into an almost 

exclusively cardiology based service from 1976 with the 

appointment of Richard Charles as his Senior Registrar. 

Again, it was Charles McKendrick’s leadership in 

establishing a secure and appropriately growing 

budget for implantable cardiac devices which catalysed 

the growth of this service in Liverpool into one of the 

largest implanting centres in Europe under Richard 

Charles, who succeeded him on his retirement from 

clinical practice in 1981. 

Despite his great strength of character and leadership, 

he also fell prey to human frailty, descending into a 

period of destructive alcoholism in the 1970s, an 

experience which he never sought to conceal. Indeed, 

his eventual complete recovery and return to full 

clinical duties under the care and support of Alcoholics 

Anonymous in many ways defined the rest of his life. 

He was completely committed to the 12-step 

programme, central to which is the continuous support 

of other alcoholics, eventually becoming the national 

chairman of AA, whilst remaining faithful to his local 

group in Toxteth. He was instrumental in setting up 

the Sick Doctors’ Trust, of which he became a Patron. 

In 1950 he married Olive Bell, a Paediatrician, and they 

were both strong and generous supporters in time and 

money to many charities; indeed, in later years he had 

to be restrained from donating to every good cause 

which came to his door. 

In retirement, whilst continuing active support of his 

favored charities, he relaxed with his great love of 

painting, initially in sketching and water colours, but 

later becoming a master of oil painting. He and his 

wife, Olive, his muse and indefatigable support 

throughout his life, were unfailingly hospitable and 

joyful company to all visitors. He is survived by their 

four children, Jenny, Posy, Jamie and Helen. 

Charles McKenrick, MA, MD (Cambridge & Liverpool). 

JP: Consultant Physician (Cardiology) Mossley Hill 

Hospital. Consultant Physician Sefton General Hospital, 

Liverpool. Died in Liverpool aged 94. 

Richard Charles 

Helen McKendrick 

MR HUW OWEN THOMAS 

Consultant Orthopedic Surgeon 

Huw Owen Thomas was born 

in 1941 in North Wales. He 

was an only child, born into a 

medical family spanning four 

generations. He had wanted 

to become a vet, but as his A 

level results were not 

sufficiently good, he found 

himself studying medicine 

instead, qualifying at the 

Welsh National School of 

Medicine in Cardiff in 1966. After house jobs in Cardiff 

and Rhyl, Huw returned to Liverpool where he had 

been brought up. 

His father Goronwy Thomas (President of the LMI 

1969) was a Consultant Orthopedic Surgeon at the 

David Lewis Northern Hospital. 

Huw shared his name with Hugh Owen Thomas, the 

Anglesey bonesetter and inventor of the Thomas 

splint, although Huw was proud to have the Welsh 

(and he would say the correct) spelling. He 

contributed some memorabilia of Hugh Owen Thomas 

to the LMI library, which he and his father had 

collected. Taking up the mantle of both his namesake 

and his father, Huw trained in orthopedic surgery in 

Liverpool, Gobowen and also at Wrightington Hospital 

under Professor Sir John Charnley. 

He had a very close and harmonious relationship with 

his father, working at one time as a registrar on his 

father’s firm, to the awe of many of his contemporary 

trainees. Whilst undergoing postgraduate training, he 

was proud to serve as a Captain in the RAMC. 

Huw was appointed as a Consultant Orthopedic 

Surgeon in Wirral, and prided himself on being a 

general orthopedic surgeon in an era when super 

specialisation was becoming the norm. He left the NHS 

at the age of 56 in 1997, thereafter concentrating on 

his medico-legal practice and tribunal work, retiring in 

2007. 

Huw’s hobbies were many. He enjoyed art, 

architecture, steam railways, fishing and shooting. His 

greatest love was classical music, about which his 

63


knowledge was encyclopedic. It amazed many that he 

could hear a few bars of a piano piece on the radio and 

would have no trouble in correctly identifying the 

pianist. As a student in Cardiff, Huw thought nothing 

of driving from Cardiff to Liverpool in his Austin Seven, 

to attend a concert given by the Royal Liverpool 

Philharmonic Orchestra, only to drive back to Cardiff 

the same night. Indeed he had a passion for all things 

beautiful, be it in music, art or buildings, and honored 

and admired those who could produce such wonderful 

works. Huw was not a pub or club man, but was 

happiest spending his time with his family, to which he 

was devoted. Sadly his last years were dogged by 

several health problems, which he bore with great 

fortitude. He leaves his wife Judith, also a doctor, two 

sons and a granddaughter. 

Huw Owen Thomas. Born Holywell, North Wales 11th 

May 1941. Qualified Cardiff 1966, FRCS Edinburgh 

1971 , FRCS England 1972, MChOrth Liverpool 1973. 

Consultant Orthopedic Surgeon Victoria Central 

Hospital (later Wirral University Hospital NHS Trust). 

Died 4th January 2015. 

Judith Thomas 

Dr CHRISTOPHER MICHAEL WRAGG 

General Practitioner & Emergency Medical Doctor 

When we stepped from the 

packed chapel to the flower 

display after Chris Wragg’s 

funeral, the crematorium rang 

to the sound of laughter, as 

we swapped anecdotes about 

this iconic Yorkshireman. 

He had spent half his career in A&E – first in 

Merseyside, then in Scunthorpe – and undoubtedly the 

A&E stories were the best. Singing ‘The Laughing 

Policeman’ over the tannoy during the Toxteth riots; 

poling himself down a corridor on a trolley, singing 

‘Just One Cornetto’; and taking advantage of an empty 

waiting room, (it was a long time ago), to sit and 

pretend to be a patient, then storm out, inviting the 

new arrivals to follow. He even once took a timewaster 

out to the ‘Accident & Emergency’ sign on the 

door, and then said, “Have you had an accident?” ... 

“No...” “Are you an emergency?” ... “No...” “Well naff 

off!” Utterly unacceptable behaviour, of course, even 

by those days’ standards, but this gentle, kind and 

generous joker still felt strongly the heritage of an 

uncompromising Yorkshire Methodist upbringing. 

At Medical School in the the early seventies, his 

singing, impromptu performances and comic acting 

were legendary. He was the only man in Whiston 

Hospital’s history to take a tuba on the ward round as 

a houseman. Despite being the life and soul of every 

party (usually coming in fancy dress or one of his many 

Victorian outfits), he never drank alcohol. Indeed, he 

was probably the only Liverpool Medic rugby player 

who did not like it. But he did like rugby. He was the 

‘hard man’ of the Medics team, (although not always 

able to carry out the role effectively, as he would still 

be getting up from the collapse of one scrum, when 

another was being whistled for). 

He went on to become a passionate rugby league 

supporter, even playing the odd game for Huyton RLFC 

– one of several teams for which he served as club 

doctor (on many occasions, it should be noted, his 

name appeared on the Huyton team list, even though 

he was in the dug-out with the sponge. The club then 

used one of their many ‘Chris Wragg’ ringers to try 

desperately, at least once in a season, to win a game). 

Later, in his eight years as doctor at Scunthorpe United 

FC, these wily tricks had become just a folk memory in 

Rugby League. 

He was potty about history, especially medical and 

military history, and began to collect paraphernalia 

and memorabilia even as a student. Want to borrow a 

top hat? Medals? Just about anything Victorian? 

Ancient text books? An apothecary’s wax seal? Pictures 

or photos of old scenes? Whatever – Wraggy was your 

man. By the time of his death last month from liver 

cancer, (ironically), he was a member of sixteen 

learned medical history societies, and had filled not 

just every room in his house and garage, but a spare 

couple of garages and a full sea-going container with 

his E-bay purchases. 

In the early eighties, he settled in Kirton-in-Lindsey, 

initially as a GP and subsequently working in 

Scunthorpe A&E. He bore his diabetes, blindness, and 

final illness with his unique mix of joviality, spirituality 

and resignation. I suppose that I should finish by saying 

that he will be sorely missed, and of course, by those 

closest to him he will. But for many, both in the 

profession and outside, the memory of Wraggy will 

live on in joy – even as we hope he is now doing. 

Christopher Michael Wragg, DTM&H 1976, DRCOG, 

DCH. Died 20th September 2014. 

Lawrence Wood 

64


Members Joined Since Last Transactions 

Badescu, I C 

Barker, T 

Crowley, T S 

Fraser, M 

Heseltine, J 

Kasbekar, S 

Patterson, J (reinstated) 

Rai, J 

Affiliates Joined Since Last Transactions 

Curtis-Summers, S 

Drury, K 

Offices of Distinction, Awards/Honours 

Dr Elizabeth Margaret Embray Poskitt 

Dr Elizabeth Poskitt, member of the LMI since 1977, helped to found the Association for the Study of Obesity, 

spent some time in Africa and was a Lib Dem Councillor. 

She has been elected Mayor of Woodstock, Oxfordshire, at the age of 75. 

Mr Roy Farquharson 

Mr Roy Farquharson is now Chair elect (2015-2017) of the European Society of Human Reproduction and 

Embryology. 

65


Liverpool Medical Institution 

Consolidated Statement of Financial Activities and Balance Sheet 

for the Year Ended 31st December 2014 

SMC regrets to announce that due to the retirement of the Finance Officer, Mr Jim Penwill, in the final quarter 

of last year due to illness, the final accounts for 2014 have not yet been audited and approved, and could not 

therefore be presented for adoption by the membership at the AGM in April 2015. 

Members can however rest assured that the situation is in hand. Succession plans are well in place, and Mrs 

Karen Alsop has been appointed by SMC as Finance Manager, in addition to her current project work for the LMI. 

The accounts will be completed over the summer well in advance of the regulators’ submission deadlines. 

Members present at the AGM in April agreed that the meeting be adjourned and re-convened in October 2015 

to complete the presentation of accounts to the membership. We hope you can join us all then. The date of the 

resumed AGM will be announced on the LMI’s programme, included with this publication. 

We wish to thank Mr Penwill for his hard work, professionalism, honesty and integrity as Finance Officer during 

the past 11 years, and offer congratulations on a job well done and a retirement well deserved. 

A Ellis 

Hon Treasurer 

66

Presidents of the Liverpool Medical Institution 


1840-65 J Dawson 1956 B McFarland 

1866 J Vose 1957 M E Thomas 

1867 J McNaught 1958 A M Reid MC TD 

1870 E R Bickersteth 1959 E N Chamberlain 

1872 J Cameron 1960 P Hawe TD 

1874 W McShane 1961 P H Whitaker 

1876 J M Turnbull 1962 R W Brookfield 

1878 A T H Waters 1963 I Forshall 

1880 R Harrison 1964 A W Downie FRS 

1882 T S Walker 1965 J C Ross 

1884 R Gee 1966 T N A Jeffcoate (Kt) 

1886 J B Nevins 1967 J W Cheetham OBE 

1888 W Carter 1968 R R Edwards 

1890 W M Banks (Kt) 1969 G Thomas 

1892 T R Glynn 1970 C A Clarke KBE FRS 

1894 C Puzey 1971 A S Kerr 

1896 R Caton 1972 J D Hay 

1898 W M Campbell 1973 T Seager 

1900 E A Browne 1974 T C Gray CBE 

1902 R Parker 1975 I Leveson 

1904 J Barr (Kt) 1976 J A Shepherd VRD 

1906 F T Paul 1977 D C Watson MC 

1908 T H Bickerton 1978 C M Ogilvie 

1910 T R Bradshaw 1979 J H Smellie 

1912 R Jones (Bt, 1926) 1980 E W Parry 

1914 E W Hope 1981 J H E Carmichael 

1916 C J MacAlister TD 1982 E Rees 

1918 W T Thomas 1983 N O K Gibbon 

1920 J E Gemmell 1984 D N Menzies 

1922 J H Abram 1985 R B McConnell TD 

1924 G P Newbolt CBE (d 9th March) 1986 P M Stell 

1924 R C Dun 1987 I K Brown (d 28.3.88) 

1926 J C M Given 1987 P M Stell (from 20.4.88) 

1928 J Hay 1988 R Shields (Kt) 

1930 K W Monsarrat TD 1989 P M E Drury 

1931 W Blair-Bell 1990 A T Carty 

1932 R E Kelly CB (Kt, 1939) 1991 C C Evans 

1933 H R Hurter 1992 W M Mackean RD 

1934 J M Bligh 1993 H Carty 

1935 C O Stallybrass 1994 M C L’E Orme 

1936 G C E Simpson OBE TD 1995 A Zsigmond 

1937 R E Kelly CB (Kt, 1939) 1996 R E Cudmore 

1938 E G Bark 1997 R A Sells 

1939 W Johnson MC 1998 S Evans 

1940 A L Robinson 1999 R Walker 

1941 O H Williams 2000 K Parsons 

1942 R G Wills 2001 J Earis 

1943 E I Spriggs KCVO 2002 C A Hart 

1944 R S Taylor 2003 J M Rhodes 

1945 R Kennon MC 2004 A C Swift 

1946 G F R Smith TD 2005 P M A Calverley 

1947 H Wallace-Jones 2006 R G Farquharson 

1948 T P McMurray CBE 2007 P D O Davies 

1949 C Wells CBE 2008 G V Gill 

1950 D Johnston 2009 W Taylor 

1951 R Coope 2010 P Dangerfield 

1952 N B Capon 2011 I Gilmore (Kt) 

1953 J B Oldham VRD QHS CBE 2012 R E Franks 

1954 H Cohen CH (Kt, Baron 1956) 2013 L de Cossart CBE 

1955 R J Minnitt 2014 M S McCormick 

67


Charitable Donations 

GIFT AID 

This is the most popular form of tax-efficient giving. Where a donation is made under this scheme the LMI can 

reclaim income tax at the basic rate (currently 20%) from HMRC i.e. LMI can reclaim a refund amounting to 25% 

of the basic donation. If the donor pays income tax at a higher rate than 20% the donor can reclaim, from the 

HMRC, the difference between their marginal rate of tax (40% or higher) and the basic rate when they or their 

accountant prepares their annual return. 

Individuals are required to complete a Gift Aid Declaration Form, copies of which are available from the LMI 

Administration Department. 

There is a strictly enforced scale of benefits that the LMI can give to donors without impairing the LMI’s right to 

the benefits of the Gift Aid legislation or its charitable status. Subscriptions and charges for attending social or 

technical meetings are subject to this scale (e.g. 2.5% of a gift up to £100). However these payments may be 

deductible under the individual’s personal tax regime. 

GIFT AID SMALL DONATIONS SCHEME 

This scheme was set up in 2013 to enable eligible charities to make a claim under the Gift Aid scheme in respect 

of small cash donations of £20 or less from an individual without the donor completing any formal 

documentation. An example would be a bucket or similar passed round a group of partygoers to make cash 

donations towards a charity. We enquired whether we could implement such a scheme at the LMI by adding a 

percentage to the bill for refreshments, however this was refused. It must be a voluntary cash donation, cheques 

and credit card contributions are now allowed, of £20 or less collected at the function concerned or by the charity 

concerned. 

The scheme has possibilities as the LMI entertains many non-paying guests over the year who might be willing 

to make a contribution to the LMI towards their evening’s entertainment. It is allowed to give a lapel sticker or 

similar to acknowledge the gift. 

Companies are not required to deduct tax from their charitable payments, the full amount of the payment is 

deducted from the profits of the company in calculating the corporation tax payable. 

LIFETIME NON-CASH GIFTS 

This includes FTSE shares and securities including AIM shares, units in unit trusts, shares in OEIC companies and 

interests in offshore funds. Relief is also available for gifts of UK lands and buildings. In general the amount of 

the relief, by deduction from income for tax purposes, is the market value of the gifted assets (i.e. the net benefit 

received by the LMI). However certain restrictions were made to this scheme from 2009 so professional advice 

should be sought prior to implementing such a scheme. 

LEGACIES 

Gifts to qualifying charities (i.e. one recognised as such by HMRC which includes the LMI) either outright or to 

be held on trust for charitable purposes are exempt from IHT. From April 2012, if 10% or more of the net value 

of a person’s estate is left to a qualifying charity the tax due may be paid at a reduced rate of 36% (as opposed 

to 40%). The net value of an estate is the sum of all the assets after deducting any debts, liabilities, relief, 

exemptions and the IHT nil rate band. The application of this reduced rate depends on the asset components in 

the estate and the circulation is best left to a qualified adviser. 

For more information, please contact Karen Alsop, Finance Officer. 

68

LMI Conference 

Centre 

An exceptional venue at exceptional value 

The LMI offers a relaxed and professional setting for 

meetings, away/training days, formal/informal dinner parties and 

receptions. 

• Magnificent Grade II* Listed venue 

• Centrally located in the Hope Street quarter and 

University precinct, opposite the Metropolitan Cathedral 

• Dedicated conference team to meet your needs 

• Lecture Theatre seating up to 120 

• Three seminar rooms seating 30-40 

• Meeting room seating 8 

• Videoconference facilities and audio visual equipment 

available in Lecture Theatre and Seminar Rooms 

• Dining Room seats 30 – extends to 90 

• Event catering for 120 

• Licensed bar 

• Exhibition and display areas 

• Fully accessible 

• Free WiFi throughout the building 

Please contact LMI Conference Office on 

0151 709 9125 ext 2 or email admin@lmi.org.uk 

A Meetings Industry Accredited venue

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