Fraser Brockington's death at the age of 101 closes a chapter in medical history which lasted for more than 150 years, a chapter in which the study of hygiene and the consequent practice of public health had raised the standards of living and the quality of life across the world.
The cholera epidemics and urban filth of the industrial revolution in the 1830s had led first Edwin Chadwick and then Sir John Simon to force legislation through, to further what Charles-Edward Winslow, professor of public health at Yale University, called "a new science and art of preventing disease, prolonging life and promoting health and efficiency through organised community efforts".
Brockington, professor of social and preventive medicine at Manchester University from 1951 to 1964, was the chief historian of this movement, and in his book Public Health In The Nineteenth Century (1965) describes how Simon's brilliant team of 17 investigators, nine of whom were fellows of the Royal Society, set standards in public health practice which improved the wellbeing of the British people and were copied in many countries. In the process, they also extended English local government, with which the public health service was being entrusted, from urban boroughs to the newly created authorities of the shires and counties.
Fraser was the only son of Sir William Brockington, director of education in Leicestershire, where he spent his boyhood. From Oakham school in Rutland, he went to Gonville and Caius College, Cambridge, and, choosing a career in public health, went on to Guy's Hospital. He walked the wards of Guy's, and because of the legal aspects of his work as a medical officer of health (MOH) was called to the bar at the Middle Temple. He also received an MD and the diploma of public health (DPH), Cambridge, and membership of the Royal College of Physicians followed. A period in general practice extended his clinical experience.
Some 15 years of practical public health in posts of increasing responsibility followed. In 1929, he became superintendent of the Brighton Infectious Diseases Hospital. From 1930 to 1933 he was Worcestershire's medical officer, and after three years in general medical practice in Kingsbridge, Devon, he was medical officer of health in Horsham and Petworth from 1936 to 1938. From 1938 to 1946 he was in Warwickshire, first as deputy, then from 1942 as county MOH. In 1946, he became MOH for the West Riding of Yorkshire.
Five years later, he entered a very different world. At that time it was common practice in England to appoint the MOH of a large city as part-time professor of public health in the local university, but Manchester University chose to act differently and to offer Brockington a full-time chair. Thus did Brockington choose the title of social and preventive medicine. The reason for "preventive" medicine is obvious. "Social" recognised the new social medicine movement led by a 20th century group of brilliant thinkers and researchers such as John Ryle, JN Morris, Tom McKeown, Archie Cochrane, Richard Doll and others, which concentrated on finding causes of non-infectious diseases such as heart disease and cancer. These originated not primarily with transmissible organisms but with human behaviour determined by social structure and values. The title Brockington chose for his chair was clear evidence that he recognised the importance of the new thinking, but he had reservations about the wisdom of overemphasising it.
He had been one of the last people to receive the DPH in Cambridge and was saddened and discomforted by the discontinuation of the course there in 1931. Forty-three years later, he reacted more vigorously and bitterly to the total abolition of the DPH by parliament. He was a Janus, who was respected at Manchester for the energy with which he sought to establish a curriculum in social and preventive medicine in a form which introduced the new gospel without omitting the important chapters of the old. The imaginative diploma course in community nursing which he introduced at Manchester, combining a vocational and an academic qualification, is still a model which indicates how in recent years the tide has turned again towards Brockington's way of thinking about public health.
New harvests are being gathered by a new generation of workers from the seeds sown by the social medicine movement, although none of the originators remain active and the expression is a thing of the past. Brockington must have been pleased to watch the titles "Public Health" and "Public Health Medicine" reappear as titles considered to be appropriate for his field and the workers in it.
Brockington was a citizen of the world on health matters. He gave extensive advice to the World Health Organisation, in particular on the health of children and of the disabled; he chaired the WHO expert committee on school health and continued as a consultant to the WHO after his retirement.
In addition to his historical work, he published numerous learned articles and books on world health and the social needs of the aged. His other books included Principles Of Nutrition (1952); The People's Health (1955) and The Health Of The Developing World (1985). He was a golfer, and in retirement on the Isle of Man practised bookbinding.
He married Dr Joyce Furze and they had three sons (one a doctor) and a daughter.
· Colin Fraser Brockington, academic, born January 8, 1903; died November 25 2004
This obituary has been revised since the writer's own death.
