Lives of the fellows

John Fairbairn Warin

b.2 September 1910 d.14 November 1990
OBE(1971) MB ChB Leeds(1933) DPH(1935) MD(1937) MA Oxon(1970) MRCP(1971) FFCM(1972) FRCP(1975)

John Warin was born in North Yorkshire; his mother was of Scottish descent and his father was a Yorkshireman, a graduate of Leeds University who taught chemistry at Tadcaster Grammar School. John was educated at Tadcaster before going on to St Peter’s in York, where he shone at hockey and science and went on to Leeds University to study medicine. He was also a prominent sportsman at university, continuing with hockey at which he represented both the University and Yorkshire. During this time he discovered a talent for sprinting, revealed when a friend - knowing of his speed on the hockey pitch -suggested he run in a trial. This he did with no preparation and was immediately included in the university team. He maintained a trim and athletic figure throughout his whole working life.

After qualification he did clinical jobs in Leeds until 1937, when he was appointed assistant medical officer of health in Blackburn and obtained an MD from Leeds University. The year before he had married Helen Simpson Bruce, also a Leeds graduate and daughter of John Richard Bruce. They had four children, two sons and two daughters.

He was a senior assistant MOH in Birmingham throughout the second world war and played a major part in organizing the emergency hospital services during the ‘blitz’. In 1946 he went back to Leeds as deputy MOH, but only for two years before he went to Oxford in 1948.

For over a century, from 1872-1974, the city of Oxford was served by just four medical officers of health. The last of these was John Warin, who came to Oxford at the inception of the NHS. He brought with him a necessary clinical acumen: a sound knowledge of infectious diseases. He was a consultant physician in the specialty with the United Oxford Hospitals, as well as clinical lecturer to Oxford University. There is no doubt that his skill in this field helped his clinical colleagues to accept him as ‘a proper doctor’ and, more importantly, to give him their full support while he was carrying out his public health duties in the city, backing his recommendations to the city council for the development of the city’s health and social policies. Throughout his years in Oxford he kept one foot firmly in each camp - hospital medicine and community health - to the great benefit of both. Following his retirement, the Oxfordshire health authority conferred upon him a signal and unique honour by naming the new infectious diseases ward at the Churchill Hospital the ‘John Warin Ward’.

There were great changes in the provision of health care when the NHS began in 1948 and Oxford was among the first to carry out the public health provisions of the NHS act under John Warin’s guidance as MOH; section 21 stipulated that local health authorities should provide health centres to unify all medical and allied services provided for people in their own homes. John Warin had the vision to make this happen by encouraging local and regional health committees to support the concept with financial resources - funding not only to put up the buildings but also to pay nursing and reception staff to work alongside the doctors. He then used his powers of persuasion to convince the GPs and community nurses of the benefits of joining in - to be jointly responsible for both treating and preventing illness in the same small catchment population.

In 1960, Oxford was one of the first health authorities to introduce health centres and, in 1964, it was the first to establish attachment of community nursing staff to all general practices. By 1967, three health centres were functioning, serving half the city’s population, and when John Warin retired in 1974 there were eight health centres meeting the needs of most of the city.

The maternity and child welfare services were equally well developed, playing no small part in putting Oxford at the top of the table for the lowest infant mortality rates in the entire United Kingdom. Oxford also led the country in achieving the highest immunization rates for children against such infectious diseases as polio, diphtheria, tetanus and whooping cough.

It was as a direct result of John Warin’s own skills in the field of public health that Oxford achieved this position of eminence. Not only was he closely involved with many national projects, he also found time to participate actively on numerous important committees such as the DOH's advisory committee on vaccination policy, the board of the Public Health Laboratory Service, the Ministry’s health visitors working party and many other professional bodies. Above all, he knew that if medically desirable change was to be achieved it was vital to be an effective and powerful advocate to the controlling authorities. He rapidly established this role with the city council, with the management of the United Oxford Hospitals and the local psychiatric hospitals, and also with the regional hospital board, all of whom he served with skill and energy for many years. The city treasurer grudgingly acknowledged his skill in diverting a sizeable part of the budget to health projects, referring to him as ‘that wily old fox’.

His abilities were recognized by the award of many honours. In 1971 he was made a member of the College by special invitation - the same year in which he was awarded the OBE for his services to public health - and four years later he was elected to the Fellowship. Following the reorganization of the NHS in 1974 he was elected to the board of the Faculty of Community Medicine.

John Warin was no dry-as-dust medical administrator. At the patient’s bedside, in his office at Greyfriars, or sitting on one of his many committees, he showed the personal attention to and respect for other views which made him an exceedingly human companion and one with whom it was very difficult to pick a fight. At the same time, when he decided on a course of action and had argued his case convincingly, he pursued his objectives with unrelenting vigour. He was an achiever, but not one who rode roughshod over others. Success came because he carried others with him in his enterprises.

Oxford was lucky in having had a firm foundation for its public health service, prepared, nurtured and developed over the years by John Warin. This service was strong enough to survive and continue along those lines despite extreme pressure on NHS finances. This may not be surprising when it is remembered that, although unification of the health service was the main aim of the NHS in 1974, the three branches of the service in Oxford had been working closely together for the previous two decades thanks to the vision and foresight of John Warin. Many doctors in the field of public health profited from working in Warin’s department in Oxford.

All eight of his successive deputies subsequently became medical officers of health or obtained similar responsible posts as area or district medical officers, as did six of his assistant medical officers. The city and people of Oxford, and numerous health workers in many fields, are indebted to John Warin for the service he gave them over a quarter of a century as Oxford’s last MOH.

Although a Yorkshireman born and bred, John War in became a part of Oxford life, loyal to Iffley and to Iffley Church and a member of the Oxford Rotary Club for 42 years. He represented public service at its best.

Both his brother Robert and his son Andrew are consultant dermatologists and Fellows of the College; the former at Bristol and the latter at Exeter.

E P Lawrence
J A Muir Gray

[Brit.med.J., 1991,302,108]

(Volume IX, page 552)

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