The following obituary has been contributed by Dr James Douglas, a GP in Fort William. Dr Douglas also spoke at Dr Macleod’s recent funeral, and the eulogy which he wrote for this will be published on RuralGP in the next few days.
Dr John AJ MacLeod MBE, DL, MB ChB, DCH, DRCOG, FRCP ( Glas), FRCGP, FFCS
Dr John Macleod and his father before him served the Hebridean island community of North Uist for 77 years. His death marks the ending of an iconic style of UK rural general practice. He had an international reputation as the world’s expert on island health care. Sir John Dewar MP chaired The Highlands and Island Medical Service report that was the world’s first government enquiry into rural health care delivery published in 1912. His recommendations to constitute an essential general practice service to address rural deprivation were not implemented until 1932 when John’s parents arrived on North Uist with some certainty of income despite the island poverty. The Highland and Islands Medical Service then became the worked example considered by the post war government for the establishment of NHS general practice in 1948.
John was born 3 years after his parents moved to North Uist, went to on Lochmaddy primary School, before secondary school in Stornoway and Keil School Glasgow. He studied medicine at the University of Glasgow and enjoyed the newfound freedoms, social life and rugby in the city. He was the BMSA representative and took his time to graduate in 1963 with national service in Royal Navy Minesweepers acting as a valuable intercalated life experience. House jobs in Glasgow were followed by teaching hospitals in London where he gained a perspective in tertiary care in preparation for his very general primary care career intentions as an island doctor.
The doctor’s wee boy returned to his island with his wife Lorna after 10 years of hospital experience as “Dr John”. His father had gone by the nickname “ Zadok” MacLeod on the island, as he was big and strong. There were stories of heroic feats to visit patients on horseback and by rowing boat. Dr Julia his mother was also a strong character who was involved in their community. They had been instrumental in setting up the early days of the Air Ambulance service in Scotland with Midland and Scottish Air Ferries in 1933. There was no airstrip or facilities so Dr Julia was famous for the “ The MacLeod Basket” she would bring to air crew to sustain them on their long cold flights. Dr John was proud of this family history and continued the hamper tradition in his early years until an airstrip and terminal building were established.
“ Dr John ” joined his father as a GP partner in 1973 until his father retired the following year. In his early years in practice he was single handed and ran the local cottage hospital and dispensing in his practice. He also covered the island of Berneray. He had a traditional style of general practice backed up by detailed knowledge of the generations.
He had high clinical and personal standards, which quickly earned him his own respect by the community in his own right. He enjoyed visiting the elderly at home and always shook them by the hand to consider hypothermia as part of his initial assessment. He would set the peat fire in the grate if needed before leaving the house. He built up excellent team relationships for patient care with all the right people from nurses in his community to tertiary consultants in Glasgow. He was well known for phoning up and demanding action on behalf of his islanders in city hospitals.
He served on many local national and international medical committees including LMC as secretary and as BMA representative.
His father had been in service at the foundation of the NHS and was a founding member of the Royal College of General Practitioners. John became an active member of the RCGP himself with a strong belief in the importance of clinical research and education. He served on the Faculty board and presented papers at several national meetings. He actively encouraged research teams to investigate the effects of nuclear discharges from Sellafield and Chernobyl on North Uist and published with them. He did clinical research on hypertension comparing rural and urban prevalence. Johns multiple duties included being Police Surgeon. He was called to the bodies of drowned young fisherman from his community and observed a pattern that their flies were open. He felt angry that they had “been dying for a pee” over the stern of the boat and started a 23-year campaign to introduce personal flotation devices to the fishing industry. He wrote letters to government, newspapers and politicians and spoke personally to visiting fishermen. He had to endure personal criticism for his dogged perseverance but was rewarded with a lifetime achievement award from “Fishing News” in 2007 for this work, which he felt just as important as his international medical honours. Sadly the work hazards of the office computer have attracted more legislation than fishing, which remains the most dangerous job in the UK.
John had 15 trainee GPs and eventually a GP partner. Groups of trainee GPs were invited to courses he had organised on island life with nurses, coastguards, policeman and the minister of religion. He inspired generations of students and school pupils into medical careers with practice attachments in Lochmaddy. He defended the importance of remote training practices at Post Graduate committees.
In 1989 he became seriously ill with a rare tick borne sheep encephalitis called “Louping Ill” and had to be airlifted by the air ambulance service his parents had started. On recovery he gave papers on the condition to raise awareness in colleagues.
The memorable acronym WONCA always raises a smile and a question as the World Organization of National Colleges and Academic Associations of General Practitioners. In 1992 John attended their world GP conference and felt there was little relevance to his remote practice so he became a founder member of the WONCA Rural Group, which has gone on to, organize regular rural conferences, policy initiatives and a journal. John never just attended meetings but always presented papers and posters and made other nationalities welcome. He published widely on medicine, island life and natural history. He became a famous international ambassador for Scottish general practice with his Hebridean generosity and kilt. He took his island to the world and then invited the world to his island. GPs, Professors and Deans of Medical Schools from around the globe were welcomed with the flag of their country flying in the garden of his house above the bay before being taken to see patients and then fishing. He was given visiting professorships and fellowships in recognition of his substantial international work for rural health and an MBE for work in the community. He was a Justice of the Peace and Deputy Lord Lieutenant. He was proud of his island traditions and organised Highland games, clubs and an initiative to establish the Comman Na Mara marine science centre in Lochmaddy. He caught fish, which were then inflated with a pump as food for sea eagle chicks.
When his father arrived on the island in 1932 a local crofter brought a gift of a trailer load of peats for the fire in welcome. In 2002 the crofter’s granddaughter returned to the island and John turned up with a trailer full of peats on the first night in her new home to welcome them back.
He retired from practice in 2000 but remained active in Rural WONCA and gave the key note address on island health at their Crete meeting in June 2009.He died following cardiac surgery two months later aged 74.He is survived by his wife, Lorna who was also his practice nurse , three children and twin grandchildren.
Dr James DM Douglas