Ordeal finally ends for paediatric neurosurgeon

I am delighted to finally be able to tell you that Tim Buxton has won his high court action against Abertawe Bro Morgannwg NHS Trust.

It has been ordered to follow the correct Trust procedures until the outcome of a properly conducted professional disciplinary panel chaired by Mr Andrew Stafford QC is known, and to pay his back money.

Just to give you a bit of background to this case, Tim Buxton was working at Swansea's Morriston Hospital when he was dismissed from his post at the hospital in June 2005 after being on ‘special’ leave since 11 March 2003. The trust claimed that relationships with his consultant colleagues had broken down. He immediately appealed against the decision.

Since then, BMA Cymru Wales, Welsh assembly members and dozens of former patients have been fighting to get Tim reinstated. On 12 June 2006 an internal appeal hearing had to be abandoned by the Trust after BMA Cymru sought a declaration before the High Court. Then a year later, His Honour Judge Simon Brown QC sitting in High Court gave a judgment that the 'Professional' procedure should be adopted by the Trust.

On 12 February 2009 His Honour Judge Simon Brown QC again sitting in the High Court ordered that the Trust must pay back pay from June 2005, up until the date of the Professional Appeal.

The High Court found back in April 2007 that the Trust had deliberately used the wrong disciplinary procedure in Tim's internal appeal in 2006. Had it used the correct procedure from the beginning, Tim would have been entitled to be paid, pending his appeal.

It is very regrettable that the Trust has seen fit to deny Tim his contractual right to a professional hearing and his pay for the past three and half years. It has actually wasted NHS funds on legal costs to deny him his rights. It is through the recalcitrant attitude of the Trust that Tim was forced to go to the High Court in order to secure these rights and get the pay which has been his contractual entitlement all along.

Significantly the judge denied the Trust leave to appeal to the Court of Appeal and he also made an immediate order for an interim payment to be made by the Trust. The Trust have 14 days to pay the judgement debt figure of £430,534.89 plus interest representing Tim's back pay since his dismissal in 2005.

The High Court's decision means that the Trust must keep Tim on its books and in receipt of pay until the outcome of the professional disciplinary panel, is known.

In future, NHS Trusts will have to follow in good faith the contractual professional disciplinary procedures which have been negotiated by BMA Local Negotiating Committees (LNCs). Trusts which 'deliberately and erroneously' misclassify matters as 'personal conduct' to deny consultants the right of a correct hearing and so avoid paying them, can now expect to be challenged through the courts.

Tim has told me he’s delighted with the result and never doubted that justice would be done and is now looking to the future with optimism and hopefulness. He’s also told me that all he ever wanted to do was to provide a first rate standard of care for patients in Swansea and west Wales, who deserve a quality service during what is for them extremely distressing times in terms of treating their medical problems.

I am of course delighted that BMA Cymru Wales has managed to lead Tim through what has been for him a laborious and distressing journey. It is astonishing that while patients recognise the importance of retaining the expert skills of this consultant, the Trust was blind to it. It has taken nearly four years to get this Trust to do the right thing by this highly trained and highly regarded neurosurgeon. During this time BMA Cymru Wales has been urging the Trust to follow the correct procedures and stop wasting public money on lawyers. The people of Swansea, as well as being denied Tim’s expert skills have also seen the Trust fritter their money away on legal costs. BMA Cymru Wales will be pursuing what this case has cost the health service in Wales. And when I find out the cost, I will let you know!

Clear link between increased rates of diabetes and obesity

A new report into increased rates of diabetes illustrates a clear link between type 2diabetes and obesity. The rate at which the condition has gone up is really quite staggering, 74% over a six year period.

As well as the link between more people being over-weight and more people being diagnosed with the condition, another reason for the leap in the number of cases can be put down to the fact that GPs are more alert to the symptoms, hence detecting more cases.

If you do have diabetes AND are overweight, it should really be taken as a warning to start leading more of a healthy lifestyle, combining exercise with sensible eating. The Welsh Assembly Government is trying to help us with this, through the work of Health Challenge Wales, which is running such initiatives as free swimming (Children aged 16 and under can use public swimming pools at certain times during holiday periods, free of charge) community food co-ops (fresh fruit and vegetables direct from a local supplier, so you pay wholesale prices and support your local community), and Lets Walk Cymru (There are a number of opportunities for you to join groups who participate in regular walks).

Wales' Chief Medical Officer's latest annual report, released late last year also highlighted some very positive plus points, not least the fact that people here are living longer and that deaths from heart disease and strokes are continuing to fall. So there is some indication of change for the better in the health of people in Wales, yet we’ve still some way to go, as the rise in diabetes cases shows.

One way to make further in-roads into tackling obesity, particularly amongst children, would be for the WAG, to work with Local Authorities in Wales and organisations like BMA Cymru and Sustrans, to put together a major joint strategy, identifying all major walk to school routes and roll-out a programme of 20mph zones across all parts of Wales.

We favour 20mph speed limits in urban areas, and particularly around schools, as a way of encouraging more of us to walk and cycle. Hopefully, this kind of initiative, if implemented, would help the vast majority of us to get more fit and active as part of our daily routine.

Misconceptions remain about organ donation

The new NHS Blood and Transplant website survey points to a growing culture of support for organ donation, but it also shows how much work is STILL needed in reassuring donors about the whole transplantation process.

In our evidence to the Welsh Assembly Government committee set up to consider presumed consent, particular emphasis was placed on the need to ensure that comprehensive information is made available to everyone about the process of organ donation.

It is obviously something we all would wish to put to the back of our minds, but what a wonderful gesture and enduring life-saving gift each one of us could potentially make after our death - if the unthinkable were to happen. You only have to read the testaments of those people fortunate to have received a life saving donation to appreciate this.

The NHS and the heath professionals who work in it strive to keep the interests of the individual patient at the forefront at all times. It is only after everything possible that could be done, has been done, that the potential for transplantation becomes an issue, and ONLY in line with the wishes of the patient and their family. It is at this time that the expert services of transplant teams come to the fore.

And I cannot better the comments of Dr. Paul Murphy in summing up the ethos of their work. I would have the complete confidence of doctors and other health professionals working in this area. Far more needs to be done to communicate the processes and safeguards that exist and reassure everyone who is considering joining the donor register that any fears they may have, are unfounded.

It is for this reason I am on the donor register myself and why the BMA and a majority of the public feel able to support a move to presumed consent.

Chance for Public Health doctors in Wales to get their voice heard

Just to make you aware that BMA Cymru Wales’ Welsh Committee for Public Health Medicine and Community Health will be opening its doors again for an open meeting on Tuesday the 21st April, 2009. This meeting is a great way for Public Health and Community Health doctors in Wales to gain a better understanding of what a national committee discusses and to see how the views of public and community health doctors are fully represented.

All Welsh Consultants in Public Health Medicine and Community Health are invited to attend this meeting.

If you would like to come and put forward your views on topics such as the Unified Public Health Organisation consultation or just to listen, please contact Laura Evans - levans@bma.org.uk, by Friday 3rd April, 2009.

Kirsty’s case highlights the need for better regulation of tanning salons

Another example in the media this week of where the hope of a golden glow’s turned into red raw skin and hospitalisation. Kirsty’s case provides a harsh and unfortunate lesson and sends a clear message that politicians need to take action to regulate the sun bed industry in Wales and across the UK.

BMA Cymru has campaigned on the regulation of sun beds for sometime now. We’ve called on the Welsh Assembly Government to introduce a new Measure on this issue and to make councils regulate cosmetic tanning salons. One of our recommendations has been to ban coin-operated and unmanned sun beds outright, exactly the sort of place where Kirsty was able to spend an incredible 19 minutes burning her skin.

It’s deeply concerning that children and young people can use these sun beds without supervision or guidance. What’s happened to Kirsty shows what short-term damage can be done to our skin from intense UV exposure – the long term damage is far worse. And children are especially vulnerable to UV rays, as exposure at this young age, dramatically increases the chances of developing skin cancer in adulthood.

I hear from BMA members who are seeing more and more young patients with skin cancer, particularly young women, who are frequent sun bed users.

By introducing a Welsh Law the Welsh Assembly Governments has a golden opportunity to steal a march on this issue, which will have a dramatic impact on skin cancer prevention efforts and reduce the number of patients who are seeking treatment for burns and accidents due to the misuse of unsupervised equipment.

Here’s what the BMA wants a Welsh Law to cover;
• Prevent the use of sun beds by children
• Protect adults from over-exposure
• Ensure that sun bed users are supervised
• End the use of coin-operated machines
• Ensure that sun bed sessions are monitored and limited
• Provide health risk information in sun bed parlours
• Inspect premises

My message is to avoid using a sun bed at all – if you want a tan and a healthy glow, fake it and get it out of a bottle, not a sun bed!

And I would like to wish Kirsty a full and complete recovery. If anything good has come out of this, it has raised this issue and given her the chance, first hand, to warn other young people of the dangers of sun beds and excessive exposure to UV light. Hopefully they will learn from Kirsty's frightening experience.

It would be great to know what you think about this issue, feel free to share your thoughts on my blog, click on the comment link underneath this post.

Violence and aggression against Welsh NHS workers is still proving to be a big problem

The BMA welcomes this update on progress with regard to the work of the Ministerial task force on violence and aggression and while much has been achieved, there is still a great deal to be done.

It remains unacceptable that doctors and other healthcare workers are exposed to violence and aggression in the workplace on a daily basis.

The taskforce is beginning to put in place processes to protect and support staff but much more needs to be done to encourage reporting of violence and aggression in the workplace and this will only happen when people feel properly supported and incidents taken seriously.

Improvements in the Training Passport and Information Passport Scheme are to be welcomed but more action is needed and it is concerning that significantly more improvement hasn’t been made in tackling the safety of lone workers, which is especially important for primary and community care staff.

How do you decide who’s “worthy” of an organ transplant?

The recent media coverage surrounding transplants being given to people with alcohol-related liver damage raises some interesting questions over the issue of organ donation and who should and shouldn’t be “entitled” to a liver transplant. It’s also an issue that probably deserves more attention and a fuller debate than a few column inches in the newspapers.

I agree with the points Dr Tony Calland (Chair of the BMA’s ethics committee) makes about organs being a precious resource and we certainly don’t have an endless supply of them.

Jeremy Laurance, the Health Editor of 'The Independent' makes a valid point too when he says “This is a judgement about the balance of risk and benefit, and is taken with the sole interests of the patient in mind.”

Of course for anyone who disagrees, please feel free to say so here, by posting a comment on this blog.

Hoping the sweet chariot comes off its wheels tomorrow

Ahead of a key game for Wales in the Six Nations, as Warren Gatland’s men prepare to take on England, I just want to wish our team all the best, hopefully replicating last week’s success against Scotland in our own back yard, the Millennium Stadium.

It seems at the moment that there isn’t much to smile about, what with the almost daily news of job losses and Britain sinking further into recession. So, this Championship couldn’t have come at a better time really providing us with a reason to be cheerful. And if England’s sweet chariot comes to a grinding halt on Saturday evening, it will undoubtedly lift our spirits for a while at least!

CALL for help about the economic downturn

Good to see the Welsh Assembly Government recognising the impact the credit crunch could potentially be having on our health and well-being. I‘ve heard from some members who’re seeing more cases of patients coming to them about anxiety and stress issues, with money worries being at the forefront of most people’s minds.

The WAG has set up C.A.L.L. (Community Advice and Listening Line) which doctors may wish to suggest to anyone they see struggling to cope with financial pressures.

CALL is accessible via a freephone number – 0800 132 737, or by texting ‘help’ to 81066

Tenovous Cancer bus providing a much needed service

Tenovous’ mobile cancer unit or cancer ‘bus’ as it’s now becoming known, is, I think, a great idea and a really practical way of trying to help cancer sufferers. By taking support and advice out on the road, it should go along way towards helping the charity reach people who may not know about, or be able to access Tenovous’ services. Even if it’s just having someone to talk to, or getting some financial advice during treatment for cancer. More information and dates and locations the bus is visiting follow this link - http://www.tenovus.com/busBlog/

Your chance to find out more about the workings of the BMA Welsh Council

We're inviting BMA members to come along to future Welsh council meetings, to get a flavour for the committee's work. The council is setting up a visitors’ scheme to give members more of an idea of how issues are debated and hopefully, to try and get more doctors involved in medico-political activities. Dates for the next couple are below.

March 11, May 18 and October 14.

For venues and more information, please contact Sarah Ellmes on (029) 2047 4604, email: sellmes@bma.org.uk.

Hope to see some of you reading this, at one of the meetings!

Time's running out for Staff-grade Doctors who want to apply for Re-grading to Associate Specialist

The Welsh Staff and Associate Specialists Committee would like to remind doctors that the window of opportunity for re-grading to associate specialist level closes on the 31st March, 2009.

Raj Nirula, Chair of the Welsh Staff and Associate Specialists Committee, says
"The benefits to Trusts of regrading are numerous and far outweigh the small cost involved. Not only will it ensure maintenance of a high quality service and the retention of experienced, highly skilled senior medical staff but it will ultimately help improve the quality of patient care.

"We hope that all Clinical Directors and others within Trusts throughout Wales will take positive action by recognising and rewarding this valuable group of doctors. It is important that they receive the regrading that they deserve. The BMA’s WSASC urges all Trusts and employing authorities to regrade to associate specialist all those staff grade doctors and others that are already performing at the level of associate specialist."

Only applications received on or before the 31st March will be considered and those that are successful will have their pay backdated to the date of application.

Further guidance on the re-grading process is available to BMA members at http://www.bma.org.uk/wa/employmentandcontracts/employmentcontracts/regrading/SASCRegrade.jsp