Surgeon concerned by waiting lists

By Peter Gould
BBC News Online

Surgeon Colin Weir says patients are waiting too long

The scene is familiar from countless hospital dramas on the silver screen.

The consultant sweeps through the hospital ward, followed by a white-coated retinue of junior doctors and medical students.

Colin Weir, a surgeon at Craigavon Hospital in Northern Ireland, is checking on the progress of his patients.

He tells them the results of tests they have just had, and outlines the operations they are facing, while his team take notes.

But this consultant seems very different from Sir Lancelot Spratt, the irascible surgeon in the old "Doctor" movies, who terrified patients and students alike.

Stress

Sometimes the work is overwhelming Colin Weir Consultant surgeon

As the ward round progresses, there's a cheery greeting for the patients, and friendly banter with the younger members of his team.

But despite his relaxed manner, Colin's working day starts at 8am and proceeds at a fairly hectic pace.

"It is a very stressful job at times," he says.

"Sometimes the work is overwhelming. You spend long hours trying to sort things out. But it is swings and roundabouts, and there are times when it is not so busy, so it changes on a day-to-day basis.

"Often we have to deal with dying patients and seriously ill patients, and we have to deal with relatives of those patients, so often there is an emotional impact from that.

"We try to cope with that as best we can, but inevitably we take some of that home. There is no way of avoiding that."

Flesh eating bug

It is not just routine procedures for hernias and varicose veins that Colin and his team are called on to perform.

Because of recent re-organisation within the NHS, the hospital has been receiving many more emergency cases, referred from other hospitals.

To illustrate the point, Colin takes me into the Intensive Care Unit. One of the patients is recovering after surgery for a rare infection called Necrotising Fasciitis - better known by the alarming tabloid headline of the Flesh Eating Bug.

The man is connected to an array of tubes and monitors, but is expected to make a full recovery. Such exotic cases clearly make considerable demands on hospital resources.

In fact, a shortage of beds means the hospital is being forced to delay many non-urgent operations, much to the dismay of doctors like Colin Weir.

"Just this week we have had to delay major surgery, important surgery, on a patient because of a lack of beds," he says.

"There are serious conditions which need treatment which we have had to delay on occasions. We will do our level best to bring those patients in as soon as possible, but delays such as this are frustrating."

Delays

After ward rounds, Colin Weir spends a couple of hours in his out-patients clinic, checking on people referred to the hospital by their GPs.

The pace of the work means that as one patient is being examined, a second is already being made ready in an adjoining examination room.

Between consultations, Colin dictates notes into a small recorder, either to say that surgery is not required, or recommending an operation.

It's the second option that is now causing problems, not just for patients worried about undergoing surgery, but also for the hospital as it tries to juggle waiting lists.

"I have seen patients who need fairly routine surgery and I cannot give them a date," he says.

"They have to go on the end of what is already a huge waiting list, and it is frustrating as a doctor to have to tell them that.

"It is not something that doctors or nurses can control, and most patients understand that. But inevitably there are patients who are frustrated, and we can well understand that frustration.

"We would encourage them to speak to their politician or the health board where the resources come from if they have a particular problem, and hopefully that will help to put pressure on the government to improve things."

Funding

The general surgical unit at Craigavon is the busiest in Northern Ireland, treating around 10,000 patients every year.

About 4,000 are day patients, which means they just come into the hospital for their surgery, and leave again without being admitted.

It avoids tying up hospital beds for relatively minor surgery, and patients are happier at the thought of a quick return home.

But while units like this can ease pressure on the hospital, Colin Weir is in no doubt that action is needed to reduce the delays for patients who need surgery.

"We would love to have better resources," he says.

"There is a clear need for extra funding and whether it is done under the auspices of the existing NHS, or in novel ways, I do not know. I am not in a position to pass comment.

"I think things are as bad as I would like to see them. I don't think the NHS could withstand any further pressure, or it's in great danger of falling apart, and patients are going to suffer."