Sandy Macara was one of the long list of eminent Scottish doctors whose values came from being a son of the manse. In his case both his father and grandfather were ministers in the Church of Scotland in North Ayrshire mining villages. This gave him an abiding interest and concern for the welfare of the poor and disadvantaged. The channelling of this into a career in medicine and in particular in public health he put down to the care he experienced in hospital at the age of six. He nearly died from the combined effects of paratyphoid fever, whooping cough, and appendicitis. Dux of Irvine Royal Academy, he went to Glasgow Medical School and the London School of Hygiene and Tropical Medicine before becoming Assistant Medical Officer of Health in Bristol.
Always a political activist, it is surprising in retrospect that he was a prominent member of the Conservative Party until he was 30 years old. The fact that his subsequent political career was in the British Medical Association (BMA) came about almost by chance. The Annual Representative Meeting (ARM) of the BMA happened to be in Bristol and he went to observe. Captivated by the vigour and slightly chaotic proceedings he started to devote more and more of his energies to the organisation. From 1982 to 1989 he was Chair of the BMA Ethics Committee and from 1989 to 1993 Chair of the ARM. In 1993 there was a backlash by delegates at the ARM against the leadership of the BMA Council because of its perceived acquiescence in the policy of the Conservative government to create an internal market in the NHS. Sandy Macara to his own surprise was elected Chair of Council and immediately championed opposition to the policy. He characterised the introduction of market forces into health care as ‘an infernal monster’. There was a marked contrast between the exuberance of his oratory and his otherwise calm and courteous manner. His Knighthood in 1997 was a mark of respect rather than warmth from the political establishment.
Away from the BMA he was a consultant to the World Health organisation for 20 years and in Bristol he became the Head of the Department of Epidemiology and Public Health at the University. In retirement he continued his long campaign for the banning of smoking in public places and lived to see this implemented.
He is survived by his wife, Sylvia and sons, Alexander and James.