His early post-qualification training was as a resident houseman at the Bristol Hospital for Women and Children, followed by an appointment as registrar to the Chelsea Hospital for Women where he began his life's work in the discipline of obstetrics and gynaecology. In 1901 he was appointed senior honorary gynaecologist to the hospital then known as the Cardiff Infirmary (later to be known as the King Edward VII Hospital and, in 1923, as the Cardiff Royal Infirmary). His commitment to education and training was soon demonstrated when, in 1904, he took charge of what would become a highly successful midwifery training course provided under the auspices of the Cardiff Medical School, in response to the terms of the Midwives' Act of 1902. During the First World War, holding the rank of lieutenant-colonel, RAMC, he served as commanding officer of the Eaton Hall Hospital for Officers at Chester and later of the 3rd Western General Hospital.
In 1921 the Welsh National School of Medicine, at that time still a part of University College, Cardiff, became a full medical school in the sense that it now provided training in the clinical as well as the preclinical years. Notwithstanding the recommendation of the Royal Commission on University Education in Wales (1918) that ‘the hospital side of the College of Medicine at the King Edward VII Hospital should be based on the “hospital unit system” under full-time professors’ it was agreed by both the academic and hospital authorities that, unlike the chairs in medicine and surgery, the chair in obstetrics and gynaecology should, at least initially, be filled on a part-time basis. In reality this meant that the post could only be filled from among the existing gynaecological staff in the hospital and of the two eligible clinicians Ewen Maclean was the only credible candidate. He was the senior gynaecologist, his teaching credentials were impeccable and he was highly respected both locally and nationally. He had also, unlike some of his hospital colleagues, warmly embraced the concept of a clinical school in Cardiff linked to the King Edward VII Hospital. He took up his appointment in the autumn of 1921 with the unusual title of ‘professor extraordinary’.
The immediate establishment of the clinical unit system, with full-time professors, in the academic departments of medicine and surgery, unsettled the relationships between the staff in these departments and the clinical staff of the hospital throughout the 1920s, eventually leading to the suspension of clinical teaching in the hospital for a year. Ewen Maclean, appointed to his chair from among his hospital colleagues, managed to escape these difficulties. Once, when asked why his department had managed to avoid all the controversy swirling round the heads of the professors of medicine and surgery, Maclean modestly replied that ‘this was not due to any merit on his part but he was in an entirely different category because the setting up of his department disturbed no vested interest’. While this was undoubtedly true, Maclean also happened to be a very nice man as one of his obituarists much later testified: ‘Nobody could meet Maclean without being impressed by his courtesy and dignity, which did not conceal from his friends a very kindly heart’. Unlike the professor of medicine in particular he went out of his way to work with his hospital colleagues, regularly attending meetings of the senior clinical staff and eventually becoming vice-chairman of the Medical Board of the hospital.
From the outset Maclean's department established an excellent reputation for its teaching, assessors from the University Grants Committee identifying for special praise the progressive approaches adopted by the professors of physiology and obstetrics and gynaecology to the teaching of their subjects. He was in demand as an examiner in midwifery and women's diseases to the Central Midwives' Board, the Conjoint Board of England and to a number of universities. Maclean was also an active researcher making several noteworthy contributions on clinical subjects to journals such as the British Medical Journal and the Journal of Obstetrics and Gynaecology and in 1926 he presented the medical school with £3,000 in order to endow the Ewen Maclean Research Scholarship to promote research in the field of midwifery.
Maclean was also skilful in his selection of departmental colleagues, notably his first assistant, Gilbert Strachan, who, during the 1920s, established a formidable reputation as a researcher, being acknowledged as a pioneer in the study of the effects of radium on cancer of the womb. Indeed Maclean relied a good deal on the support of his colleagues because, as a part-time professor, he was heavily engaged in a wide range of other interests, not least a demanding private clinical practice. Moreover, in 1919 he had been appointed to newly-created Welsh Consultative Council of Medical and Allied Services in Wales, established by the minister of health as part of the general post-war reconstruction of health services in the United Kingdom. The perhaps grandiose plans devised by the Council for the restructuring of the health services in Wales proved far too radical for the Ministry of Health and the Council was formally abolished in 1926. However Professor Maclean had cause to be grateful for his involvement in the work of the Council for, appointed its second chairman in succession to Sir Edgar Jones, MP for Merthyr Tydfil, he secured a knighthood in 1923.
Maclean gave long and devoted service to the British Medical Association. Honorary secretary of the Cardiff division between 1904 and 1907 he acted as its representative on the Association's Representative Body from 1906 to 1913. In particular he served as chairman of the Body during the height of the BMA's struggle with the Liberal government in 1911 over the introduction of the contentious National Health Insurance Bill which many in the medical profession regarded as a challenge to their status. Maclean, whose brother Donald was a prominent Liberal MP and a friend of David Lloyd George, was unfairly accused of being too lenient with the government in the negotiations. Though hurt by the insinuation, as an honourable man he stood down as chairman of the Body in the interests of the Association, to disappear from the centre of BMA affairs for some years. However, when in 1928 Cardiff hosted the annual meeting of the Association, for the first time since 1885, it was Sir Ewen who was chosen to be president, a role which he discharged with great dignity and charm.
Sir Ewen retired from the Welsh National School of Medicine in 1931 after a decade of distinguished service though sadly, unlike the professors of medicine and surgery, he never became dean of the School, his other commitments precluding this. However he played as full a part in the life of the School as he could, serving for instance, in 1926/7 as a popular president of the Cardiff Medical Students' Club. His long career did not end with his retirement from academic life. A foundation fellow of the British College of Obstetricians and Gynaecologists he was elected president of the college in 1935, holding office until 1938. During his career he received many other accolades, being elected as an honorary fellow of the American College of Surgeons in 1926, and of the Royal College of Obstetricians and Gynaecologists in 1947 when this body received its royal charter. He was given honorary doctorates by the Universities of Manchester, Edinburgh, Melbourne and Wales. With the introduction of the NHS in 1948 he was appointed a member of the Board of Governors of the United Cardiff Hospitals, serving until shortly before his death.
Sir Ewen, who never married, received the support of his sister Agnes in his public duties, and her devoted care during his last years. He died on 13 October 1953 and following a funeral service at Windsor Place Presbyterian Church, Cardiff he was laid to rest in the family grave in Llangunnor churchyard near Carmarthen, close to where David Charles, the hymnwriter and Sir Lewis Morris, the poet also lie. Inside the church is a window depicting the Ascension of Christ in memory of Sir Ewen's parents.
Dr Alun Roberts, Pont-y-clun
Published date: 2013