Obituary: Dr Patrick Fergusson

Patrick Fergusson was one of the last of the old-fashioned central London GPs. He had qualified as a doctor before the National Health Service Act of 1946, and delivered a particular, bespoke care that smacks now of another age; and, having established himself before the 1960s property boom drove so many London doctors to commute from the city's outer reaches, he lived, ever available, over his shop.

He dressed the part. With black coat, striped trousers, smart leather case and - years before antiquity demanded it - a handsome silver-topped cane (left him by a grateful patient), he was an unmistakable figure on the streets of Paddington or Marylebone. In his stately perambulations he resembled rather the local bobby, or a priest on his visits.

Medicine was for him a vocation rather than a profession. Modern London medical practices now operate in "teams", with bleeps and mobiles, working on rotas like normal people, enjoying days, even weekends off. Not for him: in the last 19 years of his practice he worked alone, without, until its last months, even an answering machine. After his loyal but rather fearsome secretary Mrs Cox (no one dared call her Cecily) died in 1980, in her mid-eighties, he never replaced her. If he left the house unattended, all telephone calls were, by an elaborate procedure, "transferred". Locums were only for his annual, three-week, holiday in Scotland.

He was born to doctoring. His grandfather James Fergusson, from Dumfriesshire, came south in the 1870s to practise in Richmond, Surrey. His father, Gordon, was a doctor in the Navy, retiring as Surgeon Rear-Admiral. His uncle and godfather, Drummond, was Virginia Woolf's doctor ("Fergie") in Richmond. His elder brother, Ian, is still a doctor in Richmond.

Patrick ("Pat" to his family) was born in 1919 in Southsea, Portsmouth, where his father was then stationed. He was educated at Stubbington, a prep school outside Portsmouth popular with the Navy, and Epsom College, the doctor's public school, in Surrey. In common with many naval children, he had no single family home. His happiest school holidays were spent at his uncle's house in Peeblesshire, Hallyards, once the home of another Fergus(s)on, Professor Adam Ferguson, the philosopher father of Walter Scott's friend Adam, who introduced Scott to the local celebrity, the Black Dwarf.

After medical school at King's College London, Fergusson enrolled in the RNVR. His wartime career was spent largely on convoy duty in the North Atlantic, his duties as ship's doctor doubling with that of cellarman and, for the Normandy landings, photographer. Photography remained one of his preoccupations.

His medical career resumed after the Second World War at the Westminster Hospital, and it was at Westminster Children's Hospital that he met his future wife, Alison Miles, also a doctor and the child of a Rear-Admiral; they were married in 1951, shortly after which Fergusson went into partnership with Dr Fraser Carey, in a general practice based initially on Connaught Square, in an area much bombed which was to be reborn as the "Tyburn Estate", the Church Commissioners' contribution to post-war town planning north and west of Marble Arch. "Connaught Village", as the estate agents now call it, was still an urban village then, with real shops, not shop-fronted offices, with cobblers, chocolate-makers, a gunsmith, a choice of fishmongers, a florist who sold Lucie Rie pots for a pittance, a dairy. It has changed slowly but utterly.

Fraser Carey, 14 years Fergusson's senior, was one of the distinguished sons of G.M. Carey, the England rugby player and Sherborne schoolmaster who was the original of Alec Waugh's "The Bull" in The Loom of Youth; another son was Headmaster of Bromsgrove, another Bishop of Edinburgh, a third Legal Secretary to the Archbishop of Canterbury. Carey's Etonian urbanity and Fergusson's quiet courtliness made them fit partners in a practice which combined, as was then commonplace, private patients on the one hand and a full National Health "panel" on the other.

After Carey's death in 1972, Fergusson, reluctant to seek a new partner, sustained both private and National Health sides until pressure of work forced him to choose between them. When he elected to go private, many of his National Health patients followed him; some he deliberately undercharged (he charged anyway in guineas long after most patients had forgotten what a guinea was), and all he never charged a "going" rate.

Fergusson was a listener, whose tentative, even ponderous mode of conversation (the length of his telephonic pauses could be startling) inspired unusual trust. His inscrutable blue eyes could give way as easily to a boyish twinkle as to an expression of elaborate exasperation (what the writer Candia McWilliam, a friend but not a patient, called his "outraged ostrich stare"); he had a very dry humour and made an art-form of gentle teasing. In playing the part, he became the part.

His pastoral care, especially as he, and his patients, aged, often involved weekly visits, regardless of need, as friend as much as doctor. His practice extended, at various times, from royalty (Princess Arthur of Connaught) to the nuns of Tyburn; but his discretion was absolute. For a long time he had the care of the formidable Dame Rebecca West, but he refused to talk to her biographers. He was honorary physician to the Royal Society of Literature, through his patient and friend Molly Patterson, its doyenne Secretary, and would boast that he had known her successor Maggie Parham (by coincidence a Carey cousin) long before his son, who married her in 1996.

After the Second World War, Fergusson never went abroad again. He didn't acquire a television until he was nearly 50. When perforce he travelled in an aeroplane in 1992 it was the first time for more than half a century. He enjoyed home and Scotland. He read enormously, especially female novelists with surnames beginning with B. He was interested in pictures, pots, watching sport and listening to The Archers. He was private, meticulous, painstaking; even his local pharmacist could read his tiny and immaculate writing, albeit his signature was prescriptively runic.

He would certainly have practised to the end, if, a year after the cruel early death of his wife in 1990, rheumatoid arthritis had not immobilised him. During two months in hospital for a pair of new hips, he decided to retire.

Death, when it came, was quick. He had gone into hospital for nothing grave, it seemed, and died just five days after the death of his favourite artist, Carel Weight. He was reading the latest volume of diaries by his cousin James Lees-Milne.

James Fergusson

Patrick Drummond Fergusson, medical practitioner: born Portsmouth 22 June 1919; married 1951 Dr Alison Miles (died 1990; one son, two daughters); died London 18 August 1997.