STATE LIBRARY OF SOUTH AUSTRALIA

J. D. SOMERVILLE ORAL HISTORY COLLECTION

OH 755/14

Full transcript of an interview with

ANTHONY RADFORD

on 6 May 2005

By Karen George

Recording available on CD

Access for research: Unrestricted

Right to photocopy: Copies may be made for research and study

Right to quote or publish: Publication only with written permission from the State Library

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OH 755/14 ANTHONY RADFORD

NOTES TO THE TRANSCRIPT

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OH 755/14 TAPE 1 SIDE A

This is an interview with Anthony Radford being recorded by Karen George for

the 30th

anniversary of the Inner Southern Community Health Service. The

interview is taking place on the 6th

May 2005 at Kingswood in South Australia.

First of all I’d like to thank you very much for agreeing to be interviewed for the

project.

Can we start by you just giving me your full name and date of birth?

Anthony James Radford, born sixty-eight years ago tomorrow.

Oh, congratulations! Which is 7th

May.

Seventh of May, 1937.

Okay. Whereabouts were you born?

I was born in Kew in Melbourne, Victoria.

Can you perhaps give me a little bit of background about your training and your

movement into Medicine, so that we can see where you’re coming from when

we’re talking about – – –?

Well, I guess I wanted to be a doctor from about the age of fifteen, and I was going

to do Medicine in Melbourne but my parents – where I was boarding; my parents

were in Hobart, and my last year of school they moved to Adelaide and so I went

into the Medical School here in Adelaide at The University of Adelaide, and

finished my course there in 1960. I then did a year’s internship, as they now call it,

at the Queen Elizabeth Hospital at Woodville, and then I did six months at the

Queen Victoria Maternity Hospital, as it then was, opposite the Victoria Park

Racecourse, and then six months at the Children’s Hospital in North Adelaide. And

I choose those two areas of training because I had a cadetship to go out to Papua

New Guinea, where I worked for most of the next ten years. And in those ten years

I had one year’s training in Public Health in America, and six months’ training in

England in the areas of Tropical Medicine and Public Health.

Where did your interest in public health and primary health care come from?

Well, I guess that I always wanted to practise where there was a greater need than

there was in Adelaide, and in Papua New Guinea you were everything: you were

the doctor, paediatrician, general practitioner, administrator, public health officer.

In one area I was the only doctor for fifty thousand people, so there are two things

4

there: anything you can get anybody else to do competently meant that you didn’t

have to do it; and one also realised that a large amount of the burden of illness and

premature death was from conditions that could be prevented, like immunisation

preventing whooping cough and reducing TB1, and simple nutritional values and

diets would stop the large amount of malnutrition, I was saying, which interacts with

infection – if you’re malnourished you’re more likely to get infected and more likely

to die. And so they were sort of principles that I transferred into the medical course

at Flinders when I came there.

I left New Guinea and went to – actually, for two and half or three years – to the

Liverpool School of Tropical Medicine, where I set up a master’s degree, I think the

first multidisciplinary master’s degree, in Public Health in Britain, if not in Europe,

in 1972, and then came back to accept the Foundation Chair in what was then called

Primary Care and Community Medicine. And I think Deane Southgate had a real

role in choosing that name. He was on the planning team for the new medical

school at Flinders, and also he was involved in establishing, as you know, probably

the first – if not the first, second – community health centre. And this was right

along the lines of my own thinking, that a medical school department should involve

not only the primary care of general practice situations but the primary care of

places of first contact: occupational health nurse, school health nurse, women and

children’s work.

And one of the problems, of course, was that medical students got very little

training in that area. The community medicine in those days, public health, was sort

of a verba non gratia, and so –

Why was that?

– people didn’t talk about public health very much. Community medicine became

the thing. I think one of the real problems – and this was about the time of the

change – is that the only doctors who went into public health were in fact ones who

found it difficult getting a job in other areas in medicine. It was looked down and

degraded – in fact, general practice was degraded by much of the hospital-based

medicine, and yet of course that’s where nine out of ten medical encounters took

1 TB – tuberculosis.

5

place – and so I was determined to establish an undergraduate medical course

stream which raised the status of general practice and students’ exposure to it, and

also of public health. When Whitlam came to power, his government was very keen

on this concept of community health and community medicine, and he in fact did

what I think only two other medical schools in Australia at that time had done: he

actually gave money to every medical school to establish a unit of Community

Medicine and General Practice. In fact, Flinders, in its dream, in its planning, had in

fact already set aside that there would be a department in Primary Care and

Community Medicine, and that was the reason even before I went to Britain that I

was interested in Flinders, in a new medical school –

Where did that idea come from at Flinders?

– with a new ethos.

Do you know?

I don’t know where it came from. I know that the dean of the medical school there,

Frankel, was particularly keen that students should have early contact outside of the

medical school, and (sound of mobile telephone interference) Deane I think

influenced them, because he had an interest which was really far wider than the

average general practitioner.

Tell me a little bit about him, I guess, and his interests.

Okay. Well, he was a graduate of also The University of Adelaide a few years

ahead of me – he was a senior medical student, I think, when I was a junior one –

and he realised that there were many aspects of general practice-type medicine that

in fact other health care professionals could do equally well or better than general

practitioners. And a lot of those aspects in fact some doctors were really not

particularly interested, and they certainly were not trained. A classical one would be

counselling, the use of community health nurses and clinical psychologists.

One of the real problems with medical education at that time was that students

didn’t know what a physiotherapist did, or an occupational health nurse, or even

what a psychologist did except talk to people. And Deane Southgate in Southern

Adelaide, what’s his name, Bonnin – no, who was it? – Richard Laycock down at

Christies Beach, Michael Bonnin out at St Agnes and Tim Murrell, who was the

6

counterpart of my department at The University of Adelaide, together with a chap

who was with Tim Murrell – might come to me in a moment: they were all leaders

in establishing the first five community health centres in South Australia. Part of

the Whitlam bag of money for community health was to get community-based

health services available. And I still believe that they’re best attached to a general

practice – whether it’s intimately attached, as they all were to start with, or

adjacently attached, for example as the Clovelly one is, where it’s in the same

building complex at Christies Beach. It was intimately attached, even more so in the

complex, and the general practice moved away from the community health services

and now two kilometres separate, away from them.

There was quite a lot of, even at Clovelly Park, an antagonism from other general

practitioners when the community health centres were set up.

Tell me about that.

Well, they were concerned that they would bleed their patients from their practice to

the adjacent practices. Absolutely no justification for this, but that was their feeling

and we had to go along with it and wear it, and wear it down and out.

How did you go about that, do you recollect?

Well, the thing is that first of all no patients that I know of – and there may have

been one or two – were ever, you know, what the pastoralists call it: ‘sheep

stealing’. They felt that if they sent their patient down to see the community health

nurse at Clovelly Park, for example, that would be the last they saw of them, they

would lose them as a patient. They didn’t appreciate either the value or roles and

responsibilities of the various components of a community health centre, and that

was one of the community health centres’ first tasks. And in this sense Deane was

an excellent person to establish this.

He had a marvellous relationship with the College of General Practitioners, he

was such an outgoing sort of guy that people related very well to him, and of course

he had this particular interest in occupational health because, being in the ribbon

development area of South Road, his practice – and I think there were about five,

from memory, in the practice at the time, and I used to do part-time work there

because Deane had a half-time appointment at Clovelly Park – it was full-time, but

he became half-time at Flinders in the School of Medicine in the Department of

7

Primary Care and Community Medicine – and so one of the areas that he

established, and this is true of most of the community health centres, they

established units in relation to the need. So in this particular area Elva Abrahams, I

think, was the first sister appointed as an occupational health nurse. And

particularly as a resource for the smaller businesses, because there are so many little

businesses along there, people who were electro-platers or something of that nature,

maybe employing two, five, ten people, that certainly couldn’t afford an

occupational health nurse. So there was this resource was available for them.

The other things, for example, in this particular area, evolved quite a concern

over the domestic violence. And I think it was one of the first, if not the first, to set

up – this was some years after they actually got under way – a program for

counselling men in group therapy who were violent towards their wives. There

were psychological services, there were school health services, there were broadly-

based community health nursing activities which were part counselling, part

parenting and so on.

Taking you back just a little bit to the beginning of the Centre, I just want to

establish the date that it’s occurring, so it’s about – you came back to Australia in

19 – – –?

July 1975, and I think the Health Centre really only got going a few months before

that, in early ’75.

And you were invited to come onto that committee.

Yes. Originally Gus Frankel, the Dean of Medicine, I think was the representative.

I don’t know whether he ever attended or very often, because he was so busy. But

right from the very beginning, Flinders had a very, very close relationship with the

Clovelly Park Community Health Centre, and Deane of course had an appointment

– well, he was of course the first director of Clovelly Park, he was one of the senior

general practitioner partners, and he was a senior lecturer and later associate

professor at the School of Medicine at Flinders. And so I took over from Gus

Frankel as the Faculty of Medicine representative on that Community Health Centre

board, as I did with the other one in our then area, the Christies Beach Community

Health Centre.

What sort of role were you to play, being brought onto that committee?

8

Well, I guess one of the briefs of the Health Centre was that they would take

students of varying professions to have attachments to the Community Health

Centre, and of course this was a particular interest, from what I’ve said, of mine:

that students were significantly involved in understanding the roles and

responsibilities of community-based health workers, other than general practitioners

– as well as. And at that particular practice where they got attachments, of course,

they often saw the interaction, because I can remember you’d take down a girl in

tears who’d come in perhaps who was pregnant and you could introduce her straight

away to the Community Health Nurse. Because many of these kinds of things, if

you say, ‘Well, ring up and make an appointment,’ of course a number of them

don’t ever catch up and you don’t know whether they’ve survived or sunk. So I was

particularly interested – I was particularly interested in the development of

community health care anyway, and so this was an opportunity to look at it.

One of my dreams was, in fact, to establish a community health nurse training

program and to try and combine the school health nurses, the community health

nurses, the mothers’ and babies’ health nurses, all in a generic training; and in fact

that they worked from community health centres all over Adelaide in those specific

roles. But of course the ‘territorial imperative’ of Robert Ardrey – I don’t know if

you’ve read any of his books – is that everybody wants their own kingdom,

irrespective of whether it’s better management or better care; it didn’t ever eventuate

as such, although some of them did combine. We had community health mental

nurse from the psychiatric services was also there – ‘mental health nurse’, I suppose

we ought to say, rather than a ‘mental nurse’.

So coming into that –

And then – sorry –

– I’m sorry; you continue, please.

– these groups, they had community groups for children, for women, as I mentioned

also for the violent men, and the psychologist, for example, had a particular role. In

fact, there was a – I think there were two counsellors there: Reg Brand, who had a

very long and extensive experience; Ross Harris was a psychologist there for a

[while] and he also was part-time on the staff at Flinders.

9

Okay. I wanted to talk a little bit about how you set up what the Centre was going

to have, because when you started there really you had the one community health

nurse, I think.

That’s right.

Kate Brown, do you recollect her?

I can remember Kate. She was an excellent nurse, I mean she was just perfect for

that kind of job. She had the right disposition.

What kind of disposition do you think someone needed to have in that role?

Well, I think (a) above all, you’ve got to be able to communicate with people; and

secondly – I think there’s a difference – you’ve got to be able to get alongside them;

thirdly, you’ve got to be able to identify needs; fourthly, you’ve got to know what

the resources are, you’ve got to be able to know what the community resources are;

then you’ve got to be able to connect those people, network those people, with those

people, into the resources they need; and then provide a follow-up that in fact their

needs are being met. And I think – I’m a great believer in middle-aged women in

these roles, particularly if they’re mothers and have successfully brought up a

family. I’m a great believer in experience in the real world in these kinds of places.

Whether they’re social workers or nurses.

So let’s talk about some of the people that were – I can just throw out some names

that were on that committee with you, and whether you can I guess give me an

insight into who they were and what they may have contributed. There was Dr

Denton, who was also at the Southern Clinic with Dr Southgate.

That’s right, Noel Denton. He was a tall, really a fairly quiet, solid individual, I

guess, is the way – – –. I don’t remember him coming forward with a whole lot of

ideas, but he was a solid person who backed the system and was able to put a sort of

mature perspective into the system.

And there was a Mr Payne from the Hospitals Department.

Oh, yes. What was his Christian name?

‘L’ – I don’t have a name.

Len, Len Payne. Len Payne was a much younger man and he was in the

bureaucratic health service mould, but he really had a very strong empathy for what

10

we were doing, as did Peter Pickering I think, who might have been before Len –

even more so, if anything. So in that sense we got great support from these people,

who also helped us tread our way through the health bureaucracy when it was

needed.

So that would have been the reason that they were part of the committee, in a

way?

Well, no; the reason of course is that they – from memory we had both

Commonwealth Health and State Health representatives, because the

Commonwealth, through the Whitlam bag, were providing the cash, but a lot of the

staff – almost all the staff – were employed by the state health system. So as I

remember it – and, gosh, it’s going back (laughs) thirty years – – –.

Well, I have a Mr Dubelly, C Dubelly, who was [from] the Australian Department

of Health, so he perhaps – – –?

Cliff Dubelly, he was a doctor and he was the husband of Marjorie Dubelly, who

was a general practitioner also working in the area and also a member of my staff at

the Department of Primary Care and Community Medicine. Cliff was, in fact, the

Commonwealth representative on that. He was a medical officer in the

Commonwealth Department of Health in Currie Street.

Dr Wadsworth, Dr R Wadsworth, from the Southern Clinic.

Bob Wadsworth. I think that – I don’t know whether Noel Denton and Bob were

there. Bob had a particular interest in hypnotherapy: in fact, he’s now exclusively a

hypnotherapist doctor. I think that the doctors who were on those committees, I

think probably it was a mistake that they were all from the same clinic.

Why is that?

I don’t know – convenience, you know. If you’re going to have a meeting – – –.

Why do you think it was a mistake?

Well, I remember saying before that to start with many of the people of the area,

many of the doctors in the area, were very suspicious of community health centres.

And we didn’t have the divisions of general practice, for example, that we now

have; and if we had had I’m sure there would have been a member of the division

would have been on the committee. And I can’t really understand why we didn’t

11

have any representative from other – it’s even possible they refused to serve

(laughs) on it, but – – –!

Well, I’ll raise one thing I found from minute books – I don’t know whether you

remember anything about it – apparently there was an evening called, inviting

something like eighty GPs2 from the general area to come and nobody came!

Well, this gives you an indication. And, you know, if Deane couldn’t do it – – –.

Deane, as I said, had this very, I think, an excellent gift of communicating with

people. He had an extraordinary sense of humour, he was always cracking jokes

and every time you met him, like three times a week, he’d tell you a new joke! And

his pipe was also a feature. But I think it just indicated the depth of suspicion, and it

seemed to us it didn’t matter what we did we had difficulty in overcoming this fear

that the general practitioners had. We had the same thing twenty years – oh, maybe

not twenty years later; fifteen years – later, when we really felt that we should try

and establish a general practice for the university. To start with, we just had Deane

and I and some of the others, and each worked in their own practices. We had six

part-time general practitioners. But we didn’t have control of the way records were

kept or the research that was done and so on that you want to do from the sort of

academic point of view, and we always had trouble getting the right number of

practices to place the students, particularly at short term if someone had to fall out.

So when we tried to establish a general practice where there wasn’t any general

practice – it was down in the Woodcroft area, and it was all fields before they – it

was just on the planning stage; and we said, ‘Okay, we’d like to establish a general

practice there,’ and spoke to – there was then a general practitioners’ group for each

area; and they were furious and adamant. One, an old classmate of mine I

remember, refused to take any more students, just because we’d set up ..... ..... We

weren’t taking away anyone’s patients, we were trying to set up in an area where

there was not yet a practice. In other words, we weren’t competing with anybody.

And it was a great pity, I think.

What about on the other side, the community around that health centre? What

sort of reaction did you have from the community?

2 GP – general practitioner, doctor.

12

Well, the Community Health Centre became very popular. In fact, its staff

increased quite markedly. Right from the beginning we had two, I think,

community representatives.

I’ll give you one name: Mr Williams, Mr D Williams.

Yes, Don Williamson, he was a businessman. Very efficient, in-out, good use of

time, all that kind of thing. And another one was Mrs Parker – what was her

Christian name?

Joy.

Joy. And they represented two quite different people. I think they were both friends

of Deane, we found it (laughs) very difficult to work out how – and I’ve been in this

situation in many places – how do you get someone who is representative of the

community? And of course my attitude is you can’t. But you can find people who

are good, solid citizens who have particular interests within the community and are

good spokespeople for community thought. So here was one businessman,

representing that side, and one person who didn’t have any particular angle to take.

Joy particularly I remember her contributions repeatedly as being sane and sensible

and relevant to people’s needs. And Don also was very good, but Joy I thought was

outstanding in that kind of representative role.

Let’s talk a little bit about that staffing, you said the staff rose from when you

started quite rapidly: how did you – I mean, that seemed to be, from the minutes,

one of the roles of the committee to talk about what kind of staff and who we

should have.

Well, first of all it was what did we see was important? And there were women –

there was a nutrition – I don’t think I mentioned the nutritionist: they had a kind of

weight-watchers’ group, as I recall – it wasn’t Weight Watchers, but it was

equivalent. One of the things – and it’s a bit hazy now – was really, I think Kate

Brown started it, it was a group for women, particularly single mothers, who were

having difficulty coping, and trying to get a life structure for them. So these were –

the kind of groups that were established and the staff were virtually absolutely

respondent to felt needs or demonstrable needs. We didn’t always have the hard

data, but it wasn’t hard to decide that an occupational health nurse should be early

on the thing, because lots of the patients in the practice were from occupational

13

health problems, and most – many, many of those problems were easily preventable.

So there was clearly a need for that kind of thing.

We mentioned the domestic violence which, in the late ’70s and early ’80s was

becoming more and more prominent, but I think it was into the late ’80s, I think, or

mid-’80s before we actually established that program.

What about the school health nurses? Tell me a little bit about that.

Well, the school health nurse – and that’s where I think Chris Birkin was involved –

I didn’t actually have a great deal to do with them, because there was, I think that

she was originally with the School Health Program, based outside within the

community exclusively, but now she was doing the same – she still belonged to the

School Health group, as I recall, but she was based in the Community Health

Centre, which meant of course that she had immediate access to other forms of

community-based health care that were thought to be required.

I’ll just stop you there, we’re going to run out of tape.

END OF TAPE 1 SIDE A: TAPE 1 SIDE B

Okay.

Yes, we were talking about school health nursing and Chris Birkin. Yes, her

husband worked at the Medical Centre, I remember, as an orderly in the hospital

there. And so she had these contacts that (a) were not there before, and (b) she was

part of, and could use them much more quickly. But I don’t remember a great deal

about her particular – – –.

One of the things – I don’t know whether it rings any bells – but talking to her,

one of the things she set up initially was a bed-wetting, or anuresis, program. Do

you recollect anything about that?

Yes, I think it might have been Ross ....., one of the psychologists took a particular

interest in that. But again, there was this concentration of resources in one place,

and not so many that it became unmanageable. They had a very good ..... too,

actually, where there were the sort of administrative assistants sort of marshalled the

people well and I thought ran it quite effectively when we had to expand. It was –

the Health Centre still is – had part of some shopfronts adjacent to the medical

practice, and then from memory they actually extended, they need to buy or lease or

14

whatever it was the next two shops adjacent because of its size. But in terms of

things, it was a very low-cost health centre compared to some of the others. The one

at St Agnes, which was purpose-built – and I used to call it the ‘Taj Mahal’ – very,

very expensive by comparison.

Was there any disadvantage to having sort of less space in those days?

Oh, no. I think the – well, there probably was never enough space. It’s difficult to

find space for groups of any size. I think its value was its accessibility: you didn’t

have to have a car to get to it, the bus stopped outside the door and it was

immediately in the centre of the shopping centre, which was really ideally placed.

And anyone going in, you wouldn’t know whether you were going in to see the

general practice or in to see the Community Health Centre, because we had a

common doorway. So that had a lot going for it, I think.

I guess primary health care and community health being a fairly new thing at that

stage, this multidisciplinary working together: was that something – – –?

It certainly was new, and I think we’re doing it much better than we used to. And of

course some general practitioners – we did a study on this, I think, I can’t remember

– never ever used it, that we knew, directly; whereas the people of course in the

adjacent general practice, the Clovelly Park Medical Centre, used it the whole time.

But gradually more and more people in the community began to realise (a) – the

doctors, I’m saying – that it wasn’t a threat and the advertising and word of mouth,

like most services, got around and people patronised it.

Through the minutes – I mean, you’re not likely to remember doing this, but it

may be just worth commenting on what you think you might have talked about –

you agreed to talk to all the staff members about their role within the Centre –

Was that me or (laughs) someone – – –?

– yes, it was you, you agreed to do it. Whether you did, I don’t know, (laughter)

the minutes don’t say, actually.

Well, to start with, we had to work out some ground rules, and I guess because of

my experience broadly in community health issues I might have been asked to do

that. But the point was we were trying to see (a) what would be your individual

roles, what aspects did you take up? And of course that partly matched with the

skills of the person, that if you came out of school health or community health

15

nursing you’d have a set of skills. Most of them because that’s the sort of person

you were, rather than definitive training. And then of course (a) trying to get a sense

of team where there wasn’t a team before – most of them had worked as individuals

– and to get a corporateness and a sense of identity for the Health Centre itself.

How did you go about that, getting a sense of identity?

Well, I don’t really remember. I probably spoke to each of them individually and

asked them what they thought their skills were and what they thought the job might

entail. If I’d been doing it now I would have said – I might have then – ‘What skills

do you think you would like to acquire that you don’t have that will be relevant for

the job?’ and make sure that the health centre system training – because we had an

ongoing training program – could provide that for them. And then I would normally

have said, ‘Well, how do you see this interacting?’ – like school health with the

community health nurse, or the community health nurse with the occupational health

nurse, or the counsellor with the psychologist, and these kinds of things. And some

of them, of course, their different programs we’d probably run corporately, maybe

two or three of them, and, as St Paul says, ‘As much as lieth in you live peaceably

with everybody.’ But, you know, it’s not the way we’re built, so the idea of

working together is not always as easy as it sounds.

One of the people that came in early there was Dr Rosemary Crowley and seemed

to be involved with parenting and various other – playgroups and – – –.

Ah yes, Rose. Well, she – very effusive, direct, get on with it, common sense. Of

course she later went on, for many years, into parliament as a senator. And

particularly, she was obviously particularly interested in women’s issues in the

community. And I can’t remember, I think she was part of that practice, was she?

Or whether she came in as a doctor from the community eventually, I just don’t

remember.

That can be found out.

Yes. I think maybe she came from outside and she wasn’t a member of that

particular practice.

I don’t think she was a member of the practice, no.

16

No, no. So I can’t see in my mind’s eye from which angle she came into it, but she

was a very active person. And she, of course, had a lateral – most doctors, in fact,

are fairly vertically-focused in their approaches, but she and Deane are much more

lateral thinking, otherwise you wouldn’t be in that kind of work. I mean, Deane was

the first chairman of the Service to Youth Council, which was trying to address

some of the youth issues, and he was Chairman, I think, for ten years. He was

Chairman – he was very, very active in Rotary; he was chairman of a housing

complex for old people. Needless to say, he was always late for his appointments,

late for his lectures, late as Chairman of the Community Health Centre. He was a

very, very busy man. But, as I said, (laughs) this marvellous sense of humour. I can

remember once when he came to work and suddenly complained of very severe

abdominal pain, and I said, ‘Well, let’s go round to the Accident and Emergency

Unit,’ which was adjacent to our department, and examining him and listening to his

chest. And I thought, ‘Goodness gracious!’ There was this huge heart murmur that

he had. And I then looked at him, he had his eyes shut, opened one of them – he

knew he had it, you see, but he (laughs) wasn’t going to tell me, he was just seeing

(laughs louder) if I picked it up! And he had quite a severe heart valve problem,

which may well have been one of the main reasons he died at the age of sixty while

playing tennis. I think the word was, ‘Here’s a serve you’ll never forget!’ And he

just dropped down. I’m sure someone else (laughs) will have given you more

information, but that’s my understanding of what happened. And I think that his

heart condition – it was just his way of just checking on whether I picked it up or

not, not saying anything and then smiling broadly. He was a wonderful colleague,

really.

You were talking about trying to find out the needs of the community in order to

establish programs, et cetera, that would fit in well there: how did you go about

just finding out the needs of – what the community was made up of?

Well, I guess some of them were really obvious, like the occupational health one.

Some of the other ones came in from people like Don and Joy and their community

base. I don’t remember us, but we might have done some little community survey,

there’s just a vague bell ringing in the back of my head that we did do a survey of

part of the community – I think we put it out in the shopping complexes around us –

to see what people wanted. Mostly it was because these were the kind of problems

17

that we were dealing with in our individual professions, and saying – and this is the

reason Deane and Michael Bollan and Richard Laycock and co, Tim Murrell, took it

up originally – is that they saw that a number of things – and it’s still true today –

coming to the doctor are better handled by other health professionals, (a) because

they’re very time-consuming and GPs don’t have the time, or (b) the GPs didn’t

have the skills or the interest – you can’t be interested in everything – to deal with

those issues. And I think particularly they were in those days lifestyle issues, which

doctors are dealing with much better these days and are trained to do so, but they

were particularly in the psychological, mental, interpersonal relationship area, and

so the programs gradually evolved around those.

You talked about Reg Brand running some of those early courses. One that the

lady that I talked to today mentioned was in effect a ‘helping the helpers’ course,

or something like that.

That’s right.

Tell me a little bit about him.

Well, we had a lot of volunteers – can’t remember how many volunteers we had in

various activities, but we established a toy library, I remember, and a number of

different groups like that in which volunteers were involved. And Reg, being a

counsellor, was very good at motivating people and getting at where they were at.

And I think he might have come from the school – Education Department, I think; I

can’t remember. But they really had an excellent team there.

One of the things that I noticed was started up was a playgroup, I think it was

Rosemary Crowley that began that, and I wondered whether that was potentially

the beginning of playgroups, which are now very common.

Well, the answer is I don’t know, but that was sort of one of these things that grew

out of need. Rosemary, as I remember, had a particular interest in women and

children’s health. You know, the idea of a toy library – there were a lot of poor

people or lower socio-economic people in that area who didn’t have access to, or

didn’t know how to access, resources that would be available for others. I’m just

trying to think: then that evolved things like speech pathology or ‘speech therapy’,

it was called, a number of these children were disadvantaged at school and they

didn’t have the capacity to access them, or couldn’t afford to, because most of them

18

were in private use, but there was a government-funded speech pathologist, or

‘speech therapist’, as they used to be called. Can’t remember whether we had

podiatry or chiropody there, it might, I don’t think so. You know, like the school

health placed their person there, the CAFHS3 group placed their staff there, and so

there was this corporateness. There was family planning, there was drug and

alcohol, and most of the things started [because] there was an obvious need.

Some of the less obvious ones might have been like the domestic violence one,

because to start with it was all fairly silent before it came out into the open. And

then later I was involved with a thing called the Southern Regional Geriatric and

Rehabilitation Advisory Committee, of which the first chairman was Michael

Gribble, the pathologist, and I was the vice-chairman – again, being another aspect.

And there was the Southern Domiciliary Care group. And most of these had

representatives, so they were interrelated. I can’t remember what Southern Dom

Care had: they were based at Repat4 at the time, and I don’t remember whether they

were represented in the area. But mental health was, women and children’s health,

alcohol. So you had some that were established by the system, in other words they

came out of Mental Health Services, they came out of CAFHS; and others were, if

you like, core staff, although, by and large, they worked very well together as a

team.

So if you like there were two teams – I don’t like to sort of say there was a core

team and an outer team, like you have in some group therapy sessions, but in fact

they were. Some of them were appointed by the Community Health Service, and

others were appointed from their parent organisation, like the community

psychiatrist who came just for – – –. A lot of the other people, like the psychiatrist,

came for a session or two or three sessions a week, whereas people like Kate Brown

you mentioned, Elva Abraham and so on, were full-time.

One of the things that later became part of the involvement of the committee was

getting the constitution going, and I just noted on that pamphlet that I handed

you, from the early days, there is a list of the objectives and the aims of the

Centre. I wondered how important it was to get those things in writing?

3 CAFHS – Child, Adolescent, Family Health Service.

4 Repat – Repatriation General Hospital, catering originally for defence service veterans and their

dependants.

19

Well, I thought it was important at the time because I’m very much an objective

person, in the sense that I like – people need to know the structure of the

organisation that they’re in. But my experience is it doesn’t matter how good the

objectives are, they’re often set aside and nobody knows what they are two or three

years down the track. But, you know, as the top line says: ‘to promote health and

wellbeing of members of the community’. So we were trying to take it out of the

sort of medical model concept: ‘You’ve got acute sore throat, let’s deal with that.’

We were looking at things like trying to raise the percentage of people who were

immunised; decrease the stress levels through these various things of parenting

groups, alcohol groups, violent groups; having counsellors there that you could just

come and chat to if things were getting a bit rough; so this concentration on health

and wellbeing, and ways in which we could do that. And we did that by, as it says,

promoting health education, promoting preventive medical care, and a very good

example of that would have been the small businesses where the – there were two,

may have been three at one stage, occupational health nurses and they’d go into

these businesses, with the support of the people there, to see what could be done to

prevent that happening again. And some of these – I can remember doing it –

someone would come in with some medical problem, whether it was a laceration or

facial injury or whatever it was, and then we’d get the community health people to

go back to the business that it came from to see if something could be put in place –

it wasn’t a sort of punitive thing – to prevent that. So the whole emphasis was on

promoting occupational health, promoting school health, promoting preventive

measures and so on.

And of course, as we were saying, talking to people. One of the things was to

promote and develop a teamwork approach to delivering health care, which of

course prior to 1975 was fairly uncommon. We wanted to base it, as the objectives

said, on the needs of the community. Now, there’s a difference between wants and

needs, and of course you can bring the two together if people are presented with

information that can become a want. A need here is something that’s identified, I

suppose by definition, by some sort of study that showed that only eight out of ten

children were immunised, or only two out of every ten women who were suffering

domestic violence received any help, or whatever. So it was trying to make wants

and needs. And the whole business of having wants and needs was one of the

20

reasons we had two or three community people on that committee that was running

the Health Centre.

Yes, the pamphlet is undated, so it can’t actually be – – –.

I remember the pamphlet well. (laughs)

Yes, we’re looking at a, I guess it would be a sort of late ’70s, early ’80s pamphlet

of the Centre.

Mm, I think it was late ’70s, yes.

Tell me about that area where the Centre is in Clovelly Park: what sort of area

was Clovelly Park in the 1970s, late ’70s?

Late ’70s? Well, it has been, I think, for certainly the – even then, in ’75, there were

very few open blocks of land left, there were just a few. Of course it had been sort

of almond areas in years gone by. But the whole of that South Road area, which

was the focus for it, developed as ribbon development. You had both small and big

businesses, you had what was Chrysler – now Mitsubishi – down one end and you

had some of these engineering firms which came up. But a lot of them were quite

small business, but often related to the automotive industry – welding, electroplating

and that kind of task. But it was very busy. Most of the people, as far as I can

recall, lived away from the area, but a number of them lived in and behind the

businesses there. And of course there were the schools, Marion High School is

nearby, and I forget how many primary schools there were.

But one of the things we did at the university in I think it was late ’75 or ’76 or

somewhere about then, ’77, we in fact established, to find out what was available in

terms of health, we made a directory of all the health services. A medical student

called Glastonbury, now an eye surgeon, and I put together a whole thing of all the

different sorts of practices, health centres, community health nurses, CAFHS, for the

area. But I guess most people seemed to operate fairly independently, I don’t know

whether that’s true or not or whether it’s just my memory, and there wasn’t so much

a sense of community like you’ve got in many other areas, and I think that’s

probably true of many industrial areas.

You talk quite a lot about Flinders and the Centre and the links between them:

how closely were they linked in – – –?

21

Oh, virtually only because of Deane and I, I think. It was more a conceptual linking.

Flinders was aiming to produce community-based doctors and people who would go

into general practice – it was one of the things that they said when they set it up –

but that never actually happened. The people who were appointed, even though

they might have had that idea, we were all products of a different system. In fact, I

had a ridiculously small department of two and a half people to cover General

Practice, Public Health, Behavioural Science, Nutrition and Occupational Health,

whereas the more traditional things like Pharamacology might have had five

government appointees or university appointees or four; smaller departments like

Anaesthetics had the same. So the relationship was – and there were always

pressures to reduce the content of students within the community. So it was never

negative, and it was certainly much more positive to begin with, and it was always

there. But apart from my own department, which had people who worked both in

the Health Centre and in the general practice there, and in the university department,

Faculty of Medicine, there was relatively little contact. I think from memory, for

example, sometimes there was an issue on children’s health, for example: the

paediatricians would be quite happy to come and talk about it, that wasn’t a

problem. And of course we also had Ross Harris, who was there for a while, who is

related to both the Medical Centre and the Community Health Centre.

What can you tell me about him?

He was originally a Methodist minister who worked out in the northern suburbs,

Salisbury area. He was a contemporary of mine at university, and then he became a

full-time clinical psychologist. In the early ’70s he had a lot to do with the

Aboriginal community and the Aboriginal Task Force – I think they were based on

North Terrace. He had a wonderful reputation as a clinical psychologist and as a

teacher, which is one of the reasons I quickly appointed him when I got to Flinders,

originally part-time and eventually full-time, as the lecturer in Behavioural Science,

and he set up one of the very first, I think, hospital counselling services. We had a

primary care clinic which was basically for people who were severely grieved or

traumatised or weren’t coping, from a psychological as distinct from a psychiatric –

they may have been partly neurotic, but they weren’t psychotic. And so his wife

was also a nursing sister, community-based, public health-oriented person.

22

I guess I was asking about that because it seems that Flinders had that – I guess

being that Deane was there and that sort of spark and connection, that it’s

interesting in the long run that the Centre has amalgamated with Flinders. The

Clovelly Park Centre, in the ’90s, amalgamated with – – –.

That must have been – I left in 1994, I don’t know what amalgamation – – –.

That happened afterwards, yes, after you left.

What amalgamation?

They’re now part of the Flinders –

They’re part of the Southern Health Services –

– yes.

– but that’s not part of Flinders as such. Flinders and Noarlunga and the health

centres are all part of the Southern Regional Metropolitan whatever it calls itself, but

I don’t know of the Health Centre being under Flinders’ responsibility. Is

that – – –?

Yes, that has occurred, in 1996 it did that.

Is it?

Yes.

Oh, right.

It doesn’t matter; that’s beyond the –

That’s beyond me, that’s after my time.

– yes, your period. I found the period that you resigned from the committee was

in 1981, in the middle of 1981.

That’s right, I’d been there for six years and someone else took on the role, I can’t

remember who.

They were revamping the committee at that stage I think, too.

That’s right.

And it said the reason you did was because you were heavily involved with the

Christies Beach and Morphett Vale Community Health Centres, which obviously

were coming – – –.

23

Well, I was on all three committees. (laughs) The Christies Beach one came on

pretty much after the Clovelly, and then the Morphett Vale one started later. And I

think that everyone at Clovelly Park knew the way I thought and what I (laughs) felt

about the way in which I could contribute.

Which was what do you think you contributed, I guess?

Well, I think I contributed (a) a wider concept of community health, because that’s

what I’d been doing for so much longer in various areas, not just in the medical area.

I don’t know that there’s anything specific that – you’d better ask the other people

what I contributed: ‘I don’t know’ is the answer to that! (laughs)

I guess it’s about your feeling, I mean you put those six years in and then you left

it behind: do you feel that you contributed to it getting going, I guess?

Well, one of the troubles is that my department was so small, I was involved in so

many activities and I had a teaching role – I think probably I spent more than twice

as much as any other professor actually teaching, face-to-face teaching; wanted to

do some research; I was involved in international health work as well, which was

perhaps my major, or one of my major things; I was involved with the – – –. At one

stage I was on thirty-two committees and sub-committees, and in one particularly

bad meeting I sat down and wrote seven resignations, which occupied me for the

rest of that – – –. In other words, a lot of them I was there just because I was the

Professor of Primary Care and Community Medicine – that wasn’t true of this one,

but many of these committees – and so I thought, ‘I’m not putting anything in, I’m

certainly not getting anything out, I’ve got other things to do.’ And one of the

greatest difficulties I found in my job was in fact deciding what were my priorities,

where should I be putting my energies. I mean, I had a wife and three children, and

often we had many more than three children in the house – five for three years – and

there were other things I wanted to do.

I’ll just stop you there and put on another tape.

END OF TAPE 1 SIDE B: TAPE 2 SIDE A

This is the second tape of an interview with Anthony Radford being recorded by

Karen George for the Inner Southern Community Health Service 30th

Anniversary Project. The interview is taking place on 6th

May 2005 at Kingswood

in South Australia.

24

So perhaps just summing up a little bit: have you kept your eye, or any sort of

involvement, with the Centre since you left in 1981, have you been aware of what’s

happened?

Oh, well, I had a much lighter interest there until the end of the ’80s and kept a very

– I was interested in what they were doing and what other programs were being

developed and so on. But I left Flinders in mid-’94 and I’ve had no contact at all in

the last ten, fifteen years.

So, talking about them being thirty years old, how do you feel about the fact that

they’ve made it – – –?

Well, I’m sure they’d make it, because the need was overwhelming when it was

established. And I think that this kind of community-based centre is usually more

accessible, is usually cheaper. As long as it concentrates on – like any government-

funded, you’ve got to work where there can be a reasonable return for the money.

You can never put enough money into child health or child development. I don’t

know what they’ve got, but if I were in charge of government spending I would be

putting far, much more money into family preparation, family formation, family

development and family joy and stability, because, even if forty per cent end in

divorce, it’s the way homo sapiens has best brought up its children is in a family

context, and I think a lot of our problems would be much less and fewer of them if –

and I’m talking about millions of dollars here – Australia would be very much better

off putting the billions of dollars into this than it is in, say, Iraq. And so I’ve

maintained an interest in things, community health; but since I retired I work now

mainly as an emergency physician twice a week, and once every two months I go

off to do a rural GP locum, and I guess three months a year I’m in international

health work, so either training or looking at programs overseas. Because I had ten

years in Papua New Guinea, which was where I developed this particular interest,

and then the training programs at the Liverpool School of Tropical Medicine.

So in that thirty years that the Centre has operated, how do you feel that field of

primary health care has changed from when it began to now?

Oh, I think the whole profile has risen. Our department in fact changed its name

from Primary Care and Community Medicine, for some time, to Primary Health

Care, because that was the ‘in’ phrase, ‘Community Medicine’, and then ‘Primary

Health Care’ – primary health care meaning the – well, people define it differently,

25

but to me you’ve got primary medical care, like a general practitioner’s situation,

and primary health care, like mothers and babies. And occupational health is

usually a bit of both.

And I think – well, rightly so – it’s become much higher-focused because the

emphasis on primary health care is on prevention and health maintenance. So on

one hand we need government policies which facilitate that, on another hand we

need education programs, I’d say from primary school level; and the community-

based programs, like domestic violence, like child development programs, that are

accessible and affordable, and this is the difficulty is to make them both (a)

accessible and (b) affordable.

Something you were talking about, the name of the Flinders department, you said

that Deane Southgate had been involved in that name, and I didn’t pick up on it.

In fact, Deane was an applicant for the job as Professor of Primary Health Care.

Deane was, right at the very beginning, chosen – I’m not quite sure how: maybe if

it was dean, I don’t know what his relationship with Gus Frankel was. Gus came

from being a professor of surgery in New Zealand to be the first dean. But very

early on, Deane was on the board – and this again shows you his lateral thinking –

of the Sturt College, which was then a separate, independent college of advanced

education and involved in some way with nurse training, I think; but he was on that

board. And then from that he got involved in the initial committee structure that

was looking at establishing a new medical school, and then the Department of – a

department which was going to concentrate on general practice and community-

based care and community things, and Deane was in those up to his neck. And I

don’t know whether he was responsible, but he may well have been, for deciding on

those names, because I can’t imagine who else would have come up with them. Gus

Frankel may have had some say in that; I think he probably just went along with it.

And Josie, his wife, might well be able to tell you whether he was responsible, but I

think it highly likely that he was.

Just to sum up about him, how integral do you think his role in the Centre was?

Oh, it was cardinal, in its establishment. But now you can see it’s roaring along

without him, like many of these things. His initial role, his initial energy, his vision

– in fact, many of the committee people just took that role or that vision, and they

26

are the ones who expanded it and added to it and got growth and development out of

it. But fundamental. He just had so much energy, it was quite incredible. (laughs)

Okay. Well, that’s the end of the questions that I have for you, unless there’s

anything else you want to add to that.

No, I don’t know anything else. I hope it’s helpful.

Good, I’m sure it is. Thank you very much.

END OF INTERVIEW.