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Seventeen years in New Guinea proved pivotal in the life of doctor and health activist Laurence Malcolm. Working with isolated highland tribes, and then with health policy makers in Port Moresby, altered his perspectives, says his wife Lyn. \"The experience reprogrammed him,\" she says. He set a new course, away from bureaucracies, towards empowering people to do things for themselves. He left the religious faith that had been important to him, but retained its values of justice and compassion, until his death on 22 June 2010. Christchurch associate Dr Murray Laugesen says Malcolm's experience in New Guinea \"laid the foundation for the way he looked at healthcare in New Zealand\", leading to his pioneering and leadership roles in planning for general practice. Health researcher Professor Ross Barnett says Malcolm was most influential in improving the spread of New Zealand's GP workforce and in moving medical planning to a horizontal integration of groups and services. Malcolm grew up in a Brethren family at Richmond, Nelson. He won a Junior Scholarship at Nelson College and studied medicine at Otago University. His years in Dunedin fostered a love of tramping and mountaineering. He married Irene Hodge in 1953. He served as house surgeon at Christchurch and Blenheim hospitals in 1954 and 1955, and then as a registrar at Christchurch Hospital. For the next 17 years he worked for the Australian Government in New Guinea. Lyn says a wish to be unconventional, with a sense of missionary fervour, drove him. He, Irene and their children were the first white people that many highland tribesfolk had seen. He led the building of churches and swimming pools in two villages. Moving about the jungle brought him into the crossfire of warring tribes. He survived a plane crash in which the pilot and passenger were killed. Medical care involved treatment of diseases new in remote areas and wounds inflicted by bows and arrows. Lack of protein in the local diet led Malcolm to initiating the growing of peanuts and sparked a lifelong interest in nutrition and growth. In his final years in the country, Malcolm developed national health plans for New Guinea, working in Port Moresby. His stay in New Guinea was broken by a study trip to Britain, where he qualified as a Fellow of the Royal College of Physicians, in Edinburgh. Research in New Guinea brought him a Doctor of Medicine degree from Otago. He added qualifications in tropical medicine, at Sydney, and public health administration, at Massey. He returned to New Zealand in 1974 determined to revolutionise public health planning. He persuaded the Director-General of Health to set up a Health Planning and Research Unit in Christchurch. While heading this unit, he married Lyn Wright, in 1982. He took a consultancy position with the Department of Health in Wellington in 1984 and became Professor of Community Health at the University of Otago's Wellington School of Medicine in 1985. Malcolm moved back to Christchurch in 1995 and, with Lyn, established Aotearoa Health, a consultancy service in health policy, management and research. He wrote papers for medical journals and articles for The Press on such issues as primary and clinical care of the elderly, M ori and under-privileged sections of society. Barnett says Malcolm was \"more than an academiche was an activist: he never let go\". He was a model for academics, as \"the critic and conscience of society\". Malcolm was elected to the Canterbury District Health Board in 2004 but was defeated three years later, a victim of voters' disillusionment with the Christchurch 2021 political movement, of which he was part. Lyn says he planned to stand again this year but as an independent. He was a member of many national and international boards and committees. Laugesen says: \"Malcolm's main passion was primary healthcare in Canterbury\". He was tenacious in his research and a pioneer in planning. The unit he headed in Christchurch was the first of its kind. His ideas were \"ahead of his time\". Christchurch GP Dr George Chisholm says Malcolm was a forward thinker and \"very committed to the development of good integrated healthcare\". He was the \"backbone\" of planning for aged people's care. \"He was meticulous in research. He challenged a lot of medical assumptions and clarified a lot of issues, \" Chisholm says. \"He was committed to the absolute, critical place of primary care in the health system. He was ahead of his time in many areas. He could be controversial but he stuck to the facts as he knew them, \" Chisholm says. Lyn says her husband loved a challenge. His fearlessness in tackling the health establishment served him also in his leisure activitiesfrom conquering high mountain peaks, to yachting in many countries, to playing the finest baroque music on his violin, to building a garden at his hillside home. Laurence Allan Malcolm, born Richmond 8 November 1929; died Christchurch 22 June 2010. Survived by wife Lyn, daughter Anne, sons Chris, David and Geoff, seven grandchildren and one great-grandchild. Mike Crean wrote this obituary; it first appeared in The Press newspaper (Christchurch). Additional tribute by colleagues George Salmond and Ross Barnett As longstanding research colleagues we seek to supplement the preceding general account of the life and work of Laurence Malcolm. Malcolm's involvement with clinical work, health policy activities and service planning in New Guinea provided him with knowledge and tools that fuelled his ambition to engage in similar work when he returned to New Zealand in 1974. At that time structured information gathering and health services research activities were just getting started in New Zealand. There was little appreciation of the contribution that could be made by the disciplined gathering, sharing and analysis of data about the allocation and use of health resources. At the time the then Department of Health has a small operations research, later a management services and research, unit based in its Wellington head office. The unit was small with limited capability and capacity. For personal reasons Malcolm wished to work in Christchurch where with a small team of researchers he set up a subsidiary health policy and planning unit. From the outset Malcolm's ideas and concepts about health services planning and delivery challenged conservative ways of thinking and established interests. In particular he was an early champion for moving the focus of health care delivery from hospital to community settings and, by advocating service planning, a way of improving coordination across different parts of the health sector. Using research evidence he also demonstrated unfairness and inequalities in the way health resources were allocated and used to meet the needs of disadvantaged groups and geographically diverse populations in New Zealand. He recognised that in a country like New Zealand with a slowly growing economy, an aging population, rising health care costs and increasing health and health care expectations, it would not be possible to sustain existing patterns of health care delivery. In future such care would simply not be affordable. This prompted his active interest in and support for service and workforce innovation and development particularly in general practice and other primary health care settings. From modest beginnings in Christchurch Malcolm broadened and deepened his information gathering and research activities as Professor of Public Health at the Wellington School of Medicine and later in private consultancy practice based in Christchurch. Malcolm's thinking was always ahead of its time, not only in New Guinea but also in New Zealand. Lack of research resources and information limitations sometimes made it difficult for him to convincingly justify the ideas and concepts he wanted to promote. Often challenging, and sometimes controversial, he was frequently a burr under the saddle of the health sector establishment. He was not just an academic researcher and a planner he was an activist widely promoting his work and that of his colleagues. If he felt that he was on sound ground he was a difficult man to budge, regardless of what opposition was ranged against him. Malcolm pushed the margins. He was an explorer, a navigator and an innovator and as such he was not always right. He was a man of spirit and courage in the pursuit of those causes he had evidence for and in which he fervently believed. He is sorely missed.\r\n

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Seventeen years in New Guinea proved pivotal in the life of doctor and health activist Laurence Malcolm. Working with isolated highland tribes, and then with health policy makers in Port Moresby, altered his perspectives, says his wife Lyn. \"The experience reprogrammed him,\" she says. He set a new course, away from bureaucracies, towards empowering people to do things for themselves. He left the religious faith that had been important to him, but retained its values of justice and compassion, until his death on 22 June 2010. Christchurch associate Dr Murray Laugesen says Malcolm's experience in New Guinea \"laid the foundation for the way he looked at healthcare in New Zealand\", leading to his pioneering and leadership roles in planning for general practice. Health researcher Professor Ross Barnett says Malcolm was most influential in improving the spread of New Zealand's GP workforce and in moving medical planning to a horizontal integration of groups and services. Malcolm grew up in a Brethren family at Richmond, Nelson. He won a Junior Scholarship at Nelson College and studied medicine at Otago University. His years in Dunedin fostered a love of tramping and mountaineering. He married Irene Hodge in 1953. He served as house surgeon at Christchurch and Blenheim hospitals in 1954 and 1955, and then as a registrar at Christchurch Hospital. For the next 17 years he worked for the Australian Government in New Guinea. Lyn says a wish to be unconventional, with a sense of missionary fervour, drove him. He, Irene and their children were the first white people that many highland tribesfolk had seen. He led the building of churches and swimming pools in two villages. Moving about the jungle brought him into the crossfire of warring tribes. He survived a plane crash in which the pilot and passenger were killed. Medical care involved treatment of diseases new in remote areas and wounds inflicted by bows and arrows. Lack of protein in the local diet led Malcolm to initiating the growing of peanuts and sparked a lifelong interest in nutrition and growth. In his final years in the country, Malcolm developed national health plans for New Guinea, working in Port Moresby. His stay in New Guinea was broken by a study trip to Britain, where he qualified as a Fellow of the Royal College of Physicians, in Edinburgh. Research in New Guinea brought him a Doctor of Medicine degree from Otago. He added qualifications in tropical medicine, at Sydney, and public health administration, at Massey. He returned to New Zealand in 1974 determined to revolutionise public health planning. He persuaded the Director-General of Health to set up a Health Planning and Research Unit in Christchurch. While heading this unit, he married Lyn Wright, in 1982. He took a consultancy position with the Department of Health in Wellington in 1984 and became Professor of Community Health at the University of Otago's Wellington School of Medicine in 1985. Malcolm moved back to Christchurch in 1995 and, with Lyn, established Aotearoa Health, a consultancy service in health policy, management and research. He wrote papers for medical journals and articles for The Press on such issues as primary and clinical care of the elderly, M ori and under-privileged sections of society. Barnett says Malcolm was \"more than an academiche was an activist: he never let go\". He was a model for academics, as \"the critic and conscience of society\". Malcolm was elected to the Canterbury District Health Board in 2004 but was defeated three years later, a victim of voters' disillusionment with the Christchurch 2021 political movement, of which he was part. Lyn says he planned to stand again this year but as an independent. He was a member of many national and international boards and committees. Laugesen says: \"Malcolm's main passion was primary healthcare in Canterbury\". He was tenacious in his research and a pioneer in planning. The unit he headed in Christchurch was the first of its kind. His ideas were \"ahead of his time\". Christchurch GP Dr George Chisholm says Malcolm was a forward thinker and \"very committed to the development of good integrated healthcare\". He was the \"backbone\" of planning for aged people's care. \"He was meticulous in research. He challenged a lot of medical assumptions and clarified a lot of issues, \" Chisholm says. \"He was committed to the absolute, critical place of primary care in the health system. He was ahead of his time in many areas. He could be controversial but he stuck to the facts as he knew them, \" Chisholm says. Lyn says her husband loved a challenge. His fearlessness in tackling the health establishment served him also in his leisure activitiesfrom conquering high mountain peaks, to yachting in many countries, to playing the finest baroque music on his violin, to building a garden at his hillside home. Laurence Allan Malcolm, born Richmond 8 November 1929; died Christchurch 22 June 2010. Survived by wife Lyn, daughter Anne, sons Chris, David and Geoff, seven grandchildren and one great-grandchild. Mike Crean wrote this obituary; it first appeared in The Press newspaper (Christchurch). Additional tribute by colleagues George Salmond and Ross Barnett As longstanding research colleagues we seek to supplement the preceding general account of the life and work of Laurence Malcolm. Malcolm's involvement with clinical work, health policy activities and service planning in New Guinea provided him with knowledge and tools that fuelled his ambition to engage in similar work when he returned to New Zealand in 1974. At that time structured information gathering and health services research activities were just getting started in New Zealand. There was little appreciation of the contribution that could be made by the disciplined gathering, sharing and analysis of data about the allocation and use of health resources. At the time the then Department of Health has a small operations research, later a management services and research, unit based in its Wellington head office. The unit was small with limited capability and capacity. For personal reasons Malcolm wished to work in Christchurch where with a small team of researchers he set up a subsidiary health policy and planning unit. From the outset Malcolm's ideas and concepts about health services planning and delivery challenged conservative ways of thinking and established interests. In particular he was an early champion for moving the focus of health care delivery from hospital to community settings and, by advocating service planning, a way of improving coordination across different parts of the health sector. Using research evidence he also demonstrated unfairness and inequalities in the way health resources were allocated and used to meet the needs of disadvantaged groups and geographically diverse populations in New Zealand. He recognised that in a country like New Zealand with a slowly growing economy, an aging population, rising health care costs and increasing health and health care expectations, it would not be possible to sustain existing patterns of health care delivery. In future such care would simply not be affordable. This prompted his active interest in and support for service and workforce innovation and development particularly in general practice and other primary health care settings. From modest beginnings in Christchurch Malcolm broadened and deepened his information gathering and research activities as Professor of Public Health at the Wellington School of Medicine and later in private consultancy practice based in Christchurch. Malcolm's thinking was always ahead of its time, not only in New Guinea but also in New Zealand. Lack of research resources and information limitations sometimes made it difficult for him to convincingly justify the ideas and concepts he wanted to promote. Often challenging, and sometimes controversial, he was frequently a burr under the saddle of the health sector establishment. He was not just an academic researcher and a planner he was an activist widely promoting his work and that of his colleagues. If he felt that he was on sound ground he was a difficult man to budge, regardless of what opposition was ranged against him. Malcolm pushed the margins. He was an explorer, a navigator and an innovator and as such he was not always right. He was a man of spirit and courage in the pursuit of those causes he had evidence for and in which he fervently believed. He is sorely missed.\r\n

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Seventeen years in New Guinea proved pivotal in the life of doctor and health activist Laurence Malcolm. Working with isolated highland tribes, and then with health policy makers in Port Moresby, altered his perspectives, says his wife Lyn. \"The experience reprogrammed him,\" she says. He set a new course, away from bureaucracies, towards empowering people to do things for themselves. He left the religious faith that had been important to him, but retained its values of justice and compassion, until his death on 22 June 2010. Christchurch associate Dr Murray Laugesen says Malcolm's experience in New Guinea \"laid the foundation for the way he looked at healthcare in New Zealand\", leading to his pioneering and leadership roles in planning for general practice. Health researcher Professor Ross Barnett says Malcolm was most influential in improving the spread of New Zealand's GP workforce and in moving medical planning to a horizontal integration of groups and services. Malcolm grew up in a Brethren family at Richmond, Nelson. He won a Junior Scholarship at Nelson College and studied medicine at Otago University. His years in Dunedin fostered a love of tramping and mountaineering. He married Irene Hodge in 1953. He served as house surgeon at Christchurch and Blenheim hospitals in 1954 and 1955, and then as a registrar at Christchurch Hospital. For the next 17 years he worked for the Australian Government in New Guinea. Lyn says a wish to be unconventional, with a sense of missionary fervour, drove him. He, Irene and their children were the first white people that many highland tribesfolk had seen. He led the building of churches and swimming pools in two villages. Moving about the jungle brought him into the crossfire of warring tribes. He survived a plane crash in which the pilot and passenger were killed. Medical care involved treatment of diseases new in remote areas and wounds inflicted by bows and arrows. Lack of protein in the local diet led Malcolm to initiating the growing of peanuts and sparked a lifelong interest in nutrition and growth. In his final years in the country, Malcolm developed national health plans for New Guinea, working in Port Moresby. His stay in New Guinea was broken by a study trip to Britain, where he qualified as a Fellow of the Royal College of Physicians, in Edinburgh. Research in New Guinea brought him a Doctor of Medicine degree from Otago. He added qualifications in tropical medicine, at Sydney, and public health administration, at Massey. He returned to New Zealand in 1974 determined to revolutionise public health planning. He persuaded the Director-General of Health to set up a Health Planning and Research Unit in Christchurch. While heading this unit, he married Lyn Wright, in 1982. He took a consultancy position with the Department of Health in Wellington in 1984 and became Professor of Community Health at the University of Otago's Wellington School of Medicine in 1985. Malcolm moved back to Christchurch in 1995 and, with Lyn, established Aotearoa Health, a consultancy service in health policy, management and research. He wrote papers for medical journals and articles for The Press on such issues as primary and clinical care of the elderly, M ori and under-privileged sections of society. Barnett says Malcolm was \"more than an academiche was an activist: he never let go\". He was a model for academics, as \"the critic and conscience of society\". Malcolm was elected to the Canterbury District Health Board in 2004 but was defeated three years later, a victim of voters' disillusionment with the Christchurch 2021 political movement, of which he was part. Lyn says he planned to stand again this year but as an independent. He was a member of many national and international boards and committees. Laugesen says: \"Malcolm's main passion was primary healthcare in Canterbury\". He was tenacious in his research and a pioneer in planning. The unit he headed in Christchurch was the first of its kind. His ideas were \"ahead of his time\". Christchurch GP Dr George Chisholm says Malcolm was a forward thinker and \"very committed to the development of good integrated healthcare\". He was the \"backbone\" of planning for aged people's care. \"He was meticulous in research. He challenged a lot of medical assumptions and clarified a lot of issues, \" Chisholm says. \"He was committed to the absolute, critical place of primary care in the health system. He was ahead of his time in many areas. He could be controversial but he stuck to the facts as he knew them, \" Chisholm says. Lyn says her husband loved a challenge. His fearlessness in tackling the health establishment served him also in his leisure activitiesfrom conquering high mountain peaks, to yachting in many countries, to playing the finest baroque music on his violin, to building a garden at his hillside home. Laurence Allan Malcolm, born Richmond 8 November 1929; died Christchurch 22 June 2010. Survived by wife Lyn, daughter Anne, sons Chris, David and Geoff, seven grandchildren and one great-grandchild. Mike Crean wrote this obituary; it first appeared in The Press newspaper (Christchurch). Additional tribute by colleagues George Salmond and Ross Barnett As longstanding research colleagues we seek to supplement the preceding general account of the life and work of Laurence Malcolm. Malcolm's involvement with clinical work, health policy activities and service planning in New Guinea provided him with knowledge and tools that fuelled his ambition to engage in similar work when he returned to New Zealand in 1974. At that time structured information gathering and health services research activities were just getting started in New Zealand. There was little appreciation of the contribution that could be made by the disciplined gathering, sharing and analysis of data about the allocation and use of health resources. At the time the then Department of Health has a small operations research, later a management services and research, unit based in its Wellington head office. The unit was small with limited capability and capacity. For personal reasons Malcolm wished to work in Christchurch where with a small team of researchers he set up a subsidiary health policy and planning unit. From the outset Malcolm's ideas and concepts about health services planning and delivery challenged conservative ways of thinking and established interests. In particular he was an early champion for moving the focus of health care delivery from hospital to community settings and, by advocating service planning, a way of improving coordination across different parts of the health sector. Using research evidence he also demonstrated unfairness and inequalities in the way health resources were allocated and used to meet the needs of disadvantaged groups and geographically diverse populations in New Zealand. He recognised that in a country like New Zealand with a slowly growing economy, an aging population, rising health care costs and increasing health and health care expectations, it would not be possible to sustain existing patterns of health care delivery. In future such care would simply not be affordable. This prompted his active interest in and support for service and workforce innovation and development particularly in general practice and other primary health care settings. From modest beginnings in Christchurch Malcolm broadened and deepened his information gathering and research activities as Professor of Public Health at the Wellington School of Medicine and later in private consultancy practice based in Christchurch. Malcolm's thinking was always ahead of its time, not only in New Guinea but also in New Zealand. Lack of research resources and information limitations sometimes made it difficult for him to convincingly justify the ideas and concepts he wanted to promote. Often challenging, and sometimes controversial, he was frequently a burr under the saddle of the health sector establishment. He was not just an academic researcher and a planner he was an activist widely promoting his work and that of his colleagues. If he felt that he was on sound ground he was a difficult man to budge, regardless of what opposition was ranged against him. Malcolm pushed the margins. He was an explorer, a navigator and an innovator and as such he was not always right. He was a man of spirit and courage in the pursuit of those causes he had evidence for and in which he fervently believed. He is sorely missed.\r\n

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

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