Lives of the fellows

Noel David Lyche Olsen

b.20 January 1946 d.2 September 2013
MB BS Lond(1969) MRCP(1973) MSc(1978) FFCM(1986) MFCM(1979) FRCP(1993) Hon FFPHM

Noel Olsen was a public health physician and advocate who campaigned vigorously on a number of health and social policy issues, specifically on the control of smoking and the impact of alcohol.

Olsen was born in Hampstead, London, the son of Frank Maurice Lyche Olsen, a chartered accountant and company director, and Dora Winifred Wyatt Olsen, a voluntary worker. He was educated at Mill Hill School, before entering St George’s Hospital Medical School for his medical training. On qualifying in 1969 he set his mind on specialising in lung diseases, gaining experience at the Brompton Hospital with Sir John Batten [Munk’s Roll, Vol.XII, web] and in Edinburgh with Sir John Crofton [Munk’s Roll, Vol.XII, web].

In 1974 he became one of the youngest consultants in the UK when he was appointed to Barking and Dagenham Hospital on the outskirts of the East End of London. The time he spent there accelerated his interest in the social origins of disease, particularly lung cancer, a disease which he increasingly saw as preventable. As a result he decided to retrain in public health medicine by gaining an MSc at the London School of Hygiene and Tropical Medicine in 1978 and an NHS fellowship to the Henley Business School.

Over the next 17 years he held senior public health appointments in Cambridge, Camden and Plymouth. Apart from conventional public health work, he was fortunate in also having an academic component at each of these localities; he benefited from the collaboration this offered, as well as the opportunity to teach at all levels. At a time when not all clinicians favoured medical audit, he was persuasive in promoting it by showing how small audits could be used effectively, not only to improve clinical care, but also in securing the resources needed to make these improvements.

He was prominent in the early days of anti-smoking campaigning when, following the RCP report Smoking and health (London, Pitman Medical Publishing Co Ltd, 1962), the lobbying group ASH (Action on Smoking and Health) started up in accommodation initially provided by the Royal College of Physicians. He later became its honorary secretary from 1978 to 1994, during a particularly intense period of its growth.

At a time when the need to control smoking is widely accepted, it is difficult to appreciate the early opposition by government, by the public and, above all, by the tobacco industry. The tobacco industry did not realise what a formidable opponent they had in Olsen, whose methods were not always conventional. Using his creative mind, he would think up effective ways to raise awareness and then propose practical action to make the necessary changes. For example, he had the idea of buying shares in tobacco companies and then turning up at their annual general meetings to ask unexpected and unwelcome questions. Another idea was to send MPs the mortality statistics for lung cancer and coronary disease for their constituencies, telling them these were preventable deaths. Such was his reputation that a confidential internal British American Tobacco (BAT) memorandum, available as part of the tobacco companies’ settlement with the US government, described one meeting with him as a one-sided conversation and concluded: ‘Dr Olsen seemed to be a remarkably able and intelligent trouble-maker’. The work to which he so significantly contributed culminated in the present day legislation banning smoking in public places and, following increasingly emphatic warnings on cigarette packages, leading ultimately to the Tobacco Advertising and Promotion Act 2002.

His advocacy extended further when he joined the National Heart Forum (now the UK Health Forum), a consortium of over 60 organisations, brought together with the aim of reducing coronary heart disease. Again, Olsen became its honorary secretary, welding together contributions from diverse organisations into coherent, effective strategies, pressurising the tobacco, food and alcohol industries to desist from unhealthy practices and promotions.

He was recruited by many other bodies. He chaired the UK Public Health Consultative Committee and was a member of the Joint Consultants Committee. He was elected to the council of the British Medical Association (BMA), to its executive board and to many of its sub-committees notably, but not solely, in public health. For example, he helped junior doctors lobbying for improvements in their working conditions, was on the BMJ management committee and the BMA board of science.

Against this background it is no surprise he was invited to participate in governmental bodies such as the Physical Activity Taskforce and the Fuel Poverty Advisory Group. As the social and medical problems of alcohol became increasingly evident, he chaired the Alcohol Education and Research Council of the UK when it was set up as a statutory body, later skillfully steering it when, as a result of a change government policy, it became Alcohol Research UK. Work on alcohol issues brought him into close alliance with the RCP’s initiatives to reduce excessive alcohol consumption.

Outside the UK he advised on coronary prevention for the European Union and on social inequality for the World Health Organization. From 1991 to 2010, he was honorary secretary of the International Agency on Tobacco and Health.

After his retirement from his public health appointments, he added an interest in higher education by undertaking university and college inspections on behalf of the authorities. He became a member of the council of the University of Plymouth during a period of academic expansion, receiving in 2011 an honorary doctorate for all his contributions to public health. Nationally his work was recognised by receiving in 2008 the inaugural gold medal of the Royal Society for Public Health.

Olsen had a delightful personality, guaranteed to keep calm even when many others would have become exasperated, always tenacious when others might have felt there was no point in continuing but never, however strongly he felt or was provoked, ever succumbing to making personal attacks on his opponents. As a skilled debater, he could be depended upon to come up with an apposite phrase or an appropriate anecdote to emphasise his point and, without acrimony, had an ability to defuse sometimes vigorous opposition to his views.

In spite of the extent of his commitments, he maintained a happy family life with his wife Nicky Tewson, whom he married in 1982, and his two daughters, Sally and Suzanna, both of whom are doctors. He had a passion for sailing, was a member of the Royal Ocean Racing Club and regretted that his medical duties had at one time prevented him from representing Britain. Even in the last weeks of his life he participated in the Isle of Wight Round the Island race, coming second in his class.

His zest and commitment for what he believed in showed right up to his last days when, even in pain and discomfort from prostate cancer, he continued working, using the phone and internet, outlining what should be done and suggesting to the rest of us ways of doing it.

Brian Kirby

[The Guardian 16 September 2013; Brit.med.J., 2013 347 6086; ASH: Action on Smoking and Health. Dr Noel Olsen – A tribute www.ash.org.uk/about-ash/ash-board-of-trustees/dr-noel-olsen-a-tribute – accessed 27 January 2014]

(Volume XII, page web)

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