Lives of the fellows

Barron Bruce MacGillivray

b.21 August 1927 d.7 December 2010
BSc Wits(1949) MRCS LRCP(1955) MRCP(1959) MB BS Lond(1962) FRCP(1973)

Bruce MacGillivray was dean of the Royal Free Hospital Medical School in London and physician in charge of the department of clinical neurophysiology. He was born in Durban, South Africa, to his Scottish father, John, a dairy farmer and businessman, and his half Swedish mother, Doreene Eleanore Oscar (née Eastwood), also born in Durban, who was a nurse. John died when Bruce was 12. Even as a child Bruce opposed Apartheid and in 1940, while boarding at Johannesburg’s King Edward VII School, he received permission to start a night school there for local black employees. In 1946 he entered medical school at the University of Witwatersrand. He joined the National Union of Students and sat on the medical school’s council.

Using a small legacy he moved to Britain in 1951. In 1955 he qualified MRCS LRCP at Manchester and also married Ruth Valentine, a fellow student. Following house jobs at Manchester Royal Infirmary, he spent two years in Stockport. After gaining the MRCP in 1959, he moved to the Maida Vale branch of the National Hospital for Nervous Diseases, initially as a registrar and then as a senior registrar. In 1962, somewhat belatedly, he graduated MB BS (London) as an external student. Appointed as a consultant clinical neurophysiologist and neurologist at the Royal Free Hospital in 1964, he spent a year in research at UCLA, before taking up the post. From 1971 he was also a consultant at the National Hospital, Queen Square.

MacGillivray was an expert on electroencephalography (EEG), a field to which his group made many contributions – not least that of enabling normal language reports to be obtained from an automated EEG analysis system. Despite the somewhat recherché nature of his work, he was briefly in the public eye around 1980 as an expert on the definition of brain death, a key issue in relation to organ transplantation, but about which there was much confusion.

From 1975 until 1989 he was the penultimate dean of the Royal Free Hospital School of Medicine (RFHSM) and deserves credit for ensuring that from 1983, albeit for a short period, hospital and school would, for the first time, occupy the same building. He became dean in unusual circumstances. When in 1972 his predecessor expressed a wish to resign, the school’s council extended her appointment by three years. It had had little consultation with the academic staff, many of whom resented their exclusion from the RFHSM’s decision making processes. Thirty Royal Free consultants (academic and NHS) complained, so a working party was set up to review the school’s governance. It recommended election of the dean by academic staff and the honorary consultants; MacGillivray was the first chosen in this way.

When he took office the future seemed grim. In 1957 the Ministry of Health had decided that the Royal Free Hospital and the preclinical school would move to a new complex in Hampstead. However, the 1968 Todd Report advocated mergers of London’s medical schools, and the siting of preclinical departments near science departments rather than teaching hospitals, so it was decided that the preclinical school would not transfer to Hampstead. Instead the RFHSM was to merge with University College and University College Hospital Medical School and all preclinical teaching was to be in new accommodation in Gower Street. The University Grants Committee therefore withheld funding for the Hampstead preclinical departments, agreeing instead to provide a smaller clinical sciences building for the new Royal Free Hospital.

When it transpired that the new Gower Street building would be unavailable until 1985, the question arose whether the clinical sciences building might accommodate all pre-clinical teaching, but to do so it would have to be enlarged. MacGillivray moved some key preclinical staff into the clinical services building when it became available in January 1978; others remained at Hunter Street with most of the administration. MacGillivray next suggested to the vice chancellor that the whole school should move to Hampstead until the merger. However, the Flowers Working Party (1980) suggested London’s medical schools should combine within six schools – and the phasing out of preclinical teaching at the RFHSM. MacGillivray led the Free’s resistance to Flowers and the senate eventually decided (in March 1981) that the RFHSM should remain independent and move in its entirety to Hampstead – but would have to pay for the extra space required.

The last group transferred from Hunter Street in the summer of 1983. The preclinical and clinical departments were united on one site in purpose-built accommodation and the quality of life at the RFHSM, academic and social, was enhanced for students and staff. It was saved but, as one of London’s smallest medical schools, it remained vulnerable. In 1998 it was merged with University College London.

The school’s financial situation was precarious before MacGillivray took over, and earlier efforts to reduce expenditure had left him little further room for manoeuvre. Inflation, initially 24%, stayed in double figures until 1982. University Grants Committee funding fell by 14% in real terms in the early 1980s, and the effect of subsequent reductions was exacerbated owing to the RFHSM’s relatively poor grades at the first research assessment exercise in 1986. Somehow, the school balanced its budgets and continued to expand. In 1988 a two-storey building was erected across the clinical sciences building’s south east courtyard. Funded from the proceeds of the Hunter Street sale in 1985/6, it allowed further expansion to increase the school’s research activity. During MacGillivray’s time research income increased from £140,000 to £4m per annum; he also sought external support through fundraising and late in his deanship he promoted the commercialisation of the school’s intellectual property – which in subsequent years generated many millions.

As chairman of the Royal Free’s computer policy committee, he was a key figure when in 1980 the hospital applied to the Department of Health and Social Security for funds to acquire for Britain a remarkable medical computer system – PROMIS – developed by Lawrence L Weed and his group in Burlington, Vermont, on which the US government had spent over $15m. Many consider it to be the best such system to have been created. The software would have been free and MacGillivray felt, as did others, that the Department of Health and Social Security’s failure to support the Royal Free Hospital’s bid was one of the most expensive errors of judgement in the history of the NHS.

He had a genuine interest in medical education and oversaw a radical revision of the clinical curriculum and of the final examination. Unlike his predecessor, he encouraged the participation of general practitioners in undergraduate medical education and in 1979 supported Gerry Shaper’s successful application to the Regional Health Authority for a grant allowing GP tutors to be appointed for a total of eight sessions a week. Shaper’s department was renamed ‘clinical epidemiology and general practice’ and its complement of GPs expanded. Some became part-time or full-time senior lecturers and, from 1981, John Horder, a local GP and president of the Royal College of General Practitioners, was a visiting professor for 10 years. By 1988 the school recognised 130 individuals as GP tutors.

Loved and respected by the medical students, MacGillivray was a strong supporter of their social and sporting activities; their nickname for him was ‘Brucey-baby’. As dean his door was always open to those with matters for discussion and this helped to create a sense of collegiate togetherness, which explained the high regard in which he was held not only by preclinical and clinical colleagues at the Royal Free, but also by those with whom he sat on university and NHS committees at local and national levels. In 1985 he was appointed as the first pro-vice chancellor (medicine) of the University of London.

When he retired from the RFHSM in 1989 he left a happier and more optimistic school than the one he had taken over 14 years earlier. Much of that was due to him. From 1994 to 2000 he was a university representative on the council of St George's Hospital Medical School, and its honorary treasurer from 1996. But he was not without other outlets for his energies during his retirement as he was a man of many parts – a gifted sculptor, potter and wood turner and a fellow of the Royal Photographic Society. He was also a qualified pilot. He died peacefully after a long, complex and debilitating illness and was survived by his wife, Ruth, and their three children and four grandchildren.

Neil McIntyre

[BMJ 2011 343 6420]

(Volume XII, page web)

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