Reading between the lines of NHS complaints in Wales

The latest figures from the WAG show NHS complaints have increased by 11% over the last year.

Here's Chairman of BMA Welsh Council, Dr Andrew Dearden's take on the figures...

"While the number of complaints received has increased we need to see this increase in the context of the total number of patient contacts with the NHS each year. In general practice alone there is some 10-15 million consultations with patients per year and this does not include dentists, community staff and hospitals, for example. The rate of complaints therefore of just over 7,000, actually suggests a good quality, patient-friendly service.

"Of course we must not become complacent with this low rate of complaints. We strive daily to improve the service, but we must also not lose sight of the fact that millions of patients in Wales are happy with the level and standard of care they receive."

BMA Cymru Wales' new chair of Welsh Council talks about his plans for the council

Dr Andrew Dearden, a Cardiff GP, talks to BMA Cymru Wales about taking over as chair of the newly reformed Welsh Council and what he hopes to achieve during his time in charge.

We must stop cut price drink offers

I couldn't quite believe my eyes when reading this article.
£5 for 5 hours worth of alcohol I think is a ridiculous price and can only serve to encourage binge drinking. The majority of us would be able to fit in an incredible amount of drink in that time, much more than £5 worth I'm sure. To try and suggest as the manager does that bar staff are keeping "an eye" on how much customers are drinking seems rather ludicrous too. How can they do that with a club full of revellers? It also begs the question, does the offer extend to soft drinks? The answer would probably be no, so those who choose not to consume alcohol have to pay through the nose for a coke or orange juice. It's a similar situation to the one created by a leading supermarket a few weeks ago, where the price of lager was cheaper than bottled water.

But then, perhaps that's where part of the problem lies, that pubs and clubs are just trying to compete with supermarkets when it comes to offering cheap booze. That just provides customers with a double whammy though, having cut price drinks from the supermarket at home, before going out. Then drinking as much as they can for £5 in their local club. Perhaps one way to stop this would be for politicans to introduce a fairer pricing system for alcohol across the board, applying to ALL premises which serve drink.

And what about the consequences of this cut price alcohol?

BMA members (doctors) see it as first hand. It can cause family breakdowns, is a major factor in domestic violence, ruins job prospects, is often related to crime and disorderly behaviour and it kills. Alcohol misuse is related to over 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems. Alcohol misuse not only costs lives it also costs the country many millions of pounds. The NHS spends millions every year on treating and dealing with alcohol problems and the criminal justice system also spends similarly large amounts dealing with alcohol-related and drink-driving offences.

It is for all of these reasons that the BMA continues to call for an end to such irresponsible promotional drink activities.

Organ donor public debates test opinion on presumed consent

My Policy and Public Affairs Officers attended one of the many Welsh Assembly Government public debates this week, examining the question of 'presumed consent' for organ donation.

The BMA has long-argued the need for a fundamental shake-up in the way organs are donated. We have some 500 people in Wales waiting for a donation.

What I can't quite get my head around is the fact that if you ask people, the majority will say they support organ donation. In fact, some 90% say they would be willing to donate. Unfortunately, this does not translate into people who actually sign the register - it stands at roughly 30%.

So we have a problem. The BMA believes that we need to adopt a 'soft' system of 'opt-out' or 'presumed consent'. It's a subtle difference but an important one. People would still be able to opt-out if they have a moral or religious objection but it would help those people who for, whatever reasons, do not get round to registering.

Families would also have a final say. Which is why Kidney Wales' recent "Tell a Loved One" campaign, is so important. You can sign up to the organ donor register and carry a card, but if your nearest and dearest don't know your wishes, they'll be less inclined to follow them out if you haven't discussed organ donation with them first. And as next of kin would have the final say, they could go against your wishes, if you haven't bother to tell them.

Unfortunately, there's still a great deal of mistrust from the public and I still despair when I hear people saying that this is an attempt by the 'state' or 'politicians' to 'take my organs'. I really don't think that this is the case. Doctors just want what's best for their patients, and ensuring a supply of organs that will meet current and growing demand must remain our ultimate goal.

Anyone wanting to register to be an organ donor, can do so here

Rhodri backs BMA Cymru's calls for the NHS to continue for the next 60 years and beyond

I had the pleasure of presenting a giant birthday card to the First Minister this afternoon, as the 60th anniversary of the NHS draws to a close.

The card was signed by politicians from all parties and patients across Wales, showing the depth of support for the NHS to continue as it is, free, at the point of need. This is also the perfect opportunity for the Welsh Assembly Government to send a clear a message to keep the NHS public.

Here's what Rhodri Morgan had to say on receiving the card;

"The creation of the NHS, providing free healthcare for all, is arguably the greatest achievement of any government of the 20th Century. We all owe Nye Bevan a huge debt of gratitude for having the remarkable foresight and courage to introduce the NHS in 1948.

The NHS today is a lot different from the NHS of 10 years ago, and vastly different to the NHS that Bevan founded in 1948. It has adapted and modernised, as any public service must, to meet the challenges of today and it will have to do so again to meet those of the future. There’s no doubt that the continued hard work of staff, together with investment and reform, has made a huge difference to the quality of care that patients now receive. As we celebrate its 60th anniversary, we can be proud in Wales that the founding principles that Bevan established are as dear today as they were in 1948."

It's right we have a PUBLIC debate about presumed consent for organ donation

I very much welcome the announcement from the Health Minister about a series of public meetings on presumed consent for organ donation.

BMA Cymru Wales has always consistently called for an open and honest public debate on the issues surrounding presumed consent for organ donation.

And, just as we have always argued for a shake-up of the way organs are donated, we accept that if we are going to have such a fundamental change, then the public needs to be informed and engaged about the issues. That is why we welcome this series of public meetings and we urge doctors across Wales and the general public to have their say.

Spotlight on domestic abuse

We fully support AM Nerys Evans' attempts to get the issue of domestic abuse, still very much a hidden problem, on everyone's radar. Launching a blog for victims to write about their experiences, will hopefully stop it from being so "hidden".

BMA Cymru Wales also backs Nerys' calls for the WAG to fund an awareness-raising campaign, aimed at changing people's attitudes towards violence against women. One way of helping with this would be for all doctors and health professionals to be given training in dealing with domestic abuse, which we've called for in a previous BMA report focusing on the issue.

Key recommendations from this report include:

1. All health professionals should receive training in identifying and helping patients who are victims of domestic abuse – this needs to be implemented on a national scale within emergency medicine.

2. Health professionals should ask patients appropriate questions in a sensitive and non-threatening manner, to encourage disclosure of abusive experiences.

3. Health professionals should recognise that men can also be victims of domestic abuse.

4. The government should promote a ‘zero-tolerance’ attitude to domestic abuse.

5. Refuges should be more accessible to transgender, lesbian, gay, bisexual individuals.

6. Domestic abuse education programmes should be implemented in all primary and secondary schools.

Hopefully, "humanising" domestic abuse in the form of victims blogging about their experiences, will make us all, including politcians, sit up and take notice.

Reflecting on Welsh Council's past achievements

In this video, former Chair of Welsh Council Dr Tony Calland, talks about what he feels has been achieved in his time in charge.

And in this video Dr Calland looks to the future for Welsh Council and tells BMA Cymru Wales what he thinks are the major challenges that lie ahead.

Are BMA's worst fears becoming a reality?

The ink is yet to dry on the Health Minister's announcement on the second stage consultation concerning the reorganisation of our NHS. Yet already there are jungle drums raising concerns about a potential "take over" of primary care and community care, and done deals.

BMA Cymru Wales, in its response to the first stage of the NHS Wales reform consultation, made the point that the new organisations sprouting from the reform, need to be new and fresh, to ensure balanced investment across patient services and ensure that re-focusing care into community and primary care, to free hospital services to get on with the job they are best at -becomes a reality and not an aspiration.

So what do we see this week? In North Wales, a new Director of Primary Care has been appointed, for the new combined NHS Trust of Wrexham and Glan Clwyd.

This maybe a short term appointment, it may have a rationale if hospital Trusts have been given the go ahead to take responsibility for primary care services. But I thought we were waiting for further detailed consultation on a proposed way forward. Whatever the truth of the matter, or however it has come about, it gives the impression that the new Hospital Trusts will in fact BE the newly proposed "unified organisations" - i.e. a Hospital Trust takeover. First impressions are everything I was always told!

GPs fear that primary care will become a cinderella service in any kind of "Trust takeover". We're still awaiting the full details of Edwina Hart's plans for an integrated body. If the developments in North Wales are anything to go by, could we be seeing hospital Trusts taking over? If so it has the risk of re-balancing the care, cash and power as difficult as ever.

If the WAG want to get ALL of the medical profession on board with these radical changes, we need better communication of the intention, and greater involvement with the process at the key decision making points. BMA Cymru Wales wants this one off opportunity of reform to get it right for patients and doctors. We have a unique insight into how health services work. We should have - our members are at the sharp end of service delivery every day - listen to us.

National Healthy living week

BMA Cymru Wales is teaming-up with other leading health organisations in Wales as part of this year's Health Living Week.

Encouraging people to adopt healthier lifestyles remains a massive challenge. The BMA Cymru Wales public affairs team - John Jenkins, Hayley Mellors and Chris Jones will be manning our stand at an event to be held at the Senedd on Tuesday 4th November.

If you're around, pop over and say hello.

Health under Welsh Lib Dems' spotlight

BMA Cymru Wales attends all of the main political parties conferences.

My Senior Public Affairs Officer, John Jenkins, spent last weekend at the Welsh Liberal Democrat conference in Swansea. It's nice to see that their new consultation document on health covers many of the areas that we have actively campaigned on. BMA Cymru Wales will be commenting on the specific details, shortly.
Watch this space...

Palliative care strategy launched

A major new report into palliative care services in Wales, has been published.

If the Welsh Assembly Government supports the key recommedations, services will be required to be consultant-led, with support from multi-disciplinary teams including specialist palliative care nurses and other health professionals.

Improved standards of out-of-hours care will also have to be met and a new patient registration card and single contact point will be explored to improve the support to patients and their families. This is welcome news - and long overdue.

Should we call time on cheap booze

Reports that a leading supermarket is selling cans of lager for less than the equivalent in bottled water, is nothing short of scandalous.

If true, then BMA Cymru Wales was right in calling for a series of tough new measures to limit the availability of cheap booze.

Last year, we unveiled a series of specific policy calls. These include:

A national roll-out of local schemes to outlaw the consumption of alcohol in public streets;

An increase in funding of services designed to treat alcoholism and alcohol-related illnesses;

Doctors to take a lead by helping to change both attitudes and behaviour with respect to the misuse of alcohol;

An increase in taxation on drinks containing alcohol, with taxation proportionate to the amount of alcohol in the product.

These proposals followed the publication of BMA Cymru Wales’ four point plan to tackle Wales’ alcohol problem.

The plan calls for:

A Licensing Measure to end deep discounting of alcohol for sale in off licences, supermarkets and other off sales outlets.

Research into the measures by which pricing mechanisms can be used in Wales to discourage heavy consumption of high alcohol products.

Legislate for alcohol labelling rather than relying on voluntary agreements with the drinks industry.

Reduce the drink driving limit from 80mg to 50mg and introduce random breath testing in Wales.

The BMA remains focused on offering practical solutions to Wales’ growing drink problem. This comprehensive set of measures is designed to cover a variety problem areas. It’s now up to the Assembly Government, in partnership with the UK Government, to ensure that these policies are taken forward. After smoking, alcohol is the next big public health issue.

The Government needs to get to grips with the problem.

Are we heading for a fairer funding system?

BMA Cymru Wales wants to know whether Wales gets enough money to meet its health needs.

Some politicians and academics say that the way Wales is funded is not fair. The so-called 'Barnett formula' allocates resources to Wales on population rather than a 'needs' basis. Put simply, we don't know whether we're getting the right amount of money.

I'm no financial expert, which is why I've welcomed the establishment of the Holtham Commission. I hope the Commission will allow us mere medics to obtain a very clear answer, to what seems a very simple question: Is Wales getting enough cash to meet its growing health needs?

Speed-up bowel cancer screening

News that bowel cancer screening test-kits are set to be dished-out shortly is VERY good news.

But I've never tried to hide my deep concern and frustration that the full roll-out is still some seven years away. 50 to 74 year olds in Wales will not have access to routine screening until 2015! Bowel cancer is the third biggest killer of men and women in Wales. Screening aims to detect bowel cancer at an early stage in people with no symptoms. This is when treatment is more likely to be effective.

I ask the simple question, how many people in Wales will die as a result of the delay?

The full programme needs to happen now - NOT in seven years time.

Another first for Wales!

Devolution allows us to put the concerns of some of the most vulnerable parts of society under the spot-light. First, it was children and now it's older people.

Wales is the only country in the world which has a designated Older People's Commissioner.

Last week the Older People's Commissioner, Ruth Marks, launched her first ever report. In that report she gave some indication of what is important to older people in Wales. Unsurprisingly she's found that the cost of long-term care; the lack of public transport, especially in rural areas; and a desire to be involved and be listened to, are all high on her agenda.

BMA Cymru Wales has already met with Ruth Marks and we look forward to working with her to ensure that all patients, regardless of age, get the treatment and respect they deserve.

Banning junk food from our schools

I'm glad to read that Welsh Lib Dem AM Jenny Randerson's attempt to rid schools of junk food is making progress. BMA Cymru Wales is backing calls for additional powers to improve the quality of school meals.

WAG hits back over free prescriptions 'nonsense'

I nearly choked on my Sunday morning cornflakes when I read in a London-based tabloid newspaper that the plug could be pulled on free-prescriptions in Wales. I don't know whether there is some concerted attempt to undermine the policy but it does seem that a week does not go by these days without negative and nonsense stories about free prescriptions.

That's why I'm glad that the Welsh Assembly Government has issued such a robust response to this 'nonsense'.

A story in yesterday's News of the World - claiming that Wales is about to end free NHS prescriptions - is absolute nonsense! The Welsh Assembly Government told the News of the World on Friday that there was absolutely no intention of 'pulling the plug' on our free prescription scheme.

The scheme is a long term investment in managing chronic conditions and improving health will ultimately reduce the cost and pressure on the NHS. The scheme is highly popular, and we are delighted that Scotland and Northern Ireland are following our lead. We're at a loss to understand where this story in the News of the World has come from.

BMA Cymru Wales response to Health Minister's statement on NHS reorganisation

BMA Welsh Secretary Dr Richard Lewis said: "We welcome the Minister's statement but are concerned that it raises more questions than actual answers. We need greater detail and clarification from the Minister and time to consult fully with our members in order to be in a position to give a detailed response to todays statement."

On the National Advisory board

"BMA Cymru Wales offers a cautious welcome. BMA Cymru Wales would much rather a fully arms-length approach, however at least with this arrangement the buck will stop firmly with the Minister, of which there can be no doubt."

On a separate Delivery Board

"It would be inadvisable for any Minister not to ensure that frontline clinicians and professional organisations like the BMA are fully represented. The NHS and patients rely on the support of doctors for delivery of care, and we seek a categoric assurance from the Minister our representation is assured."

On primary care

"We welcome the Minister's commitment to pursue a health service led by preventative, primary and community health services. The vice-chairs of the new organisations who will be made responsible for community, primary and mental health services appears to be a creative solution. Of course, we await the detailed work to be undertaken by Dr Chris Jones, chair of the RCT LHB who's been charged with development of a new primary and community health care strategy."

On the 7 new health bodies

"We await the exact details. Whilst the detail remains unavailable it puts into question the ability of the Minister to deliver these changes by April 2009. We need to get these changes right."
On a Unified Public Health organisation.

"BMA Cymru Wales welcomes the creation of a Unified Public Health organisation with executive responsibility for public health being vested with the seven NHS Local Bodies and at a national level. This will ensure a powerful voice to the National Health - as well as continued partnerships with local government.

"We believe that the local Director of Public Health position is of paramount importance in planning health services on the basis of need and also in assuring the protection of the health of the public - in line with the duties of the NHS.

"However, the BMA seeks urgent clarification as to the content and constitution of the new public health body and more importantly that it will remain part of the NHS."

BMA Cymru Wales backs call for all-Wales Tobacco strategy

Last week, I joined other members of the Welsh Tobacco Control Alliance (WTCA) in calling on the Welsh Assembly Government to develop and implement a comprehensive Tobacco Control Strategy for Wales.

The launch took place at the National Assembly - with First Minister, Rhodri Morgan and Grand Slam winner and Junior doctor, Jamie Roberts doing the official honours.

The WTCA is calling for additional measures to strengthen community action for tobacco control, ensure access for all smokers to effective and equitable cessation services and products, encourage people to go smoke free in their own homes, and for greater investment in training, research and monitoring.

Current members of the WTCA are:
ASH Wales
British Heart Foundation
BMA Cymru Wales
British Lung Foundation Cymru
Cancer Research UK
Diabetes UK Cymru
Royal Pharmaceutical Society of Great Britain (Wales)
The Stoke Association (Wales)
Tenovus
Firebrake Wales
Community Housing Cymru
Cardiff University
Children in Wales
All Wales Ethnic Minority Association
Royal College of Nursing
Asthma UK

Finally - a warm welcome for free prescriptions!

There's been a great deal of discussion on this blog about the policy of free prescriptions. Northern Ireland’s Health Minister's now announced they are following Wales’ lead and abolishing all charges by 2010.

For those doubters, it might be worth reading some of the following quotes. I couldn’t agree more …

MICHAEL McGIMPSEY, HEALTH MINISTER - "A cradle-to-grave health service, free at the point of delivery, is the founding principle of the NHS, which was founded 60 years ago this year. It is a principle that I, and the entire population of Northern Ireland, wholeheartedly support."

IRIS ROBINSON, HEALTH COMMITTEE CHAIRPERSON - "I and many of my colleagues have encountered constituents who are sometimes placed in the sad position of choosing to pay for fuel to heat their homes or drugs to help their health. No person in 21st century Northern Ireland should ever be placed in such a position."

Dr BRIAN DUNN, BRITISH MEDICAL ASSOCIATION - "This is a very positive step forward and all those patients in Northern Ireland who have found it very hard over the years to pay for their medication will welcome it - as does the BMA. It has been the association's policy, since 2002, that prescriptions should be free to everyone."

HEATHER MONTEVERDE, MACMILLAN CANCER SUPPORT - "Macmillan has been campaigning to have prescription charges for cancer patients abolished for a number of years. We are delighted the minister has listened to us and to all those who demanded free prescriptions."

MICHELLE O NEILL, SINN FÉIN HEALTH SPOKESPERSON - "This move is long overdue and will make the burden of those suffering illness a lot lighter. Sinn Féin had launched a campaign over a year ago to see that inequalities in health provision were removed and we support the Minister in the delivery of this project."

CARMEL HANNA, SDLP HEALTH SPOKESPERSON - "There was always something very wrong with having a tax on the sick. Unfortunately for many people they simply couldn't afford the high prescription charges for necessary drugs and so went without."

KIERAN MCCARTHY, ALLIANCE HEALTH SPOKESPERSON - "This move means that people who struggle to pay for important medicine to combat cancer and other long-term illnesses can now have some small element of peace of mind in future. "

PATRICIA GORDON, MS SOCIETY OF NORTHERN IRELAND - "The MS Society has lobbied the minister for health on a number of occasions around this issue and he has proven himself to be a man of his word. When we met him earlier this year on the issue he promised to do all that he could and this announcement is a real boost to ordinary people who have MS across Northern Ireland."