| Description | Prof GILLIAN NEEDHAM interview at the Sir Duncan Rice Library, University of Aberdeen on Tuesday November 29, 2022. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) GILLIAN NEEDHAM, born on 17th December 1957 in Rochdale, Lancashire. Retired in June 2015 as Post Graduate Dean for NHS Education for Scotland, covering the North Region (of the Scotland Deanery). Parents are Dorothy and David, who now live in Banchory. Father was an engineer, mum was at home, pays tribute to them. No medics in family background, but early influence on her was Tony Burkhardt, family doctor when she was a child. Education - grammar school girl when living in Rochdale, primary and secondary at Bury Grammar School, pays tribute to school, explains she left age 13 or 14 when family moved to Surrey. Went to State Grammar School there, Rosebery County School for Girls, continued great education. With her northern accent felt a bit like a fish out of water, but her English teacher liked it and she was cast in many plays. Explains she was an all-rounder at school, including facility in English, Science and History. Career in medicine decided for her, explains why. Went straight from school to study medicine at Manchester, explains why. (0:06:11) Did five-year course, but with an intercalated year, explains importance of this. One of early mentors was her supervisor Dr Graham P Rabey, senior lecturer in Anatomy. First contact with patients during and after her intercalated year. Vividly remembers first day on the wards, as a third year medical student, at Wythenshawe Hospital; recalls Mr Durn, patient who had bowel cancer, who helped her through how to take a patient history. Later did surgical pre-registration house officer job there, also her first senior house officer year in cardio-thoracic medicine. Recalls importance of her first tutorial group, explains. (0:10:38) Graduated summer 1981. Recalls crushing sense of responsibility when starting first job, really wanted to be a good doctor. Part of team in surgery at Wythenshawe Hospital, explains. Goes through a typical day back then, although says it was a long time ago. Commuted to and from home in north Manchester. Every third night, on call resident in the hospital. Had a home and a husband, so would commute back home when she could. (0:14:00) Fills in years between graduating and coming to work in Aberdeen in 1987. Second job was in Hope Hospital in north Manchester, did not enjoy it, explains why. Next was a year’s post rotating through cardiology and thoracic medicine back in Wythenshawe, fabulous year, explains why. During that time got pregnant with first child, realised she needed to find her next job; timing of start of Radiology suited her, that was why she became a Radiologist, a purely pragmatic decision; three years on Manchester rotation, fitted in with having an infant. Registrar in Radiology for three years. Thinks she applied to come to Aberdeen after becoming a Senior Registrar. Needed to relocate to Aberdeen because her partner worked in the oil industry. Much smaller department in Aberdeen than in Manchester. Came to a Senior Registrar post in Radiology in Aberdeen, joining two other senior colleagues, very small peer group. Pays tribute to her other senior radiology colleague Fiona Gilbert, whom she worked with closely for about ten years, explains; setting up breast-screening service, working closely with public health, mentions coming across Elizabeth Russell for the first time. (0:19:24) First impressions of Aberdeen, explains it was beautiful and exotic, felt like foreigner in a foreign land. Very different from Manchester; speaks of ease of access to beaches and mountains. (0:21:47) Gives first impressions of working for a much smaller department when she came to Aberdeen. Outwith her experience to be working in one of the biggest hospitals in Europe; wonderful campus, all the specialities and the medical school are on one site; in Manchester hospitals are scattered, population the size of Scotland condensed into Greater Manchester. Compares this with Aberdeen; as radiologist gave you ability to interact with many departments, specialties; met her ability to be curious, explains. Goes on to explain in detail how she came to move from being a radiologist into working in Post Graduate Medical Education. Thinks the start of her interest in education was tied to the centenary of the discovery of X-rays, seemed a good opportunity to reach out to the public. Got involved with the Royal College of Radiologists, explains in detail; elements of fighting your corner, and politics as well. Progressed from that to being a women doctors’ adviser; talks about proportion of women in medicine then and now, and difficulties of progressing career as a woman. That was her route into the Deanery, the Post Graduate Medical Education department. Learned the trade under the charismatic Post Graduate Dean, Bertie Wood, who supported and encouraged her. (0:28:59) Clarifies how the centenary of X-rays led to her becoming involved in post graduate medical education. Thinks she sometimes has a failing in offering to do things that she sees need done. Appointed Post Graduate Dean in 1999, then six month overlap with predecessor Bertie Wood, took up post in June 2000. Still did radiology part of the time, explains. About six years before she gave up radiology completely. (0:32:30) Explains in detail why there is a need for a department of Post Graduate Medical Education, and how things developed and changed over the years; went from doctor-led acquisition of skills, to programme-determined approach to growing you as a specialist. Role of Royal colleges and GMC at UK level; explains that for her Aberdeen colleagues meant it was losing the power and control of their workforce. (0:37:00) Explains how things were in Aberdeen when she took over as Dean; this applied to hospitals in Aberdeen and North of Scotland, pre-registration house officer posts, no longer exist. Aberdeen used to direct careers, now done on UK-wide basis. Speaks about the challenges she faced on becoming Dean in 2000; determination to modernise, for the sake of the doctors, no education by humiliation; same curriculum and standards wherever you were in the UK; four Deaneries in Scotland, strove to achieve this. (0:42:04) Talks about politicisation. She was invited on to the National Framework Advisory Group, commissioned around 2002 by the Scottish Government to look at the Scottish Health Service; controversial report emerged in 2005, explains it sat uncomfortably in the North-east that specialist services should probably be centralised. Training that had always been done in Aberdeen might need to move to Central Belt; unravelling of most doctors being able to do most of their training in one place, explains. Opened up marketplace for medical education across university catchments, graduates really did want to get away and experience medicine in other places. Complications for units that had been used to bringing on their own people, but also great benefits, explains. Now a single Scottish Deanery, explains; hopes people of Scotland still get great doctors, but might not be local to them. (0:46:27) Talks in detail about advent of the Scottish Parliament in 1999 and how it subsequently affected health matters, which were not initially a devolved issue; Scottish health service very distinct from English NHS. Push for centralisation. Within three years of Scottish Parliament, NHS Education for Scotland was created, spent a lot of her time in Edinburgh fighting the corner for Aberdeen and North of Scotland. But also speaks of opportunity it gave for meeting together with health professionals from other disciplines; feels Scotland has achieved more than England in NHS education. (0:51:03) Speaks more about how things changed for the department in Aberdeen between her becoming Dean in 2000 and leaving the post in 2015. But feels uncomfortable answering questions about the department, would rather it was about doing better medicine now; difference between traditional and great. (0:54:07) Is referred to part of the written history of the Dept of Post Graduate Medical Education, regarding increasing central control and loss of local control, against view that one size fits all was not always best for the diverse local communities served from Aberdeen. She takes Shetland as an example; have to offer people wherever they live a good quality of healthcare. But can’t look the same as the healthcare offered to people living in Aberdeen, explains difference between when she started in medicine and now. Then compares expectations of people in Aberdeen for specialist service; here or elsewhere? Talks of training opportunities now for doctors, will have spent time working elsewhere. Speaks of her own experience of moving to small rural community of Tarland about six years ago; community more important. Can continue to contribute at a national level from her office in Tarland, as an associate on the quality assurance programme of the General Medical Council. Still works for National Services Scotland, explains how. Excited to see future of post graduate medical education; very different to when she started in 2000. (1:01:33) Explains importance of department in keeping Aberdeen medical graduates working in the area. Absolutely crucial we continue to have a medical school here; explains why. Remembers a year when not a single pupil from a Highland school did medicine in Aberdeen, led to questioning what they were doing. Lot of effort put into outreach and engagement with teachers. Refers to climate change. Thinks need to travel to learn is something that can be addressed through technology. Clarifies her role as Dean in relation to the Medical School. (1:05:42) Talks about tension between her academic and NHS roles. NHS really important to her, lobbied hard when appointed by university for post to remain as an NHS post, which it is now. Found university to be challenging of her principles and beliefs, explains in detail; buildings named after important men, money changing hands. Sensed in university leadership at the time that they did not share her values, but the NHS leaders at the time did; she wanted to support them. Refers to case of Dr Harold Shipman, who was convicted of killing patients; changed everything utterly for the profession; explains how things were before that, and also after the Bristol Inquiry and the babies who died. Maintaining skills through continued professional development; says she found annual appraisal discussions easier in an NHS than university context. Reflects on her career at the university. (ENDS 1:13:00)
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