Doctors get sick too

Wales’ Auditor General report out today on staff sickness levels in the NHS makes for interesting reading for BMA members. It says it’s still a “significant problem”, even though some improvements have been made.

Since April 2004, time off work because of ill health has averaged out at 14 working days per year for an NHS trust worker. This is down on the previous two years, when the average rate was just over 15-and-a-half working days per year.

I don’t think it should come as any surprise that sickness levels by NHS staff are higher than in other professions. After all, they are coming into contact with various different kinds of illnesses constantly. Those with the strongest immune systems are going to succumb at some point!

Of course, we’re not just talking about physical ill health here either. “Sickness” can cover all kinds of ailments, including stress. And again, it’s hardly surprising if staff working in NHS trusts experience more incidents of stress than other sectors, considering the very stressful situations medics are faced with on a daily basis. Then you have to add to that the fact that occupational health services are found wanting in many parts of the NHS.

That’s exactly why the BMA is calling for a national roll-out of the Primary Care Support Service, as part of our consultation response to the proposed reforms of the Welsh NHS. The PCSS is currently the only occupational health service available to clinicians and disappointingly, isn’t on offer in all parts of Wales. Even the Auditor General, in his new report, highlights the need to improve occupational health services for NHS staff. If that happens, then maybe we really will start to see a dramatic fall in the number of sick days taken by employees looking after the health of everyone else.

Kicking domestic abuse into touch during the Six Nations

I’d like to commend the Wales rugby team for getting involved in the latest initiative around domestic abuse and highlighting the very real and negative consequences that can stem from our national game. Members of our Six Nations squad faced a press conference yesterday to talk about how big a problem violence in the home can become, during the championship.

It is important that sports stars give their backing to issues like this, as often the perpetrators of the abuse would no doubt look up to and perhaps take notice of a message of intolerance from Welsh rugby players, more so anyway, than others, such as the police, charities or politcians. Let’s hope it goes some way towards tackling the problem.

Information about Eligibility for Inclusion on the GMC Specialist Register: restoration of the Existing Specialist Route

Below are the contents of a letter from the GMC about its Specialist Register and the restoration of the Existing Specialist Route. The BMA is trying to circulate this to members as widely as possible, as I am aware that some members may not know about this or have been “caught out” previously.

Eligibility for Inclusion on the GMC Specialist Register: restoration of the Existing Specialist Route

Since 1 January 1997 it has been a legal requirement that, in order to take up -as opposed to continuing to be employed in -a consultant post (other than a locum
consultant appointment) in a medical or surgical specialty in the UK health service, a doctor must be included in the GMC's Specialist Register.

When the legislation was introduced to create the Specialist Register, those who were already consultants were entitled to apply for specialist registration by virtue of their status as 'existing specialists'. However, later legislation introduced in 2003 prevented those who had not already applied as 'existing specialists' from doing so without being able to demonstrate that their past specialist training and/or qualifications met the present standards required for the award of a Certificate of Completion of Training (CCT).

This mechanism was never intended for established senior consultants who are already in post and quickly proved to be inappropriate for specialists whose training had been undertaken so long ago. These changes in legislation have left a small number of consultants in a position where they are either unable to move posts or with a straightforward means to have their names included in the Specialist Register.

Earlier this year the Government consulted on proposals to amend the relevant legislation which would enable the restoration of the existing specialist route; Parliament has now agreed this change and the GMC has consulted on a scheme for the registration of persons who were consultants before 1 January 1997.

The scheme will come into force on 2 March. If you are aware of any consultants (other than locums) who were appointed in the National Health Service or the Armed Forces on or before 1 January 1997, who are not currently included in the Specialist Register, we would be grateful if you could draw their attention to the scheme,

Expressions of interest in taking advantage of the scheme can be made by emailing the GMC at pre1997scheme@gmc-uk.org.

Cancer drugs decision is a step in the right direction

The news in today’s Western Mail that our Health Minister’s telling all Local Health Boards in Wales to fund four kidney cancer drugs is a welcome move and should hopefully provide some comfort to families in desperate need of the medication.

The drugs in question are Sutent, Nexavar, Avastin and Torisel, which haven’t yet been approved by Nice for use in the NHS, because official guidance has been delayed, once again, until March. It seems Edwina Hart has decided families, who’ve campaigned for a long time to get funding for the drugs on the NHS, have waited long enough. It should put an end to a post-code lottery situation which seems to have been allowed to develop, where some patients living in certain parts of Wales have had requests for Sutent accepted, while others in others areas have had theirs turned down.

It should be pointed out that this decision by Edwina Hart is only a temporary measure until guidance comes into force from Nice. Let’s hope LHBs now roll out this important change as soon as possible, with many patients already having experienced enough of a delay in treatment.

Welsh NHS hospital buildings – "not so safe as houses"

Worrying news from the Welsh Liberal Democrats today. They’ve uncovered figures which apparently show a half a billion pound repair and maintenance bill to get NHS hospital buildings in Wales to an adequate safety level. Perhaps what’s even more of a concern is the fact that some of these safety targets were set back in 2002. So, for the past 7 years, many of our members have no doubt been working in premises which don’t meet basic health and safety regulations.

No one can deny the fact that NHS staff working in hospitals do extremely important jobs and deal with often very stressful situations. So surely the least they deserve is to have buildings that are fit for purpose, rather than having the added worry about their own health and safety when just going about their daily routines.

Let’s also not forget about the patient here too. If essential maintenance and repairs isn’t being carried out on hospital buildings, then anyone needing treatment in one is undoubtedly having their health and safety put at risk too. This really is an unacceptable situation, both for our members and the public and I urge the WAG to do something about it, now.

Free prescriptions for all English patients soon too?

Judging by the latest announcement from the DoH, it looks like free prescriptions could slowly be creeping in via the backdoor in England. From today, thousands of cancer patients can start applying for free prescriptions, with that being extended at a later date to any patient with a long term health condition.

With the current charge being £7.10 a time for a prescription, English patients could save themselves up to £100 a year. We are of course exempt from such charges here in Wales and they are also being phased out in Scotland and Northern Ireland. So, as with the Smoking Ban, could England be the last UK nation to bite the bullet and see that charging people for prescriptions is merely a tax on the sick?

Welsh children taught how to “mend” their eating habits

The Welsh Assembly Government has come up with what seems like Wales’ answer to America-style fat boot camps.

Under the Mend (Mind, Exercise, Nutrition…Do It!) Scheme, children aged 7-13, considered to be overweight can access diet and exercise courses. Official statistics seem to suggest this is a necessary step to take, with youngsters here having some of the highest body mass indexes in the world.

With any scheme like this it is important the whole family gets involved and supports it, as it’s often the parents who decide their child’s diet and eating habits. There wouldn’t be much point the child learning about healthy eating and exercise, if a plate of burger and chips is then placed in front of them. Mums and dads also need to be able to recognise when their child is at the stage of being classed as overweight instead of just putting it down to ”puppy fat”. With all the family being on board with an initiative like this, the results will hopefully last for longer than the duration of the 10 week course.

More support for presumed consent for organ donation

Research published in the BMJ today gives more weight to BMA Cymru Wales’ calls for introducing a presumed consent system (where people opt OUT, instead of IN) for organ donation in Wales.

The report looks at 13 studies that either assessed organ donation rates before and after the introduction of presumed consent in a single country, or, compared rates between countries with similar systems.

And several of them highlight a significant link between increased organ donation rates and presumed consent. In one case, estimated donation rates were increased by as much as a quarter.

This same report does also point out that it probably isn’t solely presumed consent which has triggered the change, with other factors such as overhauling the organ transplant infrastructure being equally important. There wouldn’t be much point making such a fundamental change to the system if we couldn’t cope with demand.

The BMA has always maintained a system of presumed consent is the way forward to help with the chronic shortage of donors we currently have in Wales. And we have also argued running alongside this, that the whole transplant system needs addressing at the same time, to make sure the necessary parts are in place, such as transplant centres and coordinators.

This new research is encouraging though and will hopefully be noted by our Health Minister, currently consulting on the best way forward on this for Wales.

Free prescriptions prove their worth as the credit crunch continues to bite

I think it’s worth taking a minute to point out the good that some health policies in Wales are doing to help patients stave off the credit crunch.

Prior to free prescriptions some patients may have thought twice about accessing health care, or not picked up their prescription, because of the cost. This is now one less thing for people in Wales to have to worry about.

It seems almost hardly a day passes now without more news of job losses and companies being put into administration. But there is some small consolation for us here in Wales; at least we know a trip to the doctor’s won’t leave us out of pocket, with everyone being able to benefit from free prescriptions.

This was a policy BMA Cymru Wales fought long and hard to have introduced here and it couldn’t have happened at a more fortuitous time, given the current economic conditions. And with NHS Trusts gradually phasing out hospital parking charges, people need not worry so much about the financial burden a long term health condition may have caused before these policies were introduced. It does however make the £7.10 fee patients in England currently have to pay, even more of a bitter pill to swallow.

Better access to patients’ details for out-of-hours GPs is just what the doctor ordered

The news that GPs who provide out-of-hours cover, will soon be able to access patients’ records electronically, is very much a move in the right direction. It makes perfect sense really that doctors’ should have this kind of information at their finger-tips, in order to be able to provide the most accurate decision when diagnosing and treating individuals.

It is perhaps just a shame this hasn’t happened before now, as not having basic, yet fundamental information on people’s medical histories can have major consequences on patient care. It should also have a positive knock-on effect for NHS services, meaning patients can be treated and discharged sooner, easing the pressure on our stretched A&E departments.

It’s worth pointing out too that these developments are possible through the work of colleagues in Informing Health Care. They've worked with our members and others to make sure such systems are developed with best patient care in mind, whilst ensuring that patient confidentiality and consent over access to their information is scrupulously maintained. Such assurances are something we all surely want when accessing healthcare.

Headway being made on NHS reorganisation

Yesterday, BMA Cymru Wales held its second Policy day regarding the current plans for restructuring the Welsh NHS. The day was well attended by members and I really do think those able to make it, took away a great deal, including a large dose of reality from BMA Scotland’s Chair of GP committee, Dr Dean Marshall! I know it was extremely helpful for BMA Cymru Wales, as a whole, now providing us with a great deal more focus as to the shape of our consultation response. And it’s still not too late to feed into the process. Please feel free to post your views on here, before February 25th 2009.

Let’s end the ban on using mobiles in hospitals NOW

The Department of Health in England has finally issued guidance on more widespread use of mobiles in hospitals, five years after it was reported outright bans weren’t needed.

This is an issue BMA Cymru Wales drew attention to last Summer, when it was announced hospitals it Wrexham and Flintshire were easing the rules.

It would be good for patients, putting an end to the excessive cost of making and receiving hospital calls. They shouldn’t be punished financially, at the very time they need to keep in touch with their friends and relatives.

Removing the ban on the use of mobile phones would also enable easier communication between doctors, which would be good news to patients ultimately, because it would mean better use of doctors' time.
So long as places where phones shouldn’t be used are clearly marked, and patients aren’t
unduly disturbed by others using their mobiles and they’re kept out of areas with sensitive medical equipment, then I would hope ALL Trusts around Wales will look at their current policies and remove any restrictions on using mobiles.