#ThinkingAllowed: A duty of care

Health care service should not be a lottery.  It should not be a lucky dip for patients either.  At first glance the recent survey by a doctor(s) makes for worrying reading.  But, what lies beyond the statistics and headlines?

I have always thought that in Gibraltar we are very lucky with our GHA.  In the UK newspapers are overflowing with terrifying headlines of the NHS.  Recently the Ambulance Service in England has been in the news for failing to meet response time targets of eight minutes. The NHS admitted this was a sign of a system-wide problem.  At the weekend a headline in the tabloids shocked us - a man died after an ambulance allegedly took 90 minutes to arrive at his home, which is only 1.6KM from the hospital.

Had anything similar happened in Gibraltar there would be (and rightly so) a public outcry.

One of the problems we have locally is that sometimes real issues are embroiled in a political game.  The fact that the GSD opposition has made the survey public will be seen by some as political point scoring.  Just like journalist Sophie Ridge wrote in an opinion piece for Sky News this week: “In the politics of 2016, it seems, there is only black and white.  Shades of grey are simply banned.”

This is very true on The Rock.  For the staunch supporters of one political party everything the other party says is wrong or outright ludicrous.  There is no in between (the shades of grey if you prefer).  Can you be a supporter of Fabian Picardo and agree with a comment by Daniel Feetham? Or can you back Mr Feetham but think Mr Picardo had a valid point on a certain issue?  How dare I be so ridiculous!

This is a fact - Gibraltar is a highly politicised community.  The war of words between Government and Opposition over this issue did not take long to erupt. 

GSD Leader Daniel Feetham said the results were “shocking”.  He was also quick to anticipate what the Government might say. That the survey had not been conducted officially by the GHA.  You do not need to be in Government to think this.  I thought this too. You may have as well.

However, given the possible serious repercussions of a number of doctors feeling the GHA is badly managed the new Health Minister Neil Costa has a duty to investigate this.  Whether he commissions his own survey or talks to every single doctor individually is up to him.  Mr Costa will have his own views but whatever they are the survey should not be brushed aside - even if it is non-scientific. 

Mr Costa said the GHA is “confident, that whilst more is still to be done, it remains fully engaged with the Medical Management Team and all clinicians.”  He has also this week said he intends to leave no stone unturned to improve the quality of the services delivered. 

This will be welcomed by many and the Government is right to call the results an “informal document” which reflects “opinions and perceptions as opposed to independently verified or empirical evidence”.  It does however not mean some doctors do not feel there are serious issues which may need addressing.  We need to know whether it is a true reflection of how all doctors feel generally.

But, do not be mistaken. The survey questions should have been more neutral in nature.  

“Staff morale at the hospital is good” may have instigated more angry responses from those who disagree than “How do you find staff morale at the hospital?” with a selection of options to follow.

Mr Feetham had highlighted that “for doctors to feel they should be conducting and/or participating in such a survey in these numbers, shows that they feel strongly about the current situation at the hospital”.  I am not sure this is a valid point.  According to the Government the sample fell short by around 50 doctors.

The balance of constantly keeping staff morale high, employees happy and delivering the best service for your customers (in this case patients) is like walking a tightrope for managers.  It is far from easy and can prove to be a hugely complex operation. Sometimes, it may even be impossible because the expectations of both staff and management are not in synch.  It is (like with other issues I have written about) a two-way street.  Both sides need to receive but both need to give too.

I sincerely hope this argument will not be about money or politics. The only involvement of money and politics here must be in providing the investment and facilities needed.

My own experience of the GHA has been nothing but impressive.  I have been hospitalised twice in my lifetime and on both occasions the staff were a credit to the GHA. The care and attention I received was second to none.  Wages do not buy that.  Vocation does.

With a perceived health crisis in the UK it was in October when the General Medical Council said that poor morale among doctors could put patients at risk.

This is why, even if it is only a handful of doctors who feel this way (and I take note that while it found there was a perception of morale being low, most doctors actually felt their morale was high) the Gibraltar Government should take any concerns seriously.  If nothing else it could prevent any deterioration in care, and if nothing is found it will at least put to rest the minds of many who rely so much on a professional service and its doctors to save lives.