The former surgeon-gynaecologist to the Royal family on maternity reforms, the NHS and what it’s like to deliver a future monarch. Photo / AP
The former surgeon-gynaecologist to the Royal family on maternity reforms, the NHS and what it’s like to deliver a future monarch. Photo / AP
Before Sir Marcus Setchell delivered Prince George in 2013, he remembers giving himself “a little talking to”. As surgeon-gynaecologist to Queen Elizabeth II’s household since 1990, Sir Marcus was well used to royal patients. He’d already delivered the Duchess of Edinburgh’s children, Lady Louise Windsor and James, Viscount Severn, after all.
But helping to bring a future monarch into the world, with an expectant media throng crowded outside the Lindo Wing, gave even one of Britain’s leading obstetricians pause for thought – not least when he had delayed his retirement to see Kate through her first pregnancy and birth.
“I think what I tried to do at Prince George’s birth was to keep reminding myself that actually this is just another baby with parents who are likely to be having all the same emotions and pains and discomforts as all the people I look after,” says the genial 79-year-old.
It was a baking hot day at St Mary’s Hospital, Paddington, when, after a 12-hour labour, George finally made his entrance on July 22. “Her Royal Highness The Duchess of Cambridge was safely delivered of a son at 4.24pm,” read the official notice on the gilt-edged easel outside Buckingham Palace. “Her Royal Highness and her child are both doing well.”
As the proud new parents emerged on the famous hospital steps less than three hours later, cradling their newborn, William joked that at 8lb6oz, the heaviest future king to be born in recent history, the baby was “a big boy!” who had kept everyone waiting.
Sir Marcus recalls being stunned by the flashing of camera bulbs as he too finally surfaced from the private maternity wing flanked by his colleagues Alan Farthing, who went on to succeed him as surgeon-gynaceologist to the Royal family later that year, and fellow consultant obstetrician and gynaecologist, Guy Thorpe-Beeston. It was the first glimpse the press and public had got of the delivery team because, as he now reveals, Sir Marcus had managed to slip through a side door, unnoticed, in the early hours as Kate was admitted at 5am that day.
“The press were camped out for weeks before, so I knew what that was like. But I managed to get in through the tradesman’s entrance. Afterwards we were then asked not to go out until the announcement of the birth had happened. So when the three of us came out, I in sort of absolute shock at the battery of flashing lights, put my arms out – as a sort of horror thing, and that’s what got photographed.
“My naughty son, who’s a gynaecologist now, sent me a text message saying, ‘Oh, Dad, quite the little jazz hands’.”
'I in sort of absolute shock at the battery of flashing lights, put my arms out'. Photo / Getty Images
Although he has not “formally” met George since, he was delighted to see the prince at Wimbledon last year when he made a surprise appearance in the Royal box alongside his parents to watch Nick Kyrgios slog it out against Novak Djokovic in the men’s singles final. “It was a real treat to see him nine years later,” says Sir Marcus, a keen tennis player who has the rare honour of being one of the All England Lawn Tennis and Croquet Club’s 375 members and attends the tournament every year.
Thankfully, George’s birth was much easier than when he helped to deliver Sophie’s children. The Duchess collapsed and was close to death when Lady Louise was born prematurely in 2003, after the placenta ruptured the lining of the womb. It was all the more dramatic because Sophie was rushed to Frimley Park Hospital, in Surrey, in an ambulance without her husband Prince Edward, who was away in Mauritius at the time. Sir Marcus had to race there himself in the back of a police car to oversee the emergency caesarean section. Born at 36 weeks, Lady Louise was the first royal child to be delivered at an NHS hospital.
He also led the medical care following the Duchess’s ectopic pregnancy in 2001 and performed the Duchess of Cornwall’s hysterectomy in 2007. Due to patient confidentiality, he refuses to go into any further detail – except to say how lovely Queen Elizabeth II was.
“She was absolutely fabulous. I mean she’s been such an example to leaders. She really had leadership skills but not in a brash way like politicians. She was very easy to get on with the first few times…”
He trails off. “No, I don’t want to talk about it but people who were lucky to have known her know how nice she was.”
The then Duke and Duchess of Cambridge outside the Lindo Wing after the birth of Prince George in 2013. Photo / AP
The royals are only on Sir Marcus’s radar because the day before our interview, the father of four attended a reception at Windsor Castle for recipients of the Royal Victorian Order, which he received in 2005. A dynastic order of knighthood established in 1896 by Queen Victoria, it recognises distinguished personal service to the British monarch. “St George’s Chapel was absolutely full,” he says. “There are a surprising number of recipients. If I use inappropriate words, forgive me, but a lot of ‘below stairs’ staff. Lots of priests. Lots of doctors, many of whom I knew because I held the role for nearly 25 years.”
When he was first approached for the job, “I don’t think I even knew there was such a thing,” he explains. Nor has he any idea why he was chosen and not someone else.
“There isn’t really a ‘think about it’ time. You don’t apply, and you’re not interviewed. So it’s just a case of: ‘Yes I will’.
“One of the previous royal physicians, Roderigo Lopez, was appointed by Elizabeth I. Because he was Portuguese and Jewish, others were unhappy about it, they thought he was a spy or a traitor so he got tried and sent to the Tower and then hung, drawn and quartered.
Does it make a difference whether you are treating a queen or an ordinary member of the public?
“I can remember being asked that by a local newspaper. And I said I hoped that I treated all my patients as I would treat the Queen.”
Born in 1943 and brought up in “very rural Huntingdonshire, which doesn’t even exist as a county any more”, Sir Marcus attended private Felsted School in Essex, before winning a coveted place at Gonville and Caius College, Cambridge to study medicine.
“Medicine wasn’t in the family at all,” he admits. “My father was a small-town accountant, but I actually always wanted to be a farmer.” One grandfather had been a corn merchant and another had sold potatoes so “we were good, solid fen rustic stock”, he adds.
While studying at Cambridge, he started playing tennis with some students from St Bartholomew’s Hospital in central London and because “they all seemed like such nice guys”, he completed his training there.
In 1975, two years after his marriage to Sarah, a former GP, he was appointed consultant gynaecologist and obstetrician at Barts, a position he held until 2000 while the couple raised their four children, Anna, Catherine, Thomas and David.
Although he also worked at Homerton Hospital following its opening in 1986 and ended his NHS career at the Whittington in 2008 – as well as seeing private patients throughout at the King Edward VII Hospital, The Portland and The London Clinic, he retains a special affection for Barts, which is celebrating its 900th anniversary this year. The milestone is being marked by the creation of a brand new Breast Cancer Centre, bringing all cancer care under one roof, and a Clinical Research Facility at Royal London Hospital, both financed by Barts Charity.
Sir Marcus remains an active member of the Friends of Barts Heritage, a group dedicated to restoring and conserving the 12th-century hospital’s North Wing complex, including the Great Hall, whose staircase features two 30ft-high canvases by William Hogarth. After a two-year, £10million restoration project is completed – led by Will Palin, chief executive of Barts Heritage – the newly refurbished buildings will be opened to the public – something Sir Marcus has long campaigned for.
“Until Barts Heritage started, the only way for the public to see the Hogarth [Stair] was to look on the NHS website or come on a Friday afternoon between 1.30 and 3.30, by appointment – we’ve completely reversed that. We want as many people as possible to see how much history there is at Barts.”
Founded by Rahere, a monk, in 1123, Britain’s oldest working hospital survived the Reformation in the 16th century, the plague in 1665, the Great Fire of London the following year and two world wars.
St Bartholomew's Hospital, 1752. Photo / Getty Images
When the hospital was threatened with closure in 1997, Frank Dobson, who had just been appointed health secretary under the new Labour government, reversed the decision, saying he would not allow an institution that had “treated the archers of Agincourt” to shut on his watch.
It perhaps helped that Tony Blair’s wife Cherie gave birth to their first child Euan there in 1984. Sir Marcus would go on to attend Cherie to deliver their fourth child, Leo, in 2000.
Recalling delivering his first baby at Barts, Sir Marcus says: “It was quite scary. I can’t remember if it was this one or not but very early on somebody said they were going to call the baby Marcus.”
He cannot remember exactly how many babies he has delivered over the course of his stellar career. “It would be many, many thousand but I couldn’t tell you on the range from 5 to 10 thousand how many it would be.”
It wasn’t just the “magic” of childbirth he enjoyed but also the miracle of assisted conception. Gripped by the news of Louise Brown, the world’s first test-tube baby, being born in Oldham, north-west England, on July 25, 1978, Sir Marcus embarked on a mission to provide fertility treatment on the NHS, eventually setting up the first “free” clinic at Barts.
“It was very difficult to get it in a hospital that was not charging you and I felt very strongly that it was wrong that only the rich could get this treatment.”
As he hadn’t witnessed the procedures first hand, he asked one or two of the private providers if he could spend the day observing, but they all refused.
“I knew that the London Zoo were doing it on animals so I rang them and went round and the equipment was all exactly the same.
“I raised funds by asking livery companies and things for sponsorship. I also used to be asked to go to the Middle East and see potentates’ wives and so on. One of them, whom I’d got to know very well, agreed to make a donation to Barts’ fertility unit rather than paying me a fee and that covered virtually all the expensive equipment we needed.”
Describing it as a “very gratifying thing to do”, he adds: “In the early days the success rates were nowhere near 100 per cent – many people would have three or four attempts at it before pregnancy happened. There was a lot of disappointment but the pleasure of seeing it work was very satisfying.”
Just as technology improved women’s chances of having a baby so too did the treatment of female patients. “When I first started out, I can remember that if one of the patients started asking questions, the consultant would say, ‘I ask the questions around here!’ and literally didn’t give information.
“I think that hit me fairly early on, I could see how wrong that was. The patient comes first – the woman comes first. I’d get annoyed, as well, when husbands would try to speak for their wives.”
The Countess of Wessex and Royal Gynaecologist Marcus Setchell. Photo / Getty Images
As joint honorary president of Wellbeing of Women, the only UK charity dedicated to funding research, education and advocacy across all of women’s reproductive and gynaecological health, Sir Marcus is among the many voices calling for greater continuity of care for female patients.
“Currently, there’s quite a strong number of people saying that the whole of women’s health management is second rate. Women tend to see different doctors at different stages of their reproductive life. There’s a strong movement, being supported by Wellbeing of Women and the Royal College of Obstetricians and Gynaecologists, that there should be a specialty for women, not just a GP who has never done any training in women’s health.
“Women need the same doctor they saw at puberty as when they need contraception, when they need smears and when they’re pregnant.
“Now almost nobody does obstetrics and gynaecology but for me it was a wonderful mix.”
He recalls how much he enjoyed being seconded to a maternity hospital in Norwich when he was still a trainee, where he delivered 30 babies. “If someone needed stitches you’d be sent there in a taxi. Also, the consultants in these cottage hospitals would make you the first assistant in any operations, and that’s what made me want to specialise in obs and gynae.”
Describing the NHS as being in “a very poor state at the moment”, Sir Marcus points to Covid and a loss of morale, saying: “Midwives and doctors are retiring early because they’re fed up with it.”
Although he does not support doctors and nurses going on strike, quoting the Hippocratic oath “do no harm”, he admits that those in the medical profession today are not treated as “lovingly” as his generation.
“I loved every minute of my career in the NHS. When I was a junior doctor we didn’t complain but we lived in a doctors’ residence where you were brought tea in the morning by somebody called a ‘bedder’ and your bed was made, and by the time I was a consultant you would make sure that each batch of students came to your home for drinks or a barbecue or something. I think a lot of that has gone.
“The hours that we worked were in excess of what people do now, but there’s more high tech medicine now that’s more demanding of the people at work.”
Sir Marcus also concedes that he would have found latter-day transgenderism difficult to navigate. Referring to the NHS Gender Identity Development Service (GIDS) that was recently shut down after referring children to be prescribed puberty blockers without adequate record-keeping to track their welfare, he adds: “I’m very glad that the Tavistock has fallen into complete disrepute and not functioning in that way at all anymore.
“I never did surgery to alter people’s genitalia, but if a woman who wanted to become a man said, ‘The one thing I really don’t want is periods any more’, then I would do a hysterectomy for them, if I didn’t feel there was anything ethically wrong with complying with their needs.” But as he points out – these were adult patients not children.
And what of his own children? With such a demanding career, I wonder if he ever had much time to see his own brood.
“I once asked one of my sons, did you feel I was away a lot? And he said, ‘No, I remember having just as many bath times with you as with Mum’, so I think I probably made quite an effort.
“If I had someone in labour but I knew she was going to be another three or four hours, I’d sometimes come home for an hour or so. We were very keen on activity holidays so we always had lots of good family time as well.”
With that, Sir Marcus tells me he is off to play tennis. “There’s a lovely old boys’ group at Wimbledon and we have four courts going. If I don’t play twice a week, something’s missing.
“I’m turning 80 in October which I’m slightly scared of. But whenever I’m on a tennis court people say, I can’t believe you’re in your seventies.”
One future king and at least 5000 babies later, no one would begrudge Sir Marcus taking such advantage of his retirement years.
