Obituary: Dr John Agate

IN THE early Fifties, in the aftermath of the Second World War, old people were considered something of a nuisance in hospitals, to be discharged as soon as possible to make room for younger patients. John Agate pioneered the concept that those patients deemed old (then over 65) deserved as good a quality of life as possible, expert medical care to ensure this, and above all, respect.

He was prepared to go to any lengths to achieve it. In his first winter in Bradford he threatened the authorities that he would go to the press unless the leaking roofs were mended and the temperature was raised to above 50 degrees Fahrenheit in the First World War huts housing his geriatric patients. He was prepared to resign or lose his job over it and he won; the wards were made warm and dry within three days.

Later, in Ipswich, he developed the Hayward Unit for rehabilitation and the Amulree ward, both purpose-built, which became show pieces. New geriatric consultants came from all over Britain to learn his methods. Among many innovations was the colour coding of walls and floors. Doors were brightly painted a particular colour for each type of room so that patients who could not easily read could tell which was the lavatory or the day room. Those learning to walk again could test themselves against zebra-crossing-type bars across the corridor floors, walking along a gradually increasing number of bands each day.

After Aldenham School he gained a First in Natural Sciences at Cambridge, and went on to train as a general physician at the London Hospital. He then researched into industrial medicine in Donald Hunter's department before joining the RAF for a short term in the Central Medical Establishment.

In 1953, after much soul-searching, he decided not to continue in what had been a successful research career in industrial medicine, but to face the challenges of geriatric medicine, becoming a consultant in Bradford. In 1958 he moved to Suffolk, drawn by the beauty of the countryside and the music of Aldeburgh. There he inherited four widely spread hospitals, converted from workhouses, and a view from his colleagues that geriatric patients, like psychiatric patients at that time, being "chronic", only merited a lower budget, including a lower budget for food, than acute patients.

After fighting in committees for funds from the NHS and outside, he organised an efficient and expert service for East Suffolk, trained up a highly skilled team, procured new equipment and designed new buildings. He won over his colleagues and was eventually elected chairman of the medical committee. He was a founder member of the British Geriatric Society, which helped to make geriatrics a respectable speciality; his work in this field was recognised by his appointment as CBE in 1978.

Agate's medical advice was considered and wise. Chronic back pain meant that on ward rounds he had to kneel down to examine patients while his registrar carried his shooting stick. As a staff nurse has written, "He demanded very high standards of care from his team of doctors and nurses, but I learned that as well as being the patients' physician he was their advocate for dignity, privacy and individuality."

His books included the classics The Practice of Geriatrics (1963) and Geriatrics for Nurses and Social Workers (1972), among many contributions to books and journals, even a regular medical contribution to Headlights, a lorry-driver's magazine.

John Agate had many outside interests. He loved cars, and took part with a co-driver in the Monte Carlo rally and in a rally around England and Wales in which they beat Stirling Moss, to their delight. In the early Fifties he was medical adviser to Andrew Miller-Jones's innovative television series on overcoming pain, which included Odette Churchill in the first programme. He was a keen photographer, particularly of churches, writing Benches and Stalls in Suffolk Churches (1980), thus providing much background for his wife Hester's work on the Suffolk Historic Churches Trust.

Having lectured widely on preparation for retirement, he followed his own advice, expanding his hobbies of pottery and music despite increasing heart problems. He always tuned his wife's harpsichord before her concerts and they sang together in choirs. Throughout their marriage they gave marvellous parties, including among their guests amateur and professional musicians, particularly the pianist and harpsichordist George Malcolm. Together, they provided constancy and a safe haven in their elegant home for their many friends, who will miss John's warm welcome and gentle teasing.

John Norman Agate, geriatrician: born London 20 February 1919; CBE 1978; married 1946 Hester Preedy (one son, one daughter); died Ipswich 31 October 1998.