Lives of the fellows

Michael Ashley-Miller

b.1 December 1930 d.14 October 2017
CBE(1995) BA Oxon(1951) BM BCh(1955) DObst RCOG(1957) DPH(1963) MFCM(1973) FFCM(1977) FRCP Edin(1985) MRCP(1987) FRCP(1990) Hon FRCGP(1994)

Michael Ashley-Miller, secretary of the Nuffield Provincial Hospitals Trust (the Nuffield Trust), was that rare thing, a first class medical and health services research administrator. He was a staunch supporter of public health and epidemiology, with an ability to identify potentially valuable projects and research in these fields; as a research ‘funder’ he had an instinct for emerging needs, most notably in the field of physical disability, as well as general practice and community care. He was also a man of great charm, with a warm wit and a well-developed sense of fun. Overall, he had a combination of qualities that made him liked and respected by his peers and colleagues, as well as by those who worked for him.

He was born in London. His father, Cyril Ashley-Miller, was an engineer; his mother, Marjorie Ashley-Miller née George, was a housewife. Michael was drawn to medicine during his schooldays at Charterhouse, and talked himself into a place at Hertford College, Oxford, where the application process, he later recalled, involved little more than an interview with the principal, which consisted mainly of drinking sherry and reviewing the state of the world. After Oxford, he trained at King’s College Hospital and at the London School of Hygiene and Tropical Medicine. He did his National Service with the RAF as a medical officer, and followed this with a spell in public health on the Isle of Wight.

In 1964, he joined the Medical Research Council. During this period, he developed an affinity with social sciences and social medicine, and also found himself in charge of developing computer systems within the organisation. In 1974, he accepted an invitation to set up the newly-created chief scientist’s office in the Scottish Home and Health Department (SHHD) in Edinburgh. Here he had the good fortune to work with Sir John Brotherston [Munk’s Roll, Vol.VIII, p.57] and Sir Andrew Watt Kay, but had himself to shoulder the chief burden of bridging the divide of distrust between civil servants and research scientists, and of ensuring that the research sponsored had an impact on the delivery of health services in Scotland. He later claimed, with typical modesty, that any success he achieved was due to his early decision to ask ‘user’ departments what was the single, simple piece of research that would make the most immediate difference to them, and then ensure that it happened.

His success and the high regard in which he was held during his time in the Scotland were reflected in the award of an honorary fellowship of the Royal College of Physicians of Edinburgh, and in the senior principal medical officer merit promotion he received in 1983. There was, too, a lighter side to his life in Edinburgh: on one occasion, he took a breathalyser to a gathering of the great and the good, to check how well his eminent colleagues had stood up to the rigours of an evening’s entertainment. And he claimed to have set a new record for the shortest travelling time door-to-door between the SHHD in Edinburgh and the Scottish Office in London.

In 1986 he was appointed secretary of the Nuffield Provincial Hospitals Trust, an influential charitable trust. This was the culmination of his career, in what he held to be the plum job in health services research. The secretary enjoyed a wide remit and considerable freedom to shape the Trust’s policies and determine priorities and programmes of work. Determining his approach in a period of politically charged turmoil in the NHS, he resolved on a significant redirection of the Trust’s resources to concentrate on practical problems of health services delivery, in preference to involvement in health policy development. To this end he developed a programme of grants to carefully chosen outside organisations to carry out individual projects. He was influenced by his belief that a good way to judge a society was by the way it treated its more disadvantaged citizens. The search for practical expression of this idea led him to develop the Trust’s programme of research into services for people with physical disabilities, with which group he included the frail elderly, taking the view that it was neither practicable nor sensible to try to draw a distinction here. This programme was launched with a wide-ranging survey of health services for people with physical disabilities, carried out under the auspices of the Royal College of Physicians. To Michael the underlying significance of this survey was that it drew the attention of health authorities to the needs of people with physical disabilities; his hope was that it would also serve as a catalyst for improvement.

In the wider programme he built up with the trustees he was well served by the approach he had developed in Scotland. His aim was to identify demonstration projects which, for relatively modest outlays, would achieve significant improvements and changes in perception in addressing the problems attendant on physical disability. The approach was generally arm’s length, though he kept a watchful eye on progress, and was always available to advise and offer suggestions.

Alongside this main Trust programme, he also recognised the importance of developing new ideas in the field of community care and, in keeping with longstanding Trust practice, concluded that what was needed was the creation of new centres that would serve as foci for research and dissemination of results. The trustees duly endorsed this approach through the establishment of chairs in community care at the universities of Glasgow and Leicester. His concern with research support and dissemination was also evident in other areas of Trust activity, for example, stroke services, nursing, and primary care, albeit at lower levels of expenditure.

Michael’s achievements were recognised in 1995 by the award of a CBE and the Alwyn Smith prize of the Faulty on Public Health Medicine. In retirement, he collaborated with Max Blythe on the development of the Royal College of Physicians/Oxford Brookes University video archive of interviews with prominent medical scientists. And he pursued his interest in drawing attention to deficiencies in the activities of public authorities, carrying out a lively correspondence with local and national bodies alike.

He was survived by his wife Yvonne (née Townend), daughters Amanda, Tessa and Penny, and grandchildren Christopher, Alastair, Sophie, Emily and Sam.

Max Lehmann

[The Ashley-Miller family; Sir Maurice Shock; Walter Holland]

(Volume XII, page web)

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