Obituary: Dr Ian Munro
Monday 27 January 1997
Munro had the Yorkshire qualities of sturdy independence combined with an instinctive questioning of authority. He was a true radical and a good sceptic. He disliked the self-interest of the medical establishment and was often a thorn in their flesh.
He was recruited by The Lancet in 1951 after serving in the army as a radiologist. Dr Robbie (Theodore) Fox, the editor, felt The Lancet needed Munro's radiological expertise, but it was as a writer and campaigner that he excelled. He spent the next 36 years there, striding around the office, large-framed, loose-limbed and dishevelled, emitting a curiously- pitched hum when engrossed, often irritable with people who moved less quickly than he did. When he thought he was unobserved he could be seen practising cricket strokes.
The Lancet received over 4,000 papers a year from around the world, and only one in eight made it into print. The unsuccessful authors would receive an exegesis thanking them for their flawed masterpiece and regretting that he must refuse it; nothing was ever "rejected". Sometimes his refusals were so gentle that the recipient would have to phone for clarification. Robbie Fox claimed to have appointed Munro on the strength of a letter he had written to thank him for lunch: "whoever can write a really good letter must be able to recognise a bad one and therefore has the makings of an editor".
Munro was a thunderer with his pen and wrote many of The Lancet's unsigned editorials. When the Health Service was strike-bound in 1983 he blasted forth at Norman Fowler, then Secretary of State for Social Services:
Mr Fowler might reflect again on the quality of conscience that his post requires of its occupant. How far can he permit the NHS to be devalued by the intractability of the prime minister he serves? If he has deep doubts, as The Lancet believes he should have, about the outcome of his term as Secretary of State, then he must resign.
The NHS was Munro's greatest passion, but not the only one. His other causes included world population and family planning, abortion law reform, nuclear disarmament, and the introduction of simple and effective health care measures for the Third World. He incurred the displeasure of the family planning lobby, though the cause was dear to his heart, by publishing preliminary and alarming papers on the dangers of the contraceptive pill; he did this because he felt that frightening information should not be suppressed and that women should be equipped to make informed choices. He was influenced by the work of Iain Chalmers and colleagues at Oxford, showing that increased interference in childbirth is no guarantee of increased safety. He was an early and consistent champion of Wendy Savage, the mildly radical gynaecologist who was accused of incompetence by some of her colleagues and abruptly suspended.
He was the archetypal doctor, listening with concentrated patience, and was accessible to his colleagues in Fleet Street even in unsocial hours.
Munro was, typically, on the reformist wing of the Yorkshire County Cricket Club. He played for Weald Cricket Club and for the Silhouettes, a group of Guy's graduates whose silhouettes probably grew ever less svelte with age. He also led the Lancet team on their matches - usually rounders or croquet - against a scratch side from the British Medical Journal. As a sportsman his personality changed to one of ruthlessness and he would argue ferociously about the rules with the captain of the rival team while the other players were more interested in beer and an agreeable day out - the scores were usually tampered with to produce a draw. When he joined The Lancet it was locked in combat with the British Medical Association and its Journal, partly because The Lancet was strongly for the NHS and the BMA against it. By the time Munro retired this hostility had turned to amicable rivalry and it was his counterpart at the BMJ, Stephen Lock, who organised a farewell dinner for him and the publication by the Keynes Press of a book of tributes called Swerving neither to the right nor the left (1988), an appropriate title: his liberalism and radicalism was determined by his beliefs in individual freedom and human rights. Munro would attack politicians regardless of their affiliation and wore their disapproval like a medal.
Behind the conviviality was a shy and intensely private man. Married to a doctor, he had five children, and one of his daughters is a midwife. Though not a Quaker - and not a teetotaller either - Munro's radical and humanitarian ideals fitted well with The Lancet's Quaker traditions.
His retirement in 1988 freed him to give his energies to causes dear to him: the Association for the Promotion of Health Care in the Former Soviet Union (Chairman 1988-93), Medical Action for Global Security (Vice- Chairman from 1988); and the UK branch of Physicians for Human Rights (President from 1991). He died of complications following an operation and he was, of course, an NHS patient.
Ian Arthur Hoyle Munro, medical journalist, born Bradford 5 November 1923; Deputy Editor, The Lancet 1965-76, Editor 1976-88; married 1948 Olive Jackson (three sons, two daughters); died Tunbridge Wells, Kent 22 January 1997.
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