Thomas Bewley obituary: Irish psychiatrist at heart of drug and alcohol addiction treatment in Britain

Dubliner was an ‘Irish radical, coloured by but not beholden to the English establishment’

Born July 8th, 1926

Died June 26th, 2022

Dr Thomas Bewley, the Dublin-born psychiatrist who went on to become a leading figure in the treatment of drug and alcohol addiction in Britain, has died aged 95.

Dr Bewley, who described himself as belonging to the medical stream of the Irish Quaker family — Bewley’s cafes being the other stream — grew up on Baggot Street, Dublin, where his father, Dr Geoffrey Bewley, had consulting rooms. His grandfather, Dr Henry Theodore Bewley, was also a leading Dublin physician and lecturer at Trinity College Dublin and his sister, Dr Mary Martin, was a psychiatrist at the Rotunda Hospital in Dublin.

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During his long career as a psychiatrist, Dr Bewley espoused humane approaches (for example, dispensing sterile syringes in the outpatients department and developing methadone services) to treating patients while understanding the chronic relapsing nature of their addictions.

In an interview with the Psychiatric Bulletin in 2007, he spoke about how very few doctors were interested in treating drug and alcohol addictions at the time. “I had the simple belief that much of what one does is care rather than cure. If someone gets better, it’s a bonus and you don’t see them again. If they never get better, you will have a responsibility for the rest of your life,” he said.

In the early 1960s he wrote articles for the Lancet and the British Medical Journal (BMJ) about heroin addiction. “These five papers were the best I ever wrote. You do your best work when you’re younger,” he said.

He promoted the concept of harm reduction rather than forced abstinence. “You should give sensible advice and support to help people to make a go of their lives despite their illness — when things can’t be changed, they have to be helped to cope,” he said in the aforementioned interview. Renowned for his expertise in addictions, he was a consultant adviser to the British department of health and the World Health Organisation for a time and he also treated doctors with alcohol addictions.

Dr Bewley was a prominent member of the Royal College of Psychiatrists and served as president of the college, 1984-1987. While there, he helped establish the Institute for the Study of Drug Dependence, the Faculty for Substance Misuse and the college’s research unit. He also banned smoking and lunchtime drinking after council meetings.

Following his retirement from clinical work, he wrote a book on the history of the Royal College of Psychiatrists, Madness to Mental Illness (2008). He received a Commander of the Order of the British Empire (CBE) — the highest-ranking order — for his work in the National Health Service in the UK.

Irish radical

Thomas, the eldest of two children of Geoffrey Bewley and his wife Victoria (nee Wilson), was sent to Arnold House, a preparatory boys’ boarding school in Wales, aged eight. A voracious reader, he excelled in his studies and played a lot of chess but wasn’t sporty. From there, he went to the Rugby School, then a private boys’ boarding school in England, but transferred to St Columba’s College in Dublin at the start of the second World War.

Following his secondary school education, he studied medicine at Trinity College Dublin in 1944-1950. In 1951 he met his wife-to-be, Beulah Knox, when he was a young doctor at the Adelaide Hospital and she was a medical student at Trinity. He went on to do two years of psychiatry training at St Patrick’s Hospital in Dublin. While working there, Bewley was greatly influenced by Dr Norman Moore, who revolutionised psychiatric care at the hospital by embracing various therapies, newly developed drugs and a more optimistic approach to recovery. Bewley also worked with the first members of Alcoholics Anonymous in Ireland at that time.

He followed Knox to England and worked in various psychiatric hospitals, including Claybury Hospital and the Maudsley Hospital in London. The couple married in 1955 and moved to Cincinnati, Ohio, for a year in 1957 while Bewley studied different approaches to treating alcoholism for his doctorate in medicine. Although psychoanalysis was all the rage at the time, he did not warm to it.

Back in Dublin, Susan, the first of their five children was born while Dr Bewley did a locum for his sister during her maternity leave. With medical jobs scarce in Ireland, they returned to London, setting up home in Forest Hill in southeast London. Dr Bewley then took a post at Tooting Bec Mental Hospital and gained the position of consultant the following year. The family moved into a house in the grounds of the hospital but later settled in Streatham, London.

Throughout his career, Dr Bewley saw himself as an outsider, forging his own path. “He was an Irish radical, coloured by but not beholden to the English establishment,” says Stephen Lock, former editor of the BMJ. The famous line from a public lecture by French chemist Louis Pasteur “Chance favours only the prepared mind” was his favourite quote.

Sharply observant, pragmatic and inquisitive by nature, he was more of a clinician than an academic. “He was very conscientious and thorough. He had a good sense of humour, which he used to his advantage,” says a long-standing friend, the retired infectious disease consultant Dr Hillas Smith.

“He was very principled and taught us to be respectful and treat everyone kindly,” says his daughter, Susan Bewley, a retired obstetrician in London. “He worked his entire life for the National Health Service and he was concerned about the quality of care of solo practitioners in the private sector.”

Thomas and Beulah — who became an esteemed paediatrician and lecturer in public health — had many Irish friends in London and travelled back to Dublin and the North often to see family and friends. They moved to live in Grosvenor Gardens in Belgravia in their retirement. They loved the theatre and opera and were regular attendees at the Wexford Opera Festival.

Proud of his Irish and Quaker heritage — he often described himself as an atheist Quaker — Bewley will be buried at the Friends Burial Ground at Temple Hill, Blackrock, Co Dublin, alongside his wife, Beulah, daughter Sarah and sister Mary. His portrait by Prof David Tindle hangs in the Royal College of Psychiatrists in Prescot Street, London.

Thomas Bewley is survived by his children Susan, Louisa, Henry and Emma, and grandchild Hannah. His wife, Beulah, predeceased him in 2018, and his daughter Sarah died aged of 44 from complications of Down syndrome. His sister, Mary (Martin), died in 2008.