Jim Appleyard was not only an outstanding clinician, he played a major role in national and international medical organisations including the General Medical Council, The Royal College of Physicians and the British Paediatric Association, the World Medical Association and particularly the British Medical Association, where he was variously treasurer and an honorary vice-president.
William James Appleyard was born in London on 25 October 1935, one of four sons of Edward Rollo Appleyard, a barrister, and Maud Oliver (née Marshall). He was educated privately at Canford School, Wimborne, before undergraduate medical training at Exeter College, Oxford and Guys Hospital in London. After house jobs and then junior posts in paediatrics at Guys and Great Ormond Street Hospitals he spent a residency in paediatrics in Louisville Kentucky, where his research into chromosomal damage following immunisation lead to a prestigious Alumnus Award. It was while in Kentucky that he saw an outstanding model of a unit for neonatal care that he was subsequently able to put into practice in Canterbury. In addition, he witnessed the superb teaching of junior medical staff, without the exploitation that was rife at the time in this country. These experiences profoundly affected the rest of his professional life.
Within two years of his appointment as a consultant in 1971 he had successfully acquired the Chest Clinic to house the Voluntary Handicapped Playgroup which subsequently became the Mary Sheridan Centre. This centre was unique because for the first time it encompassed diagnostics, assessment, treatment, therapy and support for families in a multidisciplinary professional environment. Shortly afterwards, using the model he saw in Kentucky, he established the Special Care Neonatal Unit at the Kent & Canterbury Hospital in 1973, the first outside the London teaching hospitals. He was instrumental in providing play and day care facilities for sick children and their parents in the children’s ward and in 1992 set up the ‘Three Bears home from home’ house with support from the Sick Children’s Trust.
I knew Jim as a hospital colleague and friend for 48 years but had been aware of him for a further 5 years before I was appointed as a consultant - Jim was one of two outstanding clinicians (the other was Mark Rake) already in post who influenced my decision to apply to Canterbury. Before I was appointed I had undertaken locum consultant posts in Canterbury and was already aware of some of the developments created by him.
I soon realized that Jim was a paediatrician par excellence with enormous energy and dedication for all aspects of childcare and health. He could often be found doing ward rounds at midnight. One former paediatric nurse Pauline McEwan told me that Jim, having been up all night had eaten her packed lunch for his breakfast at 5pm! He exuded an inspiring self-confidence, providing a good source of advice for colleagues, and most importantly was enormously respected and admired by parents. This was exemplified by the flurry of complimentary comments on Twitter and Facebook following his death, which prompted the rapid production of the glowing full-page obituary in the Kentish Gazette and subsequent long obituaries in the BMJ and The Times. He was worshipped by his staff and Barbara Armstrong, who worked alongside Jim for more than 30 years praised his approach which was ‘Always listen to the mother and when talking to children get down to their eye level’ His staff gave him a surprise leaving party in the cricket ground attended by over 150 people.
Behind a deceptively urbane character and charming smile Jim was always politically astute and sensitively tuned to various employment and childcare issues in medicine. His lifetime involvement in medical politics started while he was still a junior doctor in London fighting for the cause; the exploitation of junior doctors by their consultants and by being the first junior hospital doctor permitted to give evidence to the review body on Doctors and Dentists pay – an issue being close to his heart with Liz being a dentist!
As a powerful speaker he was an influential member of numerous important national committees including the British Medical Association, General Medical Council, The Royal College of Physicians and the British Paediatric Association. He was for five years a hugely influential treasurer of not only the British Paediatric Association but also for the British Medical Association and was subsequently an honorary vice president for 10 years until 2013. He had a huge positive influence, not only on the development of paediatric medicine but UK medicine as a whole, for which the nation should be justly proud.
With others including Mark Rake, he was involved in the establishment of the Kent Institute of Medicine and Health Sciences at the University of Kent, where he successfully combined his professional and social skills to steer the early negotiations of this venture. He retired from the NHS in 1998 and the following year received an Honorary Doctorate of Medicine from UKC in recognition of his academic and national achievements, which he said was one of the proudest moments of his life.
Jim always enjoyed travel. I well remember a visit with him, and ten others involved in medical education, to St Georges University Hospital in Grenada in 1982 to set up the final medical examinations for the International Charter Class medical students at the newly established medical school. This involvement and his subsequent quest for high standards in world medical education heavily influenced the next 24 years of his incredible professional life – achievements which were almost unknown to many within Canterbury including his former clinical colleagues. One of his first posts after ‘retirement’ was as Dean of Clinical Studies at the International School of Medicine based in Kigesi Uganda. Here he helped to establish an international problem-based core curriculum for medical students which was applicable worldwide.
Between 1995 and 2004 he was involved in the World Medical Association, the aim of which is to serve humanity by endeavouring to achieve the highest international standards in medical education, medical science, medical ethics, and healthcare for all people in the world. As chair of their Ethics Committee, he oversaw the Amendment to the Declaration of Helsinki that underpins clinical research internationally. He was their president in 2003 when he chaired the group that presented the Declaration of Ottawa on the Right of a Child to Healthcare. The International Association of Medical Colleges is a professional association for peer evaluation of medical education, maintenance of uniform standards and recognition of physicians’ qualifications provided by individual medical schools anywhere in the world. Jim was involved almost from the beginning of this association, and for 6 years from 2006 he was their honorary secretary, then president for a further 6 years until finally relinquishing this position in 2021. Finally, his passion right up to his death was with the International College of Person Centered Medicine where he was president between 2013 and 2017. In April of 2021 he was awarded their Paul Tournier Prize ‘For his Stellar Work on Ethics as Keystone of Medical Practice and Research and the Advancement of Education at the Core of Person Centered Medicine.’’
Like many local clinicians he was delighted when it was announced that a new Medical School based in Canterbury and Medway would be taking students as from September 2020. He made a generous gift to the medical school to be awarded for the best presentation and essay in the Person-Centered Medicine Student Selected Component of the program. He was at the Students Award night in December 2021 where he presented the Dr Jim Appleyard Prize for Person Centered Medicine to two first year students. I last saw Jim at the wonderful celebration of the completion of the first year of the Kent & Medway Medical School in September 2021 at Godmersham Park when I was amazed at how well he looked and how positive he remained. I regularly spoke with Jim on the telephone, and it was remarkable how upbeat he was right until the end. During my last conversation with him just a couple of weeks before he died, he jubilantly related to me the news that the book on Person Centered Medicine, for which he had written a chapter, and coordinated the contributions, was about to be published. He was a real fighter and inspirational until the end - UK and world medicine owe him an enormous debt of gratitude.
Jim died on 29 January 2022, leaving his wife Liz (Elizabeth Anne née Ward, whom he married in 1964), son Richard, chief information officer, Oregon State Police, daughter Suzanne (Susie), a neuroscientist in the US, and Lisa, who is training to be a Montessori teacher, and six grandchildren.
This obituary is based on the eulogy given by Jim’s colleague Dr Stuart Field MBE at Canterbury Cathedral on 23 June 2022.
Further reading
1 https://www.rcpch.ac.uk/news-events/news/dr-james-appleyard-obituary (Accessed 3 April 2023)
2 https://www.bmj.com/content/377/bmj.o863 (Accessed 3 April 2023)