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“Island Medics” Gets to the Heart of Health Care

by Alastair Hamilton -

For two weeks and over ten episodes, beginning on Monday 4 December, BBC1 viewers across the UK were given an intimate insight into the wide-ranging work of Shetland’s Gilbert Bain Hospital and the other healthcare services in the islands.

However – as became clear in the first episode – the Gilbert Bain isn’t just a hospital for the 23,000 people who live in Shetland. It’s also the first medical port of call for the North Sea oil and fishing industries. What’s more, its cheerful staff care for any of the thousands of visitors who arrive in Shetland every year, including those on the many cruise liners that call at Lerwick in the summer.

That means that the hospital has to be equipped and staffed to deal with every eventuality, from a sprained knee or a splinter in a finger to the most serious injuries arising from accidents on- or offshore. The most complex cases are transferred by air ambulance to Aberdeen and in one episode, nurse Emma Williamson was seen accompanying a patient on the journey.

the Gilbert Bain isn’t just a hospital for the 23,000 people who live in Shetland

In fact, a fair proportion of A&E patients arrive in Lerwick by Coastguard helicopter, often from oil installations or fishing vessels, but occasionally from remoter parts of Shetland. The RNLI lifeboats based at Lerwick and Aith, a village on the west side of Shetland, also play a vital part in rescue missions. One of the themes of the series was the way in which these services work together efficiently to cope with whatever emergencies arise.

Although the programmes focused particularly on the accident and emergency service, viewers also saw other parts of the hospital, including the maternity unit and general surgery. The film crew had also followed the work of GPs across the islands, for example at Hillswick in the north mainland, where Dr Susan Bowie tends to a scattered rural community.

NHS Shetland is keen to attract doctors to work in Shetland and, at many points in the series, the benefits of serving in the islands were made clear. One challenge is that so many doctors and surgeons specialise very early in their careers, whereas what Shetland healthcare tends to require are those who relish the prospect of a very varied workload and can care for people who present with a very wide range of symptoms. In the Gilbert Bain Hospital, doctors and nurses who have yet to complete their training can gain a wide range of experience, guided and mentored by senior staff. All of this, as became obvious, takes place in a hospital environment that’s welcoming, friendly and leavened by gentle good humour.

There are attractions in rural practices, too, apart from the appeal of living in one of the most beautiful parts of the UK. Rural GPs can expect to get to know their patients really well and, what’s more, will typically have more time to listen to them and understand their needs than someone in a highly-pressured urban setting

a hospital environment that’s welcoming, friendly and leavened by gentle good humour

Not all the patients featured in the series were human. Viewers had a glimpse of another of the islands’ emergency services, the Hillswick Wildlife Sanctuary, based just along the road from Dr Bowie’s Hillswick surgery. Pete and Jan Bevington have been rescuing and caring for a variety of sea creatures for three decades and, in one episode, we saw them co-ordinating efforts to persuade a pilot whale to move back into the open sea rather than risk stranding in the shallows of Vidlin Voe.

Indeed, the islands’ wildlife is one of the reasons people find life in Shetland so rewarding, with sightings of seals routine and occasional opportunities to see otters, whales and porpoises, not to mention outstanding seabird colonies and spring and autumn migrants. It’s no accident that several Shetland doctors – beginning with Laurence Edmondston senior, who practised in Unst nearly 250 years ago – have become expert observers and recorders of the natural world.

Thus, the appeal of Shetland goes far beyond the job. As the narration by Kevin Whately put it, “Shetland is a giant outdoor playground, with wild, stunning nature on the doorstep, offering a childhood like no other. It’s a place for getting outside and seeking adventure”.

Dr Kushik Lalla, a South African who has settled in Shetland, is the senior A&E and surgery doctor at the hospital and featured throughout the series. He says:

“I was absolutely amazed the first time I got to Shetland. The community’s very close-knit, a fantastic place for kids. It’s a safe place, you get them out, you get them active…you’ll find little kids wearing their welly-boots, playing in little lochs and streams.”

Those qualities were obvious in the programmes. Dr Lalla’s son was shown scoring goals for his football team and there were scenes from other aspects of island life, including a festival in the northernmost island, Unst. We also saw some great photography of Shetland’s landscapes and seascapes.

a fantastic place for kids

There are great indoor facilities, too. There are no fewer than eight modern swimming pools, along with other sports facilities, around the islands. In Lerwick, an arts centre offers a concert hall and two cinemas showing current and classic films. Events such as the huge fire festival of Up Helly Aa and the Shetland Folk Festival are known world-wide.

The series producer, Tom Cara of Red Sky Productions, also liked what he saw in the islands, praising Shetlanders in an article for Broadcast for being not only hardy but “incredibly welcoming, too”. What’s more, although there were some quiet spells in A&E, he said it had been “extremely impressive seeing a small team manage four serious cases simultaneously”.

extremely impressive seeing a small team manage four serious cases simultaneously

The series, consisting of ten 45-minute episodes, is currently available on the BBC iPlayer, though – as with most programmes on that platform – the number of days left to watch is reducing and the last episode will expire on 10 January.

Red Sky can count Island Medics as a success and they deserve great credit for developing and pursuing the project in the way they did. As Tom Cara explained in the Broadcast article, they spent their first week getting to know the hospital, explaining their task to staff and building trust, rather than doing any filming. That sensitivity allowed them to capture the spirit of the hospital, and indeed of Shetland.

NHS Shetland hopes that the interest generated by the programme will translate into applications for jobs and the early signs seem encouraging, with some enquiries already received. If you – or someone you know – would like to know more about the opportunities, we have a page dedicated to the Island Medics series, which has links to current NHS jobs and a way of registering your interest.

Tom Cara should have the last word. “The nurses in Shetland,” he told Broadcast, “are fantastic bakers – we all put on about a stone in weight.”

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