http://www.guardian.co.uk/Archive/Article/0,4273,4216308,00.html
Thursday July 5, 2001
An eminent consultant yesterday launched
a blistering attack on the running of the National Health Service, accusing
politicians of undermining it and making doctors "the fall guys" for a
lack of planning and resources.
Neurologist Michael Gross, 49, who
has pioneered treatment for migraine, claimed politicians had lied to cover
up underfunding and said the NHS was "in chaos from top to bottom".
In a letter to the Financial Times,
he said: "Politicians have been dishonest for years about the true extent
of the underfunding. If doctors were to tell even a fraction of the lies
I read from our elected representatives, they would be rapidly struck off."
Dr Gross, who until last week was
chairman of neurosciences at the Royal Surrey county hospital in Guildford,
Surrey, wrote in the London Evening Standard that he has never had a computer
or easy access to information technology, despite having been in the NHS
for 31 years.
"My office was approximately 9ft
by 6ft, shared by five of us and there was only one telephone and no dedicated
fax line. Secretarial support is woefully inadequate and over the years
it has taken many weeks to be able to send out a letter.
"There is no way of getting instant
access to appointments to assist any patient who telephones."
Dr Gross, of Stanmore, Middlesex,
left the NHS when his hospital closed its neurological department, leaving
a "huge list" of patients without local care. He is now working privately
as a consultant as well as with the Neurological Alliance charity.
He said his department could not
cope with the numbers of patients being referred to them.
"It is worth remembering that neurology
doctors deal with some of the worst conditions that can affect people.
"Three times every day, most neurologists
will tell people the worst news that they will ever hear in the whole of
their life and yet there is very little support that we can give due to
the stretched resources."
The hospital's hard-working staff
suffered as they attempted to cope, he said.
"So bad is the nursing situation
that I would personally now advise any individual thinking of going into
nursing to reverse that decision unless they have some desire to personally
abuse themselves."
Politicians either have no idea of
the reality "or, and I suspect this is more likely, want to smash the very
fabric of professional care for political reasons", he wrote.
"Doctors are seen as the fall guys
for the inadequate planning and resources that have plagued the health
service for years. Every day requires doctors and nurses to make forced
choices as to who will receive how much care as opposed to everyone receiving
what they really need."
Dr Gross claimed that Britain was
so far behind the rest of the world in the treatment of multiple sclerosis
that it had become a laughing-stock.
"I never thought in my working lifetime
that I would see four drugs currently available for the treatment of multiple
sclerosis and then discover that I was unable to treat my patients because
politicians feel that these young mothers were not worth the expenditure."
In his letter to the Financial Times,
Dr Gross said that most of his life had been spent on call, between every
night and every third night.
"In fact I worked 4,000 days consecutively
on call at the Surrey & Sussex Healthcare Trust before telling them
what they could do with their job. The NHS is in chaos from top to bottom.
It gets away with it because it is a monopoly employer. It abuses the staff
who work within it, particularly those functioning away from the main centres."
A Department of Health spokesman
agreed that it was wrong for a doctor to have to spend 4,000 consecutive
days on call, but said the situation was changing with new investment.
"We are giving the NHS its biggest sustained funding boost for a generation.
Between 1999 and 2004 its budget
will grow by one third in real terms - from £49.3bn to £78.7bn
in the UK. That's not spin, that's a simple fact.
"We agree with Dr Gross that it is
quite ridiculous for a doctor to have to spend 4,000 consecutive days on
call.
"The irony is that the local neurology
service is actually changing to make sure more consultants will be on call
so that they no longer have to do that. And more generally, this is precisely
why we need more doctors in the NHS. Between 2000 and 2004 we will get
them - 7,500 more of them."
The doctor's perscription
To tackle the problems, Dr Gross
recommends that:
• Government must be removed from
the health service
• The General Medical Council must
be abolished and replaced by a civic medical authority run along the same
lines as the civil aviation authority, which could restrict doctors' hours
• The career structure should be
along the same lines as the police and armed forces, with a 30-year limit
• Public funding must be brought
up to the level of the rest of western Europe
• Charges will have to be made for
some of the services provided
• There should be proper business
arrangements for the administration of hospitals, with appropriate numbers
of people for the size of the hospital or general practice.
Jeevan Vasagar
Guardian