Dr James McNulty AO Hon.MD(ECU) MB BCh BAO(Belf) DIH(Lon) DPH(Syd) FRACMA FAFOM
James Columba McNulty was born in 1926 in Belfast and gained his medical degree at Queen’s University of Belfast. After graduation he worked as a chest physician in England before migrating in 1956 with his new wife Bridget Mary (Betty) to Western Australia where he had secured a position in the Tuberculosis Control Branch of the Public Health Department as mines medical officer and chest physician at Kalgoorlie Hospital. Jim’s responsibility was the diagnosis of tuberculosis and miners’ dust diseases (chiefly silicosis and – at Wittenoom – asbestosis, lung cancer and mesothelioma). He fought the general assumption that ‘miners get dust disease’, seeking to persuade the powerful Mines Department to utilise more effective dust sampling equipment in order to enforce tighter dust controls. The Mines Department’s authority over occupational health in the mines to the virtual exclusion of the Public Health Department was a major concern. He recalls feeling ‘like John the Baptist bleating in the wilderness’.
Jim visited the now infamous blue asbestos mining town of Wittenoom regularly from 1959, examining x-rays, often advising workers to leave the industry and increasing the pressure on management to reduce dust levels. He remembers it as ‘a horrible place’ and was appalled to see mill tailings spread around the townsite. He and others within the Health Department fought to ban that practice, eventually with some success, but it was too late as residential areas, including schools and playgrounds, were already heavily polluted. He persuaded the Mines Department to agree to the use of a NSW industrial hygienist with best-practice sampling equipment to take accurate readings of dust levels in the mine and mill. The results showed gross exposures but by that time in 1966 the unprofitable works were closing. In the 1980s and 1990s he was frequently called to give evidence in litigation seeking compensation for people who had contracted asbestos-related diseases. ‘It has haunted my life’, he explains, ‘because you have got to ask yourself, what could I have done … or [was there] something I should have done’.
In 1963 he and his family moved from Kalgoorlie to Perth where he joined the new, small Occupational Health Branch of the Department, one of only two physicians together with a nurse, health inspector and receptionist. He remembers the attitude at the time that disease was a natural consequence of working in industrial trades and the resultant ‘laissez faire’ approach to workplace health dangers. ‘Sadly there was such a variety of things that were wrong’, so there was a great deal of work for the branch in the areas of dust control, noise abatement, more careful handling of chemicals and clean air control. Greater commitment to prevention was becoming evident not only in Western Australia but around most of the industrial world.
Jim was first and foremost an occupational health physician. As he was appointed to more senior positions in the Department his role became less ‘hands-on’ and more administrative but he retained his professional commitment to occupational medicine. He remembers the postwar Public Health Department as ‘very powerful’ and ‘very intrusive’ into the activities of other government departments, intrusions which were ‘often resented’. Relations could be tense with the Mines Department, Factories Department and many others. As a result, ‘other government departments became more responsible for their own activities and they gradually assumed control of them themselves, which would be a good result.’ The sway of the Public Health Department was reduced.
In 1975 he was appointed Commissioner for Public Health (titled Commissioner for Health from 1979) and held that position until 1984. ‘I inherited a very active and excellent public health service system’. He saw his role as ‘blending and melding together all the variety of interests in it, formulating policy after discussion with various groups and then ensuring that it was implemented’. He recalls the long-standing power of the Under Secretary, an administrator who was not a medical professional. Individual personalities largely determined how this traditional division of authority played out over time. Functional reviews and successive restructures occurred during his period as Commissioner. He recalls the reviews as ‘more interested in how a thing was done than what the result was’. Also notable was increasing political interventions in the department, as in other areas of the public service. In 1984 the three health agencies of public health, hospitals and mental health were amalgamated to form the Department of Health. Jim became Executive Director of Public Health and Scientific Services, one of several members of the executive of the new Department. When he ‘didn’t anticipate achieving much more’ and on reaching the age of 60 in 1987, he retired after 31 years in the public service. He had ‘enjoyed 99 per cent of the time’. He undertook some consultancy work and remained chair of the AIDS Advisory Committee and Radiological Council where he judged that he could continue to do some useful work.
Looking back, Jim sees the development of dust control and prevention of dust disease, particularly in goldminers, as major achievements. As Commissioner his involvements became more ‘diverse’ and ‘remote’, and improvements in public health of which he was part were usually the result of many groups working together. There was ‘significant success’ Australia-wide in the HIV-AIDS control program, vitally important because of the acuteness of the public health problem. As well fluoridation of public water supplies and improvement to dentition were ‘modern public health miracles’.
‘I was very lucky when I came to Australia’, he says. Given his extended professional commitment to public health improvements and his successes (shared or otherwise) it is clear that Western Australia was lucky too.
Jim McNulty during his time as the Commissioner for Health (1975-1984).
Page last updated 27 September 2012