b.9 January 1919 d.11 May 1996
MRCS LRCP(1943) MRCP(1949) MB BS Lond(1950) MD(1952) FRCP(1975)
Terence Charles Picton Williams’ professional life began before the NHS and ended with his pioneering the development of geriatric community care. He was a consultant physician and senior lecturer in medicine and head of the department of geriatric medicine for St Thomas’s Hospitals from 1963 until his retirement in 1984.
He trained at St Mary’s in London, intent on becoming a physician as his father had been before him. Having qualified in 1943, he gained initial experience locally in Paddington as a house physician and casualty officer and then entered the RNVR as a surgical lieutenant.
He returned to civilian practice in 1947 and gained wide experience in paediatrics, general medicine, neurology, cardiology and gastroenterology. Meanwhile he had obtained membership of the College and a year later re-qualified with the University of London degrees of medicine and surgery. These were the early days of the NHS and of the integration of the long established medical teaching hospitals with the University. In 1950 he was appointed as a senior medical registrar to Fulham Hospital, London. Fulham Hospital was part of the Charing Cross group of hospitals and was the site of the medical school’s department of medicine.
Having become a broadly trained and accomplished general physician, Williams was an early recruit to the emerging specialty of geriatric medicine. He attended the first postgraduate course in the specialty held in Glasgow in 1960. This was run by Ferguson Anderson, the worlds first professor of geriatric medicine and founder member of what became the British Geriatrics Society. At a time of rapid advance in the biological basis of medicine many physicians like Williams were drawn to the broader approach of geriatrics, with the emphases upon the integration of the physical, psychological and social aspects of illness in elderly people and he spent a further period of senior registrarship at Central Middlesex Hospital, an early centre of expertise in the specialty.
In 1963 Williams was appointed to the staff at St Thomas’s in London. The St Thomas’s group of hospitals included the South Western Hospital in Stockwell, which had been built from public subscription in less than two years in response to a smallpox epidemic in the 19th century. It had established a strong reputation for treatment of infectious diseases and chest medicine. It was there that he established and led the new department of geriatric medicine. He was also appointed as senior lecturer in medicine at the St Thomas’s Hospital Medical School and established the first undergraduate teaching programme in geriatric medicine in any London teaching hospital. His leadership in the clinical and teaching fields was acknowledged in his subsequent chairmanships of the NHS South East Thames regional specialty sub-committee for geriatric medicine (between 1976 and 1981) and of the Association of London Teaching Hospitals Geriatricians Club. His practical contributions to teaching were accompanied by membership of various University of London committees, notably the board of studies in medicine.
His contribution to the development of geriatric medicine services went way beyond Lambeth, notably by serving several tours of duty with the NHS Hospital Advisory Service and in addressing key policy debates and seminars convened by various learned bodies such as the King’s Fund. Service development was also the focus of his academic contributions to journals and scientific meetings, though his earliest contribution to the BMJ was on folic acid. He gained a particular reputation as an advocate of the day hospital, speaking and publishing widely on this subject. The geriatric day unit at South Western Hospital, which opened in 1975, was a celebrated innovation, jointly funded by the NHS and the London Borough of Lambeth social services department. It provided a seamless service from diagnosis and treatment through to the social rehabilitation of disabled elderly people. This was fifteen years before the Community Care Act! By the time of his retirement in 1984 an acute assessment ward for elderly patients had been established on the riverside St Thomas’s site and Williams had secured arrangements for closer integration with general internal medicine. Thus his post was replaced by two new posts of physicians who combined general internal medicine and geriatric medicine duties. His legacy was a well developed department with a number of innovative features, but perhaps most of all fond memories and enormous respect on the part of numerous patients and colleagues within the hospital and local community.
Indeed he never did quite retire, going to Canada in 1986 for nearly a year. During this time he was associate professor in the division of medicine (section of clinical gerontology) at the University of Saskatchewan. This was a post involving strategic planning, clinical care and substantial teaching. He advised on healthcare for elderly people in the province of Saskatchewan and he spoke widely in Canada on clinical and service aspects of geriatric medicine.
Although an Englishman, Williams was also proud to be made a freeman of the borough of Stirling (in Scotland). He was also a European, speaking abroad and being a host to numerous international visitors. His welcome and guidance to trainees from the Cruz Roja Hospital in Madrid is still fondly remembered there. He began a tradition of visits from their trainees which still continues.
His charitable work included serving as a member of the council of the Cicely Northcote Trust which has a long association with St Thomas’s Hospital. He remained active in the Royal Surgical Aid Society until his death, particularly with the Gloucester House Nursing Home in Sevenoaks, his home town for forty years. He married Catherine Isobel Blyth in 1945 and they had two daughters.
F C Martin
(Volume X, page 522)
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