Godber, Sir George Edward
, was born on 4 August 1908 at 18 Bedford Road, Kempston, Bedfordshire, the eldest son in the family of seven children of Isaac Godber (18741957), market gardener, and his wife, Bessie Maud, née
Chapman (1883/41957), florist. A younger brother, , became Conservative MP for Grantham in 1951, serving in the cabinet and becoming a life peer in 1979. Educated at Bedford School from 1918 to 1926, Godber won scholarships to New College, Oxford, and the London Hospital medical school (without them, he later said, he could never have entered medicine). At the latter he came under the influence of an early hero, Arthur Ellis, the humanistic professor of medicine, under whom he was subsequently to serve as a house physician. He married a nurse working at the London Hospital, Norma Hathorne Rainey (19111999), daughter of William Henry Thomas Norman Rainey, clergyman, on 21 July 1935. They had seven children, one stillborn, and three of whom died tragically young from Fanconi's anaemia (an inherited condition).
From qualification in 1933 Godber was firm in his determination not to practise in any system where patients were required to pay. Believing that there would be a national health service free to all, his ambition was to enter the Ministry of Health, which he predicted would almost certainly be running it. To fulfil the criteria for entering the ministry, after house appointments at the London and Poplar hospitals and obtaining the MRCP in 1935, he spent a year at the London School of Hygiene, gaining the diploma in public health in 1936, as well as experience as a houseman in communicable diseases at the North Western Hospital. (He paid his way by borrowing money from his wife and working five evenings a week in an east London general practice, which reinforced his view that many of the poor could not afford to pay for a GP.)
At the Ministry of Health
After serving as a county medical officer in Surrey, Godber was allowed to join the Ministry of Health in 1939, initially helping to organize maternity services for evacuees from the big cities. (He had lost an eye in a childhood accident, so was ineligible for military service.) By then another of his great heroes, Sir Wilson Jameson, had moved from being the dean of the London School of Hygiene to become chief medical officer. He asked Godber to add to his routine duties in the east midlands region by participating in a quasi-Domesday
survey of the nation's hospitals. Godber was one of the three-man team that visited all of his region's 300 institutions and wrote the subsequent 124-page report, published two years later in 1944. It showed, in his view, that Britain had the most decrepit collection of hospitals of any comparable country as well as gross defects in staffing. Thus the whole of Lincolnshire had no full-time pathologist or paediatrician, while makeshift vehicles were operating as ambulances. In one hospital the team encountered one medical officer (a good surgeon) who was proposing to try operating for the first time on a large cleft palate in a child.
Back at the ministry Godber served as a sort of personal assistant to Jamesonwho by now had chosen him as his successor but one. Thus he became party to the discussions over the proposed National Health Service (NHS), which Sir William Beveridge had envisaged in his report and had been announced by the new Labour government in 1945. The protracted negotiations with the medical royal colleges and the British Medical Association were particularly difficult and he admired Aneurin (Nye) Bevan, the minister, for his ability. Though he was sometimes bigoted, in Godber's view, Bevan also saw the essential steps to success: a service entirely free of charge for all; total separation of the hospital service from general practice (which must be independent, functioning as a gatekeeper to the hospitals); and freedom of control by local government. Within two years of the 1948 act this had come about, with the NHS centred on districts, and a start made on diffusing services across the country, as well as developing important sub-specialties such as paediatric surgery. Just as important was the next task: improving standards of general practice, several reports terming this a cottage industry. Lord Moran, president of the Royal College of Physicians, had even maintained that doctors entered it only when they had fallen off the hospital ladder. Nevertheless, such improvementthought by many, including Godber, to depend on more partnerships, attachment of ancillary staff, and purpose-built health centreswas slow to come.
Chief medical officer
Appointed deputy chief medical officer in 1950, Godber became chief medical officer ten years later. He always maintained that he was fortunate in starting his new post with two new colleagues with whom he was in close rapport. Sir Bruce Fraser, the permanent secretary, was responsible for the smooth running of a major government department, Godber commenting that not only had Fraser come from the Treasury but he was not scarred by the experience of setting up the NHS (The Guardian
, 11 Feb 2009). The second new colleague, the new minister, Enoch Powell, sent Godber to the USA to study how their hospital building programme could relate to Britain and then applied many of his findings to a new initiative at home. With many of Powell's successors Godber also ensured that their personal initiatives went smoothly. Thus Kenneth Robinsoneven if, in Godber's view, a bit too malleable by the profession, but perhaps the most sympathetic and informed minister the NHS had hadlaid stress on improving long-term care, and revolutionized general practice with a new charter negotiated with the British Medical Association. Richard Crossman, whom Godber had known at New College when Crossman had become a fellow there, began to remedy the inequalities of resources, particularly those for mental health. Throughout his career Godber always lauded the drastic reduction in hospital beds for tuberculosis that had resulted from the discovery of streptomycin treatment. If the same could be done for schizophrenia and other major mental illness, he maintained, the savings would be even greater. Other programmes such as universal immunization against childhood diseases and fluoridation of drinking water would also pay high dividends.
Concomitantly, Godber had initiatives of his own, several of which he had started when he was deputy chief medical officer. Against considerable opposition he made the contraceptive pill available on prescription. Another was the development of postgraduate medical centres. After an approach by two district hospitals wanting to build their own centres he obtained funds from the Treasury to purchase suitable sites. He then persuaded the Nuffield Provincial Hospitals Trust to sponsor a conference on the topic with Sir George Pickering chairing it at Christ Church, Oxford, in 1961. The publicity generated an explosion of new centres in district hospitals all over Britain. A similar wave of enthusiasm in general practice fulfilled Godber's continued proselytizing for better premises, with new buildings funded by the family doctors themselves after a generous pay settlement. Godber also helped facilitate a confidential inquiry into maternal deaths, selling the idea of totally anonymized reports to the Royal College of Obstetricians and Gynaecologists. This initiative formed the pattern for subsequent routine audits, such as of neonatal deaths and of deaths of those under anaesthesia, and underlay the impetus for general medical audit many years later.
Perhaps the most important of Godber's personal initiatives was his campaign on smoking and health. Another of Godber's heroes at the London School of Hygiene was Sir Austin Bradford Hill, who together with Richard Doll had shown the connection between cigarette smoking and lung cancer as long ago as 1951. Nevertheless, little official action had been taken to address the dangers, despite similar links being shown subsequently from all over the world as well as other risks such as heart disease and danger to the unborn child. To tackle the problem Godber persuaded Charles Fletcher to set up a committee of the Royal College of Physicians to study the links between smoking and health. Its report, published four years later, provided sufficient evidence to pressurize ministers into banning the promotion of tobacco. Initially progress was non-existent, however, and even later it was slow (as it was internationally when Godber took his case to the World Health Organization, whose annual meetings he attended regularly). Godber's own minister, Iain Macleod (a heavy smoker), insisted on smoking at the press conference held to announce the findings, and, even though it took a prominent role in establishing the lobbying organization Action on Smoking and Health, the Royal College of Physicians did not ban smoking in its own building until 1989. This was some twenty years after Godber had persuaded his standing medical advisory committee not to smoke at meetings. (The one press cutting he kept to the end of his life recorded this, commenting that he had embarrassed the government about smoking as much as a civil servant could.) Even late in retirement Godber was still commenting on the slow progress made against the most lethal instrument devised by man for peaceful use (Daily Telegraph
, 11 Feb 2009).
The politics of health
When he retired in 1973 Godber had become the longest serving chief medical officer in the twentieth century, and in many people's opinion, the besta verdict he always denied, awarding the palm to Jameson. Challenging this modesty, Sir Douglas Black, a former president of the Royal College of Physicians, commented that Godber's influence over health policy remained unmatched by any holder of the post. Nevertheless, Godber maintained that every chief medical officer was only as effective as the strength of the senior colleagues covering special fields, and so his or her duty was to ensure that the best candidate was appointed. Just as important a principle was that any chief medical officer had to face both ways. On the one hand, he must be totally loyal to his minister (ultimately being prepared to resign if major differences could not be resolved, such difficulties threatening Godber's own survival on two occasions) and, on the other, he had a duty to the profession, which must be able to trust him. Moreover, his advice must be totally disinterested and based on clinical rather than political grounds. Nobody could accuse Godber of flouting this principle while in officethough Joseph Godber, the Conservative peer, called him my dear left-leaning brother (The Independent
, 12 Feb 2009) and in an otherwise spiteful diary note about him Richard Crossman conceded that Godber was radical and left wing and that despite his drawbacks he didn't want to lose him. After retirement, however, he was scornful in public of many of Margaret Thatcher's policies on health, challenging for instance her reported statement that there was no such thing as society. He also commented on what he termed the saddest medical scene of the twentieth century: when British doctors had deliberately delayed the treatment of some patients as a means of supporting their claims for better terms and conditions of service.
To classify him in terms of Isaiah Berlin's essay The hedgehog and the fox is to conclude that Godber was a hedgehog, knowing one big thing. His overwhelming central vision was of a health service free of charge delivered according to need rather than the ability to pay. Everything in his training and career subserved this vision, but once attained he insisted that the NHS must not be static, and its evolution owed much to his foresight and energy. The doctor's role had changed to one as a participant in a team (the greater medical profession as he called it in a lecture of 1975; Yale Journal of Biological Medicine
, 49/2, May 1976, 137) and he or she was no longer its leader. He regretted that the profession did not speak with one voice over important issues, arguing for the development of an academy of medicine on the lines of the Institute of Medicine set up in the USA by the National Institutes of Health. In Britain, Godber maintained, such an opportunity had arisen at the end of the war when the Royal College of Surgeons was about to rebuild its premises in Lincoln's Inn Fields, London, where several neighbouring buildings were vacant. Both of the two other major colleges (the Royal College of Physicians and the Royal College of Obstetricians and Gynaecologists) were planning to find new premises, and moving there with the Royal Society of Medicine would have formed a geographical basis for a new academy. Unfortunately the president of the Royal College of Surgeons, Lord Webb-Johnson, and the president of the Royal College of Physicians, Lord Moran, were at daggers drawn. Moran refused to go through the front door of the Royal College of Surgeons, and the plans came to nothing.
Yet a good example of the need for a united professional body came in the late 1960s with cardiac transplantation. Godber himself commented on its unproven benefit, and that the extensive resources used for this would have paid for many other, known effective procedures. Having convened a meeting of heart surgeons he helped the profession decide on a temporary ban on the operation until its merits could be weighed in the balance. Such an attitude contrasted with that towards the earlier kidney transplantation, which he had successfully championed against heavy opposition. Again, he maintained that some common disabilities, such as hernias and varicose veins, then treated expensively in hospital beds, were demonstrably manageable in outpatient settings, yet there was little central professional pressure to change to the cheaper alternative.
Later years, honours, and character
Godber served as chairman of the Health Education Council in 19778, and continued to be active in the anti-smoking movement. He lectured and wrote extensively (especially, since eventually he became the only survivor of the planning team, about the origins of the NHS, but also about living with one eye). He received many honours from universities and medical organizations at home and abroad. His own college, New College, Oxford, awarded him an honorary fellowship in 1973. At the degree ceremony at Oxford University the same year, when he was made honorary DCL, the public orator saluted him as somebody who ate, slept and bathed with his budget of work at the Elephant and Castle (The Independent
, 12 Feb 2009). Certainly in hectic times Godber slept on a camp bed in his south London office, being seen early the next day tucking into bacon and eggs at the Lyons Corner House in Piccadilly. He was appointed CB in 1958, and advanced to KCB in 1962 and GCB in 1971.
With his commanding height, shock of white hair, and a monocle in his right eye, Godber might appear formidable. But he was far from it, being instantly accessible to young and old and often writing or phoning to congratulate them on a particular initiative. When he was chief medical officer he had often chosen younger members to serve on important committees to balance the senior members, saying that you do not mould the future by listening to the voices of the past (Rivett, memorial service tribute). He was generous about his opponents, though honest about public figures he thought had been over-praised (including Major Greenwood, a professor at the London School of Hygiene, Sir John Charles, his predecessor as chief medical officer, and Lord Moran, whom he nicknamed Corkscrew Charlie for his deviousness). He was equally frank about the retention of the small and inefficient Elizabeth Garrett Anderson Hospital in London, kept open by a strident feminist campaign; in Godber's view this was a bad joke (Arthur Seldon, interview). Nevertheless, he had only two real dislikes: cigarette smoking and promiscuity, though he admitted that his campaign against the latter and unwanted pregnancy had had only limited success given that nobody had succeeded in devising effective sex education. He played golf regularly until he was ninety-four, but suppressed the fact that at Oxford he had rowed twice in (losing) boat races. Though secretary of the Boat Club, he had characteristically declined to be selected a third time unless a crew member who in his view had been unfairly sacked was reinstated. (Another feature the orator had mentioned at the Oxford ceremony was Godber's lifelong teetotalism, which had meant that he had had to get the pints of beer prescribed at mealtimes for the training boat race crew waived in favour of marshmallows.)
Retiring to Cambridge, Godber joked that it had the best geriatric services in the country, but it was also his wife's home town. He devoted many hours to helping her with everyday domestic tasks given that she was crippled by osteoporosis, and would leave a London meeting early to go home and cook supper. He drove a car until he was ninety-seven and lectured on Egyptian hieroglyphics and stained glass for the University of the Third Age at Cambridge. He read widely, tending to choose popular books on archaeology and history (in which his interest had been nurtured by the warden of New College, the distinguished historian H. A. L. Fisher). Above all, however, he was still drawn to medical texts, and would telephone decision makers and editors to draw attention to new findings he had just read about, often in arcane journals, but without any suggestion that they should do anything about them.
Godber's wife died in 1999, and on 7 February 2009, after suffering from Alzheimer's disease for three years (during which, as a lifelong atheist, he had considered going to a Swiss euthanasia clinic), he collapsed and died at Milton Court Care Centre, 50 Tunbridge Grove, Kents Hill, Milton Keynesbut against a background of an attempt by an over-enthusiastic paramedical team to resuscitate him. His likely comments on this episode can be imagined. He was survived by two sons (one a geriatrician, the other a civil servant) and a daughter.
R. H. S. Crossman, The diaries of a cabinet minister, 3 vols. (19757) · T. Smith, Thirty-four years at the Elephant, BMJ (5 July 1982), 3032 · G. Godber, 40 years of the NHS: origins and early development, BMJ (2 July 1988), 3743 · S. Lock, ed., Eighty-five not out: essays to honour Sir George Godber (1993) · Daily Telegraph (11 Feb 2009) · The Guardian (11 Feb 2009) · The Times (12 Feb 2009); (18 Feb 2009) · The Independent (12 Feb 2009) · BMJ, 338 (21 Feb 2009), 479 · C. Booth and S. Lock, video interview, 2003, Oxford Brookes University · A. Seldon, interview, Wellcome L., SA/ASH/R/18, box 78 · G. Rivett, memorial service tribute, www.nhshistory.net/tribute.html, accessed on 12 Dec 2011 · Burke, Peerage · WW (2009) · personal knowledge (2013) · private information (2013) · b. cert. · m. cert. · d. cert.
Bodl. Oxf., papers relating to UN service
Wellcome L., papers
Oxford Brookes University, video interview with S. Lock and C. Booth, 2003
Wellcome L., interview with A. Seldon
BL NSA, interview recordings
group portrait, photographs, 1978 (with Jane Thomas), PA Images, London · N. Sinclair, bromide print, 1994, NPG, London [see illus.] · cartoon, repro. in S. Lock, Eighty-five not out
Wealth at death
£196,166: probate, 27 May 2009, CGPLA Eng. & Wales