| Description | Prof STEVE TURNER interview on Thursday December 1, 2022. Interviewer Eric Crockart. Summary by Eric Crockart.
(0:00:00) STEPHEN WILLIAM TURNER, born 19th February 1969 in Blackburn, Lancashire. Currently employed as a Consultant Paediatrician by NHS Grampian, and also holds Honorary Professor status with the University of Aberdeen. Father a retired GP, mother a retired Paediatric Physiotherapist; has three siblings, two of them doctors. Education; primary school in Huncoat, a deprived area of Accrington, Lancashire. Passed his 11-Plus exam and went to boarding school in Lancaster, then to Newcastle University to study Medicine from 1987-1992. Passions growing up; Sport, stamp collector. Describes how he came to choose medicine as a career, no light-bulb moment; relatives an influence, explains. Grand life as a medical student in Newcastle, describes. Played rugby, met his future wife in First Year. (0:5:54) Describes first contact with patients; Third year, Freeman Hospital in Newcastle. Liver Ward, describes having to deal with a deaf, broad-spoken Glaswegian patient. Recalls two inspiring lecturers. Graduated July 1992, describes how he decided what to do next, did not want to be a GP like his dad. Came down to Geriatrics or Paediatrics, explains; decided eventually on Paediatrics. As final year student went to South Shields, great time, explains in detail. Memorable thing was child coming in with liver failure; explains. Part of a number of things that made him choose Paediatrics. First paediatric job in Shotley Bridge, County Durham, describes it. (0:11:14) Describes working as a House Officer in the 12 months after graduation; six months of General Medicine and Geriatrics, then six months of General Surgery and Orthopaedics. Describes how he came to start work as a Paediatrician. Then how he started work as a Registrar in Dec 1995 in Hawkes Bay, New Zealand, describes experience. Talks about the patients he encountered in New Zealand; compares them with patients in UK, talks of learning about Māori patients and rheumatic fever. Also Maori have a lot of TB, talks about an outbreak he was involved with in a rugby team. (0:15:31) Describes why he came back from New Zealand. Offered a job in Middlesborough. An interesting place to be given the management and subsequent inquiry into cases of child abuse in Cleveland during the early 1990s. Paediatrician Geoff Wyatt still in post, a good man. Explains about the place and what it involved for him as a paediatrician. Stayed in Middlesborough, glad he did, for two years. But wanted to go back to the Antipodes; offered a job in Perth, West Australia. Thought he needed a speciality, explains; came back with an MD (Doctor of Medicine degree) as a tertiary specialist respiratory paediatrician. Was in Australia for two and a half years. But the UK was home, explains how this influenced decision to return; also refers to Aussie Rules Football. (0:20:59) Came back to UK in November 2001; getting towards end of his training. Went back to Newcastle to do a year of respiratory paediatrics, Royal Victoria Infirmary. Job came up in Newcastle, but he did not get it, towards end of 2002. Heard there was a job coming up at University of Aberdeen, explains he needed that job. After a wait, explains, was offered the Aberdeen job. Describes relative ease of the move from Newcastle to Aberdeen, having been around the world twice in previous five years. (0:24:42) Position was Senior Clinical Lecturer in Child Health, and an Honorary Consultant, one hundred per cent university-funded post. Describes what Department of Paediatrics was like when he arrived in April 2003; old Children’s Hospital was still open, describes it and the set up with staff. Talks about dealing with very young children as a clinician. Talks about the reputation then of the department, refers to 1960s and Prof George Russell, UK reputation; mentions Prof Peter Helms, Mike Bisset, George Youngson and Chris Driver, number of key people who had high profile. Department larger than Hawkes Bay, but smaller than Newcastle, explains. But thinks Aberdeen punched above its weight in terms of what it could do. (0:28:54) Then explains in detail the need for Paediatrics as a discipline; neonates; safeguarding; preventative work; conditions that exist only in children, gives examples; conditions that do exist in adults, but require different approach in paediatrics, example of cystic fibrosis. Defines meaning of "Child" in medical terms; when he started as a doctor, age 14 was the cut off point for child health services in Aberdeen. About 7 or 8 years ago cut off increased to age 16. Explains about sort of patients paediatricians deal with, including some adults who are the size of a child. (0:33:15) Talks of how his career in Aberdeen developed. When he started, job was 50% research and 50% clinical; now also 50% of the other stuff, that’s life! Explains how he copes with increased workload. Explains his responsibilities to the NHS when he came into the post. Says serving both NHS and Aberdeen University worked really well; lot of his research and teaching is patient-orientated, explains. When the new Children’s Hospital opened in 2004 he was just one floor above the children’s medical ward, very convenient for seeing a child patient. Talks about the challenges he and the Department faced when he started. Clinically he already had lots of experience; his research career was "very foetal" at the time, explains. Recounts meeting Steve Logan the then Dean of Medicine, who said he might be able to do some teaching; only four or five research papers on his CV. Clinically, wholly competent; academically, wholly incompetent. Talks about how he addressed that. Speaks about how he bonded very well with Graeme Devereux, a Chest Physician, who was involved with the Seaton Birth Cohort; explains this coincided with his existing interest in asthma. Started putting grants together and writing papers together, gave momentum to his previously static research career. Refers to his experience in Australia testing for Nitric Oxide, explains relevance to his Aberdeen research into asthma. Also talks about Peter Helms and the European Respiratory Society, and his influence. (0:39:47) Explains that the Seaton Birth Cohort is named after Professor of Public Health, Anthony Seaton; children born at Aberdeen Maternity Hospital between 1997-99. Still being followed up, explains. Vitamin E and D, mums who had higher dietary intake less likely to have babies with asthma; also babies who were detected as small by early foetal ultrasound scans more likely to have asthma. Explains "Consultant of the Week" on his CV, acronym COW; to address problem of discontinuity between consultants, explains problem and COW system in detail. (0:44:02) Explains his involvement with referrals from "the Buchan Cluster", involves Peterhead and Ellon; gives example, talks about Cluster Clinics; enables things to be done more realistically, working collaboratively with GPs, enabling him to see patients in Peterhead rather than them having to come to Aberdeen. Talks about his work in Respiratory Paediatrics, three general respiratory clinics a month, and how this fits in with his other work. But says as he gets less young becomes more of a general paediatrician and less of a respiratory paediatrician. Explains his involvement with NHS England, as the Registrar for the Royal College of Paediatrics and Child Health, a UK body. Involves him in regular meetings with people from England. (0:48:31) Explains his involvement as Clinical Lead for the North of Scotland regional networks. Northern region has widely spread population, networks designed to address this, explains how it works. Talks about his shared vision for a "Virtual Hospital", what this concept could provide for patients in a community-based approach, and the challenges, including IT (Information Technology) and workforce. Thinks a virtual hospital would take five or ten years to create, explains why and potential significance for current problems of the NHS. Talks about recently becoming President of the Scottish Paediatric Society. (0:54:25) Talks about his involvement with the European Respiratory Society, and whether his profession has been affected in any way by Brexit (Britain’s decision to withdraw from membership of the European Union). Talks about significance of having his lectures to Aberdeen medical students recorded. But thinks face to face lectures are also important; challenges, and benefits. Important for students to mix. Talks in detail about how the COVID-19 pandemic affected paediatrics very differently to adult medical specialties. Because for reasons not yet fully understood, COVID bounced off children. But thinks confinement placed on young people has wreaked havoc, explains; rise in suicides, eating disorders, mental health issues. Thinks we have not yet got to the worst of it. (1:00:22) Talks in detail about decisions taken during the pandemic, when he was Scottish Officer for the Royal College of Paediatrics and Child Health; very much involved with Scottish local COVID preparations, including decision about whether or not children should be vaccinated. Talks in detail about issue of Transformation of the present NHS model; present model is very hospital-based; thinks community-based, patient-centred would be better and more efficient. Talks about limited out of hours GP availability. Parents will not wait three hours for advice, will just go straight to the emergency department, which is no bigger or better staffed than it was before the pandemic. (1:05:51) Out of hours emergency care is really struggling. Talks again about the virtual hospital concept and how this would strengthen interactions between the public and the NHS. Talks about his ambitions for his career in the future. Age presently 53, has to start claiming his pension by age 60 unless he wants to face a large tax bill. Says he is looking forward to, the week after this interview, taking over the Chair of the Scottish Academy of Medical Colleges and Faculties; this will allow him to explain to those in government the benefits of patient-centred, community-based care. As we emerge from the pandemic, thinks things are going to be very tough; explains why, next three years going to be really tricky. Talks about drugs being tested in randomised control studies, to find out if Drug A is better than Drug B? But with patients who are acutely unwell, no evidence for should they be admitted to hospital, or could they be seen first thing tomorrow? Or none of those? So before he retires would like to do a randomised control trial looking at different pathways of care for children who are acutely unwell. Talks of how he has 18 months to serve as College Registrar, and how that gives him a UK profile. but could be extended till 2026. Talks about how his dad was enthusiastic about being a GP till he hit his 50th birthday, and then became disillusioned because he had been doing the same thing for 25 years and the same problems were happening. So he would like his next five or six years to be right in the thick of things as the NHS is going through a really sticky patch, advocating patient-centred, community-based care. Not just saying this is what it should be, but proving it. (1:12:32) Became a Professor in 2017, explains in 2020 he ceased being employed by the university and started being employed by the NHS. Explains why after having moved around a lot early in his career he decided to stay in Aberdeen; a warm social environment, a rich, cosmopolitan population. Extols Aberdeen’s virtues. Thinks Aberdeen has made a contribution to the discipline of Paediatrics, explains in detail. Care of children being born prematurely took off in the 1960s, Aberdeen second centre in Scotland to set up a neonatal unit; did it better than anybody had done it before, mentions Dugald Baird. In the early 1970s George Russell came along and did lots of research on how the lungs of little babies work. George and his colleague Ann Devenny did research on the growing epidemic of asthma. Inflammatory bowel disease, effect on children, Calprotectin test developed here in Aberdeen. These are three areas where Aberdeen has made a difference. (ENDS 1:17:04)
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