b.4 August 1917 d.2 September 2016
MB BCh BAO Belf(1940) MD(1947) CPH(1947) DIH(1948) MRCP(1948) FRCP(1971) FFCM(1976) MFOM(1982)
Although national differences in how health care was delivered had long been recognised, this was not considered a topic for serious research until Robert (Bob) Francis Leslie Logan and a small group changed this in the 1960s with several pioneering comparative health services research studies.
The origins of this research lay in the UK. The 1962 Hospital Plan proposed the creation of a network of district hospitals, each serving a population of about 250,000. But what size should they be? Measured in terms of beds per population, it was apparent that they varied greatly. Liverpool was among those areas most generously catered for and the Regional Health Board asked Logan to investigate. His approach was innovative, drawing on a wide range of disciplines (and launching the careers of several future leaders of health service research), using a range of methods, and emphasising what is now termed public and patient involvement. No single reason for the high utilisation in Liverpool was found, but the work contributed greatly to the development of concepts such as treatment thresholds, need, demand and use.
This work attracted international attention and researchers at Johns Hopkins invited Logan to join a 12 country study, covering the Americas and Eastern and Western Europe. This revealed large differences in how health care was organised and resourced, but there were still many gaps in understanding how this related to variations in clinical practice. This issue would be addressed in Logan’s next undertaking, the European Collaborative Health Services Studies. By now, Logan had moved to the London School of Hygiene and Tropical Medicine. He recruited a group of students who, on returning to their countries, identified a market town served by a typical district hospital. These included Colchester in England, Mostar in what was then Yugoslavia and Viana do Castelo in Portugal. For most of its existence, the study was supported by the participating hospitals. Its descriptions of how common conditions were managed provided a basis for much subsequent research.
Logan was born in Bangor, Northern Ireland, the son of Francis Logan, a whiskey blender and a mayor of the town, and Ada Lawther, the daughter of an Australian sheep farmer. He attended the Royal School Dungannon, before spending a seminal year at Loomis, an American prep school. He qualified in medicine from Queen’s University, Belfast, where he won several medals and prizes, but still found time to represent the University at athletics and rugby, playing for Lancashire and Ulster after the war. Wartime service was in the Royal Naval Volunteer Reserve, serving on troopships in the Atlantic and North Africa.
After gaining his MRCP, he moved into industrial and later social medicine at the University of Manchester, where he researched occupational lung disease among Lancashire mill workers and lead exposure in car battery factory workers. In 1954 he was awarded a Rockefeller travelling fellowship to spend a year in the USA.
Throughout his career, Logan advised overseas governments, often working with the World Health Organization. Examples included the creation of new medical schools in Algeria, a programme for training hospital managers in Saudi Arabia, strategic planning in Singapore and advice on health services for a new town in Iran. He made many trips to Latin America and the Caribbean, and was a frequent visitor to Moscow.
Logan is remembered at the London School as an innovator in teaching. Concerned that students might lack real life experience when the masters’ degree was shortened from two years to one, he introduced a ‘field service attachment’, in which students addressed a practical problem in the NHS. Another initiative brought together students from different courses to work in teams to address real problems overseas, such as the health impact of a new dam. Committed to interdisciplinary working since his days in Liverpool, he appointed staff to teach a range of social sciences, providing the basis for what would become the UK’s first health services research unit, and strengthened linkages with Brian Abel-Smith and colleagues at the London School of Economics.
For many years after he retired, Logan attended events at the London School and took great interest in the careers of his students. He was delighted to be awarded an honorary fellowship in the School’s centenary year. In retirement he enjoyed gardening, painting and travelling with his wife Betty Eugene née Howell (known as Jill). Bob Logan died peacefully after a short illness aged 99. Predeceased by Jill, he leaves four sons (Richard, John, Robert and Andrew) and a daughter (Jane), all medically qualified (something in which he took quiet pleasure), and eight grandchildren.
[BMJ 2016 354 4927 www.bmj.com/content/354/bmj.i4927 – accessed 18 January 2016; London School of Hygiene and Tropical Medicine Alumni blog Obituary – Professor Bob Logan http://blogs.lshtm.ac.uk/alumni/2016/08/15/obituary-professor-bob-logan/ – accessed 18 January 2016]
(Volume XII, page web)
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