Lives of the fellows

Richard John West

b.8 May 1939 d.1 March 2010
MB BS Lond(1962) DObst RCOG(1964) MRCP(1967) DCH RCP(1969) MD(1975) FRCP(1979) FRCPCH(1997)

Richard West was a paediatrician, clinical researcher, NHS leader, medical school dean and postgraduate dean. He was born in London, the son of Cecil John West, clerk of works at The Times. After education at Tiffin School in Kingston upon Thames, he was awarded a scholarship to Middlesex Hospital, and trained as a paediatrician at Queen Mary’s Hospital for Children, Carshalton, and at Great Ormond Street Hospital. He worked with June Lloyd [Munk’s Roll, Vol.XII, web] on lipid disorders, and his MD was on familial hypercholesterolaemia and its treatment. With June Lloyd and other colleagues, he published studies on the homozygous form of this disorder and on the wider implications for screening and prevention of coronary heart disease.

He was appointed as a consultant paediatrician and senior lecturer at St George’s Hospital, London, in 1975. He was an excellent clinician with a great affection for his patients, particularly those from disadvantaged circumstances. The Reverend Ian Ainsworth-Smith, the much-loved hospital chaplain, recalls that he was respected by his medical colleagues, comfortable working in a multidisciplinary team, and always ready to take into account a point of view from another discipline. They frequently collaborated in working with seriously ill and dying children and their families. Richard was unfailingly competent, kind and approachable, particularly in situations which were clinically and ethically demanding.

He led a group in establishing the ‘Ursula James Room’, named in honour of one of his predecessors [Munk’s Roll, Vol.XII, web]; this was a four-bedded room in a children’s ward that gave priority to severely and profoundly disabled children who might need admission for illnesses or behavioural problems that would not normally merit hospitalisation. He recognised that parents often presented their child with minor illnesses as a way of obtaining desperately needed respite care in a setting where they knew that they could trust the staff and rely on the standard of care. The ‘U J Room’ was a great success and was subsequently described in an article in the British Medical Journal (Br Med J [Clin Res Ed]. 1986 Jul 19;293[6540]:191-2).

When in the early 1980s it became clear that the extent of child sexual abuse had been underestimated, Richard arranged meetings with the local police child abuse teams, and led the introduction of training and policy development when many units had hardly begun to recognise the problem. He contributed to child protection work and would give a thoughtful and balanced opinion in these often very fraught cases.

While at St George’s, he was successively chair of the division of child health, chair of the district medical committee, consultant member of the district management team, and chair of the hospital medical executive committee, playing a key role during a very turbulent period for the hospital and the district. From 1982 to 1989, he was also a member of the South West Thames Regional Health Authority.

Richard enjoyed his time in NHS management, and this led to him being appointed dean of St George’s Medical School from 1982 to 1987. While dean, he continued with full clinical practice and teaching. During this period the medical school changed rapidly. Student numbers increased from 420 to 760, and several new chairs and departments were established. He developed the first school academic plan in 1983, and introduced a new administrative organisation. Undergraduate teaching was further developed, as were student welfare services and counselling. He negotiated the purchase of a sports ground at Cobham for the school and annually invited new graduates home to lunch.

He had a great affection for the hospital and school, and took a particular and personal interest in the needs of the medical students and junior staff. During his tenure there were several very difficult and contentious issues. and he dealt with these in an exemplary calm and dignified manner.

In 1991, Richard became postgraduate dean to the south west region and honorary professor of postgraduate medical education at the University of Bristol. He developed and improved the postgraduate education, training and support of junior doctors in the region. He established a multidisciplinary team to study the effect on doctors’ workload of changing professional boundaries and chaired various education and training committees, including the regional task force on junior doctors’ working conditions.

Within Bristol University, he worked closely with the medical faculty, chaired the pre-registration house officer committee, was a member of the faculty board and organised a course for final year students prior to becoming house officers.

In 1991 David Baum [Munk’s Roll, Vol.XI, p.42], professor of child health at the Royal Hospital for Children, Bristol (until his premature death in 1999), invited Richard to take a weekly session as an honorary paediatrician in the outpatient department seeing children with diabetes and lipid disorders.

He was also external examiner in paediatrics to the University of London, the Royal College of Physicians and the National University of Malaysia. He was vice chair of the Conference of Postgraduate Medical Deans (COPMed), and convenor of working groups on senior and pre-registration house officer training. He worked closely with the National Health Service Executive and the Royal Colleges, and was lead postgraduate dean for paediatrics.

In 1995, Richard developed blackouts and was diagnosed with sick sinus syndrome. He had a pacemaker inserted. A few months later, in February 1996, he became acutely ill with staphylococcal septicaemia arising from his pacing wire. Although he seemed to make a good recovery, his health gradually declined and he was eventually diagnosed with dementia. Ill health forced his early retirement in 1999. For several years he remained active with his family and also enjoyed an archaeology course. He received devoted support near his wife in a residential care home in Bristol for the last three years of his life.

As well as his full and varied professional life, Richard was a devoted family man, immensely proud of his three children and his wife Jenny (Jennifer Winn West née Hawkins), whom he met when she was a nurse at the Middlesex Hospital. Jenny later turned her attention to non-medical matters – she researched and published on windmills and watermills, and later wrote a PhD thesis on mills producing gunpowder. Richard greatly enjoyed collaborating with and supporting her on these various historical topics. His interests were windmills, archaeology, antique baby feeders, medical history and medical ethics.

David Hall

[Brit.med.J.,2010 340 2618]

(Volume XII, page web)

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