Palliative care pioneer takes up BMA presidency

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“You’ve always wanted to change things, so here’s your chance.” This is how BMA president Baroness Ilora Finlay was encouraged to apply to the Lords by her husband.

It was a fitting invite for someone who has changed and improved healthcare — although her modesty forbids her from taking the credit.

“That was all by chance really,” she explains. “There was an advert in the newspapers for people to apply to the new appointments commission under phase one of the Lords reforms in 2001.

“My husband saw it and gave it to me as a bit of a challenge.

“I filled out the forms and applied. I was delighted when I got on the long list, then I couldn’t believe it when I made the shortlist.

Double take

“When it was announced, I was in such disbelief I phoned up the appointments commission that morning, when it was on TV, to check they hadn’t cut and pasted the wrong name.

“That was in 2001 and it has been fantastic. It’s been very hard work, but I love hard work.

“I feel that I must do it to the best of my ability because it is such a privilege to be there. It is wonderful to be able to change things.”

A professor of palliative care at Cardiff University, Baroness Finlay’s ‘mosaic career’ saw her start off in anaesthetics, paediatrics and general practice.

After a stint in anaesthetics, paediatrics called and it was here she managed to show her forward thinking with regard to healthcare services.

She recalls: “I went for a job interview, which I’ll never forget. They asked me how did I see my career direction going and I said I wanted to run paediatrics intensive care and set one up.

“There weren’t any then. There was neonatal intensive care, but there were none specifically in paediatrics. Both the people interviewing me were paediatricians and they laughed, saying “that will never happen”, but of course paediatric intensive care has rightly developed. That was around 1974.”

The finer things

Her own children followed — “the best thing in my life that has happened to me” — as well as a stint as a GP in Scotland and a year in the USA before returning to her adopted home of Cardiff to establish a hospice service.

She says: “I applied for the job and I got it. I was asked whether I would accept it without consultant status and, even though I desperately wanted the job, I said “no” because I knew that if I was going to have an influence, I had to have consultant status.

“After much discussion it was decided that I did deserve honorary consultant status and I became a consultant. That actually opened the door for others who were working in hospices up and down the UK who were from general practice to apply and get consultant status.

“I was then involved in the specialty becoming recognised and that happened in 1987. Palliative medicine was what it was finally called.

“I’ve always had the philosophy that if we could improve care of people who were terminally ill in the Cardiff area we could ripple the pond effect out across Wales and then more widely. If Wales was an exemplar of good care we could change the world.”

Home from home

Despite being born in “boring outer London”, she is proud to call Wales her home — something reflected in her title, Baroness Finlay of Llandaff.

“I think I’ve been very privileged to work in Wales and I’ve had a great deal of support from colleagues — in particular a previous professor of general practice, Nigel Stott.

“He was an amazing mentor to me through all those early days and he could see what I was doing and encouraged and supported me.”

It is fair to say the Baroness is forward-thinking when it comes to healthcare.

In 2003 she proposed a bill to ban smoking in public buildings in Wales, three years before it was implemented.

Opting out

In 2007 she introduced a private members bill seeking to change the current system of organ donation from ‘opt in’ to ‘opt out’. The latter, however, ran out of parliamentary time to succeed.

Earlier this year, she was strongly involved in a debate which gave a new momentum to protecting children from breathing second-hand smoke in cars.

Following the success of an amendment to the Children and Families Bill in the Lords, a free vote in the Commons gave governments in England and Wales the power to regulate against smoking in private vehicles when under-18s were present.

A proud mother of two and grandmother of two, Baroness Finlay says she will use her role as BMA president to try and boost morale among doctors, who she praised as natural leaders.

She said: “I think doctors are having a pretty tough time of it at the moment. One of my important roles is to help them have a sense of reality and a sense of proportion and also to remember that, at the end of the day, the one standard that really matters is: is it good enough for my relatives?

“We have to be brave and stand up for quality and standards.”

This article was first published on BMA News.

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