OAs in Healthcare
16 November 2017
The inaugural professional networking event for those working in healthcare took place in the auditorium of the Laboratory on 16 November 2017. An audience of boys from the College were joined by students from JAGS, Alleyns and the Southwark School Learning Partnership as well as parents and members of staff to hear talks from three Old Alleynians on the challenges and opportunities facing healthcare now and in the future.
The evening was chaired by Andrew Tomkins (54-61) newly appointed President of the Alleyn Club and Professor at the Institute for Global Health. He was joined by OAs representing three very different specialities and generations. Dr Faheem Ahmed, Professor Mark Wilson and Professor Karol Sikora.
All the lectures can be viewed on our Vimeo Channel:
Dr Faheem Ahmed - Politics, Populism and Public Health
Prof. Mark Wilson - Recent advances in treating acute head injury
Prof. Karol Sikora - The future of cancer care
While all three spoke on very different themes it was clear that both society and the health service sees a future where the needs of the individual is placed, even more than it is today, at the very heart of patient care.
Dr Faheem Ahmed (2003-10) left the College in 2010 after which he studied medicine at King’s College London where he was Guy’s, King’s and St Thomas’ student president. Faheem was the youngest appointed National Clinical Entrepreneur Fellow and is a founding director of the ‘skillanthropy’ charity Selfless.
Faheem took as his main theme the need to look for the ‘causes of the causes’. He called for us to spend more time seeking to understand and then responding to the underlying social issues that result in social exclusion and poor health. He told the story of Kamal a homeless man in his mid thirties who died from a heart attack. However, as Faheem asked, was it the failure of his heart that killed him or was it his long history of living in care where he was frequently bullied? What role did his subsequent life of petty crime and drug abuse play in his death and to what extent did his time spent in prison contribute also? In other words, what was the real cause of Kamal’s death?
There is clear evidence that the poorest in society are also the unhealthiest, with obesity, alcohol abuse and smoking major killers in the western world today. It could be argued that all of these are a result of personal choice, but as Faheem pointed out that, patient needs are more closely interwoven with and rooted in, complex socio economic factors than ever before. You cannot control asthma if you have no choice but to live in damp housing. Is obesity inevitable if your neighbourhood is dominated by fast food restaurants? In a world where we live longer lives morbidity is more complex than ever, yet the sting is, as always, felt by the poorest in society.
Faheem firmly believes that while politicians have a great responsibility to act to improve the underlying causes of poor public health; change cannot be left in their hands alone. The need to proactively improve the nations health is a significant reason why he helps to lead the charity Selfless (www.selfless.org.uk) with the idea to share expertise both locally and internationally a concept he hopes will ultimately lead to a more sustainable global healthcare system.
Professor Mark Wilson (1985-92) is Consultant Neurosurgeon and Pre-Hospital Care Specialist working at both Imperial College (mainly St Mary's Major Trauma Centre) and as an Air Ambulance doctor. Mark is a Clinical Professor specialising in Brain Injury at Imperial and Honorary Professor of Pre-Hospital Care at the Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh. His specialist areas are acute brain injury (mostly traumatic brain injury) and its very early management.
Mark focussed on the treatment of traumatic head injuries, already a significant cause of death globally in the under forties but also becoming increasingly common in the elderly as we witness ‘greying populations’ in societies across the world. Mark spoke about his passion for looking after neurons, the basic building block of the central nervous system and responsible for keeping ‘you being you’. While Mark tried to convince us that unlike the idiom, brain surgery was not that difficult, he spoke about the increasing way in which technology was helping not only to save lives but also maintain quality of life.
Gyroscopic data from modern cars is helping to record the patterns of head injury sustained in collisions and the resulting information being used to trigger more appropriate responses from the emergency services. Video triage also helps to dispatch the correct help to the scene of an accident and the introduction of an app GoodSam (www.goodsamapp.org) alerts medically qualified responders about an emergency if they are within a few hundred metres of it.
In the future we will be able to use bio markers from a drop of blood to diagnose brain injury mere moments after the trauma has occurred. The US, Germany and Scandinavia already have portable CT scanners and it is hoped that before long we will not only be able to identify the blood clot at the scene of an accident but we will also be able to operate on it too.
Professor Karol Sikora (1959-65)
Consultant Oncologist at Hammersmith Hospital, where he was Clinical Director for over 15 years, he launched Cancer Partners UK, Britain’s largest independent network of innovative cancer treatment centres in 2009. Building on his experience as Chief of the World Health Organisation’s Cancer Programme between 1997 and 1999 and an adviser to the UN’s International Atomic Energy Agency, he has also formed Cancer Partners International, which builds more affordable cancer centres in the developing world. His current major project is the creation of a network of Proton Beam Therapy centres in the UK and abroad, funded by private equity.
Karol has been a consultant in oncology for thirty eight years and in all that time the challenges of dealing with cancer have remained the same. He likened it to dealing with terrorists where the police have to identify, isolate and remove a single aggressor in the middle of a room of hundreds indeed possibly thousands of innocent bystanders.
Unlike many other forms of medicine where the disease results form external forces, in cancer it is the opposite; here our body attacks us from within as cells mutate and turn against us. The skill is to remove the cancer causing cells while leaving healthy tissue intact.
The good news is that advances in technology are making this ever more easy. Computers are providing more information about the way the body works without having to resort to invasive surgery. We can efficiently and cost effectively copy or amplify small fragments of DNA through polymerase chain reaction (PCR) and through improvements in robotics and chemotherapy provide personalised treatment as never before. It is clear that before long we will be able to treat the disease far more selectively.
Increasingly we will look to move cancer care away from large hospitals, the ‘cathedrals of medicine’ as Karol called them, to small local community centres. Here treatment will be personalised and come with a cup of coffee and a friendly face, some way from the experience many of us currently face.
However, for all the opportunities that are opening up, there are still many obstacles to overcome in the coming years. We may technically be able to cure up to 70% of all cancers by 2050 but will we be able to afford the expense of doing so? Currently the cost of treating cancer is rising at a rate of 15% a year with Karol estimating that by 2050 the cost treating prostrate cancer will rise to a staggering £500,000 per patient. We will also have to consider how best to support patients emotional needs with more and more resources having to be channelled into wellbeing and other psychological support.
On balance the benefits look to far outweigh the cost and like all the speakers Karol spoke about the future with optimism. All had recognised the challenges and the hard work involved in bringing about change but the fire within each of them burned brightly for a profession that has the power to bring real and meaningful change to all our lives.
+44 (0)20 8299 5335