Dr Peter Horrocks

He’s just come in fresh and a apologetic from a meeting about infection control - of which more later - to be greeted by Warwick Hospital press officer Olivia Shaw. She sits next to him for the duration of our hour-long chat and presents him with a briefing note, listing the good, positive things to tell me about the hospital.

It’s a mite odd, because he seems to be intimately involved in almost every aspect of its operation. His role as medical director means he is a key boardroom figure, responsible for the appointment and discipline of consultants, responsible for patient confidentiality, responsible for analysing data, jointly responsible for clinical governance, responsible for handling complaints and responsible for controlling infections. He is responsible enough, one would assume, to look after himself. Trust him - he’s a doctor.

In all fairness, Olivia’s involvement in the actual interview is minimal, save for a notable interjection about how few complaints the hospital receives and copious note-taking. She wisely leaves the talking to him, a likeable 57-year-old of considerable presence. But he hopes being so senior has not meant he has lost sight of the individual patients.

He said: “I like to think I’m helping more people. As you move up the medical ladder, your horizons and your concepts of quality of care change. That’s what interests me - I like to think I’m improving the quality of care for a wider and wider population.

“That’s the spur. Most people go into medicine because they want to help people, but as you get more senior you get to help a wider spectrum of people.

“I still do outpatients and I’m still faced with the patient in front of me too, and I still get a buzz out of that. But I get a buzz out of handling and solving a complaint. I used not to like it, but as you get more expert at it you find similar satisfaction to treating a patient.”

It’s been a mixed month for the hospital. Inspectors last week gave it a maximum three-star rating - the first in its history, and a dramatic improvement on the zero-star rating it was ‘awarded’ just two years previously. But another list of figures and targets ranked it the 12th worst hospital trust out of 108 in the country for its rate of MRSA, the potentially lethal bacteria resistant, it seems, to everything except soap and water. on one’s hands.

Dr Horrocks said: “We collect quite a bit of information about MRSA. You can pick up an MRSA a bug on a swab or by collecting fluid from somewhere or by taking a blood sample.

“What’s been announced this month are the MRSAs on blood samples, which is a small area of the problem. If we look at our MRSA cultures over the last three years, there’s a slight undulation, but there’s no definite trend upwards. So the total number of cultures is staying the same, but what’s changed is that last year we had 18 blood cultures that tested positive, and this year we had 37. For a trust this size, that’s a relatively small number anyway.

“I think 18 was a lucky year, and probably less than we’d expect. So we’ve gone from a tiny amount to a small amount, but nevertheless the Strategic Health Authority is concerned about that. It’s a worry, but you can’t say two points is a trend. We need to see what’s happening over a period of time.

“It’s not just my responsibility - it’s every single doctor and nurse’s responsibility in the hospital. It needs simple things like washing your hands between each patient. It hasn’t been absolutely standard practice - I’m sure if a nurse is changing a dressing, then yes, she’d wear gloves and wash her hands before and afterwards. That’s very standard. But if I’m just walking around from person to person, and lay a hand on one person’s abdomen and then go an listen to another person’s chest, it hasn’t been absolutely standard practice. But it is now, and each note trolley now has a bottle of antiseptic gel. We’ve reduced the MRSA rate on the intensive care unit quite dramatically, simply by putting in place those procedures.

“If people don’t wash their hands, it’s laziness. Our bed occupancy is running close to 100 per cent. It’s probably safer if we ran at 85 per cent, because you’re not so stretched and you don’t cut corners so much.

But there’s always a balance between the Department of Health targets on one hand and quality on the other. The perception is that the harder you push for targets, the lower the quality goes. Part of my job is getting that balance right, and making sure that even if you do it faster, you do it in a safe way. But there is a tension, and it is an interesting dilemma.”

Peter’s main medical interest is in diabetes. It’s a condition much in the news at present, amid the media furore about the nation’s expanding waistlines. But it is something that has interested the doctor throughout his career.

He said: “I like to think of myself as a general physician. There’s a lot of specialisation these days, and the theory is you provide better care if you specialise in a smaller area. But if I’m a physician in here at midnight, I have to cope with anything that comes through the door.

“Diabetes encompasses a huge amount of general medicine. People with diabetes have eye problems, nerve problems, kidney problems, strokes, heart attacks and infections. I like it because it’s a huge broad spectrum of different abnormalities.

“And it’s certainly on the rise. Late onset diabetes is increasing at a tremendous rate, and what’s worrying is that it’s starting at younger and younger ages. We’re getting teenagers with it now.

“It’s down to being overweight and doing less exercise. They’re closing playing fields at schools left, right and centre, and that’s not good. We need to throw away the remote control for the video and television and get up and change it.

“In the States, the incidence of obesity is about 49 per cent. We’re not there yet, but we’re rapidly increasing - we’re about 20 per cent. You’re more likely to get diabetes, have high blood pressure, have high cholesterol, and more likely therefore to have heart attacks and strokes, and you’re more likely to get chest problems. It has huge implications for health.”

With such weight on his shoulders, it is unsurprising Peter relishes what free time he has, with interests include classical music, photography, wood turning and furniture-making.

He said: “You have to live a varied life, otherwise you’d go mad.

“I live about 25 minutes from the hospital, in Welford-on-Avon. The drive is a chance to switch off. -it’s essential to do that. The problem is I usually don’t get home until 8pm, and I get in for work between 8am and 8.30pm. It’s all day. You sit down and have something to eat, and you nod off, and the work you’ve taken home doesn’t get done. You need something to take your mind off it.

“I find wood turning is very therapeutic, and standing at the lathe watching the shavings coming off is really good. It’s relatively mindless - you don’t have to struggle with concepts. It’s a time when I can switch off and thinking about what I’m doing in life - I don’t have to think about having to write a report by 5 o’clock or see someone to sort out their behaviour.

“We haven’t bought many bits of furniture in our house. I thought I would make the chairman a proper gavel so he can control the board meetings better.”

Another of Dr Horrocks’s extra-curricular activities involves being secretary of Stratford Churches Together. It transpires his faith has been a key reason for the path he has taken in life.

He said: “I was brought up in a Christian tradition by my parents, and I’ve always regarded myself as a committed Christian. it is a motivating factor, and it also produces some ethical dilemmas. It is very important to treat individuals as individuals, whereas in this job I’m looking at the organisation as a whole.

“At one stage in my life, I was going to be an obstetrician. I started doing obstetrics and gynaecology, and the I changed because of the ethical reasons of not wanting to do any more terminations of pregnancies. I got out of that because at that stage it was expected that you’d do terminations. It’s very difficult - you get sucked into these things. It’s a routine, and you’re expected to do them. Doing a termination of a pregnancy is not a complicated procedure. I eventually realised I’d been sucked into this and I didn’t really want to do it. I decided the best thing was to get out, so I went into medicine. It’s changed the direction of my career.”

And in this age of patient choice, Dr Horrocks does the future of the hospital being called into question.

He said: “This hospital has a very secure future. I don’t see it being closed or merged with the Walsgrave at all. There’s always a slight paranoia about the Walsgrave, but I don’t see it.

“Our future depends on quality of care. If we don’t provide a good service, we’re doomed. Patients need to want to come here. If you don’t provide a good environment or service, they won’t come.”

And, with that, Dr Peter M Horrocks MB B.Chir MD MRCP is off and away. He thought on his feet throughout. Olivia needn’t have worried.