Attracting surgeons and other professionals to Caithness

[bagpuss]

So we are about to lose round the clock surgical cover? Hmmmm. While a hurl in an air ambulance might sound exciting, it isn't something to relish. My old dad was airlifted some years back, and it's done in a functional but basic machine. And even if Prince William was at the controls, I dare say it isn't that enticing a prospect.

Why are we so dependent on a locum or temporary contract arrangement? Is it because the far north is such a terrible place to live? Or because the people we need to attract have partners and families, and extended families?

The answer is actually staring us in the face. We do a massive sales and marketing campaign for Caithness as a desirable place to live: affordable property; Cornwall type quality of life; good schools; decent shops and entertainment; sports facilities- the very things that were used to attract the nuclear community in the 1950s and 60s. And we do something else- we finally sort out the public transport. Four hours in a train to travel the same distance covered in half the time by car is downright ridiculous in 2015. Get that rail link going down the coast with decent rolling stock, and getting to Raigmore - or anywhere else for that matter- becomes less of an issue. A two hour train journey makes it easier to get on the next train to Edinburgh, or Aberdeen- and what's to stop one carriage being a dedicated hospital transport - with medical support if required? Similarly, given that there is an airport, why not try increase services at a budget cost? The air discount scheme goes part of the way towards this but could go further.

As a population grows up, matures and ages our medical needs change too. Young families need ready access to maternity services and paediatric care; in middle age we need access to screening and acute services; in our later years it is rehabilitation and respite. Can all of these be accommodated locally? And should they be? It has only been in recent decades that the notion of a centre of excellence to deal with some conditions has been the case- and life expectancy for those conditions has risen.

Should we be looking at what realistically we need to have on our doorstep? And for everything else, find a way of getting to it as easily as possible?

[Fulmar]

I notice that you did not mention the climate in your list!
But that aside, the problem as I see it is that there is not enough work here to attract the people to come and live in the county and actually, there are very many facilities and hence opportunities that are taken for granted in the south but are simply not up here nor ever likely to be.
Going back to attracting consultants, well most who are ambitious want to see a lot of work in their area of expertise so that they can develop their skills and put the same to full use and wish to be part of a high functioning, cutting edge team in a research and teaching hospital. This cannot happen in a small general hospital serving an area with such a low number of people. Although I do not pretend to know the answers, I would imagine that this at least is part of it.
As someone who has needed a lot of treatment in recent years, I have been very grateful for the care I have had and continue to receive at Caithness General. But as regards surgery and complex care, well I wanted to go to people with a proven track record in what was wrong with me and having to go to where that was available was the least of the considerations for me.

[Alice in Blunderland]

Its not just the area the services, the roads, the social life, etc its also the job. When you can for the same amount of money go to a much less onerous position in a bigger hospital with much better support,faciliteis, further training, ability to attend proffessional development courses without having to travel hundreds of miles on a shoestring budget. Where management are part of the team and have a robust programme of investment, development and delivery of services then you might have a cat in Hells chance of recruitment.....Oh and not to mention we need to at least advertise the position. One advert in three years isnt going to quite have them hammering down your door for the job now is it ?

[cptdodger]

I'm sure I read in The John O Groats Journal, that the lack of cover and so on might put people off moving to the area. Well to be honest whoever said it is right. Before I agreed to move here in 2009, I was regularly attending Ninewells Hospital in Dundee, so I contacted Dunbar Hospital, and was directed to Caithness General, where I was assured Consultants were available. This was fine, I moved here and saw Dr Shallcross, who was excellent, then I believe it was 2011 and he left, and that was that. I think I saw one locum, and was then transferred to Raigmore. At one point last year I had to see four different Consultants, all based at Raigmore, which was a Rheumatologist, Cardiologist, Gastroenterologist and a Hematologist. Had I known there was such a shortage of basic medical services, I would not have even contemplated moving here.

[squidge]

one of the things that I wonder about is what on earth NHS Highland are doing about succession planning? It can't be possible that a surgeon or a key medical professional only gives a weeks notice and yet there seems to be nothing done to plan for retirements, people moving away or other normal staff losses. I heard recently about a situation where a key medical professional in Caithness had given 6 months notice and yet 1 month before that person was finishing there had still not been any attempt to advertise that job. Why not?

I also think that for places like Caithness, remote and rural there should be a link made with the medical schools. Surely it's not beyond the realms of possibility for us to set up a system where young doctors being trained in Scotland in the late stages of their training are required to do a stint in some of our remote hospitals. IT support can make it much easier to supervise and support them. Also as Doctors wish to progress then Remote Rural practice must be seen as part of their Continued Professional Developement. Places like Caithness require a different sort of doctoring, after all you could be dealing with Anything and everything and so maybe a new Remote Rural Medical Module should be incorporated into Doctors initial and continuous training.Maybe these things exist already though. I don't really know.

All The other things mentioned here are absolutely necessary and the transport links are crucial in my opinion, but also is the provision of housing, the engagement of the local population in making someone feel at home. Caithness is one of the finest places to live in my opinion. I loved living there but it can be difficult to adjust for some people and the local community needs to take that on board. get it right and they may decide they never want to live anywhere else.

[gerry4]

What people up here forget is that this is not just a Caithness problem or even a problem with Scotland. Rural medical services through out the UK cannot attract doctors. Even in the large hospitals, staff are leaving for work abroad. Yes it is more acute in rural areas and so a more rural answer needs to be found.
I don't know the answer, wish I did, could make a fortune as adviser to the NHS. To find the answer we need to think more about why medical staff don't want to move to rural areas, we need to think with a UK or Scotland wide. Find that answer and will may find the answer to Caithness.

To lessen the need for having consultants or GPs in rural areas mayble more could be made of electronic links. This of course depends on the type of illness but for some it would be perfectly possible and so allow better use of resources
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