“Wales may be a small country but it has a lot going for it” – Christine Chapman AM

How we get the next generation of Doctors to train in Wales continues to be a major issue and one which is not new for the BMA.

Representing an area which has traditionally suffered from high levels of health inequalities, over the last ten years I do think that we can talk up the achievements that have been made in Cynon Valley. We’ve got more salaried GP’s than ever which has helped to solve the recruitment problem we once had, new, modernised surgeries are clearly visible and in Spring 2011 the new Community Hospital in Mountain Ash will open its doors.

Across Wales, there is a choice of high quality facilities which provide first class training and education. But while clinical experience is very important, so too is the life experience.

I do think that what is attractive to those who have studied in England, particularly in the big cities such as London, is the quality of life on offer in Wales. Whether you are looking to continue with the city life or a more rural environment, Wales has much to offer. Generally house prices are lower and everyday living costs are more reasonable. In my own area, the Valleys have great opportunities for outdoor recreation, cycle trails, quad biking, mountain climbing and also its close proximity to Cardiff. Wales may be a small country but it has a lot going for it.

Christine Chapman AM Cynon Valley
Labour

“I am proud to work in the Welsh NHS” – Dai Lloyd AM

Croeso i Gymru! – Welcome to Wales! In Europe’s oldest living language, Welsh reflects the unique cultural and historical experience that is Wales. And, as a practising GP and a Member of The National Assembly for Wales, I am very well aware, naturally, that the National Health Service also, looms large in the National conscience of Wales.

From the history of the mining communities of the South Wales Valleys leading to the formation of the Tredegar medical Aid Society as a forerunner and template for the later NHS, the Welsh experience is not confined to the usual cultural issues, but extends to the Health Service too.

With the establishment of the NAFW in 1999, Health was devolved to Wales. Health Policy has developed differently here, and I am proud to work in the Welsh NHS.

Here in Wales, prescription charges were abolished in 2007. Patient care is thus not compromised by the cost of prescription items, people no longer have to choose themselves which item(s) in a multiple prescription to ditch. Northern Ireland and Scotland are following this proud example.

The internal market in Health has been dismantled with the latest NHS reorganisation in October 2009, Seven Health Boards now plan services – commissioning is a thing of the past.

In addition, no new PFI ventures are being undertaken in Wales, and the NHS in Wales remains a publicly-funded public service, with little private medicine. That is a reflection of the tremendous loyalty and trust that people still have for the NHS in Wales, a loyalty that is reflected in the esteem and respect accorded to the Nation’s Doctors and NHS Staff in general.

GPs here are not faced with the ubiquitous ‘Choose and Book” system and waiting lists have improved out of all recognition in recent years. Devolution brought more Medical Schools in Swansea and North Wales, and an exciting new, Postgraduate Medical School in Swansea.

The accent is rightly on Public Health in Wales, and history will record the first vote to ban smoking in enclosed public buildings in these Islands occurred in the National Assembly for Wales in January 2003. The absence of the relevant powers however, meant the ban had to wait until April 2007 to kick in.

For doctors certainly, Wales offers a different experience – yes, the fine scenery of mountains, beaches and breathtaking views – yes, the history and traditions – and yes, also an NHS still true to its founding principles.

Croeso i Gymru!
Dr Dai Lloyd AM South Wales West
Plaid Cymru

“What is important is that we do not become a net exporter of medical talent” – Peter Black AM

BMA Cymru have been concerned for some time about the shortage of doctors in Wales. It is a problem that we feel can no longer be ignored. For NHS Wales to maintain a high standard of delivery, sustainable solutions for the future need to be put in place now.

I have asked four Assembly Members for their take on this important issue. Today’s entry is from Welsh Liberal Democrat spokesperson Peter Black AM.



In March, the BBC reported that Wales is currently short of around 400 hospital doctors. Given that the total number of hospital doctors in Wales is only around 5,500, this is significant.

We have a significant problem with waiting lists in Wales. The latest statistics released by the Welsh Assembly Government show that there are 6,450 people who have currently been waiting for either an inpatient or outpatient appointment for over 22 weeks. The numbers of doctors available to treat them will not be the only factor in this, but it will be a significant one.

The need for new doctors in Wales is one that is not just confined to hospitals. The number of GPs under 45 has dropped considerably in the last ten years, from 951 to 743, while the number aged over 55 has increased from 272 to 450. This means we could expect roughly a quarter of our present GPs to be retiring within the next ten years or so.

Despite this, there has been no real increase in the number of GPs at the younger age of the scale during this period.

Many of those from Wales who choose to study medicine do so outside of Wales. Young people often do not want to stay in the area they have been brought up in and use their student years to explore the world by experiencing new places and people. This is natural and leads to well rounded individuals who are needed by every workforce.

However, what is important is that we do not become a net exporter of medical talent. When someone leaves Wales to study, we need to ensure that they are encouraged to return and that those who come from England to study in Wales are encouraged to remain.

As is often the case, the Welsh Assembly Government seem to have their heads in the sand over this issue. They claim that there are few vacancies and that there are good response rates to those vacancies that do appear. Even if they are correct and that is the case at present, we still have a potential looming crisis.

In healthcare, often the solution to short term problems is recruitment from abroad. However, if we have the talent, why should we have to poach professionals from other countries who have their own healthcare requirements?

The campaign currently underway by the BMA to encourage more Welsh medical students to return to Wales is a great idea and one which I very much back. Wales is a fantastic place to both live and work and we need to highlight this to students.

But this alone will not solve the problem. The government must ensure that the health boards have the funding they need to provide adequate coverage in all parts of the health service, so that the jobs are there for students to go into.

Putting off extra recruitment for later years will only make waiting lists longer, increase present GP workloads and make the problem more difficult to solve when our current medical professionals begin to retire.

The BMA are showing leadership on this issue, and now the Government need to back this up.

Sunbed ban to become law

We are delighted that the Sunbeds Bill has passed through the Lords!

BMA Cymru would like to thank Julie Morgan MP for highlighting this important issue, and for the hard work which has gone into making this law.

Doctors have been concerned for some time about the effects that exposure to harmful UV rays can cause.

Younger skin is especially sensitive to ultraviolet light, and just one day of burning as a child increases the risk of getting skin cancer as an adult.

This legislation will protect vulnerable young people, and have a positive effect on the health of the people of Wales.

We will continue to work with the Welsh Assembly Government over the coming months as the regulations are drawn up.

BMA Cymru Wales supports the call for a ban on smoking in cars carrying children

You may have read this article in the news today.

BMA Cymru Wales fully supports the call for a ban on smoking in cars carrying children.

Anything that can be done to reduce exposure to environmental tobacco smoke and ill-health as a result of smoking must be given serious consideration.

Exposure of non-smokers to second hand smoke - known as passive smoking, consists primarily of non-inhaled sidestream smoke, together with exhaled smoke.

Almost 85% of second-hand smoke is invisible and odourless gases. Only the particulate matter, in the form of smoke, is visible. Tobacco smoke contains more than 4000 toxins, including over 50 that are known to cause cancer.

Passive smoking causes illness, including fatal illness. It also worsens existing health problems.

Smoking affects many parts of the body which are listed below – in the hope that any smokers reading this will seriously consider kicking the habit!

Smoking attacks the brain. The chemicals in smoke cause the lining of the arteries in the brain to become porous which allows cholesterol, white cells and blood clots to stick to them. Clogging arteries which supply blood to the brain leaves smokers at risk of a stroke.

Passive smoking is associated with a variety of health problems in children. It increases the prevalence of lower respiratory tract illness such as pneumonia, bronchitis, bronchiolitis, coughing and wheezing. Second-hand smoke can also cause asthma in children. It also exacerbates the condition in those who are already affected. Passive smoking is also associated with cot death (Sudden Infant Death Syndrome).

Smoking damages the eyes because it reduces the levels of plasma antioxidant – a substance in the bloodstream which protects retinal cells.

Smoking affects the nose. Smoking irritates the delicate membranes of the respiratory tract – including those inside the nose.

Smoking affects the mouth. The use of tobacco is connected to 90 per cent of oral cancers, including lip, tongue and palate. Many of the chemicals found in tobacco smoke are carcinogenic, and therefore, when the tissues of the mouth are bathed in toxic substances, this can lead to oral cancer.

Smoking affects the skin. Every in inhalation creates thousands of wrinkle-forming free radicals which attack collagen, cell membranes and the skin’s fatty layer. It is also thought that smoking impairs blood flow and lowers levels of Vitamin A which is vital for healthy skin, growth, so producing a dull, dry complexion.

Smoking affects the throat. The toxic content of smoke damages the delicate membranes of the larynx, making the smoker prone to laryngitis and in more severe cases – cancer of the larynx.

Smoking affects the lungs. Lungs are so vulnerable to damage because the tar that forms from burning tobacco and clogging the cillia – tiny hairs that protect the lungs from dirt and infection settles in them, damaging the surfaces.

Smoking damages the stomach. Chronic cigarette smoke may increase the amount of acid secreted by the stomach causing peptic ulcers – lesions in the lining of the stomach. Smoking is also linked to Crohn’s disease – an inflammation deep in the lining of the intestine.

Smoking affects the heart. Tobacco smoke produces carbon monoxide – a highly poisonous gas which combines with haemoglobin in the blood and makes breathing difficult. This reduces the body’s ability to carry oxygen – putting the heart under strain. Smokers also have a higher risk of hardening and narrowing of the arteries which can cause a wide range of cardiovascular problems.

Smoking affects the bones. Female smokers face an increased risk of developing osteoporosis – a condition that reduces bone substance and results in fragile bones that are liable to fracture.

We have a collective responsibility in society to protect children from the harms of second hand smoke. It is vital that we de-normalise the deadly habit and try to prevent the onset of smoking in young people.

What do you think of the call to ban smoking in cars carrying children? Join the debate and leave a comment.