Donald Irvine (physician)

Sir Donald Hamilton Irvine (2 June 1935 – 19 November 2018) was a British general practitioner (GP) who was president of the General Medical Council (GMC) between 1995 and 2002, during a time when there were a number of high-profile medical failure cases in the UK, including the Alder Hey organs scandal, the Bristol heart scandal and The Shipman Inquiry.

He transformed the culture of the GMC by setting out what patients could expect of doctors and is credited with leading significant changes in the regulation of professional medicine and introducing the policy of professional revalidation in the UK.

Irvine was born in Newcastle upon Tyne, where his father was a sole practitioner GP.

After qualifying in medicine and spending some time working with his father, he joined colleagues from two practices to establish a multidisciplinary teaching practice and thereafter followed a career with various committees including as regional adviser in general practice, the Joint Committee on Postgraduate General Practice Training, chair of council of the Royal College of General Practitioners (RCGP) and later the GMC committee on professional standards and ethics.

Donald Irvine was born on 2 June 1935 in Newcastle upon Tyne, to Andrew Bell Hamilton Irvine and Dorothy Mary Irvine née Buckley.

He was brought up in Ashington, Northumberland, a coal mining community, where he travelled to and from school with soot covered miners.

His father was a sole practitioner general practitioner (GP) and his home was also the surgery, so his home life revolved around his father's patients.

He had one sister who also became a doctor, and they would both go on home visits with their father and help stock the medicines.

He later recounted in his memoirs that... "in those days there was a common assumption in medical families that son would follow father".

At the age of ten, during a holiday in Edinburgh, he developed rheumatic fever, and subsequently spent one year of his childhood in hospital, where he was cared for by paediatrician Charles McNeil.

He was also affected by the poor public perception of general practice in the 1950s, reflected in Winston Churchill's physician, Lord Moran's words in 1958... "that it was the place doctors landed when they fell off the hospital ladder".

His father had been involved in the formation of the RCGP in 1952 and Irvine would soon follow in its philosophy, recognising the need to improve standards in general practice.

At that time, a doctor could enter general practice with no requirement for further training and after completing just one year of hospital posts.

He attended The King Edward VI School, Morpeth, and later graduated in medicine from Durham University in 1958.

Having contracted rheumatic fever exempted him from National Service.

After leaving Durham, he completed his house jobs and vocational training, following which he joined his father's practice.

Subsequently, he joined colleagues from two other practices to establish the Lintonville Medical Group, the first multidisciplinary teaching practice in the U.K.

In his mid-thirties, and having also academically achieved a DObst in 1960, an MD from Newcastle in 1964 and a FRCGP in 1972, he was the third person to be appointed honorary secretary of the council of the College, serving for seven years before stepping down in 1978.

It gave him the foundation from which he could plan to raise the profile of general practice.

During his term he contributed to the College's evidence to the Royal Commission and to the central organisation of the three-year GP vocational training, organised on a regional basis, which provided training practices and a curriculum.

He continued as one of two secretarys for the RCGP led Joint Committee on Postgraduate General Practice Training, with Irvine as its lead.

Recognising the poor standards in general practice, he led a study that included most of the northern region GPs and hospital paediatricians.

He demonstrated that setting standards for children was feasible.

Irvine began to take up committee posts, first as regional adviser in general practice and then in the 1970s, as a member of the Merrison Committee of Inquiry into the Regulation of the Medical Profession.

In 1979, he received an OBE, in 1987 a CBE and in 1994 he was Knighted.

In 1979 he became the first RCGP nominee to the GMC.

Irvine chaired the GMC committee on professional standards and ethics and has been credited for his drive "to make medical regulation in the UK more patient centred".

His actions also resulted in a publication titled Good Medical Practice and Duties of a Doctor and a shift from "telling doctors what they should not do, to one which told them what they should do".

It transformed the culture of the GMC by setting out what patients could expect from doctors.

Between 1982 and 1985, he served as the chairman of the RCGP council, where he introduced the "quality initiative" which encouraged GPs to assess their day-to-day care in their own practices.

In the 1990s, a number of high-profile cases of medical failures had come to public attention during his tenure and had unsettling relations between doctors and their patients.

His first role as president was to chair the conduct committee that handled the Bristol heart scandal, where a whistleblower disclosed poor heart surgery outcomes in children.

In 1995, shortly after being knighted, and with the concern over the GMC's disciplinary procedures and having the job of implementing performance procedures, he was elected president of the GMC, the first ever GP to hold the office.

In 1998, two months into the Bristol inquiry, as its chairman, he commented... "we are not dealing with statistics here, we are talking about children".

On 18 June 1998 at a disciplinary hearing, Irvine told two paediatric heart surgeons and the chief executive of the United Bristol National Health Service (NHS) Trust, that they were guilty of serious professional misconduct.

In 1999 Irvine's GMC presidency was unsuccessfully challenged by obstetrician Wendy Savage, the first time anyone had stood in opposition to an incumbent president.

Irvine won by 30 votes, the GMC agreed to request revalidation and Irvine decided to step down ten months early.

It was an appointment that he kept until stepping down in 2002.

He also wrote the books, The Doctors' Tale: Professionalism and Public Trust (2003) and the memoir Medical Professionalism and the Public Interest: Reflections on a Life in Medicine (2017).

He became internationally known for his work with the Picker Institute and in 2017 was awarded the American Board of Medical Specialties (ABMS) healthcare quality and safety award.