Obituary: Dr John Scrimgeour FRCOG, FRCS (Edin), FRCP (Edin)

John Scrimgeour: Consultant obstetrician and gynaecologist renowned for foetal abnormality research

JOHN Scrimgeour was an eminent consultant obstetrician and gynaecologist who became well-known for his research work in the field of foetal abnormality diagnosis and was also the first full-time medical director of the Western General Hospitals NHS Trust.

Born in Elgin in 1939, John’s family moved to Hawick in 1950 when his father, Bill, accepted the role of headmaster of Trinity Primary School. Claiming never to have seen a rugby ball prior to his arrival in the heartland of Scottish rugby, John wisely followed advice passed on to his father by a certain Bill McLaren, namely that living in Hawick meant that playing rugby was not optional. He adapted quickly to his new environment and went on to play for the school XV as a wing forward before leaving to study medicine at Edinburgh University.

John graduated in 1962, prior to marrying Joyce Morrin, then a nurse at Chalmers Hospital, in September of that year. Following his two pre-registration posts at Edinburgh Royal Infirmary, John undertook a six-month residency in the city’s Eastern General Hospital, doing neonatal paediatrics and obstetrics and gynaecology. He then decided to enter general practice in the Craigmillar and Niddrie areas of Edinburgh in July 1964. His 18 months of experience there were highly formative, both in providing invaluable clinical experience and in influencing his subsequent career path. He helped to treat children born with such abnormalities as spina bifida and this motivated him to pursue a career in obstetrics and gynaecology, with a view to researching the cause and management of such issues.

His surgical skills were developed further under the watchful eye of George McKelvie at Stirling Royal Infirmary before he returned in 1966 to the Eastern General Obstetrics and Gynaecology unit to posts as Senior House Officer and then Registrar under the guidance of John Loudon. He was encouraged to pursue his interest in early pregnancy diagnosis of foetal disorders, including through direct contact with Patrick Steptoe, who was developing the technique of laparoscopy.

“Scrim”, as he was affectionately known by colleagues and friends, was appointed Senior Registrar at the Western General Hospital in 1969 and then, from 1970-1973, at the Simpson Memorial Maternity Pavilion under Professor Robert Kellar. There, he completed his early work on the association between alpha feto protein (“AFP”) and neural tube defects, such as spina bifida. He was awarded a grant by the Barbour Watson Trust to develop the technique of foetoscopy, which allowed the foetus to be examined directly using a small fibre-optic telescope.

In due course, this procedure was superseded by advances in ultrasound, but John’s work, in conjunction with the late Professor David Brock and others, led to the understanding of the association between raised AFP in amniotic fluid and open foetal spina bifida. From this it became established practice to screen all mothers at 16 weeks’ gestation.

In 1973, John was appointed consultant obstetrician and gynaecologist at the Western General Hospital in Edinburgh where he joined Dr Ronald Clark. His research continued and he co-ordinated the significant Edinburgh contribution to a UK-wide study on the risks of mid-trimester amniocentesis to diagnose Downs Syndrome.

In 1977, he organised an international symposium in Edinburgh that resulted in the publication of a book edited by him entitled Towards The Prevention Of Foetal Malformation.

John was in great demand as a speaker at international conferences at this time and his contributions were impeccably prepared and always well received. It was principally for his work in this area that the Edinburgh Royal Colleges of Surgeons and Physicians elected him to their Fellowships in 1987 and 1993 respectively, John having become a Fellow of the Royal College of Obstetricians and Gynaecologists in 1982.

In addition to his very full clinical commitments, including, from 1980, a successful private practice, John was also a highly competent and respected administrator. He chaired and was a member of a formidable number of committees, including the Western General medical staff committee, the Lothian Area medical and ethical committees and the Scottish Council of the BMA. He represented Scottish members on the Council of the RCOG and served on its finance and executive committee. In addition, John was the organising secretary of the 22nd British Congress of Obstetrics and Gynaecology and set up the Foetoscopy Group in 1980, involving representatives from major centres across the world.

With this background, and his highly developed organisational and interpersonal skills, John was well suited to take on the responsibility of medical director of the Western General Hospital unit in 1993.

He formed an extremely effective partnership with the chief executive, John Connaghan, and together they masterminded the hospital’s successful application for trust status in 1994.

Among their achievements in the mid-1990s were the planning and funding of the new Anne Ferguson building, the doubling of expenditure in cancer services by the WGH NHS Trust, the opening of the first Maggie’s cancer centre in the UK in November 1996 and the increase in professorial posts attached to the Western from 11 to 17.

These accomplishments went some way to compensating for the biggest disappointment of John’s career, namely the decision to close the maternity unit at the Western General in the early 1990s after significant time and effort, not least on John’s part, had been invested in planning and preparing for a newbuild unit on site. In the period between closure of the maternity unit and his appointment as medical director at the Western General, John worked again at the Eastern General Hospital.

For all his achievements in the fields of management, research and medical education, as well as his surgical dexterity, John will perhaps be best remembered for his unstinting commitment to his patients. His research work was driven by this (including his later work on HIV screening during pregnancy) and he led by example in prioritising patients’ welfare and ensuring that all staff, whether medical, nursing or support, did their utmost to provide the best possible care.

Without fail, he visited his patients on every Christmas Day morning, when he would also drop off presents for nursing staff. His enthusiasm was infectious and many people have cause to be thankful for his generous spirit and, in some cases, the life-changing impact of his actions.

Following retirement from the NHS in 1998, Joyce and he decided to move to the countryside and found a beautiful house just outside Aberfeldy in Perthshire. John was in his element, tackling the renovation project with similar gusto to his dealings with the Western’s PFI project several years earlier and also acquiring a tractor (“Rusty”) to assist him as well as provide some amusement to his increasing accumulation of grandchildren.

His transformation of the garden at Cuilaluin even attracted the attention of the BBC’s Jim McColl who featured it in a slot on the Beechgrove Garden.

John was able to devote more time to honing his unorthodox, but effective, golf swing in retirement and enjoyed taking part in medals both in Aberfeldy and as a country member at Bruntsfield in Edinburgh. He was also able to indulge his enjoyment of travel, with the Dordogne region of France being a favoured destination.

John’s health began to decline shortly after returning to Edinburgh in late 2007. He battled back with customary tenacity after suffering a stroke on his 71st birthday and was able to remain as socially active as possible, lunching weekly with his Ambler friends from Bruntsfield Golf Club and monthly with his O&G colleagues.

He also enjoyed holidays with his direct family and breaks with his closest friends from university with whom he kept in regular contact.

John Scrimgeour was hugely supported throughout his life by his wife, Joyce, who bore his illness over his last months with great fortitude. He is survived also by his children, Jill and Michael, and six grandchildren.