@Xeon4f145d96s1
Your account has done more to change the way juniors are treated than almost any of us old guard who just sat back and didn't even realise things had got that bad. I don't always respect your language, hostile digs at people but I very much respect the overall work you do!
@gaslad
Yet their terrible consultants allow this. I think enough focus is not put on my consultant colleagues who seem to propagate this abandonment of their trainees. Absolutely reprehensible in my view. As a consultant colleague I have started actively asking where their juniors are.
@telswood
@RCRadiologists
@halliday_kath
I feel like we have sleep walked into a hellscape. It is NOT good enough for colleges to say there are not enough doctors...that was up to them to force NHSE to make enough training posts. The solution is not to have non-doctors doing doctor roles?!?! Am I going mad?
@surashsurash
I'm surprised you can't see why junior doctors feel betrayed by consultants like us. I'm surprised you can't see why juniors feel hurt that people with 2 year degrees (paid for) earn more than them with >100k debt, no say where they can work and families ripped apart...
@EddCarlton
The GMC is not fit for purpose. I would argue it is actually a dangerous organisation with little (no) oversight, making dangerous decisions, has no compassion and does not protect patients. Bin it!
@wiggs1234
Does this mean one of you is the ITU registrar oncall too? If there is no ITU doctor on site then I am so sorry for you, you are being out in a terribly vulnerable position. Your consultants should be ashamed of putting you and your patients at risk. I am speechless!
@danny_mercer
It comes from decades of doctors underplaying their abilities. We allowed FY1s to referred to as 'baby docs' and like they were clueless. We let AHPs start to say the same 'oh they are just FY1s, they don't know anything' and people started to think it was easy to be an FY1
@BTHFT
@uhbtrust
This is so sad. People will think I am being elitist or suggest that doctors are hindering development of other professionals, but the truth is - they are trying to get services on the cheap, and don't care about the patient safety repercussions
@carolvorders
Is it not sad that you have achieved more to remove the Tories in 1 year, than Labour have achieved in 13 years? What a pathetic opposition party we have. Well done
@carolvorders
@Platform_crocss
@ABarotchi1
@simontutt88
@cannula_service
@Dr_Sarah_Bellum
This is the problem. Doctors have insight into their limitations. We tell allied professionals they are 'working to the the equivalent of xyz'. This means they don't see how dangerous that terminology is for the AHP and pt. How have we got to this state?
@drheffer
@steven_hassel
@parthaskar
In all honesty please put in a PALS complaint. If it were a registrar pretending to be the consultant I would advise the same. This is a serious probity issue that must be duly actioned.
@hannahamcgarvey
Haha.. our dirty little secret is that you slowly come to the realisation in ITU that all that matters is doing the basics well.
Voltaire was bang on when he said:
"The art of medicine consists of amusing the patient while nature cures the disease."
@DrEmmaNash
@DrSteveTaylor
@wesstreeting
I would argue it is even more reason to scrap it. GP's good will is too often taken advantage of.
@DrSelvarajah
et al keeps pointing... the UK gets fantastic primary care on the cheap. Next time politicians complain about GPs it is worth them realising how much it actually costs!
@RCoANews
I am so angry. I pay my fees so you support the next generation of consultants.
You are too busy pushing AAs and COMPLETELY FAILED my juniors.
Pull your finger out and pay attention to what matters!
@DoingaCron
@DeborahMeaden
@martynware
@Keir_Starmer
Cron you are absolutely right. This is all smoke and mirrors. Facts don't lie: he has not openly supported workers, he is proposing policies that essentially privatise the NHS and widen inequality. This is not about racism... I am firmly out that door! Never again Labour!
@VirtueOfNothing
@RCoANews
@AnaesUnited
I genuinely don't see the point of AAs. Why should we support this at all. I really think the question should be: 'should they exist'. My answer is NO. We have plenty of SAS and LEDs who are much better trained and versatile.
@Dr_Done_
This person is not alone. As a seasoned consultant until you highlighted this issue I was woefully unaware. Your hard work will never be fully realised but many are thankful for it.
@ShivaniM_KC
@Doc_BeTheChange
Good on him for making the time to support his best friend and be at their wedding. If the Telegraph is saying: what an amazing young man - helping to lead a grass roots movement to help JDs around the country, but still making time to support his friends... i agree 👍
@craniosurgeon
@jsnorthwest
@veggieequallife
Far easier to criticise juniors than to actually sit and listen to them. There is a reason the NHS is in the way it is... Senior doctors like us ignore people and bury their heads in the sand. It is very sad.
@BBCHughPym
@BBCHughPym
are you seriously implying that it is anyone but the government that is stonewalling? Any objective look at the situation tells you one side wants to negotiate and the other is just saying nope not doing it. The government is acting like a child. Pls report as such.
@SamGoodhand
I remember when they started becoming a thing. They were very defined roles which enhanced medical care. PAs and AAs are being used by the government as cheap doctors. 2 very different things.
@theveindoc
@_VivekTrivedi
@Dr_XYZ
Funny how retired doctors are shouting loudly and undermining junior doctors. It was our generation of doctors that failed our successors. Maybe we should shut up and support them rather than snipping from the sidelines?!?
@DrFavell
@Parody_RCGP
@ShaunLintern
@DHSCgovuk
Never understood this? Are you saying that we were overpaid 35% 10 years ago and so a systematic pay cut every year is right? Mp pay, private sector pay has gone up more relative to inflation than healthcare professionals. I would argue if you internationally we are underpaid?
@Jcalcolado
@DrSteveTaylor
Unfortunately many of our generation have not come to the same realisation. I could not do a junior doctors job now. They are skilled well beyond my abilities back then. Sad our generation don't give more vociferous support of them! Thank you for your important tweet.
@Dr_Done_
It is less about the individual person who is clearly very sketchy, but the broader point people have made, and largely dismissed that PAs are a confusing role that teeters on doctor impersonation. Those that deny it will find excuses for this profile, but that is the truth
@pulsetoday
You mean just like they did with Dr Bawa Garba. Message to my medical colleagues... Don't take risks, work within competencies and say no to anything you are not comfortable with. The GMC, your trust and the government will think nothing of screwing you over. Look at the facts.
@dave_maroni
@rebecaulfield
I don't think this is true Davide. The senior consultants were begging for external review. It was the managers and senior management team that stopped it for fear of bad PR.
@DrHenryMarsh
I was thinking exactly the same. I really can't recognise the organisation I joined as a houseman! Not saying everything was roses back then but if my bosses had a concern this grave, there would be no 'referring to senior management'. Absolutely insane
@veggieequallife
I am just desperately sorry it took so long for us to notice. I hate that AAs even became a thing and yet my amazing SHOs can't even get a job. We can't employ them locally 'because of money', but
@NHSEngland
can happily fund AA training and salaries! Absolutely disgraceful
@doctorhelgi
@AnaesUnited
Thank you for listening and taking our concerns seriously. For months people have accused many of bullying or being elitist. I hope this starts to show there is genuine concern and I am glad
@RCoANews
are part of the solution and not part of the problem
@MAbsoud
@SteveBarclay
@BMA_JuniorDocs
@Telegraph
Actually BMA keep making offers to talk - multiple days given, willingness to compromise - the government is the one stalling and pushing them into striking. If Steve was a doctor he would be so negligent the GMC would have struck him off!
@mmamas1973
My worry is 2 fold: 1) if this is what is being admitted publicly, what is happening behind closed doors 2) why are these serious concerns not being listened to? Mid Staff, Letby, Bristol Heart etc etc... we have learnt nothing
@rosieICM
@thetimes
Good on the juniors for not backing down. Time and again weak and IMHO damaging members of our profession say 'dont make a fuss', 'be reasobable' (including myself in the past). We need to realise no one else will fight for us. Our inaction has led to a generation of lost doctors
@Markgreen433
@Dr_Done_
Yet to find an SHO who does not want to do an op. There are plenty who don't want to scribe for ward rounds, take bloods, chase up scans, organise discharges etc etc. These are jobs that don't need a medical degree. Don't believe I even need to say this 😵💫
@mmamas1973
What I find crazy
@BBCPanorama
@C4Dispatches
is that there has been a fundamental change in working practices, documented patient harm and a groundswell of doctors and nurses warning against PAs/AAs and yet it is relatively silent in the media? This is a major scandal
@theAliceRoberts
@WelshGasDoc
The irony is before COVID most private hospitals would not have survived without NHS patients being treated there. Sadly now they are booming with people self paying due to waiting times. We have failed our patients for the last 13+ years (labour and Conservative govs)
@Vapourologist
More than impressive. For months they pushed the narrative that a 'vocal minority' had concerns about AAs. By that same logic... It seems those anaesthetists pushing AAs are the vocal MINORTIY who have changed national policy without giving any concern to patients of trainees...
@Dr_Done_
What annoys me is that when people like
@Dr_Done_
reasonably says that a doctor is in a better place to practice clinical medicine than someone who has not gone to medical school it is somehow rude/polemical/dismissing MDT members. It is pure fact.
@EthersonKevin
@BMA_JuniorDocs
I think you mean to direct this to the health secretary? If juniors don't sort this out, you will have to find more than 8 consultants to cover your service... there will be none coming through! Shame on the government letting it get this far!
@Dr_Done_
This is emblematic of the continued downplaying and infantalisation of doctors in training. For years people referred to FY1s as 'baby docs' or 'house monkeys' and made it sound like they don't know anything... That is insidious and we now reap the rewards...
@JanetEastham
@RCoANews
@AnaesUnited
Thank you so much
@JanetEastham
for looking into this and reporting it widely. The general public deserve to know what is happening. Over decades we fought for increasing safety in anaesthesia. It really scares me how quickly we are throwing that work by the wayside.
@alastairmiller3
Such a sad indictment that a person in power like you don't get it. YOU failed juniors by not pushing effectively for more training numbers. YOU remained silent during years of wage erosion. YOU were meant to represent trainees and training. No one wants to strike.. they have to.
@drcolinm
@davidianpyle
@drdernial
@wendyburn
@drcolinm
please please please listen to doctors before doing anything. If you believe this is a handful of internet trolls then ballot your members (the doctors paying your subscriptions). I am happy to shut up if the majority of doctors think MAPs under GMC is a good idea!
@ENT_UK
Gosh this is such a bad statement... I strongly suggest my ENT colleagues give up their subscription to
@ENT_UK
. They seem to value PAs more than you and your trainees... so sad to see
@cannula_service
Take note
@RCoANews
and
@AnaesUnited
... If anything happens with AAs we are the ones thrown under the bus. I say again... Why on earth would I supervise an AA?!?!!?!!
@ShaunLintern
@RishiSunak
Thanks for highlighting this. It is stealth privatisation. The public need to know, and only you seem to be shining a light on it. Keep up the good work
@DrBenLovell
Haha! One of the best things about teaching juniors is that I learn so much!
On a geeky note... PEEP applied properly (especially in spontaneously breathing patients) can improve BP in the euvolaemic patient, by optimising transmural pressures in the Right and Left ventricle!
@SandipP64097927
@Sarah_H_Y
@ExplosiveEnema
Surely this is a probity issue? How can PAs get away with this? If an SHO called themselves the registrar it would be grounds for disciplinary action. How can a non-doctor pose as a doctor and get away with it????
@doctorhelgi
@Dr_Done_
@oliverdevine
@Xeon4f145d96s1
Not just that... remember
@doctorhelgi
is the only one in a position of power who has shown us any respect by answering questions and engaging. He genuinely seems to care and wants to address this issue. We should give him the time, space and respect he deserves
@TomStocks1982
Don't worry... Patient safety is no 1. There definitely is no such thing as bullying in the NHS. Pathetic how our junior doctors are treated. Admittedly it is people like me who should feel guilty. We seniors have sleepwalked into letting our profession be treated like crap.
@dr_merritt
Gosh this is such a sad tweet from
@dr_merritt
. If he took the time to listen to the comments made by trainees and younger consultants he would realise there are legitimate concerns... As always in medicine, if people are sounding the alarm it behoves us to stop and listen
@Fatima13120130
If this thread does not anger every consultant cardiologist I don't know what will. Anyone who spends even a minute with a trained knows this is not an isolated experience. Why have we abandoned our trainees like this... in favour of an untested, un-evidenced role????
@mmamas1973
We do have to be mindful and sensitive to the PA. It is not their fault they were told they can do the job of a Gp after 2 yrs training.
@rcgp
you and
@NHSEngland
are the ones responsible for this poor patient's plight. Stop this madness NOW
@dr_nigel_lane
It is sad that as a obviously senior member your speciality you do not even understand where these trainees are coming from... take the time to listen and you will find they are not being unreasonable.
@Dr_Done_
@RCoANews
Well done for my colleagues. The proof that this pressure is working is
@RCoAPresident
's email saying they will put out a survey 'soon' to canvass our views... Years after they had pushed for AAs. Even the email was still pushing for AAs so already significant internal bias.
@RidgeOnSunday
@RobLaurensonD4P
Wonderful interview, tough questions answered honestly and with facts. Interesting MPs can't do the same (or even have the courage to be questioned like that at all)
@Xeon4f145d96s1
@DrCharlesL
@TalkTV
@doctorcall
What an awful person.
@DrCharlesL
you are a disappointment to all the NHS doctors who trained you so you can make so much money. I have nothing against private work, but don't throw your juniors under the bus when you benefited from the system your seek to destroy. Awful man.
@VirtueOfNothing
Omg this is awful. So much worse than what AAs say is happening. This is outrageous
@RCoANews
and
@RCoAPresident
. This MUST STOP. how is this safe or fair on patients. Completely speechless
@em_orchardx
I appreciate it may sound like a lot, but for the level of training, expertise and skill she has... She is grossly underpaid. There is a reason why places like the US, Canada and Australia are able to poach our doctors...
@veggieequallife
Wait there are already PAs on reg rotas?!?!? That can't be right? Is this widespread.. I really have sleepwalked into a hellscape of medicine
@Xeon4f145d96s1
As a matter of interest I asked how many trainees I trained in the last year went abroad. Of the 6 that replied, 5 have gone and the other is applying to Aus. Anecdotal evidence, but people saying it is not happening or 'who cares' are letting incredible trainees slip away
@dannyjnwong
100% still flabbergasting that it is somehow controversial to say that anaesthesia should only be provided by doctors who have intensive training as outlined by the RCOA itself. How on earth has that standard changed without due consideration, research and debate. Insanity
@AnaesUnited
To be honest it is not whether I want to or not. The fact is I don't think remote supervision is adequate for people providing anaesthetics of any flavour (including regional) without medical degrees. We should aspire to prevent the 1% of bad things that WILL happen.
@VirtueOfNothing
@RCoANews
@AnaesUnited
The people saying they can 'sit with a PT during their anaesthetic' miss the point that the reason we don't leave is that things change quickly (arrhythmias, airway loss, aspiration, delayed anaphylaxis etc etc). I don't want a non doctor looking after those situations
@DoctorMayJay
@dranitaraja
Outstanding... this is the passion and facts we need in this debate. Show these right wing pundits what morally bankrupt people they are!
@TTOTrainee
@alastairmiller3
It is a terrible feat of wage theft. I think all portfolios should be free for trainees. If someone has to pay it should be NHSE since it is doing their job for them. Ridiculous
@DrHuw
@gmcuk
please explain this? This is not acceptable - you must respond personally to
@DrHuw
.
@DrHuw
it is worth doing a FOI request because no doubt the GMC will ignore this if past form is anything to go by.
@DrOKaneAgain
@rclondon
@DrSarahClarke
I have been really disappointed by a number of Royal colleges pursuing and encouraging PA role without proper consultation with their membership. Im not saying PAs are bad, just how can they fundamentally change how we work without talking to us? Madness
@ukmat82
Although this person's statement is abhorrent, disgusting and actually counterproductive - i do fear that it blinds us to the truth there is a lot of anger and feeling undervalued as juniors. We need to be mindful of where these sentiments are coming from in our juniors.
@DrAhwabAlam
@veggieequallife
Does that change the fact they should have responded truthfully? Probity and professionalism are not choices, they are a responsibility. If you can't be honest with your patient, how on earth can they trust you when they are at the most vulnerable (under any form of anaesthetic)?
@DrAdamLawton
I feel sorry for new doctors coming to our profession and being expected to look after incredibly complex patients with little training!
I have released all my intro lectures to ITU on YouTube to see if we can expand on that pdf a little!
@mouseter_chef
@Xeon4f145d96s1
I actually genuinely thought this was a joke!
@rcgp
what on earth do you have to say for yourselves?!?! Do you really think this is safe? From 0 above working independently of GPs???? You need to come out hard and FAST about this. Why are you sleeping at the wheel?
@ukmat82
@BAOIA_News
Well done. It is far harder to speak up than hide away. You have always been respectful and honest. I think most people from either side of the aisle agree you are fair, honest and open. I for one would love to see and hear your talk!
@GMB
@ranvir01
What an intellectually bankrupt, horrid, nasty piece of work.
You gave up on the NHS 30 years ago, yet you have the temerity to lecture those who stick it out and try and improve it so others don't leave.
Disgusting