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Ekkehard Von Kuenssberg

Former general practitioner (b 1913; q Edinburgh 1939; CBE, FRCP Ed, FRCOG, FRCGP), d 27 December 2001.

Ekke Kuenssberg’s name will last as one of the great names in the history of British general practice.

He was the son of Professor Eberhard Von Kuenssberg, a member of the faculty of law at Heidelberg University, and with a family tree dating back a thousand years. His mother, Dr Katharina Von Kuenssberg, was a distinguished biologist in her own right.

Education at Salem, where he was head boy, led on to Innsbruck University. By 1933, however, the new Nazi regime was becoming ever more menacing, and a family decision was made that Ekke should leave Innsbruck and go to the United Kingdom to continue his education.

The account of his journey to Edinburgh and how he was accepted as a student by Edinburgh University medical school is a wonderful story in itself which is documented in the university graduates’ association journal. He graduated in 1939, but as well as his academic studies, he had time for play, and gained a blue for hockey, founded the university ski club, and was a co-founder of the yacht club.

His alien status in 1939 restricted the range of medical jobs he was allowed to do, and in May 1940 he was interned for five months. When released from internment he returned to Edinburgh and became a locum to Dr C E Munro, who was on war service. Then he was thrown into general practice at the deep end. The workload was enormous. Poverty, overcrowding, and men away at the war all caused problems in addition to the difficulties of dealing with illness with a limited pharmacopoeia. The ability to carry out domiciliary midwifery was expected of the GP and 36 confinements in the first six months were a brisk introduction to the art. This experience was also an undoubted help in his becoming a part of the community.

In February 1944 Ekke achieved his desire to join the forces and he was commissioned as a subaltern in the Royal Army Medical Corps. Three years later he was demobbed as a lieutenant colonel, having been an assistant director of hygiene in East Africa.

He returned to Granton in 1946 and went into partnership with Charles Munro. The post war demands on the new NHS were tremendous, the area was expanding with the building of new housing, and Ekke’s energies were initially fully occupied not only by the workload, but in developing his vision of general practice. New premises more suited to the modern practice of medicine had to be found, and of course new partners to help with the work (nine when he retired).

He had very clear ideas about how primary care should develop. In the 1950s and early 1960s, general practice was in a parlous state: underfunded and the doctors overworked, with no incentive to carry on good practice. The GP was separated from the diagnostic tools and ancillary help of the hospital. General medical practice was regarded as a cottage industry and its sad state was highlighted by the Collins report. Kuenssberg in his capacity as chairman of the Scottish General Medical Services Committee of the BMA was one of the four representatives of the profession who negotiated the GP Charter with the minister of health, Kenneth Robinson. The agreement reached revolutionised general practice and equipped it to deal with the problems of the second half of the century.

He had an incredible capacity for work. During the two years of the negotiations he spent countless nights in London or on British Rail sleepers and was known to take an afternoon flight home in order to do an evening surgery.

Shortly after this he was awarded the CBE, a just reward and recognition of all that he had achieved.

Patients always came first, but his capacity for work showed itself again in the way that he became so enthusiastically involved in the affairs of the Royal College of General Practitioners. He was a founder member, a fellow, chairman of council, and finally president. It would be impossible to list here all that he did. He travelled the world on behalf of the college: the United States, Canada, Australia, New Zealand, South Africa, the Middle East, and Europe. Out of all the work that he did it is difficult to be selective, but one thing comes to mind. The college council had doubts about the ability of the college to mount the oral contraceptive trial. Ekke pushed, encouraged, and persuaded his colleagues to go ahead. This trial was and remains the biggest survey of the health of women taking the contraceptive pill, and it continues to be quoted today.

Ekke had a questing, observant, and inquisitive mind. Before the effects of thalidomide on the fetus became obvious, he, with Simpson and Stanton, the neurologists at the Northern General Hospital, had drawn attention to some curious neurological disorders appearing in patients on thalidomide. It may have been as a result of this that he was invited to join the first committee on the safety of drugs, the Dunlop committee. He was the only GP on a committee composed entirely of professors.

Despite all the fame and honour that he received, Ekke Kuenssberg was essentially a very humble man, sensitive and concerned at all times with what he could do for medicine and the colleagues and patients that he was involved with.

A great deal of what has been described is on record, but what few people outside his surviving partners and the many thousands he cared for over the years know is what an outstandingly, kindly, skilled, compassionate, caring family doctor he was. He had infinite patience for those who needed his time (although he had no time for the scrimshanker). He had a shrewd sense of what was needed, not always drugs, and had the gift of the quick and pithy remark that would put a problem into perspective. He had an almost intuitive diagnostic ability. He showed immense kindness, concern, and gave practical help at all hours. He epitomised the caritas of the college motto. He worked for the good of the greater community by setting up "The Care Committee" composed of the local councillors, ministers, social workers, and a GP, the purpose of which was to consider the social problems of a deprived area and suggest ways of dealing with them. He was closely associated with the Queen’s Nursing Institute, advising, helping, suggesting methods whereby the principles of community nursing could be propagated. On his retirement from their committee, a scholarship bearing his name was created.

In all that he did he had the willing support and encouragement of his partners, but his mainstay was Constance, his wife of more than 50 years, who, with immense good humour and wisdom, put up with disruptions to family life, to frequent absences, anxieties, and appalling hours far beyond the experience of the normal GP’s wife. To her the profession is in debt. [Alan Large]