Anyone in Britain who has taken a recently marketed drug has reason to be thankful to Bill Inman, who developed effective methods for monitoring their safety. He overcame serious disability and bureaucratic opposition to perform this - and other - services to medicine and public health up to his death at the age of 76.
In 1964, aged 34, Inman left his job as medical adviser at ICI Pharmaceuticals to join the Department of Health. The thalidomide disaster had recently unfolded: thousands of children had been born with missing limbs because their mothers had taken the anti-nausea drug while pregnant. The government had set up an independent committee on drug safety, chaired by Sir Derrick Dunlop. He, in turn, invited Inman to develop a procedure to recognise adverse drug reactions rapidly.
Inman introduced the yellow card system of voluntary reporting, under which doctors and pharmacists use post-paid yellow cards to report problems experienced by patients taking newly-licensed medicines. It got fully under way in 1970, was an overwhelming success and now produces 20,000 reports a year.
Inman realised that the scheme neither provided a measure of frequency nor proved or disproved causality. Moreover, he strongly suspected (and later confirmed) that the drug companies' own post-marketing surveillance was more an exercise in marketing than monitoring. So, in the late 1970s, by which time he was running an independent monitoring unit at Southampton University, he introduced the green form system for testing hypotheses generated by the yellow cards.
Shortly after a new product is launched, all patients prescribed it are identified. Their GPs are then asked to list all events that the patient has experienced since the prescription, regardless of whether or not they seem prescription-related. Each study involves more than 10,000 patients and represents the real world of medical practice. Analysis of the data recognises dangers that otherwise might be hidden.
In the 1960s, after the first contraceptive pills were launched, Inman designed and directed studies on their role in forming blood clots. This led to the development of the mini-pill. He showed that halothane, an anaesthetic, caused jaundice in certain circumstances, and that the anti-rheumatic drug phenylbutazone could cause blood disease; it is now prescribed only to people with severe ankylosing spondylitis.
Inman was born in Banstead, Surrey, and his father was chairman of ICI's alkali division. Bill, who recognised that he had a privileged upbringing, always felt a responsibility to those less fortunate than himself. He was educated at Ampleforth school, where he played rugby, hunted, went wildfowling, broke the mile running record, scripted and performed in musicals, and sold exotic mice and spent shrapnel and cartridge cases collected from a golf course. One holiday he opened the door to a scruffy man who asked for his "father's money". Bill came back with his father's service revolver to chase him off. The man was the golf club subscription collector.
Inman went on to Gonville and Caius College, Cambridge, to read medicine. Shortly after completing his preclinical training, aged 21, he contracted polio. He was away from his studies for two years, much of it spent in an iron lung, and used a wheelchair for the rest of his life. In those days, Cambridge did not have a clinical medical school; medical students went to London hospitals, to "walk the wards". Aware of Inman's difficulties, the university arranged for him to have individual tuition and training in Cambridge. Thus he was the first Cambridge medical graduate. He delivered 50 babies and his wheelchair had a tilting mechanism that enabled him to do surgical practice.
After qualifying he spent three years as a junior doctor at Addenbrooke's hospital, Cambridge, where patients liked him for being a fellow-sufferer. In 1959 he joined ICI, moving to the civil service five years later. There he was admired for his integrity but clashed with those in authority, who warned him that he would not get a knighthood unless he changed his ways. "Well, bugger that," he is reputed to have replied. Rather than change his ways, in 1980 he set up the drug surveillance research unit at Southampton, where he was made professor of pharmaco-epidemiology.
Inman felt strongly that the drugs industry was too close to government, and that safety monitoring should be completely independent, which meant that he had perennial problems with funding. He did a great deal to wrest postgraduate medical information from the hands of the industry. However, he was generally respected by it for his fair-mindedness; because he sometimes rescued drugs that were the subject of a moral panic, and because the industry realised the sense of recognising adverse drug effects at an early stage, before litigation threatened.
Inman retired in 1994 and became medical vice-president of Remap, a charity run by engineers and occupational therapists that supplies free customised equipment to disabled people whose needs cannot be met by off-the-shelf equipment. He never expected any concessions for his disability, and was nifty at transferring himself from wheelchair to car. He continued wildfowling, tolerating huge recoils while shooting ducks from a kayak. He flew gliders, winning a trophy as best pupil of the year. He thought nothing of taking Concorde to New York, waiting half an hour while a car hire firm fitted manual controls, and setting off alone. Recently he finished an autobiography, due for publication next year. His two previous books were Monitoring for Drug Safety (1986) and Don't Tell the Patient (2002).
He was fun to be with and was a profoundly moral man with impeccable integrity and energy, somewhat fogeyish, but hugely popular, bowling people over by his kindness. Eight years ago he developed post-polio syndrome, which resembles motor neurone disease, and led to his death. Towards the end he was completely dependent on others, but never complained.
He married June Halfpenny (née Maggs) in 1962. Friends carried him and his wheelchair up the steps to the register office in style. She survives him, along with three daughters; another daughter died in infancy.
· William Howard Wallace 'Bill' Inman, medical researcher, born August 1 1929; died October 20 2005
