Professional strategies of medical officers of health in the post-war period--1: 'innovative traditionalism': the case of Dr Ian MacQueen, MOH for Aberdeen 1952-1974, a 'bull-dog' with the 'hide of a rhinoceros'.

Abstract

Recent policies concerning the enhancement of preventive medicine and health improvement have raised important questions about leadership in public health and have emphasized the roles that can be played by local authorities. In this light, it is worth exploring the activities undertaken by local authority Medical Officers of Health (MOsH), until their posts were abolished in 1974. The process leading to 1974 has often been blamed, at least partly, on the complacency, lack of imagination and demoralization of MOsH. However, when John Welshman asked the question 'watchdog or lapdog?' of the MOH, in a paper published in 1997, he concluded there was little justification for the latter label. This paper considers the career of Ian MacQueen, Aberdeen's last MOH, who is well known for the criticisms of his handling of the Aberdeen typhoid outbreak in 1964, which appeared in the report of an official enquiry. He was deemed to have made excessive use of the media and to have turned the outbreak into an event approaching a national crisis. However, in the context of MacQueen's 32 year career in Aberdeen, his use of the media during the typhoid outbreak was no aberration. Rather, it was characteristic of his determination to maintain an important role for the MOH within the NHS-era health services. There is therefore continuity between MacQueen's strategy and the ambitions of many MOsH before the NHS, who hoped for a unified health service with themselves occupying a leading role. MacQueen's actions during the typhoid outbreak also reflected his innovative activities in the field of health education, and his interest in the media for that purpose. In conclusion, MacQueen provides an example of an MOH who cannot be charged with complacency and resignation to a declining role: rather, his strategy of 'innovative traditionalism' sought to protect and extend his department's services.