Disability: Doctor felt shunned by hospitals in Wales

Hospitals in Wales "didn't want to know" about the additional needs of disabled staff, according to a doctor who was looking for work after being paralysed in a car crash.

"They wanted someone that could easily and quickly fill the post without them having to do anything," said Georgina Budd, who qualified as an A&E medic.

She ended up becoming a GP at a surgery that could accommodate her needs.

Health boards said they were committed to creating inclusive environments.

"There shouldn't be a limit because of my disability," said Dr Budd, known as Georgie, who spent three years as a clinical fellow in the A&E department at Glangwili Hospital in Carmarthenshire as part of her medical training.

"I've been in situations where I've had to deal with a medical emergency and I'm no less effective for being in the wheelchair."

But when the time came to find a full-time job, she said she faced barriers.

"I've had colleagues say: 'You're going to need to think about your career and how you tailor it to your disability'," said Georgie.

"I shouldn't have to. I should be able to work in the specialty that I want to."

Georgie said for one job application, a hospital asked her to do an unpaid "trial shift".

"It was all dressed up in language of 'so we can see how we can help you'," she said.

"What really came across was 'so we can see how many adjustments you would need so we can see if it's financially viable for us to change things around for you'."

She added: "You would think that hospitals are set up for disabled people because they are a big part of our service, but they're not".

Most hospital cupboards are out of a reach for a wheelchair user, she explained, and some buildings were still inaccessible.

"Life has been built around able-bodied people. It is not built for me and it's not built for the rest of the disabled community," she said.

Working hours is another barrier.

"It does take me a longer time to get ready and out of the house in the mornings," she said.

"Without getting up at a ridiculous hour, I might not be able to be on shift at 8am like some doctors.

"That was a problem at first because ward rounds happen in the morning.

"We are looking for reasonable adjustments, but it's very difficult to get those changes made and to get people thinking differently about disability and about a disabled doctor."

Originally from Downton in Wiltshire, Georgie started at Cardiff Medical School in 2009.

On her way to a shift at Glangwili Hospital in 2017, she lost control after a tyre on her car punctured. To avoid oncoming traffic, she swerved into a pole at 50mph (80km/h).

At the age of 30 she was paralysed from the waist down and she thought her career was over.

But she fought to complete her doctor training.

"It is not the end of the world. It's hard and there are challenges, but I kept telling myself 'my life isn't over'," she said.

She recalled her first time seeing a patient as a doctor in wheelchair: "She looked at me and... was like, 'oh, hello, love. Are you one of the patients?'

"'No, I'm your doctor today'."

Georgie completed her doctor training at Glangwili Hospital in August and was offered a job.

But after failing to find an emergency care role at other hospitals she changed her specialty and is now a general practice trainee.

Working as a GP at Tŷ Calon Lân surgery in Mountain Ash, Rhondda Cynon Taf, means more sociable hours and more flexibility.

Her typical day starts with a carer coming to her home in Merthyr Tydfil at around 8am.

"I could probably just about do it myself... but I was slipping because I was so exhausted," she said.

"Having [a carer] in just sort of makes the morning run smoother, allowing me to conserve my energy and put it into things that I really want to do."

She is co-chairwoman for junior doctors at the British Medical Association in Wales, and is currently doing research with Swansea University on the mental health needs of medical students.

"GP gives me the opportunity to be more active in medical politics and in research and still see my patients and have a good impact on them," she said.

She said it also gives her time to advocate for disabled people, including as chairwoman trustee at Adapt Gateway, a mentoring and support charity for people with disabilities.

"In an ideal world any child that wanted to grow up to be a doctor and had a disability wouldn't feel that's off limits to them," she said.

That would require a "perspective change in society" she said.

"It's understanding that disability isn't inability," she said. "Being in a wheelchair doesn't limit my ability as a doctor."

She said she wants to see full accessibility as the standard in all health buildings so no-one feels left out.

"I want more disabled kids to know that this kind of opportunity is open to them," she said.

"That it doesn't matter if their legs don't work. I know a consultant who's got one arm... he still takes blood and is an effective doctor and why shouldn't he be?"

"A lot of what a doctor does is up here," she added, touching her temple.

"I've put chest drains in, I've sutured people... all kinds of crazy stuff.

"I adapt it for me but I can still do it. It's just doing it a different way."

Georgie spent months in hospital recovering from her accident, an experience she said gives her more empathy for her patients.

"I think that knowledge is something that can really help the medical community," she said.

"Having more doctors that have gone through poor health experiences, chronic illness, disability is important to widening doctors' understanding of what their patients are going through."

She said more understanding of disability was needed in society more generally, recalling upsetting comments she overheard after her friends had to carry her into a non-accessible café.

"We were sat there and this young woman said really loudly: 'Why would she even come here, it's clearly not disabled accessible. Does she not realise that she's just a nuisance'."

Comments like that could be "hard", Georgie admitted, but said they made her more determined to "normalise" disability.

"I can spend the next 60 years miserable because I can't stand up, or I can do something about this," she said.

Several health boards in Wales said they follow an all-Wales recruitment process designed to ensure "fair and equal opportunities for all" and that disabled candidates who meet the minimum standard were guaranteed an interview.

"Only when shortlisting is complete will a candidate's self-declaration [of a disability] be visible, alerting the appointing manager that reasonable adjustments may be required," said Lisa Gostling, from Hywel Dda health board.

Aneurin Bevan health board said it offered disabled staff access to work assessments, aiming to "create an inclusive environment for our staff and patients".

Powys health board said "tailored adjustments will be made, where possible, to roles and/or workplaces through discussion between the manager and the employee".

Betsi Cadwaladr heath board said it "welcomes applications from individuals with disabilities and value all staff".

Cwm Taf Morgannwg health board said it had launched a new initiative allowing "disabled staff to record and share details of any reasonable adjustments they need at work.

"We have also developed guidance for managers so that they can better understand how to support disabled colleagues."

Swansea Bay health board said it "actively welcomes applications from people with disabilities", all disabled applicants who meet essential criteria will be invited to interviews, and current staff "with specific requirements can discuss them with their manager so that reasonable and practical measures can be taken".

Cardiff and Vale University health board said its "recruitment processes offer a fair and open approach to all applicants".

A Welsh government spokesperson said it expected "all NHS organisations to comply with the Equality Act 2010, and to follow best practice regarding the recruitment and retention of staff".