Abstract
This is a series on the working lives of medical professionals. Please e-mail any suggestions or comments to
Ilora Finlay is a Professor of Palliative Medicine and has worked with Marie Curie Cancer Care since 1987. She was Vice Dean in the School of Medicine, Cardiff University between August 2000 and October 2005.
Professor Finlay is the immediate past-President at the Royal Society of Medicine.
She was a member of the Expert Advisory Committee on Cancers to the Chief Medical Officers of England and Wales, producing the ‘Calman Hine’ report in 1995. She currently chairs the implementation board for the palliative care strategy in Wales.
Since her elevation to a Peerage in 2001, she has been actively involved in debates on health issues, particularly relating to Health and Tobacco. She is a Member of the Select Committees on Science and Technology, and recently on the Assisted Dying for the Terminally Ill Bill.
She is President of the Association of Chartered Physiotherapists, MS Cymru and Patron of Shalom Hospice, Wales. She was Welsh Woman of the Year 1996–1997 and has held Visiting Professorships at Gröningen University (Johanna Bijtel Chair) and University of Melbourne.
She has published and lectured widely on palliative care, and researched into aspects of cancer palliative care. She established the internationally renowned Diploma/MSc distance learning courses in palliative care at Cardiff University, from which over 1500 senior clinicians worldwide have graduated.
1. Please outline your typical working day
Perhaps the most typical thing about my working day is that no two days are ever the same. In fact I cannot recall a day that started out and finished as I expected it would. As my work in Cardiff is based from Velindre hospital, my office there and my colleagues in the team provide a sanctuary of safety and friendship. They are amazingly loyal, patient and kind. They recognize that my working days are somewhat frenetic and they are supportive; indeed I try to always be available for them if a problem arises.
I still participate in the on-call rota. When on call, each consultant covers South East Wales, a population of 1.5 million, with one large and three smaller hospice inpatient units and eight hospitals. Much of the work involves giving advice to other professionals on patient care, but complex clinical problems can absorb much of the weekend in hands-on care at times. It has been interesting to see the change in calls over the years now that an increasing number of medical graduates have had palliative care as part of their undergraduate experience and the hospital has access to a palliative care team, although in some hospitals the team is still somewhat rudimentary.
Since the Minister, Edwina Hart, asked me to implement the palliative care strategy in Wales, my work has changed. I have much less clinical responsibility than before as the administrative and strategic planning roles have expanded greatly. The challenge has been to work out how to achieve the fair distribution of specialist palliative care services across Wales, identify the levers for change and then pull these levers to move service provision to be more patient-focused and accessible.
The strategy was welcomed across Wales and the vast majority of voluntary sector and NHS palliative care service providers have embraced change and are really moving their service to provide the best of modern palliative care. An increase in consultants in Wales has probably been the single most important factor in providing an evidence-based approach in the leadership of services.
On top of this though is my work in the House of Lords. That involves using the train between Cardiff and London as an office, having a lightweight laptop, and not minding if the train is late! To date I have always got a seat, which is essential if one is to work for the full two hours.
The overlap of these very different jobs is greater than one might think. In Parliament, my participation in the Select Committee that looked at a Bill on Assisted Dying has resulted in my increasing conviction that physician-assisted suicide will be dangerous for patient care. I also have become increasingly convinced that it would detract physicians from their core role with patients, as foreshortening life can become an expedient when faced with problems that appear intractable.
2. One aspect of work you most look forward to each day
Having colleagues with whom I have a good rapport and enjoy working is the high spot of all my work. For me, it is the people I interact with who bring richness to each day. Ilora Finlay
3. One aspect of work you least look forward to each day
E-mails!! They must be the biggest time waster for the NHS. I dread to think how much time each day is now taken up by staff sitting in front of a computer reading e-mails. And how much does that cost the National Purse? The change has been insidious, but it has corroded clinical time, eroded face-to-face contact with colleagues and has depersonalized whole teams.
4. A person who has inspired you most at work (past or present)
My major external influence has been Cicely Saunders who started the whole modern hospice movement. But the other person has been my own father whose gentle demeanour with staff and students, and discrete acts of kindness have set principles I try to follow.
5. The most significant achievement of your career
I hope that when I retire I will have taken Wales from being a place almost devoid of any hospice care to a country that will inspire the rest of the world by having an equitable distribution of specialist services, working seven days a week, to ensure that every patient in need has appropriate care whichever bed they are in.
In my Parliamentary role it will be the push my Bill gave to banning smoking in public places and driving forward preferential (directed) donation of organs (coming in this summer).
6. List your reasons for choosing this career
I was attracted to the developing field – as it was then – of terminal care because I was so angry at the terrible absence of services for those who were dying.
7. Alternative career (in another lifetime)
Within medicine I might have tried to do surgery. Outside medicine I have always been attracted to hairdressing.
8. Non-medical book(s) you are currently reading
Obama's Dreams of my Father. This moving book must be essential reading if one is to understand how the politics of the USA unfold over the next3.5 years.
9. Song(s)/piece(s) of music you are currently listening to
I am a real softie for Aled Jones' voice, and have enjoyed the Carole King revival recently. But as my daughter is a bassoonist, nothing can equal a good bassoon solo!
10. How do you wind down at the end of the working day?
I crawl into bed and sleep! My time-out used to be shopping, but now it is looking after my adorable grandsons.