Professor Mansel Aylward CB was a major polymath within the field of medicine with a long career which encompassed general practice, pharmaceutical medicine, pharmaceutical research, entrepreneurialism with the creation and development of a successful clinical trials company, disability medicine and research, occupational medicine, public health, global health, academic leadership and was a pioneer of the bio-psychosocial model of health. He never retired.
In Google scholar he has 446 scientific publications spanning all his areas of interest.
Honours flowed with a Companion of the Bath, subsequently a Knighthood, and he was appointed Queens Household Physician.
A Welsh speaker, he was born in the ex servicemen’s club in Merthyr Tydfil, a mining village in the Welsh valleys and despite his very many achievements and distinguished positions globally he never forgot his roots, nor gave up his links or home in Merthyr and died there after a long battle with pancreatic cancer. He was a household name in Wales, immensely popular and highly respected. He was chair of the local male voice choir who sang at his packed funeral which was attended by the First Minister of Wales and many luminaries from across the UK and elsewhere. The local town councillors lined the route to the church.
Mansel was a very bright schoolboy, and went up to London, where he was top of his year, winning many prizes and through life was an apparently effortless achiever, witty, tactful, a superb communicator, but quite modest. He had the imposter syndrome -when he heard about his knighthood, he thought they had made a mistake!
As a senior medical student he was driving from London, with his wife and new baby to Merthyr Tydfil and on approaching his home was stopped by the police because of a major incident ahead. However as he had a BMA badge on his car, they enquired if he was a doctor and hearing that he was a senior medical student, waved him through the barrier as medical help was required.
Thus Mansel was the first medical person on site at the Aberfan disaster (1966) where a pit tip had just liquefied and avalanched the local primary school causing the deaths of 144 children and teachers. The subsequent enquiry concluded that this disaster was due to National Coal Board management decisions. He never talked about this experience until organising a scientific meeting which was held on its 50th anniversary and at which one of the few survivors also presented. The death of so many young children from his community influenced his decision to go into general practice in Merthyr Tydfil which was a relatively deprived community and there he was very successful, being influenced in his practice by fellow Welsh GP, Julian Tudor Hart (author of the inverse care law concept of health).
However with his restless drive and intelligence he was also an innovator and entrepreneur and while a GP, he founded, chaired, and became managing director of a clinical trials company (SIMBEC)which he based in Merthyr and subsequently also in the USA. This was partly motivated by the desire to create alternative employment in a poor community and it did create a considerable number of opportunities for local people. Accolades followed including a European small business award and he published widely. Eventually he sold the business to a larger pharmaceutical company where he became the Director of Clinical Research.
But he could not be pigeon-holed and his broad perspective and interests led him to undertake epidemiological studies on rheumatic diseases, back pain, and mental health and he became more and more interested and involved in disability medicine. Subsequently he joined the Department of Health and Social Security initially in Cardiff, later in London where he became Chief Medical Adviser, Medical Director and Chief Scientist to the DWP.
With his immense charm and innate political skills he was a significant influence on the Ministers he was advising, and created a high calibre and respected Medical group. His prodigious output seemed to be effortless. When I questioned him about that he admitted that he had the capacity to go without much sleep for one or two days if drafting a paper or urgently required ministerial briefings and policy recommendations, while still maintaining quality.
He improved the clinical aspects of assessment for benefit eligibility and pioneered a more objective functional assessment of work capacity and disabilities, developing the Personal Capability Assessment which was influenced by his considerable research on the health, social, cultural, and psychological influences and the variables which predicted prolonged illness and chronic incapacity. He introduced the Pathways to Work condition management programmes which were rolled out across the UK in 2008.
I first met him when he came to see me at the Faculty of Occupational Medicine to discuss how we could improve disability assessment and the subsequent joint work with DHSS resulted in the Faculty establishing the its Diploma in Disability Assessment Medicine in 2000 and Mansel introduced the first courses which were run in Glasgow.
He had advisory appointments to health leaders and politicians in many countries including the US, Canada, and New Zealand. On retiring from his governmental position he was appointed to the Chair of the newly established Public Health Wales NHS Trust.
He was a pioneer, together with Gordon Waddell and Kim Burton, of the importance of the bio-psychosocial model of health in clinical medicine and its relevance to policy development, and became Director of the Centre for Psychosocial and Disability Research at Cardiff University. In 2017 he was appointed inaugural Chair of the Life Sciences Hub Wales.
Another major challenge was to establish in 2008, the Bevan Commission, a leading health think- tank which advises Welsh government about the effective and relevant application of the principles established by Aneurin Bevan the Welsh politician who established the NHS.
The Bevan Commission remains as his legacy, and there he was successful in recruiting some of the best medical and non medical health experts from across Wales, the UK and internationally – all who gave their time willingly when exposed to Mansel’s charm.
He had the subtlety of the Celt and I never heard him disagree strongly with any discordant view, but somehow he would achieve harmonious agreement.
Mansell was a much loved figure with colleagues and a household name in the wider Welsh community. He advised many countries internationally; was a Fellow of the Learned Society of Wales and was one of the most distinguished physicians of our time with an impact which has been global as well as local.
Throughout he was supported by his wife Angela, herself an innovator, and their two daughters.
Professor Sir Mansel Aylward was a kind, compassionate and inspirational leader with a profound dedication to improving the lives of people across Wales, the UK, and internationally. His work will have significant and enduring impact on public health policy and practice, and on occupational health.
