Robert Makgill was a key figure in the development of New Zealand's public health system. He was one of the country's first district health officers, at a time when central government took on greater responsibility for public health.
He was to play an important role during the 1918 influenza pandemic and its aftermath, notably as ‘the chief architect’ of the ‘the most useful legacy of the 1918 influenza pandemic’: the 1920 Health Act.
Robert Haldane Makgill completed his primary and secondary education in New Zealand, having emigrated from his birthplace, Scotland, in 1881. He returned to Scotland to study medicine at the University of Edinburgh, graduating MB, CM in 1893. On his return to New Zealand he worked as resident surgeon at Auckland Hospital from 1894 to 1896, and as honorary bacteriologist from 1897. He then returned to Britain again, receiving his MD from Edinburgh (1899) and a diploma in public health from Cambridge University (1901).
By the time Makgill returned to New Zealand public health had taken ‘a major step forward’. A new Public Health Act, introduced in 1900, shifted the burden of responsibility from local authorities, where activity depended largely on enthusiasm, to a new Department of Public Health. Makgill was one of six district health officers appointed to the fledgling Department. He spent nine years as district health officer for Auckland, at times combining these duties with those of government bacteriologist (1904-08) and pathologist (1908-14).
During the First World War the number of staff working for the Department plummeted. Makgill himself served overseas for the first two years and, when he returned home in 1916, was seconded to the Department of Defence as assistant director of medical services (sanitation). He was eventually recalled to the Health Department in November 1918, replacing Dr Michael Watt (who had fallen ill with influenza) as deputy to the acting Chief Health Officer, Dr Joseph Frengley, and as district health officer in Wellington. In these positions Makgill played an important role in the latter part of the pandemic, taking the unpopular decision to close bars, breweries and wine and spirit merchants in Wellington, and then relieving Frengley in Auckland.
Following the epidemic it fell to Makgill to front up for the Department; the Chief Health Officer, Dr Thomas Valintine, was overseas. Makgill prepared the Department's submission to the Epidemic Commission, which had been set up in early 1919 in response to public's demand for answers. Once the Commission's report had been completed and their recommendations considered these were referred to him for implementation. During this period Makgill also prepared the Department's own report on the pandemic, providing evidence that the RMS Niagara, the popular scapegoat for introducing ‘severe’ influenza to the country, was unlikely to have been responsible.
One of the recommendations the Commission made, which Makgill had argued for in his submission, was for a new Health Act ‘to consolidate and simplify the existing legislation’. Though Makgill's superior, Valintine, returned to the country before the bill had its first reading in August 1920, historian Geoffrey Rice argues that the bill was ‘almost exactly as Makgill had drafted it’. In his book Black November, Rice described the act as ‘the most useful legacy of the 1918 influenza pandemic’. He went on to note that:
[The Act] was so well drafted that it survived with only minor amendments until the 1956 Health Act, which itself still followed the general pattern of the 1920 Act. At the time it was widely recognised as a model piece of health legislation, ‘said to be the best of its kind in the English language'.
Makgill may have been overshadowed in the public's memory by more flamboyant figures such as Truby King, but his contribution to New Zealand's public health system has not been forgotten. On 9 November 2006 the New Zealand health sector took part in ‘Exercise Makgill’, a major exercise run by the Ministry of Health with the aim of thoroughly assessing New Zealand plans for responding to a pandemic.
By Imelda Bargas