'Status quo is not an option' - NHS Highland claim
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CHANGES have to be made to the way surgical cover is provided at Caithness General, according to a senior NHS Highland official.
“The status quo is not an option,” said Gill McVicar, who is the health authority’s director of operations north and west.
She said the existing system is unsustainable and a new model has to be found.
A contingency plan was to be introduced at the Wick hospital in December last year after a consultant surgeon retired and another resigned, leaving only one in post. However, it was not implemented after locum cover was found but that is not a long-term option because of the expense.
Mrs McVicar told a meeting of the Caithness District Partnership in Thurso a Highland-wide approach to recruitment is needed.
“We would have more consultants in the mix and could move them around. We have to develop a new model which would bring about a safe and sustainable service at Caithness General,” she said.
“In the longer term we would hope to increase services at the hospital and make Wick a centre of excellence for a range of surgical procedures. We would bring people here for operations.”
One of the changes could be to recruit emergency doctors rather than surgeons or physicians. Such a move would reassure the public their emergency needs are being taken care of while making other services more sustainable, she said.
Thurso Highland councillor Roger Saxon said: “What’s important is the service we get, not how it is delivered. If people need treatment they have to know they will get it and we are trying our best to ensure that’s the case.”
Partnership chairman and Wick councillor Bill Fernie said the public was told more than 10 years ago the local maternity service was not sustainable. But campaigners fought plans to downgrade the service and it is still a consultant-led unit.
“Why should we believe you now when you say the 24-hour surgical cover is not sustainable?,” he said.
Mrs McVicar acknowledged the obstetric-led service was retained but claimed the unit is not the same as before. More mothers are going to Raigmore, she said.
Mrs McVicar also pointed out that it is “extremely difficult” to get surgeons to come and work a one-in-three on-call rota as would be the case at Caithness General.
“We are working very hard to bring in a safe and sustainable service,” she said.
Landward Caithness councillor Willie Mackay described the situation at the Wick hospital as “pretty fragile”. He felt a fresh approach should be considered when recruiting consultant posts as previous attempts had failed.
Bob Silverwood, the Caithness and Sutherland north area manager, said a range of options have been tried to recruit surgeons to the north including Golden Hello financial incentives.
Mrs McVicar pointed out that ads had been placed on buses in England highlighting the advantages of working and living in the Highlands.
Liz Smith, a Thurso patient representative, acknowledged the difficulties faced by the board recruiting staff. But she wondered if trying to recruit surgeons on a Highland-wide basis would make the posts less attractive given the travelling involved.
Deborah Jones, NHS Highland’s chief operating officer, said surgeons could find it more attractive to work along with consultants over a larger area. They would also be able to carry out a range of different procedures and keep up their clinical skills.
Mrs McVicar said the health authority could recruit on a Highland basis but not specify where the person lived.
“We have to be flexible,” she said.
Caithness and Sutherland area committee leader Deirdre Mackay said changes are going to happen.
“That is the message which is coming out loud and clear. We have a once-in-a-lifetime opportunity to get it right once and for all,” she said.
But she said the services provided must be safe and of high quality.
Landward Caithness councillor Gillian Coghill argued it is vital NHS Highland take “the smoke and mirrors out of the room and explain things better.”
“You have to take the public with you rather than keep them in the dark,” she said.
