b.29 October 1919 d.15 April 2013
BSc Manch(1940) MB ChB(1943) DCH(1944) MRCP(1947) FRCP(1971)
Robert Ian Mackay, known as ‘Bob’, was a consultant physician at the Royal Manchester Children’s Hospital. Over an industrious and illustrious medical career spanning over six decades he did much to care and support children with developmental disorders and their families in the north west.
Bob was the son of Alexander Mackay, a GP. He was born in Manchester and educated at Altrincham Grammar School, where he was appointed school captain in his final year. During his school career he was also a member of the Boy Scouts, an interest he continued in later life. Bob began his studies at Manchester Medical School in 1937. He graduated with an honours degree in 1943, after a distinguished undergraduate career, gaining prizes in surgery and medicine.
Bob’s postgraduate training in paediatrics was undertaken in Manchester, Birmingham and Stockport. He was admitted as a member of the Royal College of Physicians in 1947, and was elected a fellow in 1971. In 1950, Bob was appointed as a consultant paediatrician at Hope Hospital, Salford, and in 1965 he joined the consultant staff of the Royal Manchester Children’s Hospital, staying there until his ‘first’ retirement in 1982. During this time he was also a lecturer in the department of child health and an examiner in Leeds and Manchester.
Bob was passionate about the care of the premature baby, correctly believing that the outlook for these vulnerable infants (in terms of freedom from long-term disability) was significantly enhanced when they were given high quality basic care, including being kept warm and with measures taken to prevent infection.
Bob was the archetypal ‘general children’s physician’, but early in his consultant career he became deeply involved in the care of children with neurodevelopmental disabilities. As a developmental paediatrician Mackay became one of the pioneers of his era. With the metabolic consultant, George Komrower [Munk’s Roll, Vol.IX, p.297], the paediatric neurologist Neil Gordon [Munk’s Roll, Vol.XII, web] and the child and adolescent psychiatrists Pat Ainsworth and Joe Erulkar [Munk’s Roll, Vol.XII, web], he created the purpose-built Agnew unit ‘service for the handicapped child’. They recruited an excellent multidisciplinary team, establishing a diagnostic classroom for pre-school children with complex developmental problems.
It was an era of discovery in developmental paediatrics. Cytogenetics (or the branch of genetics concerned with the structure and function of the cell, especially the chromosomes) and metabolic paediatrics were evolving. Down syndrome had been found to be caused by the presence of all or part of a third copy of chromosome 21. Disintegrative psychoses of childhood were being diagnosed as inborn errors of metabolism. Psychometric, speech and language assessments were devised and standardised. Child development centres and services were being established around Britain and throughout Europe. In-service professional education was valued highly and multi-professional international conferences, including those sponsored by the medical and educational unit of the Spastics Society, were fertile opportunities for exchange of ideas and information.
In the UK, the 1970 Education Act gave all children the right to attend school, giving children with special educational needs the opportunity to have suitable individual education plans created for them. No longer were such young people shut away at home or in abysmal junior training centres, or incarcerated in bleak, rural long-stay institutions. Families could manage to care for their children with the support of coordinated multi-professional services. Self-injurious behaviour by the children reduced dramatically. Mackay was at the forefront of promoting these changes in Salford, Manchester and the north west region.
In later years the department of child and adolescent psychiatry expanded into the whole of the Agnew unit, and a new department of developmental and social paediatrics was established, aptly named the Mackay-Gordon centre, which opened in 1990. Mackay and Gordon attended the opening and closure of that department, 19 years later. The department was demolished when the hospital moved to central Manchester. The team who had worked so well together there was split up. Both Mackay and Gordon spoke comfortingly and appreciatively of the high reputation of the department and of the excellent services provided to families in Salford and beyond, through its tertiary role.
The north west regional developmental paediatrics course was set up by Mackay as a three term, 30 week, day-release course for community, hospital and overseas paediatricians, in conjunction with the postgraduate medical department of the University of Salford. Community consultant paediatricians did not exist then, but Mackay had the inspired idea of engaging senior clinical medical officers around the region as tutors for small groups of students. This enabled the students to gain clinical experience, and was also stimulating for tutors. Mackay was senior tutor for the course until his retirement. It served a major role in career development for paediatricians, including helping women progress from being clinical medical officers to consultant paediatricians through flexible training schemes.
Far ahead of his time, Mackay saw the advantage of consultant services in the Salford community, while remaining involved in the hospital service. He developed innovative clinics in schools and community health centres. This facilitated collaboration with those working in education, health and social services in the community. This saved parents the trouble of trekking to the hospital unnecessarily, and minimised time out of school for children.
As a colleague, Mackay was modest, with no airs and graces. He treated all families alike. He was down to earth and positive, with an encouraging smile when appropriate.
Following his retirement from hospital and community paediatrics, Bob was appointed as school medical officer to Manchester Grammar School (MGS), a post he held for nearly 20 years, during which time he presided over ‘one of the jewels of the MGS crown’ – the medical room. The medical room was not simply a first aid post – it was an essential part of a compassionate, pastoral care system, meeting the needs of pupils, parents and teaching staff.
Following his ‘second retirement’, this time from MGS, Bob not only archived biographies of the previous four doctors who had acted as medical officers to the school, but also wrote extensively about the growth and development of the school medical service over the past century.
Outside medicine, Bob was quintessentially a family man. A dedicated gardener and an avid reader of Jane Austen, Anthony Trollope and P D James, he ‘devoured biographies with an insatiable appetite’.
In 1944 Bob married Marion. They had two daughters, Alison and Margaret, and two grandsons, Michael and Andrew. Marion predeceased him in the 67th year of their marriage.
Robert Ian Mackay will long be remembered with warm affection by his family and colleagues, and particularly by his young patients and their families.
(Volume XII, page web)
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