A&E waiting times on the rise at Swansea's Morriston Hospital and Princess of Wales Hospital in Bridgend

“Shortage of doctors is caused by lack of forward planning and cow-towing to The European work directive. There is also the knock on effect of continual controversy in the NHS messing about with pensions. It's right to say that ambulances are waiting outside all our hospitals but what about the hospital staff being overworked? Who would want to work in an industry were it's staff are so poorly thought of.”

“Not a lot of help for the lady who spent many hours over night in Morriston in great pain with no one to help her in a monster hospital bristling with doctors because there was not a specialist available. Or a 10 year old who had a major brain operation a year before. Having to wait 5.5 hours for urgent treatment and discharged in 8 at 1.30am You would think that all the capital and reorganisation of NHS would have cured the problems. Centralisation makes it less efficient and worse. What was the difference to send part of the department from Morriston to Port Talbot instead. Beecham's centralisation plan has failed we need to get back to the drawing-board. Also remove ourselves from the EU where the laws restricting work hours came from. I started work at 15 with a 48 hour week but worked 60. I have worked in some jobs up to 90 + hours a week in my life.”

“tellyon, I agree! My bul****-ometer went into overdrive when I first saw the utterly patronising title of ABM's 5 year initiative: 'Changing for the Better'. I mean, as the gullible kasparov44 points out, we'd have to be completely mad not support a change for the better, wouldn't we...? (rolls eyes)”

“Hey PJ....


NHS shrinking.... Demand rising....


Equals -------- Top quality private healthcare systems! :)

.... for those who can afford to pay. :(”

“Einstein described insanity as doing the same thing over and over again and expecting different results. The same goes for repeatedly asking the same question until you get an answer you like. Maybe ABM should switch resources from A&E over to mental health services.”

“ABM_Health, again, despite your lengthy response, I note you still haven't answered my question;. Will the changes you are championing create more or less training posts for graduates?

Nevermind, I'll take your repeated evasiveness to mean that you know full well the changes you are championing will ultimately create less training posts, and consequently less doctors, therefore making the situation regarding the shortage of doctors even worse.

So much for 'Changing for the Better' then...”

“To answer PLJ 1967,
Sorry, I thought I had answered you queries - but I'll try again.
At the moment there are not enough A&E doctors in UK/Wales/ABMU area. We are not meeting the numbers of doctors the Royal Colleges say we need in our A&E departments.
What this means is that the chances of a patient seeing a doctor with the experience/qualification they need is not what it should be, because there are not enough medical staff on duty.
It also puts a strain on the training of junior doctors coming up the ranks, as there needs to be sufficient number is experienced doctors to aid their post-graduate training.
When there aren't enough doctors, it's difficult to staff medical rotas on lots of different sites. That's because of the distance between hospitals. If you are a doctor on an A&E rota in one hospital, then you're not available to be on a rota on another. So you have to have a minimum number of doctors times the number of hospitals.
If you can't meet the minimum number of doctors to maintain a rota, then patient safety is at real risk. They could come to harm because they may not have access to medical care when they need it.
For example - with NPT Hospital, we got to the stage where we fell below the minimum numbers for an Acute Medicine rota, and so we had to stop the service.
By consolidating doctors for some services on fewer sites, then we can overcome the staffing issue for safe medical rotas, because the doctors are gathered together on fewer sites.
This means patients will have better access to teams of doctors who are experienced and specialised; and junior doctors will be properly supervised, and therefore able to go on to become senior doctors themselves.
None of this means reducing any staff (and therefore saving money). The same number of staff will be employed - they will just be moved.
But what it will mean is that we won't have to spend anything like as much as we do at the moment employing expensive temporary agency doctors to fill gaps to try and keep services running. Last year ABM spent £3 million on such doctors.
So it also makes financial sense to reorganise services to make the most of our substantive staff.
I hope this clarifies the situation.”

“ABM_Health, you still haven't answered my question; Will the changes you are championing make the situation regarding the shortage of doctors better or worse in the long run?

This is the third time I have asked yet you seem intent on avoiding answering that question... Is it because you know that consolidating services will ultimately create less training posts, and consequently less doctors, therefore making the situation regarding the shortage of doctors even worse?

After all, how can medical schools in universities provide post-graduate courses if there are not enough hospitals providing placements in which to train?

For example, how do you propose to increase the number of doctors desperately needed to be trained to work in Emergency Medicine (A&E) if you're closing A&E departments?

As for your question; "Why would we 'orchestrate' a shortage of doctors?", I didn't suggest ABM Health were orchestrating a shortage of doctors, I'm merely suggesting the claim you make about the shortage of doctors is perhaps what some people may call over simplistic, misleading or maybe even disingenuous.

Finally, I'm somewhat confused by your rather emphatic statement, "this isn't a financial issue" because the link you provided earlier clearly says,"We don't hide the fact that finance is a big problem".”

“To answer PJL 1967,

Just to clarify, doctors are trained by medical schools in universities, not by Health Boards, although part of their practical training does take place on wards. This is a UK-wide problem, which seems to affect Wales more than other parts.

The Welsh Government is aware of the problem and has a campaign called Medical Careers Wales to attract more doctors to Wales. Here's it's website if you want to find out more: http://tinyurl.com/csl63qd

Why would we 'orchestrate' a shortage of doctors? As we've stated, this isn't a financial issue. We want to employ more doctors, but the numbers are just not available to fill the gaps.

The ideas for change which we've been talking about would consolidate staff on fewer sites across South Wales, rather than try to keep spreading them so thinly.”

“ABM_Health, I have read your reply and the information in the link you provided but I see nothing to answer my question; Will the changes you are championing make the situation regarding the shortage of doctors better or worse in the long run?

I fully accept there may be problems recruiting qualified doctors but patently if nothing is done to provide more training places for graduates to get the experience they need to fill the shortage of doctors the situation will not improve and you will be going round in ever decreasing circles..

And to use the quote in the link you provided, Albert Einstein once said: "Insanity: doing the same thing over and over again and expecting different results."

So, the obvious question is, if the shortage of doctors is really the reason for the changes, why aren't more training posts being created as a priority to remedy the situation?

Could it be because the so-called shortage of doctors is being orchestrated and used as a rationalisation to make cuts in NHS services, when in fact the main reason for the cuts in services is, in all honesty, because of cuts in finance?”