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National Health Service History

Geoffrey Rivett

home inheritance1948-19571958-19671968-1977 1978-1987  1988-19971998-2007 2008-2017envoishort history London's hospitals

  

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Dr Geoffrey Rivett

I am honoured to be asked to speak today.  George was great.  He was a giant, and you do not find many giants around the place these days.

I first met him in January 1974.  I needed a new job and he was on the interview panel.  The following morning I found a thick envelope in the post.  It was a note from George who had obviously returned from the interview and written to me.  It was pure George, a brief note – eleven words – but it said everything - and more - that one wanted to hear.  George could inspire loyalty. 

Subsequently, in the couple of years that I was in the Department of Health before he retired, he selected me to be secretary of a committee he had established between the Department and British Medical Association and the Royal College of General Practitioners.  It was a new task for me, but he taught me how to do it, encouraging me when necessary.  Before he left he counselled me on my career.  I did not see him again for some years, by which time I was writing a history of the NHS.  He went through the first three chapters that covered the time he had been in the Department, added to my knowledge and picked up some errors.  He and his wife entertained me in Cambridge, and we continued to keep in touch. 

George had a habit of selecting young people, helping them in their career, and using their talents.  ‘You do not mould the future by listening to the voices of the past’ he said, and many of the people he selected outside and within the Department went on to greater things.  He was loyal to Ministers and Government, and simultaneously to the medical profession, not an easy task.  However he felt deeply that people were best served by a health service in which the professions were willing partners.  He covered the water front – he was not a single issue guy.  He had the knack of spotting what was going wrong, like his good friend Gordon McLachlan at the Nuffield Provincial Hospitals Trust, and acting fast.  He had a regular meetings with new doctors in the Department and told them “you can achieve anything in this place if you do not insist on claiming the credit for it.” 

As I came to write the history of the NHS I repeatedly found his finger prints on things. There were many and these are just a few.  In 1942/3, early in his time in the then Ministry, it was decided to survey all hospitals in England and Wales to help the planning of a future hospital service.  He was one of the two people, an administrator and a clinician, who surveyed what became the Sheffield region.  The deep knowledge of the hospitals and their problems helped him to form a conceptual model of how things ought to be, how they might be. 

In 1947 as Bevan was developing his plans, he secretaried a group of senior consultants who were trying to define the specialists needed in a district hospital.  It covered all fields from thoracic surgery to mental deficiency.  Now long outdated, it then provided the young health service with an invaluable guide at a time when everyone was new to the job of creating an equitable system. 

In the late 1950s, appalled at the inexorable rise in the number of deaths from cancer of the lung, and the desultory response of the Ministry, he undertook what would now be called a piece of skunk work.  He went outside the Department and with Charles Fletcher influenced the Royal College of Physicians to publish its iconic report that became the key to subsequent action on smoking. 

In the mid 1960s the morale of general practitioners was at rock bottom and that part of the profession was in crisis.  George understood that primary care was the rock on which the service was built, and with Kenneth Robinson and Sir James Cameron from the BMA a new contract was put together that led to a renaissance in general practice.  When there were doubts about its funding, he quietly made this a resignation issue. 

Always a believer that doctors should be involved in the management of the service, in 1966 he created the Cogwheel committees, the very name implying the need to work together.

When, in 1968, the first heart transplants were taking place with 100% mortality, he gathered together the great and the good in heart surgery, as a result of which the profession placed an informal embargo on further operations until the techniques, the immunology and the animal work had been sorted out.  Some years later when the success rate in the USA was high, Papworth and Harefield began work. 

A good friend and colleague who knew George well, Dr John Ball, said that there was a unit of measurement of the quality of CMOs.  It was the godber.  He said that no other CMO had ever exceeded 0.5 godbers.

 

home inheritance1948-19571958-19671968-1977 1978-1987 1988-1997  1998-2007 2008-2017envoishort history London's hospitals

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