Macdonald resumed his local political career in 2004 when he was elected as Mayor of Manly, serving until 2008. He was re-elected as a councillor at the 2008 Local Government Elections following his announcement of not running for mayor and retired at the 2012 local government elections. In the 2011 Queen's Birthday Honours, Macdonald was presented with the Medal of the Order of Australia (OAM) "For service to local government, and to medicine."Medal of the Order of Australia, OAM, 13 June 2011, itsanhonour.gov.auCitation: For service to local government, and to medicine..
