Being John Moxham - part one

Prof John Moxham [pictured below], Director of Value Based Healthcare at King’s Health Partners, has announced he will retire in October 2019.

His career spans nearly 50 years, and he has either held positions at or supported work right across our partnership. And he is something of a legend within the London health system, having influenced regional and national policy, including campaigning for the integration of mental and physical healthcare. Few others have had a club, namely the King’s College Hospital Moxham Club, named in their honour.

In this first part of a wide-ranging interview, our Communications Officer Rachel Brooks, sat down with John to hear about why he became a doctor and his career leading up to King’s Health Partners.  

You have had an incredible career – did you always want to be a doctor?

I think I was certainly always in awe of doctors because when I was a child our local GP – a chap named Dr Savory - had a remarkable influence on our family.

This was in the days before the NHS existed. My father had died when I was a young child and I have no memory of him. After my father died, Dr Savory came voluntarily and regularly to see my mother to check how she was coping and give her support as she had three young boys to raise on her own.

I can’t emphasise enough that his care for my mother was extraordinary for the time, when most paid for their healthcare and those who couldn’t afford it went without.

My mother had left school at age 15 because of her poor eyesight and worked in a shop. Although I do not remember feeling poor, we obviously were poor. Many people in our small market town in Worcestershire were kind, having known my mother all her life, and regularly left fruit and vegetables for us.

And how much did these early experiences impact your later choices?

A huge impact. By the time I became a teenager the notion that I might become a doctor was often in the back of my mind. Plus I rather liked hospitals! I had spent quite long periods in an orthopaedic hospital near Birmingham. I liked being there – everyone was wonderfully cheerful and kind (the nurses used to give us chocolate!).

When I was at Grammar School I chose to do science A levels, however I still had nagging doubts that I could be good enough to be a doctor. There were two other boys there who wanted to be doctors. One was the son of the Headmaster and the other was the son of a doctor.

The school arranged for me to discuss my ambition with several local GPs. These visits turned out to be very anxiety provoking. It became increasingly clear to me that their world was totally different to mine; they were of a totally different class. In fact they were in a different class from most people in our town. I am sure they meant well and I was being over sensitive – perhaps a result of reading too much Orwell! But I have to say that even now thinking about those experiences makes me feel uncomfortable.

So what changed?

It turned out to be a long journey! One of the teachers at my school was particularly supportive to me. He knew I was very interested in politics and social sciences so suggested I should stay on at school for a further year, study Economics at A Level and apply to the London School of Economics (LSE).

And did you?

I did exactly that. My time at LSE had a big impact on me. In the 1960’s it was a very dynamic and stimulating place. Anyone who was anyone gave visiting lectures and I was greatly informed and influenced by the leading social science academics. Of course, there were many demonstrations! It was the time of Rhodesia, Apartheid and Vietnam.

I became very interested in how organisations work, particularly the notion that it was difficult for individuals to achieve change in pyramidal structures. I concluded that for an individual to have a real impact on improving the lives of others they had to be at the top, the boss, or at the bottom, working directly with people.

All of this took me back to thinking about medicine again. You can’t sort all the problems of patients but you can help and support them to get the best out of their lives.

[Image: John pictured 'on the road' in Kabul in 1969]

Where did your career go from there?

I graduated from LSE in 1967 and started Medicine at University College London (UCL) in the autumn term of 1968. My clinical years at University College Hospital were wonderful and after the final examinations I was appointed to be House Physician on the Professorial Medical Unit.

Over the next nine years I worked in several London hospitals and while I did not plan my career, I was totally engrossed in my work. I really enjoyed both my studies and clinical work - it is a wonderful thing to learn how to talk with patients and understand how to best help them.

During this period I had lots of opportunities to do research and write papers. In those days the hours of work were very long but the clinical experience was immense and the involvement in teaching and research stimulating.

[Image: John in the 1970s surrounded by paper records, before electric records existed, working on research]

Although I must confess - years later my wife Nicky was rather peeved when she realised that many of my visits to the hospital in the evenings and in the night were related to research studies and were not really clinically necessary…

What brought you to King’s College Hospital?

In the early 80s consultant posts at London Teaching Hospitals were few and far between.

Eventually, a consultant post was advertised at King’s College Hospital.

Neither Nicky nor myself had ever been to King’s College Hospital - we were living in Hackney at the time - so we made the journey across the river and looked around Camberwell, Brixton, Peckham and the Hospital…

[Image: King's College Hospital in 1980 taken by John]

What did you think?

Well we both agreed that this was a ‘real’ place with lots of ‘real’ people. It was, and in some cases remains, a seriously deprived area of London, with huge healthcare needs and a hospital that was and is still a crucially important asset to the community.

I applied, survived the meeting with all the consultants of King’s College Hospital who wanted to meet the applicants - which in those days was referred to as the trial by sherry! - and was appointed. I joined a wonderfully supportive consultant colleague, Dr John Costello, and started in October 1982.

As soon as I started as a consultant at King’s College Hospital I knew we had made the right decision. Nicky and I had already agreed that it would be important for us to live within the community served by any hospital that I would work at for 30 years or more. Within a year we had moved to a house in Camberwell and we remain enthusiastic ‘Camberwellians’ to this day.

[Image: John and his wife Nicky at a dinner function]

Join us for part two, where we find out how John went from King’s College Hospital to King’s Health Partners, his favourite moments and his advice for those taking up the baton.