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The first meeting of the 2002/2003 session for the Section of Surgery of the Manchester Medical Society was the Presidential Address which took place on Tuesday 8th October 2002 at 8.00 pm in Chancellors Conference Centre, University of Manchester. Following the Annual General Meeting Mr D Allan, the outgoing President, introduced the incoming President, Mr R W Nicholson (Consultant Surgeon, Blackburn, Hyndburn and Ribble Valley Health care NHS Trust) and handed over the Presidential Medallion to him. Mr Nicholson thanked Mr Allan for his year of office and then proceeded to speak on his Presidential Address entitled: - "Crisis equals opportunity" Mr Nicholson's title was based on Chinese philosophy and calligraphy, where the characters for Crisis and Opportunity are interchangeable. His address covered the twin issues of increasing specialisation and increasing control by management in the NHS today. Specialisation was a double-edged sword, which led to increased efficiency but also resulted in de-skilling and lack of variety. It is a common misconception our European colleagues are even further along the path to super specialisation. In France for instance, GI surgeons tackle the whole of the gastrointestinal tract, and very competently. On the role of management in the modern NHS, Mr Nicholson pointed to the paradox of increasing loss of control by clinicians, whilst the clinicians took all the responsibility. Mr Nicholson then went on to relate his results over the years in a number of areas of colorectal surgery. Over the years he had supervised his SpRs for an increasing proportion of his major cases without a perceptible change in morbidity and mortality. He concluded by saying that we risk going too far with specialisation and that general surgery should be recognised as a subspecialty in its own right. The Presidential Dinner was held in honour of Mr Nicholson in chancellors Restaurant before the address at 6.30 pm when he was joined by members and guests of the Section.
A meeting of the Section of Surgery of the Manchester Medical Society, took place on Tuesday 12th November 2002 at 8.00 pm at Chancellors Conference Centre, University of Manchester. Mr R W Nicholson, President of the Section, was in the chair and introduced the speaker for the evening Dr W Lawler (Home Office Pathologist). Dr Lawler gave his lecture entitled:- "The forensic autopsy - the ultimate laparotomy" He started his lecture with a breakdown of 1414 police calls he had received as a Home Office Pathologist. About a third of these were for homicide. In many cases the perpetrators were friends or relatives and there was an increasing trend for the use of firearms as the murder weapon. He went on to describe a series of fascinating cases that kept the audience spellbound. With these he illustrated the difference between seeing, observation and interpretation. There followed a lively question and answer session and Mr Bob Pearson gave a vote of thanks. An informal dinner was held prior tot he meeting in honour of Dr Lawler, in Chancellors Restaurant, when he was joined by members and guest of the Section.
The Michael Boyd Memorial Lecture of the Section of Surgery took place on Tuesday 7th January 2003 at 8.00 pm in Chancellors Conference Centre, University of Manchester. Mr R W Nicholson, President of the Section, introduced the evening's speaker, Professor sir Peter Bell (Foundation Professor of Surgery, University of Leicester and vice President of the Royal College of surgeons of England) gave the Michael Boyd Memorial Lecture entitled:- "Vascular Surgery - Then and Now" He outlined the changes in surgical practice and in vascular surgery in particular over the last 30 years. Both surgeons and surgical practice had changed enormously during this period. Until the 70s, the archetypal surgeon was an imposing man who interacted very little with patients and whose practise was rarely scrutinised by his peers and press. As surgeons have become less aggressive and patient friendly, so has surgery. There has been rapid growth in the development of minimally invasive investigations and treatments for vascular disease. Sir Peter illustrated this with a discussion of Duplex scanning, subintimal angioplasty and endovascular aneurysm repair. These had resulted in an improvement in morbidity, mortality and limb salvage. Although some techniques required further assessment, he urged vascular trainees to learn such procedures, as they are likely to ultimately replace open surgery. He concluded by describing the surgeon of the future as an individual who was pleasant, communicated clearly with patients, was surgically competent in open and keyhole techniques, a specialist who could stand up to scrutiny and who was legally aware. An informal dinner was held prior to the meeting in honour of Sir Peter, at Chancellors Restaurant , where he was joined by members and guests of the Section.
A meeting of the Section of Surgery took place on Tuesday 11th February 2003 at 8.00 pm in Chancellors Conference Centre, University of Manchester. The President of the Section, Mr R W Nicholson, introduced the main speaker of the evening, Dr J A N Slade a general practitioner who served in the Royal Medical Army Corps as a helicopter pilot until 1997 and also saw action in the first Gulf War. In his lecture entitled "Safety is no accident" Dr Slade drew parallels between surgery and aviation. Similarities between fields include the fact that they attract the most able individuals and require a high level of practical skills, the reliance on teamwork and the catastrophic consequences of errors. The obvious differences are that aviation training can be performed to a high level by simulation, the mandatory continual assessment of skills and the fact that interactions between surgeon and patient. Also, whereas aircraft accidents are infrequent, of the order of 24 accidents per 7.5 million commercial departures, the incidence and consequences of serious medical errors is unknown. However 70% aviation disasters were due to human error, the commonest causes being fatigue, high physical and cognitive workload, poor interpersonal communication, flawed decision-making and system failure. He illustrated how almost all of these factors were implicated in the Kegworth disaster. He concluded by suggesting that although there are fundamental difference, medicine could learn from aviation by adopting a systems approach to avoiding errors, raising awareness of error inducing behaviour and developing sophisticated simulator-based training. After a lively question and answer session, Mr Nicholson thanked Dr Slade for his thought-provoking contribution and Mr Kiff gave a vote of thanks. Prior to the meeting an informal dinner was held at Chancellors Restaurant where a small group, including the speaker enjoyed a three-course meal.
A meeting of the Section of Surgery of the Manchester Medical Society, took place on Tuesday 11th March 2003 at 8.00 pm in Theatre 2 of the Medical School, University of Manchester. Mr R W Nicholson, President of the Section, chaired the meeting and introduced the speaker for the evening, Professor Sir Peter Morris (President of the Royal College of Surgeons of England) who gave a lecture entitled "Can the NHS be rescued?" Sir peter started by endorsing the ethos of the NHS and went on to describe how the NHS had been in steady decline over the last 15 years. He cited the under investment as the main reason illustrating this with comparative data on healthcare spending in other developed countries. The UL also had fewer nurses and doctors compared with many European countries. Outcomes in many areas, including cancer treatment and infant mortality are worse than Europe. In surgery the current problems were inadequate capacity, shortage of surgeons, increase in medical emergencies taking up surgical beds and the reorganisation of the NHS. He went on to consider how government spending was addressing some of these issues, and suggested various solutions. It was important to channel the new funds allocated to the NHS to the front line rather than funding the raft of regulatory bodies, some of which are of dubious value. There had been some improvements from the recent increase in funding, such as more critical care facilities but a lot more needs to be done. Ways need to be found to persuade existing surgeons to stay on longer, as the current average age of retirement of surgeon was 58. In conclusion, he felt that the NHS could be rescued, that the concept of the NHS remains worthy, that change is imperative but there must be less central control. There was a lively discussion following and Mr A Hargreaves gave a vote of thanks. An informal dinner was held prior to the lecture, in one of the private dining rooms at the University Refectory, when Sir Peter as joined by members and guests of the Section.
A meeting of the Section of Surgery, took place on Tuesday 8th April 2003 at 6.30 pm at Chancellors Conference Centre, University of Manchester. As with last year, the audience were given scorecards to evaluate the presentations. These were handed in at the end of the meeting and compared with the judges' decision. The President, Mr R W Nicholson, was in the chair and introduced the trainees along with the titles of their presentations as follows: - Mr I Virlos Dr R James Mr V Kaushik Miss P G Roy Mr Nicholson thanked all four presenters for the exceptional quality and standards of their presentations. He thanked the audience for their participation and announced that the winner would be declared during the meal following the lecture. After much deliberation amongst the judges, the cheque for £250 was awarded to Mr V Kaushik.
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MANCHESTER
MEDICAL SOCIETY
