The end of something

In this film I attempt to tell a bit of the story of the beginning of the end of Usan.

Behind the Keith Mausoleum on the rock of Skae I noticed a Celtic cross that commemorated a doctor: Dr W A Mackintosh who died in 1911 just before the war. I wondered who he was?

Back home I discovered that he was the last Laird of Usan and had died suddenly in his bath. This was the beginning of the end for the Fishertoon of Usan.

In this film I find a connection between an enamel bath (vessel) and the Trawlers (vessels) that did an end to the laird and hand-line fishing respectively. Usan then went into decline.

At the time of this Angus adventure I was reading Ernest Hemingway’s short stories “in our time”. They were written not long after WWI and reflect his terrible experiences. They are somewhat brutal.

The music in this film all comes from the BBC Proms: Scott Walker Revisited. I have been rather moved by this performance of words and music of yesteryear (words and music that were barely noticed for decades)

The end of something from omphalos.

NHS Scotland – it should not take courage to care

On the 17th July 2017, the Scottish Government announced an “Enhanced service for NHS Scotland staff”

The Scottish Government began this announcement stating that:

“Staff in Scotland’s health service will continue to benefit from external support should they have any concerns about patient safety or malpractice”

From 1 August, the NHS Scotland Confidential Alert Line will be re-branded as the Whistleblowing Alert and Advice Services for NHS Scotland (AALS).

This was reported in the Scotsman of the 17th July 2017:

The Scottish Government confirm the enhancements that have been made:

Some personal thoughts:

I have never been a “whistleblower”. I have however raised concerns relating to patient wellbeing and safety in NHS Scotland, and in particular for our older generation. I share the view of Sir Robert Francis that “freedom to speak up” is a better and more encompassing term.

My experience of trying my best to put patients first in NHS Scotland has left me with an interest in this matter and I have followed developments over several years now.

My concern is that this “enhanced service” has taken little account of the evidence presented to the Scottish Parliament from a wide range of individuals and professional bodies, including Sir Robert Francis.

Lifeboat NHS from omphalos on Vimeo.

The “enhanced” service will still not be able to independently deal with any concerns raised and so can offer only to “pass concerns on to the appropriate Health Board or scrutiny body for further investigation”. In practice this will be either to the NHS Board the employee works with or to Healthcare Improvement Scotland which is neither independent of Government nor of any of Scotland’s 23 other NHS Boards.

It worries me that senior Scottish Government officials continue to use words such as “grievance” or “pursuers” when talking about those who are trying to put patients first in NHS Scotland. It seems that the Scottish Government are as quick as any of us may be to label individuals.  This “expanded service” has been re-labelled in a positive way when the opposite has happened to many of us who have raised concerns about patient care.

In summary:

I feel that this is a disappointing outcome given the determination of the Scottish Parliament, and the Health and Sport Committee in particular, to ensure that there is freedom in NHS Scotland to speak up and put patients first.

I would suggest that despite this “enhanced service” that it is still going to take a great deal of courage to care in NHS Scotland:

Courage to care from omphalos on Vimeo.

Lifeboat NHS

A film about freedom to speak up in NHS Scotland based on an edit of the evidence session of the Health and Sport Committee, Scottish Parliament, held on 13th June 2017.

This is just an edit. A subjective view. Nothing more and nothing less.

Improvement science and consent: a failure of NHS Governance

I am an employee of NHS Lothian and have been ‘sign posted’ to the “New Capacity and Consent intranet page: important information for all staff.”

This is a screenshot taken on Friday 2nd June 2017:

The Capacity and Consent intranet page begins by reminding all NHS Lothian staff of the ‘Obtaining Consent’ Policy (2014):

The NHS Lothian ‘Obtaining Consent’ Policy (2014) informs staff that “failure to secure consent may constitute assault under common law in Scotland”.

All NHS Lothian staff are also reminded that “acquiescence when a patient does not know what the intervention entails, or is unaware that he or she can refuse, is not consent”.

Two years ago I wrote about national improvement work undertaken by Healthcare Improvement Scotland for older people in hospital in NHS Scotland and my concern that “compliance” had replaced consent.

Given my experience that the guidance from my employers (NHS Lothian) on consent and the explicit requirements of “compliance” mandated by Healthcare Improvement Scotland seem to go in opposite directions, I wrote seeking further guidance. I have had this reply from Healthcare Improvement Scotland.

In conclusion: I would suggest that a failure of NHS Governance in Scotland has led to a confusion about the rights of older people to give consent.

Habitually made marginal comments

Filmed at the abandoned farm of Bishopsfaulds, near Comrie.

Words: by me and some ‘borrowed’ from Liz Lochhead

Music credit: ‘The lost Prince’ – Adrian Johnston (2003)

Submission on PE01651: Prescribed drug dependence and withdrawal

As an NHS Psychiatrist who has worked in Scotland as a Consultant for over 15 years I want to offer my full support for this petition.

Recently at a Cross Party Group meeting held at the Scottish Parliament it was stated that “depression is under-recognised across all age groups” and that “maintenance treatment has a good risk-benefit ratio.” This was said without acknowledging that these statements cannot be made with absolute certainty.

I have found that my profession in Scotland seems to resist evidence of experience and at the same time prioritise the opinions of experts.

Potential for Expert Bias (one):
There is evidence that establishes that senior Scottish psychiatrists, who have provided expert input to Scottish Government strategies, and who have been involved in developing National prescribing guidelines, have had significant financially-based vested interests.

Potential for Expert Bias (two):
It is worth perhaps pointing out that Scottish Psychiatry has been traditionally orientated around biological determinants of mental health. Like myself, many academics have concluded that Scottish psychiatry lacks real-world, pluralistic breadth to the science of the mind and brain. Across the border, in England and Wales, the approach is far less reductionist. This includes the involvement of experts whose interests are not solely focussed on the bio-medical determinants of mental health.

I do prescribe psychiatric medications including antidepressants but I do not agree with the ‘experts’ that prescribing in Scotland is “conservative”. 1 in 7 Scots are now taking antidepressants.

Appropriate and informed prescribing is what we seek where there is open discussion about the potential benefits and potential harms of such treatments. This and an honest consideration that for many medications we cannot be certain of long-term effects.

                      Dr Peter J Gordon
                      GMC number 3468861

‘Dig the grave and let me lie’

On the early morning of Sunday 7th May 2017, I set off to visit ‘Stank’.

I was looking for the ruined mausoleum to Lord Esher.

The Stank Mausoleum was built in 1925 at the point in this old Roy map where the four sections just happen to meet:

No place could perhaps appear less like it ‘sounds’:

Lord Esher’s Scottish home was at the Roman camp in Callander. Since his death it became a hotel:

It was at this hotel that my grandfather Rab Scott met The Beatles and had a drink with them:

Today, Esher’s Mausoleum is marked this way:

Lord Esher was thought to be the grandson of Napoleon Bonaparte (his mother was thought to be Napoleon’s illegitimate daughter)

Lord Esher was:

Lord Esher was different:

Lord Esher was married with four children but it is considered that he was probably more attracted to his own sex

Lord Esher was respected for the clarity and beauty in his use of language:

Lord Esher’s ruined Mausoleum is on the route to Ben Ledi. Thousands of walkers and mountaineers pass it by each year without knowing.

It was with considerable difficulty that I found it.

Even Hale Bopp found it a struggle to find!

It may be that Lord Esher’s remains, despite his wishes, are not here at Stank?

If that is so, perhaps this is why this mausoleum is sadder than sad.

This was how the Mausoleum appeared at the time of Lord Esher’s death in 1930:

Lord Esher was clearly a great admirer, as I am, of Robert Louis Stevenson.

These inscriptions, of poems by Robert Louis Stevenson, survive by the collapsed doorway to Esher’s Mausoleum:

I needed to visit Stank.

Hundy Mundy

call it folly, call it my pursuit
a sense of loss,
the secret of art.

[the body of work reflects the disappearance of the artist himself]

Music credits:
(1) Bluebell, cockleshell 1-2-3 by King Creosote (From Scotland with love)
(2) Leave your body behind you – by Richard Hawley

At the end of the corridor

 

The funeral took place in radiant sunshine

Auchengray House has been a ruined shell since a catastrophic fire in 1937. At the time all was going horribly wrong for the multi-millionaire owner, J M Colville. Not only did he lose in the fire his collection of fine antiques and paintings, but not long before the fire his mother had died and then his sister jumped in front to a train.

It was this darkness that led to the building of Gribloch, the new hoose, one of light, designed by Basil Spence.