History of the SPS - 1962 to present

The beginning of this period in the history of the Society coincided with a time of momentous change in Scottish paediatrics. A progressive increase in knowledge and clinical skills brought specialisation, and new large hospital services for children replaced a fragmentary service based on visiting staff.

Eric Coleman

New knowledge and clinical skills

From its first flowering there had been a progressive increase in the body of new knowledge and in the clinical skills that until now could be assimilated by every practising paediatrician in the children’s hospital centres then existing. This was no longer possible, and specialisation had entered clinical paediatrics.

The process was to accelerate and bring about a degree of separate identification among paediatrics, - those with expertise within the boundaries, of a single body system, or of an age range, of inborn biochemical disorder, or of an area of clinical management. The equally great change gaining momentum was the establishment and development, in the main centres of population away from the medical schools, of independently staff in-patient and out-patient hospital services for children and with right of access by paediatricians to the newborn. This replaced a fragmentary service based on visiting staff.

These developments and unprecedented advances in therapeutic potential led to substantial increases in consultant paediatrician and senior registrar members of the Society. But for financial constraints the increase might have been even greater.

The membership and complexion of the Society have been profoundly affected by other events.

NHS reform 1974

National Health Service reform in 1974 promised integration of general medical practice, public health services, and the hospitals, with the prospect of a comprehensive system of child health care. Twenty years passed in parts of Scotland before the integration which was to bring together clinical medical officers in child health and hospital paediatricians took place; this logical and long awaited practical alliance between hospital and community has already been of benefit to numerous children and their parents. The Society looks forward to an increasing number of physicians from community child health within its membership. In May 1997 the Summer Meeting of the Society held at Paisley jointly with the Scottish Association of Community Child Health was acclaimed as a popular and successful innovation.

In the last ten years, a number of family doctors, after appropriate instruction, have taken on the developmental surveillance of pre-school children. The Constitution provides for the admission to membership of general medical practitioners with a special paediatric commitment.

Major changes to the training of young paediatricians in the last five years or so, new grading structures and training programmes, specialist registration and continuing medical education for all, have affected the Society. The eligibility for membership of specialist registrars recognises that this appointment signifies entry into consultant training and a commitment to a professional life in paediatrics. The eligibility for membership of established staff grade paediatricians acknowledges these as substantive posts within the establishment.

Contributions by non-paediatricians

From its earliest days the Society has been increasingly aware of the outstanding contributions made continuously to the work of medical paediatrics in Scotland by those who are not medical paediatricians.

Acknowledgement is accorded to those who belong to a list of distinguished associates; paediatric biochemists, haematologists, microbiologists, oncologists, pathologists, radiologists, child psychiatrists, geneticists, non-medical scientists, and others. Paediatric surgeons and other surgical colleagues merit particular mention because of a contribution which goes back to the beginnings of the Society and beyond.

Their eligibility for membership of this Society has never been questioned, but, as mentioned elsewhere, in 1947 the Scottish Surgical Paediatric Society arose as a more appropriate forum. At present, 10 per cent of Ordinary members are specialists from outside paediatric medicine.

An effort is made to admit shoe who wish to take an active part in the scientific proceedings and whose interests in child health disease are wide. Meanwhile, members have a duty to invite specialists from other disciplines to Society meetings.

The growth of specialisation within medical paediatrics led to the expectation of new consultant posts each confined to a single specialty. In the event few such appointments have been made, and most specialties within paediatrics are sustained by consultants with acceptable specialist training, maintaining also a continuing commitment to general paediatrics. Most of those now in training will be aiming to fulfil the criteria laid down for inclusion in the specialty register for paediatrics, with supplementary training appropriate to a special interest within paediatrics.

The effect of this on the Society is that a broad area of common clinical interest is likely to be preserved, and that its meetings will continue to allow specialist to speak intelligibly to specialist.

Mid-20th century

It is difficult now to imagine the state of regional paediatrics in Scotland at the middle of the 20th century, to recall that in most areas it was a meagre service, provided, largely for outpatient work, by a visiting consultant paediatrician from one of the main teaching hospital units, that most in-patients were in adult wards and most sick neonates remained under obstetric care. The new paediatric service, led by single-handed consultants, was set up in county towns and other populous places. From modest beginnings it has advanced remarkably with improved facilities in new general hospitals and maternity units; the consultant staff structure, at least, has become more appropriate to clinical and educational needs. The training of specialist registrars through a rotation of posts , includes district hospitals. The Society has an interest in these centres where many of its members are employed, and provide teaching, training and examining functions, essential to the national paediatric interest.

Through times of momentous change, the Society has retained its function and its distinctive character. Its objectives remain the advancement of knowledge in Child Health and Paediatrics, and the promotion of friendship among paediatricians in Scotland. Through the work of individual members, it is active in the setting and maintenance of high academic and professional standards in paediatrics within the framework of the practice of medicine. In adheres to the policy agreed by members of avoiding political activity, even on issues where opinions are strongly held; members have alternative channels through which to make their views known.

Membership

The Society throughout its history has had a total of only 364 members. Its membership since 1947 has consisted of consultants, senior registrars, others in equivalent grades, with the recent addition of specialist registrars and some staff grade paediatricians, all holding posts in Scotland.

The total number of members has risen from 62 to 209 in 35 years, and of Ordinary Members from 51 to 172. For practical reasons the Presidential term of office has been reduced to one year, which by coincidence comes closer to the Constitution of 1922 which found no place for a President, but merely for a chairman of each meeting.

Meetings

The Minutes, published formerly in the Archives of the Disease in Childhood, now in the European Journal of Pediatrics, testify to the high standard of research communications at winter and summer scientific meetings, and to the wide range of clinical presentations.

Hearty discussion on the interpretation of clinical signs has long been replaced by the measured appraisal of courses of action based on diagnostic precision. Clear and succinct presentation owes much to the excellence of medical illustration, which has been instrumental also in sparing patients from a personal appearance, to embarrassed silence followed by embarrassed applause.

The content of the standard half day meeting has been increasing, but the balance between scientific communications and clinical presentations has scarcely changed. Most meetings are held in Aberdeen, Dundee, Edinburgh and Glasgow, the winter meetings being alternately in Edinburgh and Glasgow. The Society has met at Inverness on several occasions, at Ayr, Bellshill, Irvine, Kirkcaldy, Paisley, St. Andrews, Stirling, and, in both Golden and Diamond Jubilee years, with the British Paediatric Association, at Aviemore.

The triennial Jubilee Lecture, by a person of professional distinction who is not an Ordinary member, and which may be published by the Society, was established in 1972, with additional Lectures in the Diamond Jubilee and the 75th anniversary years. Its funding until 1990 was by Glaxo Laboratories, taken on in 1993 by Wyeth Nutrition. The Winthrop Essay Prize, donated in Diamond Jubilee by Winthrop Laboratories was awarded on two occasions.

The Scottish Paediatric Society continues to provide a unique and friendly forum for the exchange of information and ideas about the health and welfare of children. With undiminished vigour it retains the ability to respond and adapt appropriately to the changing needs of changing times.