National Health Service
1
59 Obituary ALBERT WILLIAM LILEY KCMG, MB NZ, PhD, FRCOG Sir William Liley, who died on June 15 aged 54, was professor in perinatal physiology at the New Zealand Medical Research Council School of Obstetrics and Gynaecology in the University of Auckland. From a humble home he achieved an outstanding scholastic record at Auckland Grammar School and Otago University. His humanism made him abandon neurophysiology under the Nobel laureate, Sir John Eccles, to become in 1957 the first obstetric research fellow at the University of Auckland. There he so refined the prenatal diagnosis of rhesus haemolytic disease that his discovery in 1963 of the technique of intrauterine transfusion seemed surprisingly inevitable, simple, and effective. The world reaction startled this modest man, but it was really a tribute to his demonstration that the fetus was as much a patient as anyone, and that previously unasked or unanswerable questions could now be approached more hopefully. His later work included communication with the fetus via light and sound, the importance of blood volume and absolute weight in the hypertensive syndromes, and the accumulation of many family histories demonstrating that propensity to rhesus iso-immunisation is genetically determined. There is little doubt that most work emanating from National Women’s Hospital, Auckland, over 25 years owes something to his influence. Honours sat easily on him: those he valued most were the compliment paid to the youngest medical school in the southern hemisphere when the ancient one of Vienna sent a staff member to study under him; his ad-eundem admission as FRCOG; and membership (as a non-Catholic) of the Pontifical Academy of Sciences. Understandably he believed passionately in the rights of the unborn; one answer he made to criticism of his uncompromising pro-life attitudes was to adopt a daughter with trisomy-21 who might not have achieved birth otherwise. His breadth and depth of knowledge, medical and non-medical, and his readiness and ability to impart it and catalyse new efforts from the recipients, made him an ideal research professor. His wife, Dr Margaret Liley, is a staff physician at National Women’s Hospital, Auckland. They had two sons and three daughters. (j. H. Cj. CHRISTOPHER AMYAS WRIGHT DSc Lond, FIBiol Dr Wright was a leading world authority on the biological mechanisms responsible for schistosomiasis of man and animals. He died on June 19 aged 54. He was born in Montevideo, and during the early part of his life in South America he became deeply interested in the natural history of that region. He was educated in Canada and later at Shrewsbury School. He graduated with first-class honours from Imperial College, London. In 1954 he joined the staff of the British Museum (Natural History) and began working on mollusca and the parasitic worms which they harbour. This became his leading professional preoccupation. As time went on he realised that the only way to solve many of the difficulties concerning molluscan behaviour was to apply experimental techniques, and in 1964 he set up in the Museum an experimental taxonomy unit which he directed throughout the rest of his life. His inquiring and original mind led him towards a profound understanding of the relationship between snails and the trematodes they harbour, and reintroduced enzyme analysis to study their populations. His field work took him on 16 expeditions in 12 tropical countries. His published work included about 100 scientific papers and a unique book on flukes and snails. This work had a tremendous impact on those studying and working against human schistosomiasis; and its universal influence was promoted by his appointment to the World Health Organisation as a member of its expert panel on parasitic diseases, a post which he held from 1964 onwards. He was a leading member of many committees and societies, having been the secretary-general of the International Union of Biological Sciences, the president of the British Society of Parasitology, and vice-president to the Institute of Biology, the Zoological Society of London, and the Royal Society of Tropical Medicine and Hygiene. His cheerfulness and wit endeared him to all his medical and scientific colleagues and to a host of other friends. His fortitude and steadfastness were never more apparent than during the illness which he so courageously faced during the last year of his life. He is survived by his wife, Pam. The work in which he excelled has been of immense benefit to mankind, and will be for long applied to the discovery of a solution to one of the world’s most widespread communicable diseases. A. J. D. National Health Service Mr Fowler’s Reassurances Mr Norman Fowler, Secretary of State for the Social Services, made his first major pronouncement since the election at the annual general meeting in Harrogate last week of the National Association of Health Authorities. He sought to reassure health authorities’ delegates of the Government’s good intentions towards the NHS. He declared: "This Government’s commitment to the National Health Service is clear and unequivocal. As I made clear in July, 1982, we are also committed to the present system of financing the NHS. That statement stands as Government policy today". His speech, however, did little to convince some of the 500 delegates at the conference, who could detect in his words Tory encouragement for privatisation. Mr Fowler emphasised that the goal of health care-to provide the best that was possible for the patient-required "a deeper and more constructive partnership towards all those involved in providing care. In that partnership the National Health Service has a central and dominant position". He warned that the NHS could not simply rely on its past high reputation to justify its present position. Flexibility and open- mindness were needed in order to adapt to changing circumstances. He was, of course, referring to fmances. "The NHS", he said, "costs the people of this country a great deal of money-about D80 per head for every man, woman, and child in the country ... spending on the NHS in Great Britain has gone up from £ 73/a billion in 1978-79 to an estimated .051/2 billion in 1983-84." Mr Fowler did not see any merit in simply spending more money on the health services, since it only financed wasteful spending. "What is absolutely essential", he observed, "is to ensure that the money we put in the health service is money spent well and wisely". His view was that the economic framework was inescapable: "And at a time of growing demand for care that framework will inevitably restrict our ambitions. A major responsibility of management is to choose priorities within available resources and to try new methods where these are indicated". Earlier NAHA delegates were warned of the likelihood of an outbreak of increasingly bitter industrial action in the NHS. Prof Roger Dyson, chairman of North Staffordshire Health Authority, emphasised the matter of pay determination: "If NHS pay settlements are allowed to develop along the lines of the Megaw report on Civil Service pay, NHS staff will find their pay levels drifting below the comparable services in local government and the Civil Service". A call for positive discrimination by the NHS in favour of the socially deprived came from Prof Jerry Morris (professor of community health, London School of Hygiene and Tropical Medicine). He referred to the Black report on the inequalities of health and pointed out that as far as their health was concerned, "the professional and the middle classes do well, the unskilled particularly badly, and the skilled manual workers are in the middle". He described these class differences as "the first area of concern for the Health Service-to seek equity as well as efficiency and effectiveness in the delivery of services".
Transcript of National Health Service
59
ObituaryALBERT WILLIAM LILEY
KCMG, MB NZ, PhD, FRCOG
Sir William Liley, who died on June 15 aged 54, wasprofessor in perinatal physiology at the New ZealandMedical Research Council School of Obstetrics and
Gynaecology in the University of Auckland.From a humble home he achieved an outstanding scholastic
record at Auckland Grammar School and Otago University. Hishumanism made him abandon neurophysiology under the Nobellaureate, Sir John Eccles, to become in 1957 the first obstetricresearch fellow at the University of Auckland. There he so refinedthe prenatal diagnosis of rhesus haemolytic disease that his
discovery in 1963 of the technique of intrauterine transfusionseemed surprisingly inevitable, simple, and effective. The worldreaction startled this modest man, but it was really a tribute to hisdemonstration that the fetus was as much a patient as anyone, andthat previously unasked or unanswerable questions could now beapproached more hopefully. His later work includedcommunication with the fetus via light and sound, the importanceof blood volume and absolute weight in the hypertensivesyndromes, and the accumulation of many family histories
demonstrating that propensity to rhesus iso-immunisation is
genetically determined. There is little doubt that most work
emanating from National Women’s Hospital, Auckland, over 25years owes something to his influence.Honours sat easily on him: those he valued most were the
compliment paid to the youngest medical school in the southernhemisphere when the ancient one of Vienna sent a staff member tostudy under him; his ad-eundem admission as FRCOG; andmembership (as a non-Catholic) of the Pontifical Academy ofSciences. Understandably he believed passionately in the rights ofthe unborn; one answer he made to criticism of his uncompromisingpro-life attitudes was to adopt a daughter with trisomy-21 whomight not have achieved birth otherwise. His breadth and depth ofknowledge, medical and non-medical, and his readiness and abilityto impart it and catalyse new efforts from the recipients, made himan ideal research professor.His wife, Dr Margaret Liley, is a staff physician at National
Women’s Hospital, Auckland. They had two sons and threedaughters. (j. H. Cj.
CHRISTOPHER AMYAS WRIGHTDSc Lond, FIBiol
Dr Wright was a leading world authority on the biologicalmechanisms responsible for schistosomiasis of man andanimals. He died on June 19 aged 54.He was born in Montevideo, and during the early part of his life in
South America he became deeply interested in the natural history ofthat region. He was educated in Canada and later at ShrewsburySchool. He graduated with first-class honours from ImperialCollege, London.In 1954 he joined the staff of the British Museum (Natural
History) and began working on mollusca and the parasitic wormswhich they harbour. This became his leading professionalpreoccupation. As time went on he realised that the only way tosolve many of the difficulties concerning molluscan behaviour wasto apply experimental techniques, and in 1964 he set up in theMuseum an experimental taxonomy unit which he directed
throughout the rest of his life. His inquiring and original mind ledhim towards a profound understanding of the relationship betweensnails and the trematodes they harbour, and reintroduced enzymeanalysis to study their populations. His field work took him on 16expeditions in 12 tropical countries. His published work includedabout 100 scientific papers and a unique book on flukes and snails.This work had a tremendous impact on those studying and workingagainst human schistosomiasis; and its universal influence waspromoted by his appointment to the World Health Organisation as amember of its expert panel on parasitic diseases, a post which heheld from 1964 onwards.
He was a leading member of many committees and societies,having been the secretary-general of the International Union ofBiological Sciences, the president of the British Society ofParasitology, and vice-president to the Institute of Biology, theZoological Society of London, and the Royal Society of TropicalMedicine and Hygiene.His cheerfulness and wit endeared him to all his medical and
scientific colleagues and to a host of other friends. His fortitude andsteadfastness were never more apparent than during the illnesswhich he so courageously faced during the last year of his life. He issurvived by his wife, Pam.The work in which he excelled has been of immense benefit to
mankind, and will be for long applied to the discovery of a solutionto one of the world’s most widespread communicable diseases.
A. J. D.
National Health Service
Mr Fowler’s Reassurances
Mr Norman Fowler, Secretary of State for the Social Services,made his first major pronouncement since the election at the annualgeneral meeting in Harrogate last week of the National Associationof Health Authorities. He sought to reassure health authorities’delegates of the Government’s good intentions towards the NHS.He declared: "This Government’s commitment to the NationalHealth Service is clear and unequivocal. As I made clear in July,1982, we are also committed to the present system of financing theNHS. That statement stands as Government policy today". Hisspeech, however, did little to convince some of the 500 delegates atthe conference, who could detect in his words Tory encouragementfor privatisation. Mr Fowler emphasised that the goal of healthcare-to provide the best that was possible for the patient-required"a deeper and more constructive partnership towards all thoseinvolved in providing care. In that partnership the National HealthService has a central and dominant position".He warned that the NHS could not simply rely on its past high
reputation to justify its present position. Flexibility and open-mindness were needed in order to adapt to changing circumstances.He was, of course, referring to fmances. "The NHS", he said,"costs the people of this country a great deal of money-about D80per head for every man, woman, and child in the country ...spending on the NHS in Great Britain has gone up from £ 73/a billion
in 1978-79 to an estimated .051/2 billion in 1983-84." Mr Fowlerdid not see any merit in simply spending more money on the healthservices, since it only financed wasteful spending. "What is
absolutely essential", he observed, "is to ensure that the money weput in the health service is money spent well and wisely". His viewwas that the economic framework was inescapable: "And at a time ofgrowing demand for care that framework will inevitably restrict ourambitions. A major responsibility of management is to choose
priorities within available resources and to try new methods wherethese are indicated".
Earlier NAHA delegates were warned of the likelihood of anoutbreak of increasingly bitter industrial action in the NHS. ProfRoger Dyson, chairman of North Staffordshire Health Authority,emphasised the matter of pay determination: "If NHS paysettlements are allowed to develop along the lines of the Megawreport on Civil Service pay, NHS staff will find their pay levelsdrifting below the comparable services in local government and theCivil Service".A call for positive discrimination by the NHS in favour of the
socially deprived came from Prof Jerry Morris (professor ofcommunity health, London School of Hygiene and TropicalMedicine). He referred to the Black report on the inequalities ofhealth and pointed out that as far as their health was concerned, "theprofessional and the middle classes do well, the unskilled
particularly badly, and the skilled manual workers are in themiddle". He described these class differences as "the first area ofconcern for the Health Service-to seek equity as well as efficiencyand effectiveness in the delivery of services".
