Dr Sir Alexander Macara

Sandy Macara, who has died at the age of 80, was only six and desperately ill when he discovered his vocation would be in the field of public health and not the family tradition of the Church.

Suffering from paratyphoid fever, acute appendicitis and whooping cough, he spent three months in hospital, later describing the young consultant who saved his life as an almost God-like figure.

That doctor went on to become a professor of public health and mentor to his former patient, the son and grandson of the manse, who eventually went up to Glasgow University to study medicine, inspired to become a medical officer of health.

During an exceptional life of public service Dr Macara worked tirelessly to improve the health of people around the world and spoke out fearlessly, including railing against the "monstrous and cynical" tobacco industry, as an influential medical politician. He also trained legions of young medical professionals and was a leading figure in the British Medical Association (BMA) for 30 years.

Born and raised in Irvine, his childhood as the son of a Church of Scotland minister had a profound effect on his life. Growing up as "public property" in the manse made him sociable, while the experience of witnessing dreadful poverty and raising funds for the local hospital fuelled his lifelong commitment to the NHS.

Though his early education suffered due to his multiple and potentially fatal infections, he became school dux and was proud to be a former pupil of Irvine Royal Academy.

He graduated MB ChB from Glasgow University in 1958 and spent the next couple of years working in Glasgow teaching hospitals and gaining general practice experience in Glasgow and London. He saw first hand, during district midwifery, the deprivation and neglect rife in the slums and observed the public health problems afflicting dockers and miners. These experiences were to make an early and enduring impression on him.

He left his beloved Glasgow to train at the London School of Hygiene and Tropical Medicine, gaining a doctorate in public health in 1960 and becoming Bristol's assistant medical officer of health and then honorary community physician. Meanwhile he was also lecturing at Bristol University from 1963 to 1976, becoming acting head of the department of public health in 1974.

In 1976 he became consultant senior lecturer in epidemiology and public health medicine at the university and honorary visiting consultant to Bristol Royal Infirmary.

A visiting professor to a number of foreign universities, he was a founding member of the Association of Schools of Public Health in Europe and has been honoured by numerous international medical schools and health organisations.

He also chaired or served on a variety of working parties examining issues including child protection.

His service to the BMA stretched back decades: he chaired its medical ethics committee for seven years from 1982; was deputy and then chairman of its representative body from 1987-92 and chair of its council from 1993-98.

He attended more than 40 BMA annual representative meetings and attracted great admiration as a speaker, having overcome a stammer to develop an eloquent voice. One notable speech is still remembered – his searing attack on the internal market or "infernal bazaar" in 1995.

He was equally adamant there should be a ban on tobacco everywhere and played a considerable role in securing smoke-free public places. More recently he argued that the MMR jab should be compulsory for children, believing they should not be able to go to school unless they had been vaccinated.

"The profession has lost a great doctor," said BMA council chairman Hamish Meldrum.

He was a consultant to the World Health Organisation for more than two decades and founding secretary-general of the World Federation for Education and Research in Public Health.

Over the past 13 years he also served as both chairman and president of the National Heart Forum, from where tributes poured in from friends and colleagues who admired his mischievous wit and great wisdom coupled with deep personal humanity and humility.

Knighted for services to the medical profession in 1998, he was regarded as a powerful role model whom others aspired to emulate. As one who had been taken under his wing said, he was "someone who spoke truth to power, who never shirked from the difficult issues, whose oratorical skills were unmatched".

Outside his professional life, he focused on his family, his garden and the Church.

Along with his wife he was an elder at his local United Reformed Church at Henleaze, Bristol, and loved to spend time in his garden where he raised asparagus, beans and tomatoes.

He also established stunning swathes of tulips and snowdrops as well as nurturing roses, a legacy from his father who kept an internationally-renowned rose garden.

Always positive and a man who gave his all to whatever he wanted to achieve in life, Sir Sandy, as he was known, had a commitment and streak of determination that even his illness could not diminish latterly.

On his deathbed he consulted his diary and considered the possibility of cancelling his chemotherapy, citing a meeting he would rather have attended.

He is survived by his wife, Sylvia, their children Alexandra and James and his sister Ann.