Pioneering doctor and medical health officer in Liverpool who battled against infectious disease, slum conditions and pollution
From 1948 until 1974, Andrew Semple's patient was the city of Liverpool. Semple, who has died aged 101, was one of Britain's great 20th-century city medical officers of health. Under his guidance Liverpool tackled some of the persistent problems of infectious diseases, slum housing and air pollution that were a result of its rapid and often unplanned 19th-century growth. His ability to see the city as a living being, in which the health of residents was implicitly bound up with the declining fortunes of the economy, was one of his strengths.
Semple was born in Glasgow and educated at the city's Allan Glen's school, notable for producing an unusually large number of politicians, scientists, actors and entrepreneurs. He graduated in medicine from the University of Glasgow in 1934 and specialised in public health, serving as an assistant MOH (medical officer of health) in Paisley, Portsmouth and Blackburn.
During the second world war he served in the Royal Naval Volunteer Reserve, electing for active service in the Second Submarine Flotilla, where he gained the rank of surgeon commander. Following an accident in the Tay estuary in which two British submarines attacked each other at night because they failed to recognise each other's signals, Semple made an important contribution to naval safety. He recognised that submariners who went from the brightly lit interior to the observation tower were unable to quickly dark-adapt their eyesight. His recommendation for internal submarine and ships' lighting to be amber (later changed to red) was immediately implemented.
After 18 months with the submariners, Semple was transferred to Liverpool as medical officer for the Western Approaches. He took with him his wife, Jean, whom he had married in 1941. Within a year of settling in Liverpool, Semple was posted again, this time as naval medical officer for Malta and the central Mediterranean.
After the war he returned briefly to Blackburn before promotion to senior assistant MOH in Manchester. He became deputy MOH in Liverpool in July 1948 and arrived shortly after the creation of the NHS. Semple was employed not by the NHS but by the city council, as all MOHs had been since 1847, when Liverpool pioneered the role with the appointment of the doctor William Henry Duncan.
The creation of the NHS was a missed opportunity to unite preventive and curative health services under one administration, but there were advantages for public health being based within the local authority as it provided closer working relationships with social services – a model that is now being reinvented.
In 1953, on the retirement of Dr William Frazer, Semple was promoted to MOH for Liverpool, simultaneously taking on the positions of port medical officer and professor of public health at the University of Liverpool. He now had full responsibility as the city entered its postwar economic decline. There were persistently high rates of infectious diseases such as tuberculosis, which Semple tackled with boldness and creativity. He devised a mass x-ray campaign to run in 1959. Requisitioning mobile x-ray vans from around Britain, he urged every Liverpool resident – around 500,000 people – to attend for a chest x-ray to uncover asymptomatic tuberculosis cases.
There was initial hostility from the dockers, who suspected that if found to be infected they would be declared unfit for work and were advised by their union representatives not to participate. Semple got around this by talking to the dockers' wives and setting up raffles and other incentives. He worked with the local press, cajoling resident and visiting celebrities such as Ken Dodd, Yul Brynner and Margot Fonteyn to be photographed after having x-rays. The campaign uncovered a significant number of new TB cases and led to a dramatic reduction in new infections.
Semple was also instrumental in securing priority rehousing for families of TB patients through his lobbying of members of the council's housing committee such as Bessie Braddock, whom he took on tours of the Victorian slums. He helped to design replacement housing estates on the outskirts of Liverpool: Kirkby, Speke and Knowsley. His fact-finding visits to New York in the 1960s to witness high-rise urban living convinced him that Liverpool should follow suit. Locals berated him for breaking up communities and many people viewed his proposed internal lavatories as more unsanitary than the outside ones they were to replace. For many years after rehousing, men travelled back into Liverpool by bus to drink in their old pubs, now left marooned in the slum-cleared wastelands.
Semple also made child and adolescent health a priority, introducing immunisation schemes for whooping cough and polio, and establishing one of the first health education teams in Britain, in 1971. His concern with the rising number of babies being born "out of wedlock", as he put it, led to him setting up a municipal family planning service to supplement the struggling charitable one then working in Liverpool. He initially disguised his annual budget allocation to this service by calling it a "mothers' welfare fund". When city councillors asked for more information, many of the Catholic members were appalled to learn that they had been effectively condoning contraception "on the rates" for several years. Semple fought his case that Liverpool needed a "balanced community" and that working-class women should not be denied the family planning services that their middle-class counterparts could more easily afford.
His success in establishing this free local authority family planning service is testament to his political nous and tenacity, which he exhibited in many successful battles with the city council, such as the introduction of one of the UK's first smokeless zones under the 1956 Clean Air Act. This targeted atmospheric pollution, especially from Liverpool's coal-burning Clarence Dock power station. Its three tall chimneys, known as the ugly sisters, deposited acidic grit on buildings and cars, and contributed to high rates of chest diseases.
Semple's suggestion that the town hall committee rooms should be (tobacco) smoke-free was a step too far for local councillors.
He was a gregarious collaborator, keen to push Liverpool city council as far as possible to improve public health and social services, and he demonstrated concern for the welfare of elderly people through the creation of bespoke residential units and care homes. Under his direction Liverpool was one of the first local authorities to employ mental welfare officers, and he helped to establish an employment unit for adolescents with learning difficulties.
At a national level he used this expertise to serve on the 1959 Younghusband Committee on social workers, and on government committees tackling the elimination of smallpox and rabies. He was a member of the faculty board of the Royal College of Physicians, chair of council and treasurer for the Royal Society of Health, and, from 1963 to 1965, honorary physician to the Queen. Semple was closely involved with the World Health Organisation and his work in Liverpool was the feature article of the World Health magazine in 1963.
Semple's retirement coincided with the abandonment of the MOH title and the reconfiguration of the role as community physician within the new NHS area health authorities. He worked part-time for the Liverpool AHA, advised junior colleagues and conducted occupational health medicals for seafarers. His long association with Liverpool ended when he and his wife moved to Northamptonshire to be closer to their daughter, Maureen. He was a witty and precise raconteur of his Liverpool endeavours, delivered with an undiminished broad Scottish accent.
Jean died in 2012. Semple is survived by Maureen, four grandchildren and three great-grandchildren.
• Andrew Best Semple, doctor, academic and health official, born 3 May 1912; died 15 November 2013