BMA Cymru Wales - the voice for doctors in Wales

1. The neonatal intensive care unit at the Royal G...

2010-06-21T14:59:59.447+01:00

1. The neonatal intensive care unit at the Royal Glamorgan Hospital in Llantrisant was downgraded to a level two unit due to a shortage of middle grade doctors - not as a result of new and improved services. It is this sort of example which the article is referring to. If downgrading was taking place as a result of these “new and improved services” which you refer to, our members would not be expressing concern, they would be expressing delight.

2. Again, I will provide one example which highlights the sort of situation the article was addressing. The emergency transfer of inpatient paediatrics from Singleton to Morriston Hospital in Swansea last year highlighted the problem that the NHS in Wales is having attracting middle-grade doctors to work in Wales.

3. That is not what the BMA are advocating and this was not suggested in the article. Initial reviews of the EWTD have shown that it has reduced training opportunities for junior doctors. Working less hours per doctor combined with the chronic shortages of hospital doctors in Wales can lead to an increased risk to patient care. These are issues which need to be addressed.

4. Junior Doctors do not earn above average salaries in Wales, they earn below the average salary. It is not our job to provide the information on cost. It is our job however, to highlight and address the concerns that members bring to us regarding below standard accommodation, including digs with no hot water, bed bugs and broken central heating units.
We have severe shortages of hospital doctors in Wales, and free accomodation for the first year after qualifying goes some way towards creating the culture which is necessary to attract the best medical talent for the future. Ultimately that will bode well for Welsh patients.

5. We fully recognise the hard work that those working in and for the NHS contribute. However, the terminology used to describe what could happen to the NHS in Wales (note the actual sentence said “fast approaching breaking point”) is the collective view of our members - those working on the frontline delivering services. People are always going to have opposing views in life, but it is our job to represent the views of our members, and that is what this article did.

IS VERY GOOD..............................

Yes - a couple comments and questions, which I hop...

2010-06-16T12:03:53.465+01:00

Yes - a couple comments and questions, which I hope you will publish and respond.

1. Please name the hospitals that have been downgraded. Where hospitals have been downgraded - do the decency to explain why. In most cases it's as a result of new and improved services.

2. Provide the full breakdown of wards that have closed and why?

3. In terms of the WTD - is the BMA seriously saying that it wants to return to the bad old days when Junior Doctors worked 24hr days and patient care was put at risk?

4. How much will it cost to bring Junior Doctor accommodation up to scratch and please explain why Junior Doctors, who already earn above average salaries in Wales, should have their digs subsidised by the dustman, the plumber, the window cleaner.

Finally, to describe NHS Wales at 'breaking point' is a slap in the face for all of us who work so hard for it and irresponsible in terms of impending spending cuts.

Well done for the BMA for giving such a stron lead...

2010-06-09T15:33:22.936+01:00

Well done for the BMA for giving such a stron lead on this subject which is an ever growing public health concern. I am sure that a mimimum pricing regime as well a linkage of tax levels to alcohol stength should be part of of any immediate response.

There are also real opportunties to link this campaign with a range of wider issues.

The Association has been active tackling domestic abuse where the links with alcohol abuse are well established. Reduced consumption would also make our roads and work places safer as well.

Our wider communities also suffer from growing alcohol abuse not least due to anti-social behaviour and a wide range of related activites.

It is somewhat paradoxical that at a time of high levels of alcohol use, we find so many of our traditional community pubs are closing. They just cannot compete with the ultra-cheap drink outlets.

As well as being demoralising eyesores, the closure of local pubs is resulting in a loss of an important community asset and a much more regulated drinking environment.

Perhaps some of the taxation raised on alcohol sales could be used to allow our local pubs to compete on a more even playing field?

As a GP working in Wales, I believe that the Welsh...

2010-06-08T20:36:04.359+01:00

As a GP working in Wales, I believe that the Welsh Assembly has spared us from some of the worst excesses of the English NHS such as outsourcing to private providers and so-called payment by results. I would also say, having previously been in England, that subjectively most patients are a nicer bunch to work with.
However, I have seen it said somewhere that GPs in Wales are paid typically £15000 less than in England. Part of this is to do with the skewed way in which disease prevalence weightings are calculated.
Perhaps the move to publish GP incomes will help to establish whether there is any factual basis for these claims. All I know is that doctors will need to see that there are benefits to working in Wales if the recruitment situation is to be improved.

If only Welsh Students could obtain places at Wels...

2010-06-08T16:25:33.013+01:00

If only Welsh Students could obtain places at Welsh Medical Schools they would not go to places ,like London ,to study and be lost to Wales forever.

This is an excellent project and post. I can wel...

2010-04-23T15:54:23.481+01:00

This is an excellent project and post.

I can well understand people having no choice or deciding to study outside work. And, well, one thing leads to another and they settle down there.

But Wales has made a big investment in her children - financially through education, but also culturally (and where the Welsh language is a factor, a linguistic investment too, in passing on the language). It's such a pity then that Welsh doctors, surgeons, nurses don't practice in Wales.

As you say, there's an excellent quality of life here, their wages will go further and they have the added bonus of knowing that they're contributing not only to the physical health of people here but also to cultural and linguistic health too.

Wales welcomes all kinds of people, and long may that continue, but it makes me very happy indeed, when I hear a professional has chosen to return to Wales to work.

Made my day.

Cardiff Boy

The article is absolutely on the nail. The grass a...

2010-04-23T11:57:50.937+01:00

The article is absolutely on the nail. The grass always looks greener until one leaves to seek one's fortune, then you realise what you have left. Its time then to make tracks back to sanity and this lovely land.
Born in similar wonderful countryside but its nowhere as untouched, uncommercialised and uncluttered as Wales.

The above does not include the fact that any perso...

2010-03-24T14:07:50.895Z

The above does not include the fact that any person & child inhaling secondary smoke ingests cyanide amongst other poisons!
Smoking is just a stupid unnecessary activity with no benefit for anyone and any intelligent thinking person has to agree and stop this innocuous habit anywhere! No one would condone giving a child heroin so why is cyanide/cigarette smoke OK?
That is apart from the other dangers to other drivers from dropped burning fag ends while driving!!

Yes, well done to the Kidney Wales Foundation for ...

2010-03-04T19:02:29.682Z

Yes, well done to the Kidney Wales Foundation for an excellent campaign. Without them, this would never have happened

Nice to see doctors taking an interest in somethin...

2010-02-08T16:28:29.537Z

Nice to see doctors taking an interest in something other than themselves. A worthwhile campaign and good content .... lets hope AMs agree.

Generally practices should aim to take calls for s...

2010-01-12T10:58:27.009Z

Generally practices should aim to take calls for same day appointments until at least 10.30 or 11 and obviously advance booking should be throughout the day as should genuine emergency appointments. Practices may vary and this shouldn't be looked at as prescriptive but certainly a half hour booking slot seems unreasonable and appointments for the future should be taken throughout the day. Some practices may wish to reopen same day slots in the afternoon - it is not for BMA to dictate exactly how it should be done, merely that it should look fair and reasonable to the practice's patients.

what is the reasonable window referred to?

2010-01-12T09:45:22.658Z

what is the reasonable window referred to?

Why not just have dual registrations so you can se...

2009-09-17T16:36:57.872+01:00

Why not just have dual registrations so you can see a GP near work or home?

At least over the border, the Govt is willing to take on the forces of conservatism and at least try and shake-up things for the benefit of patients.

Richard, Thanks for your views on what is an emot...

2009-08-14T12:02:33.789+01:00

Richard,

Thanks for your views on what is an emotive and controversial subject for many.

I think it important to address some of your points here and reiterate why the BMA feels very strongly about this policy.

The BMA supports an opt-out system of soft presumed consent for those over the age of 16, where relatives’ views ARE taken into account. As an added safeguard, if the individual had not registered an objection, the relatives would be asked if they were aware of any unregistered objection. If there is no known objection, the intention would be to proceed with donation. However there should be scope not to, if it is clear that doing so would cause severe distress to the relatives.

Unlike the current system, there would be a clear mechanism for protecting the wishes of those who do not want to become donors. There is no opportunity at the moment for someone who does not want to donate to register those views and ensure they are respected. This means that relatives may be giving consent when the individual would not have done so.

In its summary the UK Organ Donation Taskforce reported, as one of the arguments in support of a shift in legislation of the “apparent correlation between high donation rates and opt out systems in countries around the world”. The BMA also supports many of the Taskforce’s recommendations, including an improved transplant infrastructure with trained counsellors, which you also point out as being important.

The number of people on the organ donor register has doubled since 2001, from 8 million to more than 16 million, but the gap between the number of organs available and those needed continues to grow. Around 1,000 people die each year in the UK waiting for an organ. The BMA believes a change in legislation could make a real, tangible difference to these rates.

The BMA is also a democratic organisation, formulating policy based on members’ views debated and voted on at its Annual Representatives Meeting. This is what happened with presumed consent in 1999. And it was reaffirmed at the BMA’s Annual Representatives Meeting in 2006 and 2008.

This is an utterly misguided policy - what efforts...

2009-08-11T23:34:03.447+01:00

This is an utterly misguided policy - what efforts have BMA Wales made to consult with members, not to mention specialists in the field? An opt-out policy would see recently-bereaved relatives forced to see their loved ones' organs being harvested against explicit consent. It would create genuine hostility to our much-valued transplant programmes. I do not know of a single doctor involved in transplantation who supports such a scheme. The way forward is through a system of having trained organ donation specialist counsellors in every hospital - this is how Spain has achieved the highest per capita donation rates in Europe. The BMA have got this policy completely wrong.

I am writing in support of Option 7-Junior Doctors...

2009-08-05T15:13:45.423+01:00

I am writing in support of Option 7-Junior Doctors BMA Campaign urging doctors, especially junior doctors to report to the BMA in strict confidentiality their concerns regarding intimidation, bullying, harassment and discrimination as well as unsatisfactory working and training conditions.

The time has come to say enough is enough and we are not going to tolerate such practices whether you are a junior or a senior doctor. Yes, even consultants can be on the receiving end of such bad practices. As trainees, you only have one career opportunity to properly train and choose a career that will enrich your life rather than be a burden. Please take advantage of this BMA initiative and let us know what goes on or else you may inadvertently through your silence become part of the machinery that perpetuates bullying and systematises it in the NHS.

Thanks for sharing your views on what is for some,...

2009-06-02T15:19:39.779+01:00

Thanks for sharing your views on what is for some, a very contentious subject Martin.

Whilst I appreciate the point you make, and it is an interesting suggestion; it does oversimplify the debate.

There may - to a number of people be legitimate reasons why they would opt out - and such an approach would then in essence be punitive.

I know punitive measures in health care are not supported by the BMA and the profession as it comes up in many other debates, and its not something I would be able to personally support, either.

A trusted opt out system with comprrhensive transplant programs will meet the need of those desperately aewaiting organs, even if some people opt themselves out.

Dear Phantom Nurse, Thanks for taking the time ...

2009-06-02T15:17:13.762+01:00

Dear Phantom Nurse,

Thanks for taking the time to comment on this issue. A consistent nurse uniform across Wales will undoubtedly be of help to patients and staff alike.

I believe the way in which the statement was issued certainly made me wonder about adequate laundry support and plentiful supply of uniforms. Your comments support that concern - which will be a concern for other nursing colleagues too.

I think WAG and employers need to be pushed further on this point.

I agree with you Mr. Lewis, that the laundry issue...

2009-05-24T13:24:15.419+01:00

I agree with you Mr. Lewis, that the laundry issue needs to be clarified and made clear. This is a loophole where most Trust could get-away with imposing a uniform protocol in accordance with WAG mandate, la di blah di blah, but not giving staff support in line with this issue by not giving sufficient laundry support. Staff then has to shoulder costs to these changes. As a debt-laden nurse in this economic crisis situation, I am not very happy with it.

I don't think that "flapping doctors" remark was meant to cause offence. Well, I hope not anyway. If any doctor was offended by it, I am compelled to apologise. As a nurse in Wales, I do not like to see a fellow nurse disparaging any member of the multidisciplinary healthcare team, may it be a doctor or not. And at a public domain at that. Besides, it is against the NMC Code of Professional Practice under Team Working.

PhantomNurse

have opt-in or opt-out system, but a radical chang...

2009-05-19T10:04:00.000+01:00

have opt-in or opt-out system, but a radical change should be to make this cut both ways.

If an opt-out system, anyone opting out is therefore disqualified from receiving a donation. If opt-in, only those who have opted-in should be allowed to receive a donation.

This is fair, and would increase donor numbers whilst decreasing demand.

Thanks for your supportive comments. I am pleased ...

2009-04-27T21:49:00.000+01:00

Thanks for your supportive comments. I am pleased that we managed to raise the profile of this important issue. I hope that Doctors across Wales will highlight bed occupancy with their executives and boards, and put patient safety first.
Dr Stefan Coghlan
Chairman Welsh Consultants Committee

I welcome anything that can be done to reduce the ...

2009-04-24T16:57:00.000+01:00

I welcome anything that can be done to reduce the risk to staff and other patients due to violence, either verbal or physical, while in A&E departments.

CCTV cameras are one way to increase the security and safety of our staff, but we must not see them as the "answer" alone.

The Minister's announcement is a welcome step in stamping out unacceptable behaviour being directed towards staff. It's right though to point out other areas of the NHS where aggressive behaviour is increasing for example, GP practices.

I couldn't agree more with every word said in this...

2009-04-24T08:54:00.000+01:00

I couldn't agree more with every word said in this post. Average number of wards elderly frail patients in my Hospital with multiple pathology visit in one admission episode is 3 and they are under at least 3 consultants at varying times of their stay in Hospital during that admission episode.
Over the years we, the clinicians haven't voiced enough concern about this and mannagement have bulldozed every "re-organisation" in name of cost efficiency which thay themselves can't explain. It is high time we as clinicians looking after these patients (who end up being confused/ disorientated), say enough is enough and REFUSE to comply and tell the BED managers that ALL frail elderly patients should be first priority in terms of being on right ward from the day of admission as mortality is higher than Acute MI / Cancer / Respiratory failure put together.
We need to name and shame the management to help our patients.

Binge drinking and broken shop windows - not to me...

2009-04-17T09:50:00.000+01:00

Binge drinking and broken shop windows - not to mention drunken teenagers falling of the castle walls - have been a feature of life in Denbigh since long before we arrived over 30 years ago.
Is there ever anything much new apart from the Alcopops that recrit even younger drinkers?