What Have We Learned? What Next? - Panel Discussion, Medical Directors with Audience Participation, April 28, 2000

Michael Bagshaw, MD, Head of Medical Services, British Airways

DR. LIESE: So maybe I can start with Michael and ask him to start the discussion.

DR. BAGSHAW: Thank you very much. It's a great pleasure to be the honorary Brit on the panel, and I thank you for giving me this learned position.

I've thoroughly enjoyed the last two days, and I come from a unique viewpoint, really. I've been presented to you as an aviation physician. But I think it's important to realize that, as well as being an aviation physician, I also head up the occupational health services for a 65,000-employee corporation. And I've listened with great interest to what has been said and what has been presented, and so often I have nodded in agreement.

The lessons on this side of the Atlantic are no different, really, from the lessons on the far side of the Atlantic. And as we began with the psychological problems, I was interested to think that, in fact, the psychology and the psychiatric manifestations of travel stress is something we don't see. It's very dangerous for a head of a medical department to say never, but it is indeed something very rare.

The question of jet lag, of course, plays a very important place in our company, and I wondered, as I sat listening to the various presentations, whether indeed the physical signs, what we see as physiology, which is manifested in, shall we say, the effects of jet lag, are indeed the interplay between the physical and the psychological. And I take a view, as I'm sure we all do in this room, that well-being is a holistic thing. We cannot look at the physiology without the psychology or without the emotional and the spiritual.

And, of course, the biggest driver is what the individual shows to the outside world. What the individual really feels, what the individual is really thinking is driving what he or she wishes to present to his peers or her peers and to his or her superiors.

I think we mustn't lose sight of that fact that we're dealing with individuals. It's so easy to get down into statistics and to get down into trends and into analyses, but we're talking about people. And every person is different.

Without stealing the Chairman's thunder, I think the overview from my point of view is that we have these multi-strands. We have the overseas medical service. We have the travel health service. We have the pure occupational health service. And, of course, in my own business, we have the biggest group of constant travelers, 14,500 cabin crew, 3,500 flight crew, who spend their lives traveling on duty. And as I said in an aside in my presentation two days ago, the family problems that we see bear out some of the things that have been raised.

So perhaps when I say we don't have psychological problems, perhaps they come up in other ways; they're not presented as psychological morbidity or pathology. But there are stresses and there are functional disorders.

And I think the challenge and the way forward is how we indeed draw together all these strands. How do we bring together the psychology, the physiology, the spiritual, the emotional, the support? Who pays? Whose budget pays for the repatriation? Is it my budget, or is it his budget? And that's a constant problem within the corporate thing.

And I would finish by saying that I'm very fortunate. In the British Airways, we have the unique structure that the Director of Health Services reports direct to the chief executive, so there's nobody in the way. We're kept separate. We're not part of personnel. We're not part of legal. We're not part of safety, even. We stand alone and that's a unique situation.

You may know that we've just appointed a new chief executive, and next year I might not be here because I'll have been touting my C.V. around. But I hope to go back to a continuing situation where health services is seen in British Airways as a prime independent supporter.

And I was quite surprised at some of the questions asked when people were in the forum in the other room yesterday, where people were talking about staff not wanting to come to the occupational health service. We don't suffer that problem, and I think we're very fortunate, and I'm grateful.

Thank you very much for the insight. Thank you very much for giving me as much to think about as I've told you, and I look forward to participating in the discussion over the next hour. Thank you very much.

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