Medical Thread

I hope that we can move the medical discussion from the "RAF Defector" thread, because it rather seems to have taken it over.

"Elvis" Reed has not left the building, yet, but it is imminent. There is no comparable talent at 1* in the RNMS and, let's not forget, LEAN will reduce the promotion potential level of the medics in the very near future.

All Purple Now has postulated that the Army Medical Service has broken the duck of non-doctors / dentists getting to the top - well not to my knowledge, it hasn't. Whilst there have been a few 1* MSOs I have no recollection of anything beyond this. Certainly, there has never been either a MDG(N), DGAMS or DGMS(RAF) that has been anything other than a doctor.

Why does the senior level of either medical service need any particular "clout"? I have to admit that I was hoping that DG Healthcare would bring a fresh eye to healthcare provision for Servicemen and women, but there has been no evidence yet of any "blue sky" thinking, which has left us wide open to the scrutiny of the Gilligans of this world.

We currently have a perfectly serviceable medical facility, albeit on the haemorrhoidal tip of the UK (just above the "floater" that is the Isle of Wight!) which could be preserved as a Service facility for the increasing number of severely injured personnel returning from ops. It will always cost a lot to keep it, but if we give it up, another government department - Heritage - would have to pay for its upkeep, anyway. So why don't we cut our losses, move Headley Court's work to Haslar, staff it with Service medical, nursing and paramedical personnel and even develop a genuine centre of excellence?

 

Bloody right.Afterall Haslar is ideally situated for a RNH.Even if they close down GUZ as a base its not going to impinge on Haslar or the throughput of patients except to increase it.RNH H has a huge amount of history and also has been redeveloped(witht he Crosslink).its daft having small MOD units in NHS Hospitals.Maybe we can then return to training the best Medical Staff of all 3 services.

 

As I understand it, Maj Gen Hawley's predecessor as DGAMS was an MSO. I may be mistaken about this & am willing to be corrected. Unfortunately, it is rather harder to check the RAF & RAMC lists as these do not appear to be available on the web, unlike the Navy List.

Haslar has been on the run down for some time; part of the problem AIUI is that the AMS didn't really take to it (partly because if its heritage). In addition, the Gosport peninula is the Devil's own place to get to; the opportunity to create a triservice hospital was lost when RAF Wroughton closed; geographically at least it was in an ideal place near Brize etc. Geographical considerations would prevent recomissioning acute services at Haslar as DMSTC is due to move to Lichfield; it makes little sense to have the sole medical facility (which is what I think you're proposing) 200 miles from the associated training establishments.

I have heard several senior MOs say that they feel the 'service hospital' ethos is more nostalgia than hard fact - I am too junior to have set foot in such establishments, but I have also heard the stories about how little acute work there was - hardly conducive to training & maintainance of acute clinical skills. Perhaps one who served in e.g. RNH Stonehouse might wish to comment?

APN

 

Yeah right shippers, just like we have a perfectly functioning Government, and as long as said dipshits are in power evey fcuker can worry there socks off.

For instance, vote Labour and get taxed to death. Do you realise that you are paying at least 85% tax on fuel because of fat lazy baskets who have no other interest than to fill their back pockets.

Having said that, the other ********* who consider themselves to be upholders of the British economy are simply lying bastard. OOP's sorry, meant to say conservatives.

Then we have the weeny liberals who squeek regularly, but are totally inefectual (hope I spelt it right cos I'm pissed).

Notice how quickly things changed from your emergency to topics of total shite? :lol:

 

The whole MODHU concept arose as a direct result of Medical Staff being faced with real war injuries and not having a clue how to deal with them, either due to lack of experience and knowledge or due to shock at seeing real blood and guts for the first time. Sitting in your comfort zone at RHH did not prepare you for dealing with multiple gunshot, blast and burn injuries at the sharp end. So, we farmed our Medical Staff out to the A&E Departments at various regional hospitals and they got some good, valuable and useful clinical experience that stood them in good stead in wartime.

The flip side is, of course, that due to the way the contracts with the local health Authorities are handled, when we do need to send any of our Nurses to war, we have to pay the health Authority to recruit another Nurse to replace what they see as their Nurse being sent to Iraq/Bosnia/Afghanistan/insert name of shithole here. There's also the lesser penalty of our Nurses spending so much of their time working with the NHS that they tend to develop a, shall we say, "flexible" attitude to the whole idea of being in a military service. Notions such as "orders" and "doing what you're damn well told" don't have the same black and white meaning for them as they do for the rest of us.

On the bright side, they may think a direct order is a suggestion that they may want to consider doing something at some point in the future when it's convenient to them, but they no longer faint in horror at the sight of a sucking chest wound, so the good outwieghs the bad imo.

 

MDHUs came about because of the Lawrence Report, which was one of the plethora of studies that was supposed to save money for the AF. Whilst you are correct that the acute experience our people get now is hugely superior to that gained in Service hospitals of yore, I don't recognise your descriptions of those who worked with me, either at Haslar, Plymouth when single-Service or at Haslar after tri-Service working began.

What the Lawrence report failed to take on was that our investment in the basic training of doctors, dentists and nurses, not to mention that there are far too many of the former in non-operationally required specialties, is a total waste of the medical staffing budget. Pay them enough of a bounty when they have been trained and they'll join. We don't need them to stay that long, just join, enjoy the crack for a few years and leave - everybody happy.

Sailors, soldiers and airmen all pay into the NHS and therefore should be treated while in the UK by the NHS, with the Services only having to pay for their treatment as priorities, if this is even a requirement.

Wroughton was the logical place to put a Service core hospital, but Haslar was chosen and is currently still "owned" by MOD, so is the only option for a Service facility large enough to make a difference for the guys returning from ops with serious injuries. DMSTC being at Lichfield some time in the future has no bearing on where any secondary care facility should be sited. If you don't think that the injured would appreciate being treated in a Service-owned facility, talk to some of them who feel cast aside by the Services.

A return to Service hospitals would be madness, but an orthopaedic and rehab centre at Haslar would be the answer to a pressing need. None of this is beyond the wit of man, but the usual pat response of Haslar being difficult to get to is trite. Granted, when it first became tri-Service it was very unpopular with non-Naval staff, but several other-Service colleagues now see it as their ideal!

 

Shame about that whole Military Withdrawal From Haslar thing, then. Five months from deadline and Portsmouth Hospital Trust still haven't made their minds up what to do with all the staff currently employed there.

With regards to the tongue-in-cheek description of our QARNNS colleagues, please bear in mind I'm not referring to their superb and professional clinical conduct. They just seem to think that anything that occurs outside the Ward happens by magic, and with no input from their own good selves. You know, like leave, pay, allowances, travelling expenses, etc. Take as an example the Nurse who deployed to Iraq, came back, had two months leave, returned to work and only then decided it might be a good idea to question why he'd paid food and accom charges for the duration and not received any LSSA. Turns out that he'd been drafted, trained, equipped, deployed, shot at, returned, sent on leave, and called back in to work without anyone, from the highest echelons down, stopping to think that perhaps the UPO might like to know about it all. He was eventually instructed to report to the UPO with full details of his movements. Luckily for the UPO staff they didn't bother holding their breath waiting for him, he's still not been back since.

This is far from an isolated example. As I said, our Medical people are by and large highly trained and dedicated people, but there's a certain lack of interest in anything that extends outside the Ward or Laboratory, like reading your Orders and reporting as ordered.

 

I don't remember Maj Gen Lillywhite ever having completed MSO training. If he did, then he will be the first MSO to be Surg Gen and I will shut up.

 

Scribes, it's a good dit, but if true it means that your own UPO procedures have fallen over big time. Who receives the draft orders first?