| Description | Prof Sir GRAEME CATTO interview on Tuesday December 13, 2022. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) GRAEME ROBERTSON DAWSON CATTO, born on 24th April 1945 in Aberdeen. Explains he has had serial retirements; retired from King’s College, London as Vice Principal and Dean, and from the University of London, where he was Pro Vice-Chancellor, in 2005; retired from the General Medical Council in 2009; and thinks he retired from the University of Aberdeen at the same time. Family background - father a doctor and 1939 graduate of Aberdeen, explains; married his mother Dora Elizabeth Spiby during a week’s leave from the Army in 1940, then went to India and Persia for nearly four years. Contracted polio, invalided out of Army in 1944, came back to Edinburgh Castle. Father came back to Aberdeen after being demobbed in about 1946, joined partnership in Woodside with Dr Harry Mackay who died within a couple of years, father became senior partner. Lived in practice house in Clifton Road for about 20 years. Graeme educated at Robert Gordon’s College between age 5 and 18, explains what it was like; tempted by career in History, talks of interests at school, including Scouting, which after he left school involved him taking leadership of a troop at St Andrew’s Cathedral, explains. Became Scoutmaster at Pittodrie, explains; gave up in about Second Year at university. (0:04:16) Explains why he chose Medicine as a career; influenced by his father, explains in detail. Talks about life as a medical undergraduate, amazing fun, explains; met his future wife Joan, who studied Law. Explains his first contact with patients was as result of his father being a GP, and the practice being in the family house. At end of his First Year studying Medicine got a job as a nursing assistant in the medical wards at Aberdeen Royal Infirmary, talks about what he learned about then dealing with patients. Talks about importance of getting on well with all the hospital staff, and speaks about his work at that time. Speaks about his medical course, no particular problems dealing with patients while being supervised; but recalls shock of being singled out by name by the Professor of Pathology. Recalls his first locum in a surgical ward, and giving too much history about the first patient. Recalls how consultant reassured patients, even though he knew nothing about them. (0:11:25) Inspiring lecturers included Prof Fullerton, describes. Talks of career immediately after graduation in 1969. Decided he wanted to do Medicine rather than Surgery. Applied to become a Senior House Officer with Dr Gauld at Woodend, supposed to start after finishing his House Officer posts in August 1970. But in May that year met Dr Calum Macleod who offered him research post in Dept of Medicine so he could do an MD, accepted. Explains in detail how he came to specialise in Renal Medicine; talks of his first day in Dept of Medicine, including meeting redoubtable Departmental Secretary Miss Mann. (0:16:29) Describes what the Renal Unit was like when he first started there as a Research Fellow, employed by the university, but with an honorary Senior House Officer contract with Aberdeen Royal Infirmary. Renal Unit based in two parts;Ward One shared with other professorial members of staff, and a small renal unit in the new build in Phase One of the infirmary, had about 12 patients. Graeme saw these renal dialysis patients got crippling bone disease over period of time, saw research possibility; Prof Fullerton retired and Prof Stuart Douglas came up from Glasgow, determined that young people like Graeme should not do too much research at expense of their clinical work, encouraged him to get his clinical degrees, explains. Talks in detail about very different methods back then for treating kidney patients, and problems these caused. Talks of staffing and reputation of Renal Unit in those days; small unit, Edinburgh main unit at that time; Dr Calum Macleod in charge, Dr Neil Edwards, a Registrar and Graeme was the staffing, only two or three new patients a year. (0:21:11) Explains in detail about working in the United States between 1975 and 1977; became interested in renal bone disease, wanted to measure calcium content of bone. Went to Prof Mallard, then running the Medical Physics Dept, who told him how to do it, explains; by 1974 had published a fair number of papers, had MD degree under way (did not qualify till 1975), realised could not stay in Aberdeen and needed to move on. Went to Royal Free Hospital in London. But went to see Prof Douglas to let him know what he was doing; Prof Douglas encouraged him to apply for a grant for a Harkness Fellowship to spend two years in the United States. Deadline for applications very soon, explains what happened, and how he got the fellowship after finding a base in the States that would accept him, with Prof John Merrill at Harvard. Describes in detail how the grant paid for him and his wife and two young children to go to the States, and what he learned from the experience, including a four-month trip round the States with a tent in the summer of 1976. Reveals it was not first time he had been in the States; as medical student in his Fifth Year was awarded a Carnegie Scholarship to study in North Western University, Chicago; huge eye opener, explains. Talks of time in Boston at Harvard, went to do bone disease but was persuaded by young doctor from Australia to switch to transplant immunology instead, explains. (0:27:39) Talks of how studying in America changed him completely, and advantage of having been to Harvard in future grant applications. Prof Stuart Douglas keen for him to come back to Aberdeen in 1977, to become a consultant and senior lecturer, which he did, but had to re-establish himself professionally. Mentions Prof Keith Peters of Hammersmith who made him part of research groups; again refers to his experience gained in America, and how it demonstrated that being in Aberdeen wasn’t enough, although he found being Scottish and from a small place was actually a huge advantage in being well known. Talks of what he learned from Prof John Merrill in the States, surrounding himself with a team of young and enthusiastic colleagues. (0:32:04) Talks of influence of his American experience and how Prof Stuart Douglas in a sense put him in charge of the curriculum of the Medical School in Aberdeen; need to rescue power from the vested interests, explains; get everyone working together on Medical education as an entity, an end in itself, not just series of different specialties. At that time Prof George McNicol became Vice-Chancellor and Principal of Aberdeen University, arrived at difficult time of cutbacks; he too had had a Harkness Fellowship, so decided Graeme could not be all bad. Recalls going to visit Prof McNicol in the Chanonry, world opening up for him as a young man. Assesses his success in pushing through changes at that time; not just him, there was an appetite for it to happen. Talks about changes in mid-1980s to structure of the NHS, general management brought in. The general manager Hance Fullerton asked Graeme if he would like to become the first medical director at Foresterhill. Explains how a short time later he became the Clinical Co-ordinator, effectively the medical director. Mentions controversy over the move for the hospital to become a Trust Hospital; university supported that, though he says the Dean of Medicine Prof Hugh Pennington and the Vice-Principal Prof Derek Ogston did not seem to be aware of that. Recounts what happened with Prof McNicol; also Prof Hugh Pennington, the current Dean, and Graeme’s boss, Professor of Medicine Richard Himsworth; ended with Graeme becoming Dean of Medicine in 1992. (0:39:13) Speaks about his first day as Dean on April 1st 1992, meeting Campbell Murray the Executive Dean, who was entering things on a list with pencil and rubber, and deciding the need for this to be computerised. Never used the Dean’s office, talks of need for it to be changed, and Medical School needing to link much more effectively to the university than previously. Lot to do, but loved it; still undertaking his clinical work, nor did he stop it when he became Medical Director, explains why. Talks of his duties and responsibilities as Dean; need for good research and good teaching, to attract high quality people to come to Aberdeen. (0:43:08) Talks about taking on additional role of Vice-Principal of Aberdeen University, while still Dean. Brought him into university administration, more than previously, explains this involved senior management group meetings on Monday mornings at King’s College. Prof John Sewell was there, Prof Iain Torrance, we were complete opposites, it was enormous fun; pays tribute to then Principal Maxwell Irvine. Achievement as Vice-Principal, moving entire Medical School out of Marischal College, explains why. Explains how he kept up clinical work, very lucky to get a Senior Lecturer and Consultant when he became Medical Director. Others added later. Dr Neil Edward NHS consultant on Renal Unit, shared a ward; Dr Alison Macleod came in as a senior lecturer, Dr David Power came in after her; increasing number of us on the academic side, all funded from different sources, partly through some of Graeme’s activities. Took on more and more tasks; Prof Kenneth Calman, former Chief Medical Officer in Scotland, moved to England about 1993 or 1994; Scottish Office offered the post to Graeme, but he turned it down; months later offered chance to become Chief Scientist for Scotland, applied but post given to Prof Bouchier from Edinburgh. Explains how he became representative for Aberdeen on the General Medical Council, then how Scottish Office asked him again to apply for post of Chief Scientist, which he became in October 1997. (0:49:01) Also confirms that in 1996 he was on the Scottish Higher Education Funding Council, while in 1995 he became Chairman of the Board of Governors of Robert Gordon’s College, his old school. Explains how the latter came about, and how he appointed a new headmaster. Talks about the things he was involved with in his role as Chief Scientist up till 2000; wanted Scottish medical schools to collaborate together, explains what he did about this, and collaboration among the specialties; team work also involving nurses, and patients. Explains importance of Scottish Patient Data Base for high quality clinical trials in Scotland, not possible in many other countries including England. Explains why he moved to London in 2000; kind of ran out of space. Duncan Rice was then the Principal of the university, Graeme did not want to pick up the details for Prof Rice, looked around to see what else he might be able to do. By then was Chair of the General Medical Council Education Committee, explains what this involved, mentions Prof Weatherall of Oxford Medical School. Sir Cyril Chandler, Dean at King’s College, London mentioned he was going to retire, encouraged Graeme to apply, and he was duly appointed as Dean of Guy’s, King’s College & St Thomas’ Hospitals’ Medical & Dental School. (0:56:34) Explains challenges he faced, particularly with running dental school, and dealing with in-fighting in hospitals that had just been brought together. Explains in detail about his early success involving the Institute of Psychiatry and his opposition to their initial plan to build a new research lab. Confirms his roles also included being Vice-Principal of King’s College, London, Professor of Medicine for the University of London, and from 2003 Pro Vice-Chancellor, Medicine, for the University of London. Explains he came back to Aberdeen after five years because he got ill, had radical prostectomy. Decided to cut back duties; by that time was President of the General Medical Council, decided to stick with that. Explains that University of Aberdeen had granted him a leave of absence, so was still on their books while he was in London. Tried to raise some money and do some work to get the teaching centre at Foresterhill going, so the Suttie Centre was part of his brief when he came up to Aberdeen, also continued to teach medical students. (1:02:31) Talks in detail about his time as President of the GMC, enormous fun; also in detail about the set up of the GMC, and how it operated; crying out for reform. Elected in 2001 as President, effectively with a remit to change the GMC, explains what happened by 2009. Got on well with the Ministers of State he dealt with; Alan Millburn was the first; person who helped him most was Patricia Hewitt; ended up with Andy Burnham when he was Secretary of State for Health; all Labour politicians, while he was President of GMC from 2002 to 2009. (1:08:27) Explains he was knighted before he became President, for services to Medicine and Medical Education. Talks about when he came back to Aberdeen in 2005; still President of the GMC, so spent most of the week in London. Research into bone disease had changed completely, explains. Talks about kidney transplants in 1970s, how patients died, and need to do something about it; graft survival, his group and another little group in Oxford at forefront of that. Drug ciclosporin completely resolved transplant survival, explains. So his research work moved over to what facilities patients with renal failure require. By time he came back to Aberdeen his colleague Prof Alison Macleod, daughter in law of his first mentor Prof Calum Macleod, had largely taken over that research. (1:12:54) Talks about which of the areas he served in he is most proud of. Management work gave him most difficulty, explains. Talks about which role he found most satisfying, expresses some regret at not doing more as a doctor. Thinks his greatest success may be the General Medical Council, explains; but also grateful for the chance that Aberdeen University gave him. (1:17:16) Explains where Renal Medicine in Aberdeen now stands; a jobbing renal unit, explains this applies to many renal units; adds he fears the hospital is like that too, just all right. Fewer high profile individuals around now than in his earlier years; explains why this might be. Reference to this interview being recorded two days before members of the Royal College of Nursing about to strike for first time in their history. Gives his assessment of the National Health Service now; frightening, terrifying and disappointing, explains in detail. Refers to Don Cruickshank, another Aberdeen graduate, who became Chief Executive of the NHS in Scotland, used to say we were employed to run the best health service the government give us money for; thinks that’s right, explains. Does not think nurses are right to strike, but qualifies this, with reference to his own life and career. (ENDS 1:23:44)
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