Lord Darzi, our own
Zelig
Dr
Dermot J Ward
Some
of you will have seen Woody Allen’s 1983 film, Zelig. Briefly, Woody’s
pseudo documentary was
about a fictional 1920s media sensation, Leonard Zelig, a human chameleon
who develops an ability to take on the characteristics of anyone he
happens to be with at the time. Using fake creative newsreel editing, the
movie hilariously depicts its comic hero magically at the side of almost
every major personality of the early and later 20th century
e.g. Hitler, Susan Sontag, Castro, Saul Bellow. A twist for cineastes is
his eventually finding compassion in the arms of his psychoanalyst Mia
Farrow.
The connection with surgeon, Professor Ara Darzi, later Professor Sir Ara
Darzi, next Professor Lord Darzi of Denham
and then a health minister and Zelig is purely an association of ideas
that assailed me. Surely nobody can doubt his good intentions. The Lord
Darzi has distinguished himself in the surgical domain but appears to have
strayed far afield into serious medical politics: the murky machinations
of the NHS. He seems to have been regarded as specially gifted with
excellent ‘listener’
skills, and it appears this greatness was thrust upon him. But more of
that later. Gordon Brown, shortly after becoming prime minister invited
him to carry out a wide ranging review and to lead the reorganisation of
the NHS presumably to make it more fit for purpose over the next ten
years. May 2007 saw him (Lord Darzi) publish his magnum opus, Our NHS:
Our Future. Strategic health authorities, (SHAs) and PCTs had been
required to draw up policies for NHS primary and secondary services
according to local priorities. According to one general practice source
The Lord Darzi visited 7 general practices and now feels equipped to
reorganise NHS general practice countrywide. This has been derided as
farcical.
These
plans in so many instances followed mass public consultation meetings
(‘listening’ to local folk’s views). Strangely, perhaps, these
meetings, intended it was thought to divine and deliver what the populace
and health staff wanted of and for their NHS have
incensed many as patients, public and professionals sense the
opposite: that their concerns about losing their
access to their treasured local GP because of distant Darzi
polyclinics, loss of district vital hospital services such as A&E,
paediatric and maternity services; apparently ignoring patients kernel
wishes for ease of reasonably near, safe and trusted services.
Instead
worries abound about treatment delays from longer travel distances
magnified by high traffic density further (dangerous) delays to more
remote already oversubscribed other district services to receive
appropriate medical attention. The bureaucrats and health ministers
however seem satisfied. The public expected not mere hearing but some
heeding of their concerns. Instead they feel utterly ignored. Many suspect
that even before these public consultations decision had been decided in
advance behind closed doors. This at least is the take in my Chichester,
West Sussex back yard. And how the local press reflects this.
Another blow. Government has pledged for years to abolish mix-sexed wards
because of so much adverse criticism. However in February 2008 Darzi announced this could not be done. (In that
same month 41 year old Dean Galley was jailed for sexually assaulting an 82
year old woman on a mixed sex ward in Royal Bolton Hospital). Sir Norman
Browse, a past president of the RCS in a measured attack on Lord Darzi
revelation was one of many defending wards for separate sexes reminding
him in a public letter that ‘hospitals have had no difficulty in
providing separate wards for men , women and children for hundreds of
years’. The sensitivities of women and their vulnerability have been
ignored by the noble lord.
The
issue of u-turning is not confined to mixed sex wards. In January 2008 he
overturned a decision taken a week earlier to ringfence funding medical
training in a letter to the House of Commons.
Psychiatry
too has not escaped the attention of The Lord Darzi. Readers will be
interested to note that on April 1, 2008 (you will make what you will of
that date) he spoke of giving allotments to individuals ‘recovering from
mental health problems’. Meanwhile the Mental Health Act Commission
report Risks, Rights, Recovery,
focuses differently on the psychiatric scene and warns that mental
health (they mean illness) wards are becoming increasingly overcrowded and
are ‘tougher and scarier’ than a decade ago: that pressure on beds
makes it difficult to provide good care to patients.
Let
me return now to those listening skills of The Lord Darzi. In November
last Hospital Doctor carried a particularly pithy letter from Dr Ian
Verber, consultant paediatrician, University Hospital of North Tees,
Stockton-on-Tees.. He was supporting an earlier letter, also critical,
which suggested that the noble lord’s listening skills had atrophied at
the time of his appointment to government. “Nothing”, wrote Dr Verber,
“could be further from the truth. Sir Ara (as he was then) was asked to
make recommendations on the reconfiguration of services on Teesside in
2005. He did visit but did not think it necessary to talk to
paediatricians, paediatric anaesthetists or paediatric surgeons. His
recommendations included the establishment of a centre of excellence in
obstetrics in a hospital without neonatal intensive care; the
establishment of a centre of excellence in paediatrics in a hospital
without paediatric intensive care, paediatric anaesthesia or paediatric
surgery; the provision of paediatric surgery and trauma services on a site
with no paediatric medical inpatients; and the splitting up of adult
vascular surgery onto more than one site.
“None
of these recommendations was workable and each was repudiated by the
independent panel which was brought in to sort out the mess.
A
happy ending for Teesside but as for the architect of this shambles – a
seat in the House of Lords and appointment as chief adviser to the
Department of Health. You couldn’t make it up”.
I
have spoken with Ian Verber and can assure you he is not a comedian. But
can you chide me for that Zelig free association with the noble lord.
However, unlike woody Allen and Zelig there is nothing remotely
funny in the mosaic political activities and health service consequences
of The Lord Darzi.