b.6 February 1906 d.25 September 1995
MRCS LRCP(1929) MB BS Lond(1930) MRCP(1931) MD(1935) FRCP(1989)
Harold Gordon McGregor’s professional career a a consultant at the Royal Sussex County Hospital successfully spanned the transition from the medical paternalism of charitably funded pre-war medicine to the establishment of publicly funded more managed, care which evolved with the NHS. He followed a rare path to the top of his profession which required an unusual degree of self-confidence, determination and persistence for which he was eventually rewarded.
He was one of a medical family - his father brother and a maternal uncle were all medical practitioners. He was born in Portsmouth and was educated at Charterhouse and then at Guy's Hospital. He qualified in 1929 and graduated from the University of London in 1930. One year later he obtained his MRCP.
Between 1929 and 1931 he held house officer posts at Guy’s in surgery, medicine and paediatrics. In 1931 he became RMO at the private clinic of Sir Arthur Hurst [Munk’s Roll Vol.IV, p.509], New Lodge Clinic, Windsor, and later RMO at Colindale TB Hospital and the King George Vth Sanatorium, Milford. He also became school medical officer at Portsmouth.
In 1935 he gained his first honorary consultant appointment at Bognor Regis and in 1937 was appointed consultant in general medicine at the distinguished voluntary hospital, the Royal Sussex County at Brighton, where he practised as a general physician with a special interest in cardiology.
This chronological account of his career does not do justice to his originality and determination which is revealed as his professional career evolved in a medico-political climate quite different from that of today. We know much about the way in which he overcame difficulties and disappointments because he wrote a personal but unpublished account of his experience in hospital practice. It reveals much about the qualities of an unusually determined, persistent and perceptive man.
When Gordon McGregor graduated the majority of medical practitioners went straight into general practice for which their training was less than comprehensive. Some would spend a short period as a poorly paid house physician or surgeon at a local hospital before entering full time general practice. A small number of the more successful or more ambitious would stay on at their teaching hospital for further, specialist training, especially if they were keen to become consultants in due course. But the route to a consultant appointment in medicine was precarious and normally started from general practice in which some special skill or knowledge was offered. Consultant appointments to the local hospitals were advertised, but the choice was in the gift of the existing consultant staff where nepotism was possible. Anyone following other than the traditional route to a consultant appointment was unlikely to succeed, but Gordon McGregor was different.
By his own accounts, he was an individualist. He recognized from the outset that to achieve his goal of consultant physician would be difficult. He did not particularly wish to be an ordinary undifferentiated GP. He had acquired a wide range of expertise in his hospital appointments - cardiology with J M H Campbell [Munk’s Roll, Vol.VI, p.86] at Guy’s, gastroenterology with Sir Arthur Hurst, chest disease at the sanatoria at Colindale and Milford. He also had a major interest in psychiatry pursued through work at a mental hospital, the Tavistock Clinic and the Cassel Hospital for nervous disorders.
He did not wish to interrupt or dilute his specialization by entering general practice and waiting and hoping to gain an appointment some years later at a prestigious voluntary hospital. He did however undertake several six month terms in general practice, either as an assistant or locum.
He recognized the need for further experience and greater maturity necessary for consultant status - but how was this to be achieved? Postgraduate training was virtually non-existent and certainly not a requirement. There was an alternative, relatively unpopular, career ladder which was to gain a salaried appointment as a specialist at a municipal hospital. But these posts had the disadvantage that transfer to a more prestigious voluntary hospital was well nigh impossible and there was no possibility of private practice.
He decided to ignore all advice and set up as a young consultant in general medicine despite having no hospital consultant appointment and few capital funds. He chose to try his luck in one of the towns on the south coast of England and Brighton seemed to hold the most advantages. The Royal Sussex Hospital itself was impregnable without local experience and contacts. Through a colleague he learned of a consultant appointment with twenty five beds at a small cottage hospital in Bognor Regis from which base he could offer his services to the local GPs. However, the GPs were incredulous and only an occasional consultation arrived. He made a number of unsuccessful applications for consultant appointments at the Royal Sussex County Hospital, Brighton, and recognized that he would have to change tactics. He decided to set up as a consultant in the ‘Harley Street’ area of Brighton to be at the heart of the medical community from where he might be more successful. But disappointments continued and the situation looked desperate as young doctors from Bart’s were appointed to vacancies as they arose. But fortune smiled on him when an unexpected vacancy arose through illness and he found himself the only applicant. He was appointed - the first young provincial consultant in medicine in Brighton to have followed this route! The year was 1937.
Together with the other (relatively) new consultant appointees, McGregor set about modernizing the service in the hospital - including the appointments system, medical photography and blood transfusion service. It is clear that he respected and was respected by his colleagues as they strove together to improve their services and the environment in which they worked. But within three years war with Germany was declared and he was drafted into the Army as a medical specialist with the rank of major. He served with various units including the Military Neurosis Centre, Birmingham, where he was responsible for organizing the medical side of the work. After service abroad he was promoted to lieutenant colonel and commanded the No 36 General Hospital.
After demobilization he returned to consultant practice in Brighton, resuming his appointments at Brighton and Bognor, only resigning the latter when the two hospitals were placed in different regions with the advent of the NHS. In 1948 he was appointed as regional adviser in postgraduate education within the London Postgraduate Medical Federation and thereafter was involved in organizing educational facilities for GPs and for consultants at many centres in the region. He was inevitably involved in many committees, including medical advisory, appointments and postgraduate committees.
He continued to play a prominent role in the development of modern services in his hospital within the Regional Hospital Board of the South East Thames Region. His comments on the role of the senior regional administrators reveal that he retained his independence of thought and probably action as the power of the consultant staff became merged within the broader management process.
He was an active member of the BMA and became secretary of the Sussex branch. His personal account of his experience (kept on file at the Royal College of Physicians) is a valuable record of the trials, tribulations and rewards of pre-war and pre-NHS medicine and the way in which this changed over the 23 years until his retirement from medical practice in 1971.
J B L Howell
(Volume X, page 316)
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