Refreshing slice of medical student life

As promised when I last blogged on here last week, I said I would write about the next generation of Welsh medics, so here it is!

I went to our latest Medical Students Committee meeting a few days ago, and I have to say how refreshing it was to hear from young people, who are so enthusiastic and committed to their vocation. In general these days, youngsters get a fairly bad press, often seen as disinterested and disengaged. So I was really proud to see and hear this group wanting to improve standards and their overall educational experience, to make sure they become good doctors. It was somewhat unfortunate and disheartening to also hear how the training and resources, may not match the students’ dedication. It is worrying and disappointing that with members of this committee wanting to be good doctors, working to excellent standards, the system seems to be letting them down with poor educational experiences in some hospitals in Wales.

We all know medical students face an excessive financial burden, so it’s even more important that they are getting good training, to feel as if they are making a sound financial investment in their future. And the medical student experience looks likely to get ever more expensive as well in years to come with the WAG’s plans to refocus student finance in Wales (ie. scrapping the tuition fees grant), so what we need is a. for youngsters not to be put off a medical career because of excessive financial burdens and b. those who do undertake training, to ensure they are getting value for money and the best educational experience possible.

There are significant junior doctor vacancies in Wales already, which in the long term will affect patient care, so it is imperative we do all we can to support and provide high quality training to stay working in the NHS here.

Where are all our young GPs?

Glad to see that the issue of the very real prospect of a GP shortage in South Wales is getting some attention. Dr David Bailey, Chairman of our GP committee is highlighting the problem in the South Wales Echo as new figures show that most doctors here are now aged 60 or over, without younger ones coming through to replace them.

This seems to suggest that young medics are choosing not become a GP and perhaps some work needs to be undertaken to look at why this is. After all, it should be seen as a very attractive career option, what with being your own boss, being able to make decisions about patient care on the spot and having a direct and important link with the community you serve.

Perhaps what’s even more worrying still is the fact that, hearing from some medical students yesterday, it seems in years to come, this situation is likely to worsen, as many youngsters are being put off considering medicine as a viable career option at all, because of the increasing cost of training to be a doctor. But I think that’s a whole new topic for discussion on here in more detail another time! Or maybe some medical students reading this maybe might want to comment on here about how finance can be a barrier to entering the medical profession.

Getting tough on violence in the NHS

Myself and a GP member of BMA Cymru Wales gave evidence to the Assembly Audit Committee yesterday, on the back of the Auditor General’s latest report into violence and aggression against NHS staff. The committee’s holding an inquiry into the report findings, because the Auditor General has found that violence is still a big issue for NHS workers.

That’s despite the fact that the Auditor General first looked into this four years ago and uncovered serious concerns back then.

It would be unfair of me to say that the WAG hasn’t made any progress on this in that time, as some improvements have been made (for instance, the launch of the training passport scheme in 2005) but I’m afraid there is still along way to go. And what is worrying for doctors, is that the emphasis on tackling violence seems to be focussed on hospitals, when in actual fact, a big area of concern identified in the report is NHS employees working alone, such as GPs and their support staff. More investment needs to be made here with the introduction of safety measures such as panic buttons and CCTV being installed.

This inquiry is very timely, as it’s now, during the on-going NHS reorganisation that systems like the Primary Care Support Service could be given more scope for development, to help in areas like violence and aggression against doctors.

I generally got the impression yesterday that AMs sitting on the Audit Committee are extremely concerned about the issue and there is a strong will to change things. I just hope that happens sooner rather than later and that ways of tackling this growing problem feature heavily in the Health Minister’s NHS reorganisation plans.

Ways for BMA members to broaden their horizons

This post will hopefully be of interest to most of our members, but it may be of particular interest to junior doctors, who may find it a bit easier at the start of their careers and whilst still relatively ‘young’ (not that I want to in any way be ageist here!) to head off to another country. I just want to highlight some new guidance issued by the BMA about doctors working in developing countries.

’Broadening your horizons: a guide to taking time out and work and train in developing countries’ outlines national policies, as well as examples of best practice. It’s aimed at both doctors and those in medical education and employment. It supports doctors at all stages of their careers to take time to work in developing countries and make it a valuable part of their NHS careers.

The guidance is available on the BMA website at http://www.bma.org.uk/careers/working_abroad/broadeningyourhorizons.jsp

How much worse does binge drinking have to get before our politicians take action?

This article in the Wales on Sunday makes for disappointing reading for the BMA and its members, who deal on daily basis, with the very real consequences of alcohol misuse. The fact that many Assembly Members don’t think that raising the cost of drink won’t in any way help prevent binge-drinking, is quite staggering.
I hope this doesn’t stop the Welsh Assembly Government from continuing to support the idea of setting a minimum price on alcohol, with the Social Justice Minister, Dr Brian Gibbons saying he’d like to see a graded form of tax on drink, where a lower tax is placed on weaker alcohol and a higher tax is placed on stronger alcohol.
Last year the BMA published a report ‘Alcohol misuse: tackling the UK epidemic’, calling on governments in the UK to implement a full range of effective control policies that will reduce the burden of alcohol misuse.

It highlights how recent governments have worked too closely with the alcohol industry, pursuing policies of deregulation and liberalisation regarding alcohol control, contributing to the destruction of many people’s lives. It causes 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. The government approach has led to increased consumption levels and alcohol-related problems and demonstrates a failure in the political drive to improve public health and order.

As well as the human cost, it also costs the NHS millions every year, treating and dealing with alcohol problems and the criminal justice system also spends similarly large amounts dealing with alcohol-related and drink-driving offences.

Key recommendations from this report include:

• Higher taxes on alcoholic drinks and this increase should be proportionate to the amount of alcohol in the product.
• An end to irresponsible promotional activities like happy hours and two-for-one offers.
• Standard labels should be displayed on all alcoholic products that clearly state alcohol units, recommended guidelines for consumption and a warning message advising that exceeding these guidelines may cause the individual and others harm.
• The legal limit for the level of alcohol permitted while driving should be reduced from 80mg/100ml to 50mg/100ml throughout the UK.

Mass public awareness campaigns, which some AMs seem to be pointing to as a possible solution, may be politically attractive and increase knowledge about alcohol misuse, but they are very expensive and ultimately ineffective if unsupported by broad based policy. Targeted approaches are vital, including measures to reduce the availability of drink.

And we are not calling for minimum pricing of drink, to be killjoys, this is just part of it. The BMA also recognises that preventing alcohol-related harm requires accurately pin-pointing those who misuse alcohol. Yet, there is currently no system for routine screening and management of alcohol misuse in primary or secondary care settings in the UK. So, we would like to see a more comprehensive system of identifying patients at risk which could be done through screening questionnaires, when individuals visit their GP, or attend for a general hospital appointment, or when they go to A&E. So, if the WAG wants to continue with its plans for dealing with alcohol misuse, it has our full support.

Read the BMA’s report on this in detail http://www.bma.org.uk/ap.nsf/Content/tacklingalcoholmisuse