More MS news articles for July 2001

NHS in chaos from top down, says consultant

http://www.guardian.co.uk/Archive/Article/0,4273,4216308,00.html

Thursday July 5, 2001
Jeevan Vasagar
Guardian

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.