Tuesday, January 13, 2009

Doncaster seven dead children and multidisciplinary working

It makes us sad and angry to hear of more deaths of innocent children. While it is impossible to comment on individual cases without knowing what happened exactly the dreaded words multidisciplinary working bring back traumatic flashbacks for me when I read that mayor thinks doctors are to blame. Presumably, this is a division along the class lines and doctor is outnumbered in a multidisciplinary team. Is it 12 to 1 or more? For some multidisciplinary working is like sitting in a parliament and passing votes: a democratic process. But medicine is not like that at all. Some of us are better qualified than others to make diagnosis and it is not up for grabs and selection by votes. Sense of responsibility also varies a great deal amongst people. Some gain comfort from team responsibility. There is no such thing. Teams change, people leave, new come in. Team still has the same name. Those who wish to act responsibly and have some power to do so are often prevented. If one goes against the crowd one gets lynched and left for dead as a professional. So, anything for a quiet life in an institution (for example, in local community teams) is how the daily business gets done everywhere in UK now. It is easier to say: we shall look after difficult cases at home than pay private care outside area as this is cheaper. What if parents get so stressed they want to kill their children who are too much of a challenge to them? Stress is not an excuse in the eyes of the law. Many adults who have been traumatised as children probably do not get the treatment themselves when needed and later on cannot cope. NHS does not give patients or doctors choice to work properly together. Even those who have insight that psychological help is required often do not get a chance to even start therapy. I remember when in 1980's I opened the residential treatment centre for adults who have been sexually abused as children there were people who were willing to work with me in Doncaster but not a single client was ever referred by local services. The whole of UK was informed of facility, but only a couple of referrals came through from social services nationwide. Naturally, patients want to avoid painful memories, but surprisingly for good treatment to work it is not necessary to dwell on those. There are techniques that work without too much pain. With unemployment, and other social stressors children are likely to suffer more.

1 comment:

an Unnamed Jedi Knight said...

Dobre Vece Helen

This is your locum SHO from Northwick park who you thought had a bosnian accent...

The GMC have been nasty to all of us