Howard Croft column: Doctor who played a key role in establishing the NHS

Dr Charles Wilson, The Right Honourable Lord Moran
Dr Charles Wilson, The Right Honourable Lord Moran

In 1992 I published under the imprint of the Royal Society of Medicine a biography of Dr Charles Wilson, later Lord Moran, written by Professor Richard Lovell. Richard Lovell trained as a doctor at St Mary’s Hospital in Paddington, London, where Wilson was Dean, and after wartime service as a Surgeon Lieutenant in the Royal Navy, he returned to St Mary’s where he joined the Professorial Medical Unit.

In 1955 he was appointed Professor of Medicine at the University of Melbourne, Australia where he remained until his retirement in 1983.

The title of the book, which is no longer in print but second hand copies are readily available on the internet, is Churchill’s Doctor: A Biography of Lord Moran.

There was a bit of a struggle with the second Lord Moran, Charles’s elder son, John, who came to see me about it.

He was concerned that the title gave the impression that his father’s only distinction was that he had been Churchill’s doctor throughout the Second World War (and beyond, until Churchill’s death in 1965), whereas he had distinguished himself in other ways too.

This is true, but Churchill’s name on the cover would sell copies, a factor important to me.

He wore a brown trilby I remember, headgear favoured by male members of the aristocracy at the time and by race-goers of both sexes to this day.

I also remember that he didn’t remove it throughout our meeting, nor did he tip it when he entered my office. That’s the aristocracy for you – beautiful manners.

I prevailed, I am happy to say, even though he was himself a distinguished Foreign Office diplomat with considerable experience of dealing with tricky customers.

The book, which I have just re-read twenty-five years after its first appearance in print, does full justice to the first Lord Moran in all his achievements, not least his role in the development of the NHS.

As President of the Royal College of Physicians from 1941 to 1950 he played a central role in negotiations with the British Medical Association, which was hostile to the proposed NHS and represented mainly the interests of General Practitioners, and the Department of Health.

His conduct of these negotiations earned him the nickname Corkscrew Charlie, which was not kindly meant.

Without Moran’s efforts it is unlikely that the medical profession would have backed the NHS, at least at that time, and it was his experience as Dean at St Mary’s Medical School, a failing institution which he reformed.

He was not himself an especially distinguished medical student (he was educated at Pocklington Grammar School, after all), but on graduation he secured a much coveted house appointment at St Mary’s.

It was said at the time that he only succeeded in this because it was inconceivable that the captain of the St Mary’s rugger fifteen would not be so rewarded.

He was ahead of his time in insisting that senior hospital doctors should formally take responsibility not just for patient care, now called “service delivery”, but also for medical research and for teaching, something that we now take for granted.

He also advocated the organisation of family medicine into group practices based in health centres where minor surgical procedures and investigations would be carried out, but the implementation took several years.

He was concerned about lone GPs, and thought that they should be phased out. It was only after the GP Harold Shipman murdered a number of his patients, possibly running into hundreds, that a concerted push was made fully to implement this reform.

It is odd to think that doctors now are as hostile to the dismantling of the NHS as their predecessors were to its introduction in the early forties.

Doctors then did not have such a good deal; for example, hospital consultants received no salaries for working in public hospitals, but had to scratch a living from private patients – after hours.

One explanation for their opposition might be the ludicrous proposal that doctors should be controlled and managed by the 148 local authorities of the day.

He spoke scathingly of such people of consuming “the drowsy syrup of bureaucracy”.

So, not much has changed in that regard.

I once asked a local council employee how quickly I might expect a reply to an email; she told me that they were expected to respond to emails “within twenty-eight days”.

Be still my beating heart.