HCSA

The Hospital Consultants and Specialists Association (HCSA) is a trade union that represents the interests of senior hospital and medical staff

Campbell needed to raise EWTD’s profile

By Stephen Campion - 6th August 2010 2:14 pm

My days of having to take holidays when the children are not at school are, thankfully, long over. But the lure of a few days away from the office and attending a number of courses (some with more attractive 19th holes than others) got the better of me. When I got back I switched on the TV News and was arrested by this headline “Campbell Court Case drama!”

“What on earth has Alastair been up to now?” I wondered, whilst at the same time angry with myself for possibly missing a high profile political drama. Then I realised it was not the model of spin in the dock, but Naomi. Apparently she went to bed after dinner with Nelson Mandela and was woken up in the early morning by two men knocking at her hotel bedroom door who thrust a pouch of dirty stones into her hands. Nice work if you can get it. Those stones turned out to be diamonds; but who cares? I would willingly have volunteered to be the delivery boy - and would certainly have done the gentlemanly thing and washed the stones first.

Still upset that Alastair had not made prime-time viewing I suddenly felt a twinge of sympathy for Mr John Black, the president of the Royal College of Surgeons. He managed to raise the stakes in the increasingly bitter and divisive arguments over the infamous Working Time Directive. His survey shows what many medical practitioners and commentators have been saying for some time - training is being diluted, and patient care put at risk, as a result of well-meaning but poorly executed legislation.

Why the sympathy? If Naomi can overcome Alastair to be the top news story, what chance has Sir John got? It is clearly not the importance of the story that captures prime-time news but the celebrity involved. Now, if Sir John really wants to apply news pressure on the Working Time Directive I would suggest we team up to knock on Naomi’s door.

Even if we make no progress it would liven up the news!

Reading between the lines on GP commissioning

By Stephen Campion - 12th July 2010 1:24 pm

Many years ago Buckingham Palace was seeking an increase in tax payers’ money at the same time as Crystal Palace Football Club was lying perilously close to the bottom of the (then) 1st division.

As the football season neared its close, towards the end of the second half of a vital match, the centre forward scored a goal giving them hope for survival. The scorer was none other than Gerry Queen who gave rise to this fabulous headline in the Sunday Express: ‘Queen strikes to give hope for struggling Palace’.

Over the years there have been some wonderful headlines: ‘Freddie Starr ate my hamster’ and the like. But on more topical matters this headline from BBC News caught my eye ‘NHS shake-up hands power to GPs’. Now that really is a worry! I thought modern political dogma was to hand power to the patient; but no! It’s the GP who now apparently stands to control the NHS. The BMA is quoted as saying GPs are “ready, willing and able to meet the challenge”. That’s all right then!

But looking closer at what this means we might be forgiven for reminding ourselves of what happened to GP fund holding under the Tories and then the model of practice based commissioning under Labour. Hardly beacons of success.

That was largely not through any failings of the GP’s, many of whom can be heard bemoaning the pressures on their time and being unable to meet the needs of their patients as it is. Unless GP commissioning is done at night or weekends it is difficult how this shake-up can work.

Alternatively, of course, ‘at risk’ managers from the local PCT’s and SHA’s could be brought in to commission health care under the direction of the GP practice.

My nightmare scenario is the same people doing very similar work (and still not very effectively) but in new offices, with new titles, higher salaries, costly IT systems, tortuous negotiations and creating unhelpful tensions between primary and secondary care. But fortunately I read beyond the headline to see that in this ‘shake-up’ the Secretary of State for Health ‘has emphasised the need to liberate the NHS to focus on outcomes and improving results for patients’.

Moving chairs on the Titanic might not be the best way to liberate the NHS. When the Titanic sank a local paper carried this parochial headline ‘Grimsby man hurt in ship tragedy’. Underneath the headline is the real story; and we should read it with considerable interest.

Pension shake up creates uncertainty

By Stephen Campion - 23rd June 2010 9:48 pm

In the old days the Budget came around once a year. The night before everyone would fill their petrol tanks, stock up on alcohol and tobacco or other such luxury that might be targeted by the Chancellor and prepare for a heavy moan the following day. Now the Budget is like the proverbial London bus; you wait a while and suddenly they all turn up at the same time. We have had two Budgets since March - and in October the spending review will no doubt add further pain to an already reeling public.

A few thoughts hit me when I studied the Chancellor’s statement (albeit belatedly having first watched England hammer the Aussies in the first one day cricket international). Golden rule of management - get your priorities right! The first was that by the time the Budget was delivered no-one would have surely been surprised by what was announced. Either this was mastery of political spin or the product of well engineered ‘leaks’ but either way we had been conditioned to anticipate the worst - and sure enough the worst was, in part, not as bad as we had been led to believe.

But the second, and real worry, was that the Chancellor was at pains to say that upping the retirement age to 66 would be “accelerated” but did not say when (2016 is being discussed in the press) and hinted at major changes to public sector pensions confirming that this would be subject to a “review”. Neither helps those in the NHS (or indeed public servants generally) aged around 50. In fact it creates the very same individual economic instability and uncertainty that created such havoc with the national economy.

But for me (as long as I can afford it) the glass remains half full! I imagine the Doctors and Dentists Review Body and all the other quangos examining public sector pay will be consigned to history. They will not be required for a while and surely fall into the category of the now defunct Treasury’s ‘Euro Preparation Unit’. That should save a bob or two!

The other optimistic development is the Chancellor’s wish to engage the public in proposing cost saving ideas. Now there’s a challenge to readers of Hospital Dr - I reckon the editor should award a prize or two for the leading suggestions. Let me kick off, (hopefully better than our illustrious football team) by asking “Why on earth do we, as taxpayers, pay the winter fuel allowance to UK citizens living and sunning themselves in Europe during the winter months?”

Answers, on a postcard please to Number 11, Downing Street, London SW1.

Read more on the Budget.

World Cup confirms that progress can be overrated

By Stephen Campion - 16th June 2010 10:31 am

I am one of those who treated themselves to high definition in readiness for the World Cup. Silly really as I am not a great follower of football but the golf more than makes up for it.

So watching England v USA, red wine in hand, trying to observe the nanny state’s recommended units (failed!), I was one of countless thousands who missed the England goal through what was described by ITV as a “technical fault”. My brother watching on the ordinary bog standard TV was meanwhile revelling in Gerrard’s opener past the American keeper.

Throwing away all ambition to keep to just two units of alcohol I pondered on whether investment in modern technology is actually such a good thing. Modern cars (electric or otherwise) get stuck on the M25 as much as their older counterparts, my old wind-up Timex watch still keeps accurate time, and alas the greatest technological advance of all time, Concorde, is no longer a magnetic creature of the skies.

Perhaps this is a sign of getting old! But, as the country struggles with economic forecasts of gloom, we should realise that progress is fine so long as it is cost beneficial and adds value to what we do.

So I cheered when I learnt that the stringent vetting of those dealing with vulnerable people would be led by a more common sense approach, I was delighted that some of the less than sensible health and safety regulations might be discarded and welcomed the suggestion that more laws would be considered by public petitions as opposed to what our politicians might imagine or insist is good for us.

Progress is not always good; sometimes a step backwards is not a bad thing before embarking on the unknown, untried or untested. The football score against the USA would still have been 1-1 had I watched it on HD, colour or black and white. But the fact is that as a direct result of expensive modern technology I was let down. There has to be a lesson for government in there somewhere!

Can we have a coalition within the NHS?

By Stephen Campion - 27th May 2010 9:49 am

I am beginning to enjoy this coalition business. The emergence of ‘new’ politics and the realisation that no single party has a monopoly on all the right (or wrong) answers somehow seems to have given a refreshing injection of enthusiasm, team working, and pulling together in the national interest.

So, if the warring Tories and Liberals can now work together is this a model that can be applied to the NHS? I hope so - but the signs are not good. Only this week I have been involved with a trust adamant that whatever the employment contract says, consultants not prepared to work weekends will face the threat of redundancy; another trust that has thrown a doctor’s rights under agreed disciplinary procedures out of the window; and yet another who frankly thought that DDA stood for the Dangerous Dog Act rather than the Disability Discrimination Act!

Listening to the Queen’s speech this week I had hoped that Her Majesty might have said: “My government will ensure that all staff working in the NHS will be treated fairly and with respect…” Although she let me down I can’t help but wonder whether this new style coalition, or working together, approach born from the ‘Dave and Nick love-in’ is worth trying in the management of our hospitals.

It can’t do any harm; it may actually do some good. My NHS coalition style of management would see Machiavelli replaced by consensus. Remember that speech of Margaret Thatcher when she was elected: “Where there is discord let there be harmony etc…”

That speech may have been cringe making to watch but the sentiment holds firm. Decades on perhaps we are only now beginning to understand that the NHS will only survive the challenging next few years through coalition of all its talents, and not by exploitation, bullying or fear.

Finding an alternative to Picasso’s mistress

By Stephen Campion - 6th May 2010 10:46 am

I have long been an admirer of art in hospitals. Pictures of Mickey Mouse do remind me of some trust management styles, although the bright spark who commissioned a fountain as the central piece in the urology out-patients department was soon advised that this was not such a good idea.

It is a shame though that the recession has hit investment for art in our hospitals. I saw in the news that a mere £70.3 million would secure a Picasso.

What a small price to pay to adorn a shining, brand spanking new Private Finance Initiative hospital! Alas the days of spend, spend, spend seem a distant memory; although we will continue paying for these developments for many years to come. 

If a business case for a Picasso to be hung in the entrance foyer is unlikely to find its way into the capital budget what might be a suitable alternative? Well most trusts have a rogues’ gallery with photographs of the great and the good who manage the organisation. The thought struck me, what would be cheaper - a Picasso at £70.3 million, or the cost to the taxpayer of covering severance payments to executives whose photograph no longer appears in the frame?

Perhaps a Picasso might actually provide better value for money!

Trusts unsympathetic to volcanic ash disaster

By Stephen Campion, HCSA chief executive - 22nd April 2010 9:56 am

Readers of the regular bloggers on Hospital Dr will surely be impressed at the number of times they refer to accessing work e-mails whilst on holiday. Something to do with loyalty, dedication and commitment perhaps (or, is it a sign of the times that being away for a short while enjoying their holidays actually fills them with concern about what is going on behind their backs?).

Two stories this week made me wonder whether the latter is truer than I originally thought. The first concerned a consultant who whilst on holiday in Africa had been ambushed, had his money stolen, and was threatened with his life. Having survived this trauma he managed to get back to his hotel to find his return to the UK delayed as a result of Iceland’s second attempt to ruin the British economy, so he opened his e-mail to tell his trust what had happened and his predicament. The reply was a pretty sad, but not untypical: “Take the time as unpaid leave.”

The second (again true) story comes from another consultant stuck in Portugal with his wife and four young children. His story is similar to many who had been stuck in foreign parts although not many had, like him, been required to deal with the sudden death of a fellow ‘strandee’ whilst queuing for tickets to get home.

He was unable to resuscitate the fellow passenger; he was also unable to book a passage home in time for his Monday morning clinic. He advised his trust ‘business manager’ of his plans and confirmed that he had followed the advice of consular officials, the travel company and the Foreign and Commonwealth Office.

The trust is not impressed; he is now desperately trying to get home with four tired children, an upset wife and daunted by the prospect of disciplinary proceedings.

Sound familiar? It reminds me of the management response when staff were caught in snow drifts, ice and road closures only a few weeks ago. “Get here or else” is surely not the sign of a caring, sympathetic management.

Are these isolated examples? I am sure Hospital Dr and its readers would like to know…   

A manifesto that everyone would support

By Stephen Campion, HCSA chief executive - 11th April 2010 10:22 am

Gordon Brown has asked the Queen for her permission to dissolve Parliament. How could she possibly refuse? Apart from the constitutional considerations of doing so surely Her Majesty would agree with her loyal subjects that we could not have been expected to live with this Parliamentary shower any longer - some might add that an election should have been called a long time ago. I would!

The Archbishop of Canterbury may have got himself into hot water by suggesting that the Roman Catholic Church had lost all credibility in Ireland, but if his sentiments had instead been directed about our politicians then few would have raised an eyebrow. Credibility is as much at stake in the forthcoming election as the policies of the political parties themselves. Anyone listening to John Humphreys’ rants and raves against Lord Kinnock on the Today programme this morning might also be tempted to think that the credibility of that very programme is similarly at risk.

And we have four more weeks of this! Of shouting matches, pathetic attempts at points scoring, arguments never finishing because of interventions by radio or TV interviewers, cynical poster campaigns (what is an ‘air brush’ anyway?) party political broadcasts and patronising economics likening our recovery to Wayne Rooney’s sore ankle. Oh Bless!

I really don’t think I can put up with the unrelenting nonsense that accompanies what should be the greatest democracy on earth. The only saving grace is that it can’t possibly be as cringe-making as we see across the Big Pond - can it?

So I have decided to join the former chief executive of Lincoln Hospitals in attempting to join the NHS hero, Dr Richard Taylor as an MP. My manifesto is not about pleasing people but is about making those tough choices, hard and difficult decisions, about what is good for this country.

Put me on the radio, John Humphreys, and I will sell myself to the people. Petrol guaranteed never to be above 70p a litre, all pensions, public and private, to be based on final salary (except those engaged by Her Majesty’s Revenue and Customs dealing with doctors), no enforced working beyond 50 years of age, Wednesday’s officially to be declared a mid-weekend, and mobile phones formally banned from railway carriages (“I’m on the train!” would be as outmoded as Chaucer’s English).

What would Noel Coward say on being a doctor?

By Stephen Campion, HCSA chief executive - 24th March 2010 11:21 am

The trouble with going on holiday is that when you get back you need another one to recover from the backlog! Actually that is unfair to the HCSA team who provided a seamless service whilst I was away. On reflection, the more depressing aspect of getting back is to find that nothing has changed: the same old problems remain. 

Consultants facing a pay freeze (or a cut in real terms), and Machiavellian management styles from aggressive trust regimes, would perhaps have some empathy with Colin Tucker brought in to turnaround the Social Services Department in Birmingham. In an honest appraisal of what had gone wrong in social services he said on Radio 4’s Today Programme that he would not want one of his children to become a social worker in today’s climate.

Noel Coward had flair with words and music, as the ditty ”Don’t put your daughter on the stage Mrs Worthington” demonstrated. But I wonder what advice he would have given to her if she decided that her daughter should become a hospital doctor instead? Something like this perhaps:

Don’t put your daughter into medicine, Mrs Worthington,

Don’t put your daughter into medicine,

The profession is undervalued

And a consultant’s life is tough;

I admit the fact she’s bright

And yearns to treat patients right

But she will for ever be a trainee at night.

 

She has nice hands, to give the wretched girl her due,

Quite dexterous from a surgical point of view

But in years of validation

And control beyond imagination

They will soon become hard

With no time for preparation,  

As management find ways of

Reducing SPA’s by two.

 

If targets are her thing

And performance the “be and all”

Then who knows she may walk tall.

But if she wants a life of fun

When her life has just begun

Do you want her reduced to tears

As the pressures take their years?

Then I repeat

Mrs Worthington,

Sweet Mrs Worthington,

Don’t put your daughter into medicine!

Now Mr Coward - what about Mrs Worthington wanting her daughter to be a lawyer or accountant?  

Goodwill to be biggest casualty of NHS cuts

By Stephen Campion - 10th February 2010 5:10 pm

Two news items caught my blogging eye this week. Number one concerned a leaked document prepared by the Foundation Trust Network that shows beyond doubt (if there ever was any doubt) how the boom years have turned to bust.

Call it ‘strategic financial re-alignment’ or ‘savage cuts’, the fact is that the NHS, its patients and staff are all in for a hard time in the coming years.

Yet we see the absurd spectacle of NHS ministers fuelling public expectations in the run up to a general election, while behind closed doors their NHS managers are trying to figure out which services and staff they must savage to balance the books.

What makes me so angry is that the NHS Foundation Trust Network appears to be riding roughshod over the very terms and conditions that its political lords and masters agreed with staff representatives. I may not be a keen supporter of the 2003 consultant contract but that does not mean I can ignore it! But that is precisely what appears to be the case here.

Secret meetings discussing redundancies, the plundering of pensions, the tearing up of national agreements and other consequences of financial crisis hardly suggest health service personnel are valued, far from it. The NHS has always depended on the goodwill of its staff. But that goodwill may well be the biggest casualty of the cost cutting knife.   

Irritant number two was directed towards the appalling abuse of power and trust by a senior police commander, Ali Dizaei. I wondered whether four years in jail was sufficient. His actions were grossly unacceptable, let down the people he was appointed to serve, brought his profession into disrepute and demonstrated a total lack of accountability.

The judge had his own reasons for imposing the jail sentence but I could not help but wonder whether he should not have turned to precedent when another senior public servant was also found guilty of an abuse of power. Surely the least the judge could have done was to call for a complete overhaul of the way the profession polices itself, and introduce relicensing, revalidation, appraisal and the appointment of Responsible Officers.

It may be hugely bureaucratic, costly, time-consuming and tiresome, but at least we will be reassured that nothing like this can ever, ever, happen again - can’t we?