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Obituary: Richard William Beard

Obituary presented to RCOG Council January 27th 2012

Richard Beard was Professor of Obstetrics and Gynaecology at St. Mary’s Hospital, Paddington from 1972 to 1996. He was an innovator who championed breakthroughs in the care of pregnant women and their babies that changed clinical practice. He was one of the pioneers in the development of fetal monitoring during labour, the management of diabetes in pregnancy, computerised maternity information systems and research into chronic pelvic pain in women.

Born in Sussex in 1931, he was educated in India and at Westminster School, London. He read Natural Sciences at Cambridge University and then qualified from St. Bartholomew’s Hospital in 1955.

It was during his National Service in the RAF in 1957 that Richard had his first taste of what would become an ongoing concern for the welfare of women and their babies. He was made responsible for the obstetric and gynaecological care of 10,000 service personnel and their wives at the Changi Hospital, Singapore after only six months experience in the subject. On his return to the UK, appointments followed at Queen Charlotte’s Maternity Hospital and at the Chelsea Hospital for Women. He obtained his Membership of the RCOG in 1963 whilst a senior registrar in Poole and in 1964 he was appointed Senior Lecturer and Honorary Consultant at Queen Charlotte’s.

In 1968, Richard joined Sir Stanley Clayton, his greatest mentor, at King’s College Hospital where Beard’s work on the physiology and management of diabetes in pregnancy gained him international recognition. He demonstrated that poor control of maternal blood glucose levels during labour leads to fetal distress. This resulted in the introduction of the use of intravenously administered insulin infusions for diabetic women in labour, now routinely practised.

His MD thesis, awarded by Cambridge University in 1971 was based on the use of fetal blood sampling during labour, a technique which he pioneered alongside his colleagues David Morris and Eric Saling. Richard demonstrated that the acid base balance of a fetus in labour is an indicator of fetal wellbeing in labour and a predictor of perinatal outcome. These 2 discoveries alone must have done more for mothers and their babies than the vast majority of obstetric researchers achieve in their lifetime.

In 1972, Beard was appointed Professor and Head of Department at St Mary’s Hospital Paddington - the same year as he was awarded his FRCOG. His first commitment was to the development of an undergraduate teaching programme. Richard was passionate about the welfare and development of his students. Under his direction, students were involved with “on call” and expected to actively participate in ward rounds and decision making. He never missed the opportunity to encourage a young doctor to pursue an academic career in obstetrics and gynaecology and of his many trainees, seven went on to become professors.

A traditional doctor by training and outlook, Beard was open to innovations from different disciplines and points of view: it was his idea to appoint an endocrine physician – firstly Howard Jacobs and then Stephen Franks - to develop reproductive endocrinology within the department. He was ahead of his time when he drew up a list of conditions that women should be entitled to expect during their pregnancies and their labour. He promoted the desire of some mothers for abdominal contact with their newborn infant at birth, allowing the husband or a supportive friend to be present in the delivery room. He strongly supported the promotion of better antenatal education and a more personal, less authoritative, approach by obstetricians. The homely décor of the labour rooms and postnatal wards that he introduced in the 19th century building at St. Mary’s were the result of his wish to create a sense of welcome and calm not usually experienced in obstetric wards and the interior design skills of his wife Irene.

Amongst the many innovations he initiated at St Mary’s was a system of data collection utilising the University of London’s main frame computers. This maternity information system proved to be so informative that obstetric units throughout the North West Thames Region were provided with the necessary hardware to enable them to contribute to the data set. He also set up a maternity risk management group at St Mary’s and persuaded the St Mary’s Trust to develop risk management for all specialities, long before this became standard in the National Health Service.

Richard also established a long term collaboration with a team of bioengineers in the further development of fetal monitoring and in the investigation of chronic pelvic pain. Together with Mike Carter and his long term protegee Philip Steer he did much to progress the role of intrauterine pressure monitoring and CTG’s in day to day obstetric practice. Earlier this week I asked Phil to tell me what he thought was Richard’s best characteristic. He came out with three – scientific honesty, never prepared to accept second best and quite prepared to change his mind when faced with the scientific facts – and when you consider for a moment that Richard had backed research horses like the immunology of recurrent miscarriage and was committed to stamping out pelvic pain wherever it occurred, that is perhaps just as well.

In addition to his impact at St Mary’s, Beard was influential through his many contributions at national and international levels. He was Expert Advisor to the Social Services Select Committee of the House of Commons between 1979 and 1984, contributing to the second publication on Perinatal and Neonatal Mortality in England and Wales. He was a member of the Standing Medical Advisory Committee to the Secretary of State for Health and Social Services 1981-1983. As Consultant Advisor to the Chief Medical Officer at the Department of health, he was co-author of the Maternal Mortality Reports from 1986 – 1992. He was advisor and external examiner in Obstetrics and Gynaecology to the faculty of Medicine at the University of Hong Kong.

Richard served as a Fellows representative on the RCOG council from 1976 – 82, was co-opted from 1983 -86 during his chairmanship of the Scientific Advisory Committee and Subspecialty committees, returning again as a Fellows representative from 1988 – 93. He was a member and then chaired the RCOG Wellbeing Research Advisory committee from 1984 -90, was on the Journal editorial board from 92-98 and chaired the European Board and College of Obstetrics and Gynaecology from 91-95.

Following his retirement from St Mary’s, he was invited by Professor Peter Richards (who sadly died last year and whose memorial service is taking place in Cambridge today as I speak) to join Northwick Park and St. Mark’s Hospital where he continued his clinical and research involvement into the problem of chronic pelvic pain.

As his successor I was honoured to arrange his Festschrift and was impressed by the number and diversity of the people who came from all over the world to pay tribute to him. It is always difficult to put one’s finger on precisely what it was that makes a predecessor special. In Richard Beard’s case several things come to mind. He was fascinated by clinical research and expected everyone else to be equally interested. He was a skilled administrator and a consummate politician – anyone who saw him at work on a committee was left in no doubt about his agenda. He had enormous sympathy for the role of the patient and he had a genuine love of teaching, both the medical students and his trainees. I will remember him as a larger than life personality who was sometimes difficult to work with; but although his reputation for having a short fuse was legendary, he did not bear grudges and was a generous colleague. One of his last deeds at St Mary’s was to volunteer to be the registrar on call for the labour ward one Friday night in order to let all the juniors attend the Victor Bonney Ball. It was a memorable night for all concerned and when I arrived early on the Saturday morning to take over from him I found the staff, patients and Richard in a state of shock.

When he finally retired from clinical medicine at the young age of 72, he collaborated with his wife Irene in setting up the charity Book Link in Ethiopia, providing schools in the country with over 3 million books sourced from publishers in the UK. He also advised the Pulitzer family on the work they had started in Ethiopia helping children suffering from the effects of famine, where they encouraged research into the effectiveness of play as a healing activity. The role of Play Therapy is now being evaluated officially as part of the Ethiopian Health service. When his wife was diagnosed with Motor Neuron Disease he left no stone unturned in his quest to provide her with the best possible treatment and having concluded that there was little to offer her, he set about raising enough money to build the first research institute for MND in Europe now based in Sheffield.

Richard enjoyed travelling to far corners of the world with his family. Nearer to home, he was a keen off-shore sailor from the family’s home in Loch Eyne Ireland. He much enjoyed attending musical recitals and continued to play tennis with a highly competitive approach until October last year.

Richard Beard died at home surrounded by his family on 13th January 2012. He had been suffering from cancer. His wife Irène survives him along with his sons, Charles and Nicholas from his first marriage and Thomas and Sophie his stepdaughter from his second.

A Memorial Service will be held on Tuesday February 21st at 11 am at St James Church Holland Park London W11.

Lesley Regan, 27.01.2012