Lives of the fellows

Ralph Geoffrey Moore

b.11 October 1919 d.11 September 1998
MB BS Lond(1942) MRCS LRCP(1942) MRCP(1943) MD(1952) FRCP(1965)

Ralph Moore was appointed consultant physician to the Portsmouth Health District when he was not yet 30 and had been qualified for only six years. It proved to be an inspired appointment. The year was 1948 and the advent of the NHS provided a unique opportunity to build up medical services in a large health district. Nobody could have been better equipped to take the opportunity than Moore.

He had been a brilliant student, winning a scholarship to St Edwards School, Oxford, and another to St Thomas’s Hospital. At St Thomas’s he won the William Tite scholarship, the Musgrove scholarship and the Sultan Sams prize, qualified in the shortest possible time and passed the MRCP examination a year later. He was then house physician to Sir Maurice Cassidy [Munk’s Roll, Vol.IV, p.528] and it was from him that he acquired a love of cardiology, the specialty to which he was later to make an important contribution. But for the time being his career plans had to be set aside; it was 1943 and he joined the Navy.

After a period of hazardous service in destroyers he was sent to Australia in 1945. On the voyage out he had to deal with a major outbreak of gastro-enteritis in a crowded ship which was badly run, insanitary and short of drinking water. It was one of two early experiences he regarded as particularly valuable. The other was when, as a GP locum after demobilization, he saw patients whose treatment had been fatally delayed because they could not afford to go off sick or pay a doctor. This convinced him that a National Health Service was needed and that it must be made to work.

He returned to St Thomas’s as resident assistant physician, and it was from this prestigious post that he moved to Portsmouth as a consultant. His brief was general medicine, with a special interest in cardiology and thyroid disease. Medicine in Portsmouth was at a low ebb when he arrived. There were too few doctors and skilled nurses and no specialist provision, not even for children. The wards and labs were antiquated, and there was no serious attempt to teach the staff. Moore often had to be his own house physician, do his own pathology tests, sometimes even his own post-mortems. On top of that, and in spite of his youth and relative inexperience, he immediately found himself inundated with requests for consultations. He quickly realized that something must be done to overcome resistance to change and improve clinical services. Luckily he found an ally in Michael Darmady [Munk’s Roll, Vol.IX, p.114], the only pathologist in the district and a man who shared his enthusiasm and vision. Together they set about transforming Portsmouth into a centre that would set a leading example in the new NHS.

The first thing was to get funding for more medical and supporting posts, and to make sure that the posts were filled by young people as enthusiastic as they were. Moore saw that the key to this was education. Good candidates would come if they could count on good training. So regular teaching sessions were introduced, case presentations to visiting experts and a weekly journal club, as well as daily teaching on the wards. The other consultants began to take part. So, of course, did the junior staff and, increasingly, the GPs. Moore also helped Kenneth Robertson [Munk’s Roll, Vol.VII, p.498] to start the Wessex Physicians Club, which set out to do for the region what he and Darmady were already doing for Portsmouth. It spread their reputation and their network of friends and allies further afield.

In the late 1950s Moore and Darmady started another new enterprise, the Portsmouth Medical Society, to raise funds for the construction of a Postgraduate Medical Centre at St Mary’s Hospital. It was designed to serve a social function as well as its educational one, so a dining area and bar were provided in addition to the lecture theatre, reading room and library. When it was opened in 1963 the centre was the first in the country, and many others have been modelled on it.

Moore’s next innovation was in his own clinical specialty. Following ideas gathered during a short period of study leave in the USA, he set up a coronary care unit. Again it was one of the first outside an academic centre - certainly it was the first in the Wessex region. Initially he carried out all the technical procedures and trained the staff himself. The unit thrived, and its example was also widely followed.

In the early 1960s plans began to be made for the new medical school based at Southampton University. Moore was involved from the start, because he strongly supported the aim of the first dean, Donald Acheson, that the school should be a regional one with Portsmouth as an integral part. The idea met with a surprising amount of opposition from some colleagues, but Moore’s wisdom was by now widely recognized and his quiet diplomacy prevailed. A few years later, in 1972, he moved to Southampton to become regional dean of postgraduate studies. During his seven year tenure of the post he did an immense amount to ease the introduction of Southampton’s students and young graduates into the Wessex region’s hospitals and general practices. The computer matching scheme for house appointments which he set up was again widely copied.

By 1980 Moore was tiring of administrative work and longing for a return to clinical medicine and teaching. Luckily an opportunity arose to share the medical firm of David Barker at the Royal South Hants Hospital. It was typical of Moore’s modesty and conscientious nature that he insisted on preparing himself for this responsibility with a refresher course. He had been a busy consultant physician for nearly a quarter of a century, but still felt that during his period in administration he might have become rusty.

Both in Portsmouth and later in Southampton Moore’s quiet wisdom was put unstintingly at the disposal of countless colleagues and students, as well as his patients and their relatives. He and his wife Ann were devoted partners, not only in his social life, but in raising a happy and talented family. Three of their four children trained as nurses and four of their ten grandchildren took up medicine.

A Polak

[Brit.med.J., 1999,318,468]

(Volume XI, page 402)

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