Consultant cardiologist Professor Varma: on his retirement

As the embers glow in his fireplace, the 74-year-old reads a newspaper, seated at an expansive window overlooking the Fermanagh countryside he loves so much. 

One would be forgiven for thinking that retirement will be a quiet time for the cardiac consultant, who has lived in Fermanagh since 1982. However, Professor Varma has an array of voluntary roles in the health sector and a range of hobbies that are sure to keep him active as he faces the next chapter of his life.

Born and raised in South Africa, of Indian origin, Mahendra Varma was the first of his family to attend university. He gained his primary medical degree from The Royal College of Surgeons in Dublin, followed by a PhD at Trinity College Dublin and higher exams in the Royal College of Physicians in Ireland and in the United Kingdom. He trained in Belfast, Dublin and New York. He saw the Consultant Physician post advertised for the Erne Hospital in 1982 and applied because he “wanted to work in the country.”

“I didn’t know what Enniskillen would be like – it’s been great!” Professor Varma told The Impartial Reporter. 

He retired on December 31, 2016, aged 74, after 35 years in the Erne Hospital and the South West Acute Hospital.

An arrangement was in place with the Western Trust that he would remain until the two posts he had in cardiology and diabetes were filled. Two new consultants, Dr. Monica Monaghan (cardiology) from Fermanagh and Dr. Emma McCracken (diabetes) from Belfast, are now in place.

One of the defining moments of Professor Varma’s career was spearheading the first use of clot busting drugs via the mobile coronary care unit in the British Isles. The mobile coronary care unit saw doctors and subsequently nurses delivering clot busting drugs to a patient with a heart attack in their home, before transporting them to hospital.
“Our doctors and nurses were the first to give clot busting drugs for heart attacks in people’s homes. Nobody else was doing it,” said Professor Varma. “Over 30 years later, the initiative is regarded as the gold standard for heart attack victims unless they can get to a PCI (Percutaneous Coronary Intervention) centre within two hours.
“We travelled to international cardiology meetings and presented our work in Japan, the Philippines, America, Europe, the UK, India,” he recalled.

With the support of Northern Ireland Chest, Heart and Stroke, of which he is currently Chairman, Professor Varma also set up the Fermanagh Heart Bus at local mart days, offering cardiac risk factor screening for members of the public, especially farmers.
“I knew that we had a high incidence of heart disease and there were many risk factors: lifestyle, diet, smoking, high cholesterol, high blood pressure, diabetes. That was all well-known but nobody was doing anything about it. The Fermanagh Heart Bus was the first of its kind in Northern Ireland,” he said. “When I first came here I would see in the region of 250-300 heart attacks a year. Now, it’s 75-100 per year. That’s because all the preventative measures were carried out by myself and my colleagues,” commented Professor Varma.

Professor Varma was the first person to suggest an acute hospital west of the Bann in 1998. When the South West Acute Hospital (SWAH) was opened by Her Majesty Queen Elizabeth in 2012, he saw it as “an ambition fulfilled.”

As chairman of the medical staff at the Erne, he called a meeting of fellow chairmen at Mid Ulster Hospital in Magherafelt, South Tyrone Hospital in Dungannon and the Tyrone County Hospital in Omagh to formulate a policy for an acute hospital, where “everything could be centralised, rather than all these small hospitals, where the expertise gets diluted.”

Read: Recommendation for new hospital came from local doctors

Omagh, Magherafelt and Dungannon are all now closed and Professor Varma is “happy” with how SWAH is operating. “The hospital has great expertise in cardiology, paediatrics, diabetes, surgery, emergency care and has one of the finest stroke units in Europe, better than any such unit in the United Kingdom,” he pointed out.

He is aware of general public opinion which calls for all services to be delivered locally in the state-of-the-art hospital, rather than patients having to drive long distances for treatment. In response, he said: “It’s difficult. People have perceptions. What they don’t realise is, any illness that you have is best managed by someone who is an expert, who tend to be concentrated in larger hospitals as they are able to keep up to date with changes in medical practice.”

He added: “When I qualified 48 years ago, cancer existed but we didn’t have cancer experts as we do now. Because treatment strategies are changing, you need experts to give optimal care.”

Asked what future he sees for SWAH, Professor Varma replied: “I don’t see it closing down anyway. I see it becoming more important and becoming a centre that provides more services not only for the people of Tyrone and Fermanagh, but also from across the border in Cavan and Monaghan. There is already cross border work being done in several specialties, it’s just a matter of expanding that.”

Read: Recommendation for new hospital came from local doctors

He would also like to see SWAH becoming a larger teaching centre and is pleased to note that Queen’s University Belfast recently began sending students to the Erne and SWAH after many years of refusing. Now, SWAH is the only hospital in Northern Ireland to host students from three universities: QUB, the Royal College of Surgeons in Dublin and University College Galway.

The health service is under severe pressure and local staff are feeling the strain. Professor Varma lays the blame for pressures firmly at the feet of the politicians, who, he believes “need to work more efficiently and more proactively and should think of the country and its population needs, especially with regards health, education and social welfare, rather than thinking of themselves and their political party.”

He has witnessed many reviews of the health service, including the most recent Bengoa report. “In my opinion, this report does not shed light on problems that have already been highlighted in many reports from the Department of Health. I often wonder, over my 40 years working in the NHS, how much all these reports have cost and none of them to date have ever been properly implemented. It appears to me that every time a new Health Minister comes into post, a costly new report has to be commissioned, all of which say the same thing – what a waste of money!” he said.

At a recent public consultation on the future of health care, a SWAH Emergency Consultant warned that unless more junior doctors are sent to SWAH now, “we will stand no chance of recruiting consultant colleagues to lead the service in the future.” In Professor Varma’s view, junior doctors “want to live in cities where they have all the social interaction with their friends and peers. They are under the illusion that this does not exist in the country.” His message to junior doctors is: “The quality of life in the country is infinitely better.”

He concluded: “In my time I did what was required. It’s time for others to do what they think is appropriate. I just feel sorry for my colleagues because they work so hard and they don’t get the appropriate resources for them to do their work properly.”

During retirement, Professor Varma will continue as an examiner for the Royal College of Physicians in Ireland and the UK and to sit on the NI Research and Ethics Committee. 

He will also maintain his teaching role on wine in Dublin and Belfast and his involvement with Music in Fermanagh. 
In addition, he will spend time with his two daughters and son and his four grandchildren.