Editorial. APRIL 2004
It is sad to record that Donal Early died on Easter Monday in Frenchay. Donalwas a psychiatrist with a marvellous Irish sense of humour. He was areal enthusiast and a great raconteur. A great man to have at aparty! One of his major professional contributions was the setting upof the Industrial Therapy Organization (ITO) which provided paidemployment for many people with mental health problems who wouldotherwise have been unemployable. We hope to publish a fullappreciation of this great man later in the year. In the meanwhile,we send our deep sympathy to Prue, his wife, and the family.
We have just that heard that Geoff Scaife, Chief Executive of the StrategicHealth Authority has been killed in an accident on the M4 motorway.We extend our sympathy to his family. Mr. Scaife had only been in thepost for 15 months and had been getting to grips with Bristolsdesperate financial situation and the reconfiguration plan.He had puttremendous effort into sorting things out and had arguably had thetoughest SHA Chief Executive post in the country. His death comes ata particularly unfortunate time for the Bristol health community.
The Bristol Health Services PlanMeeting held on March 30.
This was the first opportunity that many Bristol doctors have had to hearabout/discuss the plans. 74 people attended. It would perhaps havebeen desirable if more practising doctors could have attended.However, there was much interest and enthusiasm and a welcome lack ofrancour. This was largely due to the excellent chairmanship of SandyMacara and Paul Dieppe. Two hours was clearly not enough but it was astart. There seems to be some demand for further meetings. A numberof students were present and they asked a number of pertinentquestions at, and after, the meeting. Some expressed a desire to havea similar meeting organized by/for the Galenicals. This issue of thewebsite contains a factual account of the meeting. A number ofmatters seem worthy of further comment:
Overhanging the whole reconfiguration project discussion is the financial deficit..It is still not at all clear how this can be dealt with without an unacceptable reduction in services for patients. Kevin Woods Delphic statement that the deficit will be worked out and not wiped out did nor fully clarify the matter.
Time is extremely short. The initial outline case is about to be presented to the Dept. of Health. The contents of this were not discussed at the meeting but your editor formed the impression that a great deal of work remains to be done.
It is clear that much discussion within Trusts, and possibly between Trusts, has been going on for the last 2 or more years. Many people have done a lot of work. This makes it all the more surprising that so little documentation, dealing with the key issues, were/are available ( eg ,trauma and emergency services, intermediate care, palliative care etc,etc). There seems to be an unwelcome element of secrecy which is not helpful at a time when informed debate is so urgently required. Lack of knowledge about what is going on was very obvious at the meeting and in the discussions afterwards. Key documents should be published on the web or elsewhere. They must be in the public domain.
The issue of a single hospital has not gone away. Many consultants still consider that this is the only way for them to go. However, the politicians have apparently decided that the idea is unacceptable. For the moment the matter should be put aside and possibly revisited when the integration of specialist services has been debated and settled.
Doctors in Bristol want to work together and there is much support for the idea of a single acute trust. There has long been managerial objection to the idea but this should not be allowed to obstruct this welcome desire for integration.
Integration of specialist services emerged as THE most important matter facing the medical profession. The SHA is keenly awaiting a document from Bristol on the subject. This needs to be ready by late May at the latest. Over to the consultants to agree this between thembut you need to get your skates on! Many of the important elements were included in the presentation by Derek Alderson.
A number of matters were not discussed. In particular, there was no discussionas to how the BHSP will be taken forward now that Hugh Ross is going.Another leader is required. Surely this should be a doctor withvision, common sense and fire in his belly! He should be supported bya team which includes public health, clinical, managerial andresearch expertise. Dedicated sessional time will need to beallocated for a limited period.
I end by thanking all those who contributed so ably to the meeting on March30. From the perspective of this editor it was a real success!
Please note again that we welcome comments and suggestions.
e-mail. janet@bristolmedchi.co.uk
web address. www.bristolmedchi.co.uk
RLH. (joint editor).