Collins's background and vision

Collins had undergone his medical training in Scotland, attending medical school at Edinburgh University from 1951 to 1957, and then doing his residency there in both pediatrics and cardiology. He completed his postgraduate training at the Toronto Hospital for Sick Children in 1964.

From 1966 to 1968, Collins practised pediatric cardiology at the Toronto Hospital for Sick Children as a staff member. He joined the staff at McGill University Medical School in 1968. However, he spent much of the following 13 years in Kenya, as part of a Canadian International Development Agency program to establish a medical school in that country. During that period, he spent two years in the pediatrics department in Nairobi.

In 1981 he became the director of the heart catheterization laboratory at McGill University's Children's Hospital. He continued to practise pediatric cardiology and served as an associate professor of pediatrics. He directed the residency-training program, chaired the McGill Undergraduate Education Committee and was also quite involved in research activities.

The Winnipeg Health Sciences Centre recruited Collins in 1981. For the first six months of 1982 he worked part-time in Montreal and part-time in Winnipeg, taking on full-time duties in Winnipeg in the summer of 1982. Collins accepted the position because, in Manitoba, he saw an opportunity to put into action some of his thoughts and views on the delivery of pediatric cardiac services.

Before Collins agreed to take the position in Winnipeg, he and representatives of the hospital, as well as Winnipeg's medical community, discussed in detail whether or not a major commitment would be made to a complete pediatric cardiac surgical program. From the outset, Collins indicated that he was interested in coming to Winnipeg only if such a commitment existed. He felt that such a program would require a considerable amount of financial and moral support. He came to Winnipeg because he felt that such support was present, particularly after meeting with the President of the Health Sciences Centre, Peter Swerhone.

Collins's experience at both McGill Children's Hospital and the Toronto Hospital for Sick Children had convinced him that children who were referred from other programs or communities for cardiac surgery did not get the same care and attention as regular patients who received ongoing treatment from a local program. He felt that parents who arrived the night before surgery without any family support rarely received the briefing, education and attention that family members of local patients received.

He was also concerned about a distant program's inability to provide appropriate patient follow-up. He recalled that, in the early days of his involvement with Toronto's and McGill's pediatric cardiac services, a considerable amount of palliative surgery was undertaken, and many out-of-town patients never returned for a definitive repair, as would have been the case with a local patient.

Collins believed that a full-service program was needed to attract the best intensive-care and operating-room nurses, the best cardiologists and the best surgeons. He believed a surgeon was an essential part of any pediatric cardiac program. Without the presence of a pediatric cardiac surgeon, for example, pediatric cardiologists are unable to undertake any invasive cardiology-a growing and necessary field of treatment.

Collins felt the answer lay in the development of smaller pediatric cardiac surgery programs. The major programs in Canada at the time were in Toronto and Montreal, but Halifax, Edmonton and Vancouver were developing smaller programs. Collins came to Winnipeg because he believed that the evolution of pediatric cardiac services in Canada called for the development of such a service in this province.

Collins's ambitions for the program were high. His view was that Winnipeg could and should have a complete pediatric cardiac surgical program, capable of looking after the needs of children not only from Manitoba, but also from nearby provinces. He also had ambitions to provide cardiac services for children from Third World countries.