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Work after retirement: restoring ancient woodland


The valuable work of The Meningitis Research Foundatiom
Harold Lambert Physician
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I'm still doing some data safety and monitoring committees for the Medical Research Council, AIDS trials. The deal there, as you know, is as clinical trials got more and more complex, partly for scientific and particularly for ethical reasons, it became the norm to have a committee which was overarching, didn't plan or conduct the trial and where the people involved, who obviously included a layman, had no financial or academic glory or interest in the trial. I mean, not... you were interested, but not anything, there wasn't any bonus for them about it. Who actually - it was quite a taxing thing. The code of the trial is broken at set intervals, which are predetermined by the nature of the trial, and the people doing the trial don't know the code is broken. Oh, they know the code is broken, but they don't know what, what it says. They know the total result, but they don't know the difference between the placebos and the test group or between the two test groups and the data safety committee ponders these results with the help of the statisticians, and there's always a statistician as part of the committee. And you have... basically, in principle it's very easy: if the trial is doing so much good it would be unethical to prolong it, you say to them, 'Would you stop?' They don't actually, you don't actually have the final word. They could argue with you or take... say, 'We don't take any notice of you', but it would be quite difficult to do that. Or you may say, 'You're poisoning the patients more than helping them'. I mean, in principle, that's what it is. In actual practise, it was remarkably difficult things; equations to, to ponder between the numbers, the likelihood that something else would emerge with another six months of the trial and we've had, particularly in AIDS trials I don't think it's appropriate to go into them in detail but with AIDS trials many, many... there's scientific, but there are also kind of operational problems. Is it possible for the people to do on doing it and all sorts of operational and ethical things, but the basic thing is the ethical one. Are you doing too much good to go on or too much harm to go on? In principle that's what it's all about actually.

And the other big medical thing I've gone on doing is, you know, as you know, I've been interested in meningitis for a long time and I'm involved, I'm a trustee actually of a trust, of a thing called The Meningitis Research Foundation, which I think is a very good charity. Always watch for low overheads, spending most of the money on the action and not on the office and all those criteria and don't have a separate fundraiser and all those criteria which you... kind of judge whether you're doing something serious. And they do a very good research programme and also a lot of both public and professional education bits of decision pathways or pamphlets for junior doctors, paediatricians, ambulance men, general practitioners, nurses, all things directed at early diagnosis of meningitis septicaemia. And I really do feel we, we... they, they disperse hundreds and thousands of these things and I really do feel... We've had specific examples where somebody has rung up the charity and said, 'Oh the baby's ill and grizzly and I didn't think it was anything very much, but I saw these spots and did your test and I took him hospital, you know, and they detected... you've got septicaemia', and I think it has done a lot of good and also there's a 24-hour helpline. They can ring up night and day, 365 days a year to get help and I really do feel, you know, really proud of that charity. I think it's done well and very good administrative people who keep their eye on the ball.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: The Meningitis Research Foundation, Medical Research Council

Duration: 4 minutes, 11 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008