Paediatric nephrologist who led the development of his specialty in the UK and internationally.
Martin Barratt who has recently died aged 77 from a progressive form of muscular dystrophy, was Professor of Paediatric Nephrology at the Institute of Child Health, London and Consultant Nephrologist at Great Ormond Street Hospital for Children (GOSH). He was one of the first to establish a specialist service for children with kidney diseases in the UK, developing a model of interdisciplinary care that was later adopted by many other centres throughout the world. His research led to improved understanding and treatment of many common childhood kidney diseases. He was role model, mentor, supervisor and teacher to me and many of the current generation of paediatricians and paediatric nephrologists.
Today all major children’s hospitals have teams of consultants providing specialist services for children, and paediatric nephrology is a well established specialty. Before the 1970s specialist care of children with kidney disorders was usually provided by general paediatricians with an interest in nephrology, who often had commitments to multiple hospitals. Martin was one of the first of a new breed of specialist paediatricians, committed to full-time NHS hospital and university service, with a major commitment to research.
At the time he entered the field most childhood kidney diseases were poorly understood, and often without effective treatment. Martin saw research to improve understanding of diseases as inextricably linked to provision of good clinical care. His combination of intellect, passion for research, scientific rigour and his warm and supportive nature attracted a succession of bright, aspiring clinician-scientists to work with him. His scientific contributions to understanding children’s kidney disease included new methods to measure renal function; the immunology of the nephrotic syndrome; pathogenesis of haemolytic uraemic syndrome; management of urological disorders; and genetic studies of inherited kidney diseases. He lead early clinical trials that established effectiveness of immunosuppressive treatments of the nephrotic syndrome that remain in use today.
Martin was educated at Clifton College, Bristol and won scholarships to Trinity Hall, Cambridge where he gained a first class degree in natural sciences, and then St Thomas’ Medical School. After internships and his initial research experience with Professor Barbara Clayton at the Institute of Child Health, he spent a year gaining research expertise at John Hopkins Hospital, Baltimore before his appointment in 1967 as the first Lecturer in Paediatric Nephrology in the Department of Immunology, headed by Professor John Soothill, in the Institute of Child Health. In 1971 he was appointed Senior Lecturer and Consultant Paediatric Nephrologist at GOSH and promoted to a personal Chair of Paediatric Nephrology in 1978.
Martin worked initially as a single- handed consultant. He was joined, in 1974, by Michael Dillon, whose expertise in hypertension and renovascular diseases complemented Martin’s expertise in immuno-nephrology and renal physiology. Together they developed the renal service at GOSH, working alternate nights, weekends and holidays to provide consultant clinical cover – a commitment that would seem unimaginable today.
Martin saw the need for inter-disciplinary care of children with kidney diseases, and collaborated clinically with urological surgeons and radiologists to develop an interdisciplinary model of care. He campaigned for a regionally organised service for children with renal failure, and oversaw the introduction of the new technologies of
hemodialysis and renal transplantation into the routine care of children.
Under Martin’s leadership his department became one of the leading academic
departments of nephrology internationally. He earned the lifelong admiration of those who worked with him for his astute clinical judgment, his enquiring and rigorous approach to research, and his kind, thoughtful and concerned approach to his patients, colleagues and trainees.
Martin’s belief in” giving back” led him to take on editorship of the textbook of Paediatric Nephrology, which has become the standard reference book of the discipline, now in its seventh edition. In 1989 Martin was persuaded to accept the position of Director of Clinical Services at GOSH. He led the hospital through the difficult transition to the new marketdriven, competitive NHS, the rebuilding of out-dated buildings with charitable funds raised by the Wishing Well Appeal, and its emergence as an NHS Trust in 1994.
Martin’s administrative abilities were recognized by his appointment as President of the
Association for Paediatric Nephrology, and he was a leading figure in both the European and International Paediatric Nephrology Societies and associations. He worked closely with parent support groups and charities such as Kidney Research Aid Fund, to publicise the need for research and improve services for children. He was awarded the CBE in 1997 in recognition of his services to medicine, and in 2002 received the Royal College of Paediatrics and Child Health’s highest award, the James Spence medal, for outstanding contributions to the advancement or clarification of paediatric knowledge.
Martin was born in North London and was the youngest of three children. His father ran a family law firm, while his mother was one of the first women Cambridge undergraduates.
Soon after qualifying, in 1966, Martin married Gill Owen, a social worker who later trained as a group analyst and psychotherapist. Martin and Gill were a wonderful mutually supportive partnership, whose shared warmth, humour and interest in others made their home welcoming to countless colleagues, international visitors and trainees. The annual Christmas parties at the Barratt’s became a fixture in the lives of many of Martin’s colleagues and trainees.
Martin’s gradually progressive weakness led him to retire early from clinical work. He
continued to pursue many interests, including cooking and art, and created beautiful
mosaics and, in his last years, painted watercolours. Although his illness eventually confined him to a wheelchair, and he spent his last years cared for by Gill, his children and health professionals, he remained uncomplaining, unfailingly cheerful and interested in the evolving lives of his children, grandchildren and friends. He is survived by Gill, and his children Thomas, Emily and Josy.
Thomas Martin Barratt, paediatric nephrologist, born 13 February 1936, died 17 January 2014.
