Friday, 14 October 2016

by Athena Karsera, Cyprus Weekly

Creating a strong foundation in primary care is something stakeholders would be wise to keep in mind while creating Cyprus’ long-awaited new National Health Scheme (NHS,) an international expert has suggested.

Medical Director for Royal College of General Practitioners (RCGP) Europe and RCGP Representative to the World Organisation of Family Doctors (WONCA) Professor Valerie Wass told the Weekly one of her main aims after many years in the health sector was helping the international medical community realise just how important the work of a General Practitioner (GP) really is.

Wass was in Cyprus to speak at the University of Nicosia Medical School’s John Howard Symposium in Family Medicine. The October 7 event was held in Howard’s memory and in honour of his efforts to promote the work carried out by GPs.

“John was doing very valuable work here, developing a Master’s programme on Primary Care … he was an amazing man who saw the importance of developing primary care globally,” Wass said.

She continued that Howard had hoped to achieve this through education: “As Nelson Mandela said: ‘Education is the most powerful weapon which you can use to change the world’”.

Wass noted that primary care in the international medical sector was becoming increasingly important and required a strong foundation, particularly since the sector was changing so much.

“Before the focus was one disease, even though the same patient may simultaneously have diabetes, heart disease and a mental health issue such as depression. I have seen patients on up to 26 different kinds of medications,” Wass said.

While acknowledging specialists would always be needed for very serious health issues, she continued that a patient could receive treatment for a range of simpler problems from the same doctor, a GP. Instead of, for example, being sent from a diabetes doctor to an Ear, Nose and Throat (ENT) specialist for an ear infection and then perhaps also on to a psychiatrist, when their GP could have also prescribed anti-depressants.

Wass said education and policy around the world had to keep up with developments. A UK report has suggested half of the nation’s doctors should be in the primary care sector, with US experts backing the idea that having GPs as gatekeepers to specialists would help keep sector costs down. “This is certainly something Cyprus should also consider,” she said.

“Seeing one doctor is also much nicer for the patients,” Wass added, noting that the world’s population was getting older and that it would be easier for people “to see one physician instead of five”.

Recently awarded an OBE for her services to medical education, Wass acknowledged that part of the battle had to be fought within the medical community itself. She said that although medical students had begun to grasp the importance of the GP’s role, some of the elder guard still pushed students towards specialities.

valerie-wass-2“Perhaps when the NHS in the UK began in 1948, the doctors who were unable to become consultants became GPs instead but, as I used to tell medical students, it is now the most-challenging sector. You need to know a lot, perhaps not to a specialist’s depth, but you never know what is coming through the door next,” Wass said.

She revealed that she had loved her years as a GP and felt privileged to have had the chance to connect with entire families.

Something else the global medical community, including the one in Cyprus, needs to take into account in the world’s increasing global diversity, Wass suggested.

She recalled her time at London and Manchester practices where 150 different languages were spoken.
Wass speaks several languages herself. Forced to wait a year to attend medical school after graduating high school early, Wass picked up German, Italian and French while working as an au pair in Europe. She has since also travelled widely, carrying out consultancies in over 20 countries.

The experience has taught her the changing face of the world and the challenges ahead, as well as what different parts of the world can learn from each other, also should be taken into account when preparing the doctors of tomorrow, she said.

“I spent 10 years in South East Asia and it was fascinating to learn about how people do things in a much less resource-rich area,” Wass noted.

Her immediate plans include chairing WONCA’s Educational Steering Committee and working with medical schools to better educate students on primary care and how health care will be delivered in the future.

“Perhaps my biggest aspiration is to get people to understand that an education on what and how important primary care is must start in medical school. Some students in the UK have even told me they do not understand what being a GP means,” Wass said.

Clearly passionate about her work, Wass will also be assisting the medical sector in countries including Rwanda shortly, and plans to do charity work.

This was her second visit to Cyprus. Wass was on the island earlier this year for the University of Nicosia Medical School’s recognition as an academic member of WONCA.