Obituary: Professor Donald Court

Seymour Donald Mayneord Court, paediatrician: born Wem, Shropshire 4 January 1912; James Spence Professor Child Health, Newcastle upon Tyne University 1955-72 (Emeritus); CBE 1969; President, British Paediatric Association 1973-76; Chairman, Committee of Child Health Services 1972-76; married 1939 Frances Radcliffe (two sons, one daughter); died Newcastle upon Tyne 9 September 1994.

ONE OF the most influential paediatricians in recent decades, Donald Court played a pivotal role in establishing the importance of research into the social and behavioural aspects of illness in childhood and in making the British public, the Government and the medical profession more aware of the needs of children. His work culminated in the publication of Fit For the Future (1976), the report of the Committee on Child Health Services which proposed the most radical change in the medical care of children this century.

Although at the time, the 'Court Report' was received with muted enthusiasm by much of the medical profession, some recognised it to be a decade ahead of its time. The principles, which included a move from care of children in the hospital to care in the community, expounded in it have been proved sound and lasting and almost all of its recommendations, for example transfer of much of medical surveillance to general practitioners, have eventually been implemented.

Donald Court was born in Shropshire in 1912 and enjoyed a rural upbringing. He started a career in dentistry but after three years changed to the medical course qualifying in the Birmingham Medical School in 1936. He proceeded to work at Great Ormond Street and the Children's Department at Westminster Hospital and after that in the Emergency Medical Service. He moved to Newcastle upon Tyne in 1946 to join the department of child health in Durham University, which later became Newcastle University, to undertake research in the developing Department of Child Health led by Professor James Spence, who in 1943 had been appointed to the first full- time Chair of Child Health in England and Wales.

At the time Spence's team was designing the 'Thousand Family Study' - a seminal research project which followed a thousand babies born in Newcastle and continues to report at intervals on their social, psychological and physical development and the relationship between early events and subsequent progress. Court joined this work and took an active part in it, particularly between 1947 and 1954. The work took him into thousands of Newcastle homes and the experience left a profound impression and helped him to formulate his objectives for the development of Child Health services which he later summarised in his Charles West Lecture of 1970, 'Child Health in a Changing Community', delivered at the Royal College of Physicians of London.

In this he said:

We must continue to strengthen the foundations of paediatrics in the biology of development; extend our studies of the social determinants of health and disease in child and family, especially by the use of well-planned local records; seek with psychology and psychiatry for a better understanding of the development of personality in the hope that we may find ways of diminishing maladjustment, excessive anxiety, and destructive aggression in children and parents; treat our patients with increasing skill and consideration and try as honestly as we can to overcome the dichotomy of treatment and prevention; establish these principles in the education of doctors and others professionally involved in the care of children.

During the early years in the department Court worked closely with a number of colleagues including Fred Miller and Gerald Neligan. Dr Will Pickles, of Wensleydale, author of Epidemiology in a Country Practice, had a close association with the department at this time and the departmental annual visit to his house at Aysgarth was one of the highlights of the year.

In 1950 Court was appointed Reader in Child Health and succeeded to the Chair of Child Health in 1955 on the death of Sir James Spence. He was committed to teaching and took a particular interest in the welfare of young students. He was instrumental in introducing a personal tutor system in the Newcastle Medical School which still exists. He was always genuinely interested in the views of the young and showed them a natural respect which he encouraged and stimulated.

Donald Court retired from the Chair and his clinical work in 1972 to become President of the British Paediatric Association. He was the first to hold this post for three years during which he had a profound and lasting effect on paediatrics in Britain. His ideas were developed in Paediatrics in the Seventies (1972) after which he was invited to chair a government committee to review the Child Health Services.

Donald Court had interests outside medicine which centred on his family and his wife, Frances. He enjoyed a meticulously tended garden and liked to remind friends of his academic achievement in this sphere - a school certificate in gardening - of which he was very proud. He was interested in painting, porcelain and poetry. His speech was deliberate, clearly enunciated and economical, which allowed precise nuances of arguments to be displayed in sharp relief. His writing has the same characteristics.

Donald Court will be remembered by those who came into contact with him as a man of integrity and thoughtfulness. The ideas he developed and transmitted so clearly have been adopted gradually and carried forward by the next generation of paediatricians and others involved in the care of children. He would have sought no other monument than this.

(Photograph omitted)