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Robert McKechnie
LDS DDO RFPS(Glas) FDSRCPSG

Reminiscences recorded in conversation with David McGowan and Bill Smith

We talked to Bob McKechnie recently in the West of Scotland Dental Postgraduate Centre in whose foundation he played a material role, and discussed his professional lifetime in the public dental service. Brought up in Barrhead he later attended Kilmarnock Academy and from there entered Glasgow Dental School in 1944, just as the War was ending. In contrast to today's classes there was just one girl in the intake of 25. He remembers particularly Mr MacNaughton, a tutor in "cons", and the Dean, Dr Forbes Webster, who by then was approaching the end of his long period in office.

He was a somewhat brusque and distant figure who commanded the young visitor to his office to "Get aff ma carpet". His response to a student complaint about the end of day "soup" in the sterilising boiler was that "It may be dirty but it's sterile". Malcolm Gibson was in charge of the dental laboratory where the students spent many tedious hours packing rubber sheets for vulcanite dentures - the introduction of acrylic was a great relief. Some also took the opportunity for a spot of private practice, making dentures for their friends and relatives. The dental school only became part of the University in 1948, too late to have any real affect on the course provided to Bob's year who took the LDSRFPS in 1949. For a short period while awaiting call-up for National Service he worked as an assistant in a Bournemouth general practice, where he also attended his first of many BDA meetings.

Arriving at Moreton-on-the-Marsh for basic RAF training in 1949 Bob was surprised to find a classmate Bill Simmons alighting from another carriage. After a posting to St Athan he spent some time in a mobile dental unit touring the RAF Stations in the East of England which were still operating as radar stations, and where large quantities of unused bombs were being disposed of. This was a rather casual and scary procedure with men carrying live bombs along precarious ramps before disarming them .The dental work was fairly routine but there were special procedures for fillings in air crew, ising Zinc Oxide underlinings with the aim of preventing barodontalgia. GA retractions were needed frequently and while Nitrous Oxide was on hand, Oxygen was not always provided. (See Rufus Ross's article.)

[n 1952 he obtained a post as a Dental Officer with Hampshire County Council where he especially enjoyed treating children, and a year later was able to come back home to a similar post with Renfrewshire. He became engaged to Beth in that year and they married in 1954. For some six years he had a part-time attachment to Glasgow Dental Hospital with Professor White, where he was able to train in Orthodontics and prepare for the DDO which he obtained in 1960. This lead to an appointment as County Orthodontist in 1961, holding clinics in Paisley, Greenock and Clarkston. Combined with this were administrative duties as Chief Dental Officer for Renfrewshire - responsible for the provision of dentistry within the maternity and child welfare services, and for the school dental service under the Education committee. The work at that time involved much patient education - promoting filling of carious teeth rather than extracting them as many patients expected or preferred. Since extracting the most severely affected teeth was a logical first step many courses of treatment never got beyond the first visit. Indeed some believed that "fillings rot your teeth". A new era opened in 1974 with the reorganisation of the National Health Service which swept away the whole local authority involvement with the provision of health services. The Health Boards were to have Chief Administrative Dental Officers to represent dentistry within the new structure. The largest Board in Scotland and the first to appoint a CADO, as they were to become known, was Greater Glasgow, and Bob McKechnie was their choice. He had applied, as was permitted, for three posts and was also offered the Argyll and Clyde post, but preferred Glasgow, thus becoming the first to be appointed to such a post anywhere in the UK.

So began seventeen years in a central role as the advocate for dental services in a multi-million pound organisation with many conflicting priorities, serving an area with arguably the worst health problems in the UK. It started well with the new dentalcolleague being welcomed and supported. More money was made available and integrated planning of dental services was to be possible for the first time. There were high hopes that water fluoridation could be achieved but, though the argument was won, and the anti's defeated in a lengthy court case, the judge found the law inadequate to permit the introduction of this sorely needed public health measure and plans were frustrated eventually by a vote of the Strathclyde Regional Council. (Bob has recounted his experience of the case in Issue No. 14) Sadly flouridation is still awaited in the West of Scotland, and we may be tempted to think that a less scrupulous and more aggressive PR campaign might have been more successful.

All in all Bob feels that dentistry was fairly treated by the Glasgow Board, though competition for resources got tougher and tougher as the SHARE (Scottish Health Areas Equalisation) formula began to bite and Glasgow, despite its problems, became a net loser because of its declining population. Coffee time with the Chief Executive could be productive! There was scope to try preventive strategies and to incorporate dentistry into the new Health Centres. There were attempts to provide innovative incentives - the famous "Woodside Terms" to encourage general dental practitioners to leave their own, often antiquated, surgeries and join the primary health care teams in the modern purpose-built premises, but most remained fiercely independent. Specialist service provision from the Dental Hospital did expand greatly. It was a time when extra consultant posts could be had for the asking. On one occasion faced with a choice between two excellent candidates for a consultant post Professor White asked if both could be appointed and this was agreed - a sharp contrast with the "stated cases" and detailed justifications required in later days. There were unexpected advantages for dentistry when the GGHB offices were in Bath Street. The then Chairman Sir Simpson Stevenson, (whose name is on the centenary commemoration plaque in the Dental Hospital entrance hall- Ed.), used to park in the Dental Hospital car park. Arriving for Two o'clock meetings, he was impressed by the number of patients he saw attending for the afternoon session, and would frequently remark on all the hard work that was going on there.

More dramatic changes came with the arrival of Laurence Peterkin as the Board's first General Manager in 1986. He is remembered for asking "Why do we have a Dental Hospital in Sauchiehall Street?" i.e. on such a commercially valuable downtown site, but also "Why do I get no complaints about dentistry". There were fundamental changes at this time with the Board acquiring administrative responsibility for general practice - the largest area of dental activity. In 1987 the Districts were abolished and from then till his retirement in 1991 Bob was the General Manager of the Dental Hospital in addition to his work as Consultant in Dental Public Health. Despite the supposedly "ring-fenced" central funding of the hospital the financial screws continued to tighten and progress was difficult to maintain.

A constant feature of Bob's professional life has been his involvement with the British Dental Association. He joined at qualification - the BDA and the MDDUS were, with the GDC, the organisations all were then encouraged to join. He was a regular attender at the old Paisley section which was the home territory of such BDA stalwarts as J Marshall Banks and Rankine Crerar, and was secretary of the West of Scotland Branch from 1968 till 1979 when he became Branch President. He chaired the ScottishCouncil from 1978 to 1984 and the Scottish Committee for Community Dental Services
from 1979 to 1991. He was a long-serving member of the Representative Board of the Association from 1968 to 1990 and a member of the executive of the Central Committee for Community Dental Services from 1975 to 1991. This involved many visits to the Association's headquarters in London and many hours of travel, though enlivened by the company of friends such as Rankine Crerar and Charlie Downie.

Even in retirement Bob continues as West of Scotland representative for the BDA Benevolent Fund, and he was the prime mover in the creation of the unique "Senior Members Group" of the West of Scotland BDA which he still runs. This group meets throughout the year, with a series of lunchtime talks and a popular summer outing, and provides an opportunity for retired colleagues to meet reminisce and enjoy discussing topics apart from dentistry. The Association made him an Honorary Life Member in recognition of his contribution to their affairs over many years. Bob is, of course, an
active member of the HODRG, and has contributed frequently to the Newsletter. At its last meeting the Lindsay Society for the History of Dentistry chose him as President - elect to take office in 2006.

Retirement has meant more time to be with the family and Bob and Beth now have three children (two in medicine and one in law) and four grandchildren. The garden also gets more attention now than it did during his busy and varied professional life!

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