George Godber, who has died aged 100, was a medical lay saint. The three terms may be separately incompatible, but together they form the ideal description of a man whose name still recalls, more than 35 years after his retirement as Chief Medical Officer (CMO), a nostalgic recollection of the halcyon days of the NHS - an epoch to which he himself had contributed so much.
As the last surviving member of the 1940s planning group at the Ministry of Health that gave rise to the NHS, Godber had worked alongside Aneurin Bevan, its chief architect, and William Beveridge, the father of the modern welfare state. As deputy CMO from 1950 to 1960, and CMO from 1960 to 1973, he exercised an influence over health policy that remains unmatched by any holder of those posts.
Brought up in Bedford and educated at Bedford School, New College, Oxford (where he was a rowing Blue), and the London Hospital, he chose to enter public health medicine. He did his post-graduate training at the London School of Hygiene, obtaining the diploma in Public Health in 1936, three years after medical qualification. The same year, he joined the then Department of Health, where he spent the next 37 years, becoming Deputy Chief Medical Officer in 1950. More or less at the time when health was conglomerated with social security, he became Chief Medical Officer to the DHSS, likewise to the Home Office and the Department of Education and Science. What he thought of the merger at the time is not recorded, but it is a fair surmise that its undoing was one of the few changes of later years which he would have welcomed.
The part which he himself played in the planning and implementation of the NHS can be well gauged from Rudolf Klein's classic 1983 book The Politics of the National Health Service, and from his own account in The National Health Service: Past, Present and Future, written in 1974 after he retired.
As early as 1948, when still a Medical Officer, he was the architect of the plan to improve the distribution of consultants throughout Britain. This was one of the early achievements of the NHS, even though Godber himself came to regret the tardiness with which certain of the more deprived regions applied for additional consultants for which finance was at that time available. He was also influential in welcoming and implementing the proposal for a confidential inquiry into maternal deaths, which was set up in 1952, and did much to improve matters in that area. Indeed, it became the model for later confidential inquiries into deaths associated with anaesthesia and surgical operations.
When Enoch Powell was appointed minister of health in 1960, it marked, in Klein's phrase, "the end of the Ministry of Health as a political backwater". Ministers come and go, so perhaps it was still more important that the new permanent secretary, Sir Bruce Fraser, not only came from the Treasury but was also not "scarred by the experience of setting up the NHS". Most vital of all was the promotion of Godber as CMO, for he had a rare understanding of the genesis of medical advances, and of how these may be applied to the health of a nation.
In Godber's own words, "The NHS is comprised of very many services rendered daily by physicians, nurses, dentists, pharmacists and others. The content of these services is defined, not by planners, but by essential professional knowledge and skills. Change in method and practice is brought about by intra-professional exchanges; it may be abrupt because of a scientific development such as the advent of a new drug, or it may occur gradually with experience." Such an analysis of how a service should be promoted leads naturally to the encouragement of dialogue with the health professions, and of a consensus style of management, both of which Godber fostered in his term of office, and in which he greatly welcomed the support, always acknowledged in later years, of Fraser.
As CMO he provided advice to other departments of state, including that of education. This brought Godber an early insight into the cavalier attitude of Margaret Thatcher, then Secretary of State for Education and Science, to scientific advice transmitted from experts by way of the civil service. Within the DHSS, as it then was, there was a group of expert committees on medical aspects of various matters, each abbreviated somewhat infelicitously as Coma. There was a Coma on nutrition, which should at least have been informed of, and preferably consulted on, a decision to withdraw free milk from school children aged eight to 11. But I have it from Godber that he was given no time even to notify members of his Coma in advance of a public announcement that the milk was to go.
Even ordinary politicians, with their bias of "illogical positivism", find it hard to understand that science is probabilistic, not categorical; and that their quest for certainty can rarely be met to their satisfaction. Not the least of Godber's qualities was the honesty and self-confidence that allowed him to deny a politically plausible claim, or - more difficult still - to say the balance of evidence on a particular matter was inconclusive.
The shape of the NHS in the mid-1970s was very materially determined by Godber's influence, acting of course within the constraints of what was medically, politically and economically possible. Among the qualities which enabled him to exercise such influence were, as I have said, honesty and self-confidence. But there was much more. He had within his range the capacity to be at one time endlessly patient, at another time magisterial; and the discernment to know what behaviour was appropriate to what occasion. He deployed such skills not as exercises in manipulation, but in untiring pursuit of a hope earlier enunciated by Nye Bevan, of "universalising the best". In this he had largely succeeded when he retired in 1973, a date coincident with the first of many attempts to substitute administrative devices for adequate funding of the NHS. Athough a civil servant is debarred from public criticism of government policy, as a private man in retirement he made no secret of his regret at the policies which were transforming a service into a business.
Physically, he was a commanding figure. Tall and well built, he played a regular round of golf well into his nineties. He neither drank nor smoked. He continued to drive until the age of 97, but was irked in recent years by the signs of his decline, and hoped that medical opinion might change to take greater account of patients' wishes in deciding when their life might end.
To an interesting extent, he was both aloof and approachable. No amiable chatterbox could have attained the influence which he enjoyed in the formative period of the NHS; but "off-duty", and at times when "on duty", he could and would speak at length, formally or informally, but always to the point. His wealth and variety of experience made him an interesting companion; but while he was in his post, he was economical of his leisure. In his weekly staff meeting as CMO, he could be formidable. Although he never paraded benevolence, he not only wanted to do good but actually did it. In an age clamorous of rights, he saw and pursued his duty in promoting the rights of others.
Like anyone who had the privilege of working with him, I recognised him as a great man, and as a friend to be proud of.
He was appointed CB in 1958, advanced KCB in 1962 and GCB in 1971. In 1935 he had married Norma Rainey and her support was crucial to him, particularly in the period in the 1940s when they endured the death of a son and daughter within six months of each other. She predeceased him in 1999. He is survived by two sons, Colin and Steve, and a daughter, Bridget.