The Breast Cancer Care Carol Concert

 

Photograph © Matt Banks

It’s been an intriguing, and emotional week, with a number of clinical and political issues being brought to the fore.

It’s always nice to get an evening away from College, and a poignant highlight this week was attending the Breast Cancer Care Carol Concert at St. Paul’s Cathedral. It was an exceptionally moving evening, punctuated with some beautiful singing from the choir and 14-year-old Faryl Smith. Jane Hinnrichs, the Chair of Trustees for Breast Cancer Care gave a truly inspirational talk. In it she spoke about what it is like to live with breast cancer. It was incredibly moving; her story of living with breast cancer since 1994 resonated deeply with me, and felt very similar to the story of my own family.

I have also been actively involved with a contentious and emotive issue – that of the appalling treatment of children and young people in immigration removal centres. The College and I have been in discussions with the Royal College of Paediatrics and Child Health, the Royal College of Psychologists and the Faculty of Public Health, and have put together a joint statement recommending that this shameful practice is brought to an immediate end.

Dr Les Ashton and Dr Jane Roberts have been leading the work of the RCGP on this issue, and I commend the hard work and commitment they have shown.

As a civilised society, we cannot sit back and allow these practices to continue – they are unethical and unacceptable. Reading the testimony of children who have been detained in these centres upset and angered me. Children should not be asking, as one girl did, “Why do they have to put us in cages?” One child described the process of being taken into custody: “We were sleeping and the officers came. It was scary and mum was crying.”

This outrageous practice has attracted a lot of media attention, as has the joint stances of the Royal Colleges and the Faculty of Public Health. I spoke about child detention on BBC Breakfast last week, and echoed the call to bring child detention to an immediate end. While I do not usually watch my own interviews, I was proud to bring attention to this horrendous story.

I must thank the hundreds of you who responded to the questionnaire I circulated from Professor Mike Richards. Your excellent submissions on the role of the GP in early diagnosis have now been sent to the DH for consideration. Professor Richards’ responses were published in the December edition of RCGP News, and I’ll keep you informed of progress.

As always, I value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.

The RCGP AGM

It’s been another exhausting two weeks, the culmination of which was the RCGP AGM in London. The AGM was, as ever, a fantastic opportunity to highlight and reflect upon all of the excellent work that goes on in College.

The AGM is always an odd time, as it combines the welcoming of new members with the departure of old friends, and this year was particularly poignant, as we said goodbye to David Haslam and Maureen Baker, who left their offices as President and Honorary Secretary respectively.

The College owes a huge debt to both David and Maureen, who have worked tirelessly above and beyond their duties.

David has the distinction of being one of a small band of College members to have served both as Chairman of Council and President; he has carried out the role of College President with great charm and charisma, a crowning achievement at the end of many years of service to the College.

A particular highlight of the AGM was the unveiling of David’s presidential portrait. David’s diplomatic skills are legendary, and it is perhaps this trait that the portrait best captures. It’s an excellent likeness, and the skills of Bing Jones, the artist, are to be commended. What’s also interesting is that Bing is himself a doctor, and divides his professional time between work as a portrait painter, and as a doctor in blood and bone marrow transplantation.

Our new President and Honorary Secretary, Iona Heath and Amanda Howe are already embracing their new roles with energy and enthusiasm.

As we welcome new members, it is interesting to see that the average age of the Council continues to decrease. This is an exciting time for College, and I for one am looking forward to what this continuing injection of youth and energy will bring in the future.

I recognise that the first years after training can be a difficult time for new GPs. They may find themselves working in an unfamiliar practice and may miss the guidance of a trainer, and peer support from their VTS group which they enjoyed as an AiT. The College is working on a new initiative called First5 which will support new GPs from completion of training to the first point of revalidation at five years. There are five pillars to First5 which are: connecting with college, mentoring and peer support, help with revalidation, career guidance, and continuous professional development (CPD).

The idea of First5 was suggested by Dr James Parsons, South Yorkshire AiT rep, was developed by the AiT committee in 2008 and was recently supported by College Council. This is a major project for us which is being taken forward by a First5 task group led by Dr Clare Gerada, Vice Chair of Council. Dr Clare Taylor, Chair of the AiT Committee has recently been appointed as First5 CPD fellow. Her role will be to identify the specific CPD needs of First5 and to develop CPD materials and resources to address these needs. I will keep you updated on our progress with this exciting new project.

Like many of you, my attention this week has been focused on the plight of those caught up in the flooding in Cumbria. In this difficult time I urge you all to spare a thought for all of those who have been affected, and for the GPs who are coping with these adverse conditions. It has been particularly impressive to see GPs setting up temporary surgeries and ensuring that the disruption to patient care remains at a minimum. Our own Mike Bewick, the Medical Director of Cumbria Primary Care Trust has been heavily involved in the relief effort and has been keeping us informed of events.

I am really impressed with the hours that Mike and his colleagues have put in – GPs always rise to the challenge as professionals when needed – well done to all of you.

The effects of climate change on health is a huge challenge that we as GPs cannot afford to ignore. I must commend Tim Ballard, the RCGP Sustainability Lead; at the College we are embarking on an ambitious programme to take a critical look at the environmental impact of our activities and how to decrease our carbon footprint. The decisions being taken about any relocation from Princes Gate to a new HQ will have at their heart the sustainability of either a new build or an adaptation of existing premises.

GPs can make a difference to this daunting problem. Some of the actions we can take to help our patients now have the added co-benefit of helping with carbon reduction. Examples include encouraging more walking and less car use and decreasing the amount of red meat in the diet, to name but a couple.

We are in the privileged position of being highly valued by the population and through this we have an opportunity to take a lead and make a difference. Not only will our patients listen to us about their health, they are also likely to take a lead from our wider concerns and take note of our personal actions.

I’ve spent the last two weeks on something of a whistle-stop tour of the UK, visiting and speaking at a number of RCGP Faculties up and down the country. My travels have seen me as a far and wide as Glasgow, Edinburgh, North Wales, Dorset and London. It is always so interesting and valuable to see first hand the College at work at a local level.

This month I also attended the Proprietary Association of Great Britain Conference on Self Care – the resounding theme of which was changing the culture of dependence in the NHS. For the first time the conference was co-sponsored by the RCGP and it raised some very important points, particularly on the navigational role of GPs.

Very often these days, and rightly so, patients come to their GP pre-armed with information they have downloaded. What is crucial is that, as GPs, we take a guiding role, as is the very ethos of General Practice, to direct patients to information that is credible and evidence-based.

The conference report and a podcast of views from the speakers (including myself) can be found at http://www.pagb.co.uk/

I would also like to point you, and your patients, in the direction of The Hippocrates Prize. The Prize, supported jointly by the Warwick Institute of Advanced Study and the UK national Fellowship of Postgraduate Medicine, is a new international poetry competition, on the theme of poetry and medicine, with an Award fund of £15,000. More information can be found at http://www.hippocrates-poetry.org/

RCGP Conference and Beyond

It’s been an exhilarating, if exhausting, week. Our Conference last week in Glasgow was an enormous success, and as ever it was a brilliant opportunity to meet many of you there. I was particularly impressed to see how many associates-in-training had attended the Conference this year and to see the excellent small group work taking place.

I would like to take this opportunity to offer my enormous thanks to Clare Gerada, who has worked tirelessly with her team over the past year to organise what was a fantastic, inspirational conference. Clare’s vision, creativity and hard work ensured that the Conference was such an enormous success, and without her continued commitment and enthusiasm it would not have been possible.

I would also like to thank the in-house staff at the RCGP for their efforts in ensuring the Conference went without a hitch, and Profile Productions, our organisers, for their invaluable assistance.

Of course, the Conference is not céilidhs and coffee mornings – I also found time to attend some excellent speeches and presentations. I felt that one of the big successes of the Conference were the variety of Revalidation themed sessions.

The headline Revalidation workshop – Revalidation Ready? – was a particular highlight, and demonstrated an encouraging shift in attitudes toward Revalidation as it edges ever closer. There seemed to be a general feeling of confidence and positivity among the attendees, where previously there was anxiety and fear. This is a fantastic development, and one which I support wholeheartedly.

There was a good response to the CPD credit scheme, and any remaining concerns are now in the hands of others. With this now in place, the RCGP is ready to lead the way in ensuring that we have an appropriate appraisal scheme and systems of CPD. I believe very firmly that Revalidation is actually about professional development and not about finding another Harold Shipman.

It’s difficult to single out any particular presentations, but I must mention Gordon Moore’s. His views on the US healthcare system offered invaluable insight and were enormously thought provoking.

Of course, discussions on the issue of Practice Boundaries dominated the Conference. I’ve commented widely on this issue to the media, and it was a key feature of my keynote speech. There are a small number of patients who want the continuity of care provided by GPs but can’t get it because technically their home is not where they spend most of their time. There are patients who wish to choose a high quality practice but currently are having difficulty in doing so because of how boundaries are drawn. We said we’d work with the DH to look at solutions, and I know that the GPC has also indicated its willingness to discuss the issues with them. Providing excellent patient care should, and must always remain our priority, and continuity of care is vital in achieving this – isn’t it fantastic that people are calling for more opportunities to have the high quality and continuity of care provided by GPs.

I’ve returned from the Conference to a flurry of media interest, and have given a number of interviews over the last week to discuss issues raised at the Conference. On Wednesday I was interviewed by CBS to discuss the UK’s swine flu vaccination programme. The CBS interview aired late last week, and in it I talk about the contrast between the UK and US response to swine flu, and our comparative vaccination programmes.

In my keynote speech, I commended the current UK programme and its ability to target those most at need, in comparison to the US programme, which I said was "the survival of the fittest and the richest".

It’s a contentious issue, and one which is very close to the heart of a particularly angry American woman who got in touch with me this week in order to respond to my comments. She wrote:

“You and the rest of the world can go jump in a lake. Any idiot that opens his mouth - publicly criticizing hard-working Americans - should do just a little more research into what has really been happening in my country. And.....here's a BIG clue for you! You are NOT going to see it on CNN or any of the mainstream media. I never thought I would live to see the day when our media was as corrupt as Russia's was when I was growing up. You will need to do a little seeking to find the real stories - basically, they will be the OPPOSITE of what you are apparently basing your uninformed opinions on.”

I suppose this just highlights the old cliché that you can’t please all of the people all of the time…

I believe that we are very fortunate to have a national health service with general practice at its heart. It made me very proud to see you all at the Conference and to hear about the brilliant work you’re doing day to day to raise standards of care for our patients ever higher. I look forward to seeing you all again at the Conference next year.

As always, both I and the College value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.

Yvonne Carter

Today’s blog is devoted to just one subject.

This has been a very sad week for us at the College, and for me personally. Yvonne Carter, Dean of Warwick Medical School and Pro-Vice Chancellor of Warwick University, has died, and yesterday I attended the funeral in Kenilworth as a friend and on behalf of the College as a whole.

I’ve known Yvonne for years; in practice, College and university. Throughout the years she's been a great friend and colleague. She was a determined woman with a wicked sense of humour.

Yvonne was a role model for GPs and, in particular, for women doctors. She was a great teacher, brilliant researcher and highly effective leader.

She died aged 50 - far too young - having battled breast cancer for many years. She leaves her husband Michael, her son Christopher and her sister Alma. My thoughts go out to them.

The funeral, held at the St Francis of Assisi church in Kenilworth was packed with her many friends and colleagues from across this country and further afield.

The family have requested that contributions in memory of Yvonne are made to Cancer Research or the Yvonne Carter Memorial Fund. The Yvonne Carter Memorial Fund is being established at Warwick University with the intention of benefiting the support and recognition of Warwick Medical School students throughout their studies.

Donations to the Yvonne Carter Memorial Fund can be made online. Cheques should be made payable to ‘The University of Warwick’ and sent to FREEPOST RSBC-JAAG-TEST, Development & Alumni Relations, University of Warwick, University House, Kirby Corner Road, COVENTRY, CV4 8UW.

The First Post

This is my first post in the blogosphere proper - thank you for joining me

You may be aware that i have been publishing messages and sending them to members of the RCGP over the past two years - indeed i have also published them on the RCGP website - but now i plan to make them available online so that i can share ideas and concerns and receive your thoughts and comments

This is a short post to say hello and test the system! The College IT system is not up to blogging so i have opted to break free!

And why you may ask use the title The Point of Kairos well it comes from a book written by my good friend Roger Neighbour - the Inner Apprentice - Roger's Inner Consultation helped me to understand the consultation while his Inner Apprentice helped me on my road to becoming an educator - thank you Roger!

Kairos is the Greek word for the right time for action - well I believe that the time is right and we have reached in Roger's words the 'critical moment when something significant is poised to happen'.

The financial crisis has focussed the minds of politicians and those running the NHS. The departments of health in all four countries that make up the UK are going to be under severe financial pressure regardless of who wins the election. But, there are tremendous opportunities for GPs to influence what health care will look like in the future. The time has come for strong medical leadership across the UK - lets seize the moment and ensure that we continue to have a National Health Service that we can be proud of.