Paediatrician Roger Tuck Retires

Paediatrician Dr Roger Tuck retires from Northland DHB on March 1 and leaves a legacy of 37 years of seeking the best for the young people of Northland. Roger was for many years head of child health, then clinical director and for a time was chief medical officer. He was was awarded the John Sands College Medal by the Royal Australasian College of Physicians in 2014.

Roger’s wife, ultrasonographer Ruth Tuck, retired on January 18. The two are aged 68 and will enjoy retirement in Parua Bay where they have lived since 1983 (having arrived in the Bay of Islands around 1981). Meanwhile, Roger and Ruth’s daughter Dr Ailsa Tuck is joining the Child Health Centre at Whangarei Hospital as a consultant paediatrician in the same week Roger leaves.

Dr Jonathan Jarman, who was Northland DHB Medical Officer of Health until 2013, worked closely with Roger tackling ‘diseases of poverty’ and described Roger as “an outstanding paediatrician” whose groundbreaking work on rheumatic fever prevention “ended up being a model for the rest of New Zealand.”

Farewelling Roger at a ceremony on February 26 were colleagues from the Child Health Centre, midwives, management and many descendants, including Roger’s son Oliver who spoke about his father’s renown.

As he prepared to retire, Roger reflected on his career path, values and deep concern for reducing health inequities between indigenous and other populations.

From England to Northland

Roger was born and raised in South East England and studied medicine in London. Roger recalls getting the impression from medical colleagues that leaving urban adult healthcare for rural paediatrics would be “professional suicide.” Roger was drawn to paediatrics, which he felt was a speciality of optimism rather than despair.

Roger and Ruth at first worked at Princess Margaret Hospital for Children in Perth. That location seemed remote but it was nothing in comparison to the beautiful Kimberley region of northwestern Australia, where he became immersed in healthcare for indigenous peoples. “The day my wife and newly-born first child and I arrived in Derby, the town was just emerging from floods of biblical proportions,” Roger recalls. “Supposedly-vital supplies of alcohol and tobacco were being offloaded, ahead of food and other supplies, at the town wharf after weeks of isolation. We were meant to stay for six months; we left after a year with indelible memories ranging from the wonderful to the very raw. This was my first encounter with the consequences of extreme deprivation and cultural alienation, and the realisation that although I was able to treat disease and save the lives of many of my almost exclusively Aboriginal child patients, I could only rage at the determinants of those diseases.”

Bringing Indigenous Healthcare Experience to Northland

After a couple years of sailing, Roger and Ruth arrived in the Bay of Islands. While the Bay impressed him, he soon decided the “utopian and egalitarian state” of New Zealand he had heard about wasn’t the reality for all of our population.

In a 2011 essay for the Royal Australasian College of Physicians Roger described Northland as a place in which “The very wealthy have bought tracts of our stunning coastline, and rub shoulders with Māori kids on dirt floors and third world rates of rheumatic fever.”

“The health status of my predominantly Māori child patients and their families was, to me, disappointingly reminiscent of my experiences in the Kimberley. Fortuitously, I had become well versed in the diseases of poverty such as rheumatic fever, child abuse and neglect. I believe that clinicians who want to make a difference cannot ignore the social, cultural and economic context within which they practice.”

Being challenged with uncomfortable socioeconomic realities in patients’ lives is important for healthcare providers, Roger believes. Roger says he warns beginner doctors, “For caring and careful clinicians, comfort zones are infrequent stops on one’s professional journey.”

Telepaediatrics

Something which Roger says he felt “less cynical about” as he prepared to retire is seeing solutions to child poverty becoming actionable instead of simply election talking points. A major improvement to the healthcare Northland DHB can offer children is the advent of consultations with medical experts through telecommunications. Roger convinced the DHB to become the first provincial member of Telepaediatrics NZ and sat on the board himself. Telehealth enables professional development of staff, consultations with experts at Starship Hospital and secondary and tertiary supporting of remote practice across Northland. Telepaediatrics now increasingly enables clinical patient management throughout NZ.

Rheumatic Fever reduction

Reducing urban-rural disparities through telehealth ties in with Roger’s mission to prevent third world health conditions before they can take root. “We deal with too many downstream consequences but we should be fixing the upstream problems. We are aware of the determinants [of health inequalities], but we have yet to address those determinants in a meaningful way.”

Roger is proud of setting up rheumatic fever clinics, in which the 90 or so people who live with the acute or chronic effects of rheumatic fever in Northland are monitored, brought regularly to clinics and given management plans. While Roger says he can’t fix with his prescription pad the root problems of overcrowding, material deprivation and poor access to healthcare, interventions in schools and the rheumatic fever register (set up with former public health nurse Corey Pia) have had a positive effect.

Roger says he plans to spend retirement working with the Bream Head Trust “As I am passionate about conversation as well as conservation!” – an example of the type of pun for which Roger was renowned in the workplace.

Other passions include playing piano, listening to music, reading and cycling. Roger says there are eight grandchildren whose lives he and Ruth want to be part of.

Farewell from the Child Health Centre

Senior paediatrician Dr Vicki Cunningham described Roger as an “astute, wise and widely respected clinician.” Roger was one a small group of paediatricians who bought the Advanced Paediatric Life Support Programme (APLS) course to NZ.

Under Roger’s leadership of the Child Health Centre, a truly multidisciplinary team was grown. Roger was always “unfailingly available and supportive to his colleagues,” Vicki said.

“Roger was a community paediatrician before it was even a thing and he was arguably one of the first true community paediatricians in the country.”

“He has always reminded and challenged us with the truth that nothing will change for Northland’s children if we are only ever a highly skilled ambulance at the bottom of the cliff.”

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