WORK-LIFE BALANCE POLICIES OF THE TRUST (Audio started 00:01:05) Gratien David: Thank you Gordon for your

time. Gordon Mazibrada: No problem here. Gratien David: I knew your job title. Which department do you work for? Gordon Mazibrada: Thats Neurology. Gratien David: Neurology, okay. Gordon Mazibrada: Yeah. Gratien David: And how long had you worked at the trust? Gordon Mazibrada: Well, at this trust, since 2003. Gratien David: Okay. Gordon Mazibrada: I became a consultant in 2006. Gratien David: Okay. Gordon Mazibrada: Prior to that, I was registrant. Yeah. Gratien David: Okay. And how many people report to you directly? Gordon Mazibrada: Well, theres a team of SPRs so how many -- it depends, five, six, seven -- depending how many at reserve at a given time plus three or four essentials... Gratien David: Okay. Gordon Mazibrada: Plus the nurses, we have three specialist nurses -- MS Specialist nurses who report to me. Gratien David: Okay. And so are you -- how many hours do you work in a week? Gordon Mazibrada: Well, same as other guys so. Its just -- I suspect they work -well, its nine to five, thats what -- 40 hours, probably more than 50 hours. Gratien David: More than 50 hours?

Gordon Mazibrada: yeah definitely because you know -- Every day I stay longer I work at the (Inaudible) (00:01:13) as well. Gratien David: Okay. Gordon Mazibrada: Plus the travelling time. So its more than 50 hours. Gratien David: Okay. Gordon Mazibrada: Yeah. Gratien David: And do you work Monday to Friday or is it a 24/7 -Gordon Mazibrada: Yes, Monday to Friday, yeah. Gratien David: Okay, great. Gordon Mazibrada: Im on call. Its a -- 24 hour on call from home, and thats three times a year for a week. Gratien David: Okay. Gordon Mazibrada: Yeah. Gratien David: Are you personally making use of any flexible working options about trust? Gordon Mazibrada: Id love the possibility of a flexible working option simply because of the work load. Gratien David: Okay. Gordon Mazibrada: Yeah. Gratien David: So what time do you normally start on working? Gordon Mazibrada: Well, I come here at nine and then -- and thats - what else, -- Six, you know, On Wednesday have to stay longer but its -- apart from Friday, I tend to leave at five thirtyish there about... Gratien David: Okay. Gordon Mazibrada: Thursday, Im not working here anyway. Tuesday, I work longer hours with hope (ph), this was my second rounds with them.

Gratien David: Okay. Gordon Mazibrada: Monday I stay longer here -- Wednesday I stay longer here. Gratien David: Okay. Gordon Mazibrada: And moving on to your view on work-life balance. Balance means different to different people. Gratien David: Yeah. Gordon Mazibrada: What is your understanding of balance -- of work-life balance? Gratien David: Well, I dont think I would clear understanding what that is, you see. Gordon Mazibrada: Right. Gratien David: So I think my impression is that we work too much. I think in terms of a -- I mean, for example, if we look at the number of neurologists per population, there is around 170, 108 thousand people on one neurologist. If you go to Europe, the numbers are much lower like for example, in anytime would be (ph), one in thirty or forty thousand, so hence the workload is much higher for us. Second thing is I have a special interest in AMS. MS chronic condition, not many people look up to, but you know, from the neurologist point of view look like people of conditions (ph) have interest in them, so therefore the workload is increasing their chronic pressure that often come back to -- with the various complaints, that there are relapse, they had attacks of MS (ph) and -- So I think the workload is very -- very severe Gordon Mazibrada: Okay. And so do you have people -- was that of work of flexible working options are available in your department? Gratien David: I know that are very plenty of options -- I mean there are presumably if you go part-time but then not much work will presumably affect your salary. At the end of the day you have the sudden population inflations (ph) you have to look after. So I dont see how Gordon Mazibrada: Okay. So everybody in your department work Monday to Friday, nine to five? Gordon Mazibrada: I mean, there are -- all the consultants fulltime so Gratien David: Okay. How about the nurses, essentials Gordon Mazibrada: I think there as far as this wellness nurse (ph) which is -- shes part-time here, part-time in the university. I cant tell you about the registry. Right with this trust, again, the current log. Everybodys working fulltime in this -- well I think I

met some individual who are part-time and a few consultants in the region who are parttime. Gratien David: Okay. Gordon Mazibrada: But nothing this much so Gratien David: Okay. And so nobody has come to you asking, Can I work part-time? or Can I Gordon Mazibrada: Nobody is. Nobody is asking. Gratien David: Nobody is asking, but can I work flexible hours, start early, finish early or start late, finish late, nobody? Gordon Mazibrada: No, I think the nurses though start a little earlier with than us, theyre the big role model here and MS specialist nurses. Gratien David: Okay. Gordon Mazibrada: Now, on certain days they stay longer, I think one day a week they stay longer each one of them, but I think they start at eight and finish at four, sometime. Gratien David: Okay. So do they normally ask you with -Gordon Mazibrada: Not me. Not me. Thats the consideration before I came so -- Its a long term arrangement. Gratien David: Okay. Gordon Mazibrada: Yeah. Gratien David: And is that affecting your service? Gordon Mazibrada: No. Gratien David: Provision, no? Gordon Mazibrada: No. Gratien David: So youre happy with the arrangement? Gordon Mazibrada: Yeah. Im happy with that. Gratien David: Okay. Because I understand there is about more than 1500 different shift patterns in the trust.

Gordon Mazibrada: Im not sure. Probably -- and obviously nurses on the rote. They work (Inaudible) (00:05:49) rarer shifts I cannot comment on that, really. Gratien David: Okay. And to what extent do you think people having flexibility in your department will help you to run the department successfully? Gordon Mazibrada: I dont think it will help I think you need more people so you can then -- if I had help one or two colleagues, Ill perhaps consider working flexibly or less. But then you know, that problem affects my salary so -- But in terms of the work hour, theyve been -- it has to do with working on so Yeah, so make it rule[ph]. If wed work in real life you know, Im not sure how will that work. Gratien David: Okay. Because if you still work flexibly, without reducing your hours it wont affect your salary, like probably starting early and finishing early still keeping the same hours. Gordon Mazibrada: I dont think, you know, if she, you know, in terms of consultants, let me just increase work. You know, Im working fast work you know, so I dont think Id be better if I come at 8 oclock instead of nine. Gratien David: Okay. Gordon Mazibrada: And then finish at four. I would now finish at four; I think Ill carry on doing it until Im finished. And see whatever comes its no longer day or night. For example, I might as well send like 40 plus emails at least, which means that theyll probably read around 40 emails those safe to emails (ph) not just emails per se so Gratien David: So mostly the consultants like you, you dont have a good work-life balance. Its always work, work, work life. Gordon Mazibrada: That makes me who I am. Gratien David: Okay. And so, how do you think -- so -- do you think it would be good for you to have some sort of flexibility because you know at the end of the day, youre a human being? Gordon Mazibrada: Well, Im sure, you know. I think Ive been more than that -- Im mostly bothered but I think it will happen. I mean, now that theyll even ask you to -When we go on holidays, then our clinics are cancelled. Yeah, so it was a round for two or three weeks, then when they cancel the clinics, -- Now what I do now, theyre asking me to see those patients as an extra. You see, so that is not paid extra to me and the comment is that my patients the chronic patients that I have sorted out. So you go ahead and leave, you see for a few weeks, essentially dredging the small work, in the sense that I have to catch up with the work Ive left you know, or havent done over that period of time.

Gratien David: Have you been able to talk about these to your superiors? Gordon Mazibrada: Oh yeah -- we did speak on several occasions but its just that -you know. They response and answer them but Gratien David: No, no solutions were worked out. Gordon Mazibrada: No, no solutions. In anyway, you can understand that, you know so tell me hes coming to see you and then he misses that appointment just because you will leave where youre going to a conference. Yet have to see that patient somewhere, you know, at some point you know, so in a way, it is your responsibility but hey youre not advised to plan to give them, you know and no extra pay is derived for that. You know. Gratien David: So do you think this affects your productivity or your commitment and because Gordon Mazibrada: No, I dont think it affected my productivity that says that I have to work harder, you see. But Im sure over the years that their attitudes are for everybody will change to the sense that youve started very enthusiastic and very keen and then you expect to see the consultants make it, you know, speak to them. You know, that kind of goes down because its, its just constant and a constant work and the high pressure and the -- you know, long hours of session. Gratien David: So Gordon Mazibrada: I dont think -- I mean we are able to pay for that. Thank you. If you think (inaudible 00:10:05-00:10:10:05) you know. But you know, if you compare it to some GPs, some in GPs then that would then cost our consultants work. We have to believe and work they work less than us definitely too -- and. Gratien David: And so do you think that in the long run, therell be lot of burned-out -of consultants? Gordon Mazibrada: Yes, absolutely. And I think thats why you see consultants retiring early. Its the only solution for them would be that you know, that simply burned out especially in the -- the older generations where they would go doing very frequent phone calls and perhaps you know. Several times a week and overall only a few months free. It took a long time to become a consultant from a registrant to senior registrant level etc. So its not surprising in that theyre retiring that early and sort of like 50s around or 60s, you know. Gratien David: All right.

Gordon Mazibrada: Theyre simply burned out you know. I mean, I think my generation; Im still less of everybody else. I was, I was trained before that. Then new deal, thats actually Gratien David: The working time directive. Gordon Mazibrada: Yeah, absolutely. So effectively, I can spend ten years to become a consultant so far. But then youre already almost you know, not starting up then youe starting up very heavy, you know, workload. You know. Gratien David: So do you think that -- like sometimes seeing members senior like clinicians at the factor (ph) level feel that you know consultants or clinicians choose to work at this trust because of its reputation because of its teaching research. All the other possibilities are there for them to grow Gordon Mazibrada: Yeah. Well thats for both of reasons. This isnt the measure how strong the MNO is with works. I mean, from neurologists, its specially centered. Theres no neurogenocide (ph) theory, we all work in DGHS which is different also. Its a centralized place from neurology, neurosurgery you know so obviously thats why Im working here. Yeah. Gratien David: So probably because of limited consultants its bringing a lot of pressure on your Gordon Mazibrada: Yeah, I think there are -- I mean that, I can tell you, up until January 2010, because we know lots are going on were on the second year now. I was the one and only consultant for three years covering MS patients in this region file I was on a lecture, theres nothing standardized theres a very small population of patients in city hospital. So my area was around 4 million people so effectively I was the one and only consultant managing MS in the size of a small country. And I was going three MS clinics per week plus two general clinics plus extra clinics in terms of waiting list in etc. You know. Theres not enough consultants in the U.K. But there were people who say no, so that their workload is heavy, you know, theres lots of paperwork plus handy work you know. Gratien David: So do you think that -- because Im sure you must be having a family also -Gordon Mazibrada: Yeah. Gratien David: And you might be, you know, you like to probably set times to drop your children at school or pick them up or Gordon Mazibrada: Yeah, why not. Thats -- my wife does that and does it for me and that which she cant work you see. You know, three kids so she cant work because shes

taxing children around and doing this and that so I cant be involved rather than the weekends when Im not working. Gratien David: Okay. So how would you feel -- because you yourself working so hard -Gordon Mazibrada: Yes. Gratien David: Youre sacrificing other priorities in life because of your work? Gordon Mazibrada: Yeah. Gratien David: How would you feel if somebody -- some- of your junior doctors come to you and ask you to work flexibly or Gordon Mazibrada: Well, I wouldnt mind to see them off but the problem is theyre saying now, I think as long as that does not mean that I have to do that work, which is often the case, you see. You know, if you have a gap you know, then I think it has -somebody has to fill the gap and if you are around, youll be asked to do that so I mean principle is fine but in real life its different. Gratien David: Do you think by extending the working hours that because of flexibilities, some people starting early, finishing early and some people starting late and -- so you got an extended opening hours would that probably well take some of your . Gordon Mazibrada: I dont think so. Gratien David: You dont think so? Okay. And so flexibility is a challenge for your team, for your department because of the -Gordon Mazibrada: I dont think youre -- if -- I dont observe it that you can do, you know, with the current numbers of people; -- you can -- you can shift things around and then make sense. I mean ultimately it wont make any big difference. Gratien David: Okay. Gordon Mazibrada: You see, this all about the numbers. You know, we could do, for example, with two extra MS neurologists from tomorrow, you see. That will help me a lot, and have probably have a normal Monday to Friday. No, I think Im working extra and that you can satisfy you know the service. Gratien David: So is there a budget for extra neurologist or .? Gordon Mazibrada: There isnt and we are just -- that wanted it to general, two neurologists, one for epilepsy, and one for acute so

Gratien David: And have you had employees coming back from maternity leave or paternity leave or long-term sickness in your department? Gordon Mazibrada: Yeah, from time to time. Yeah. Gratien David: Okay. What sort of support do you give them to settle back in? Gordon Mazibrada: I dont give them any support. Just let them get on with it, you know. so Gratien David: Okay. So because youre so busy, its difficult for you to help them as a line manager to help them settle back into their role. Gordon Mazibrada: Yeah. Gratien David: It is challenging because you have no time so Gordon Mazibrada: Yeah, so valiant. Gratien David: Okay. And so you think if you have flexible working or you need in your department part-time working its going to be a challenge to achieve your goals in the department? Gordon Mazibrada: That would be impossible to complete the work. I cant work for eight days you know. They will show a way flexibly or part-time and you know, complete the workload. I just count. Gratien David: But even having people in your team working flexibly will that mean -that youll put pressure on you, you think? Okay. And -- Im just trying to change the question because of youre Gordon Mazibrada: No, its not that Gratien David: Because of your -- because your generation is very different. Gordon Mazibrada: Yeah. Its different. It is. Gratien David: It is very different. Yes. So I think its very interesting because for some people -Gordon Mazibrada: it would be different if you speak with clinicians to be older Gratien David: Yes. And its starkly different because youre -Gordon Mazibrada: Thats interesting about the driving and I have to drive to work it takes I think, 40 minutes, I mean I live south Buckingham and third get here in 30 or 40

minutes each day. When I work in South County thats one hour thats two hours in driving, you see, theyll respect me from that. Gratien David: Yeah thats true. So it is -- it is affecting. And also you have limited resources. Gordon Mazibrada: Yeah, so I think its -- you told the same. I think it just comes out the same and you have to plan from them. Gratien David: Yeah. Gordon Mazibrada: I mean, its up -- I think you give lots of you know, hours for free. If I have to charge, everything I do, I think, everybody does that you know and I think I would just go out straight away. Gratien David: Thats true Gordon Mazibrada: You know, because there wont be enough to pay. Gratien David: Yeah. And what sort of an impact do you think the working time directive as had on the smooth running of the department? Gordon Mazibrada: I think -- Yeah, to a degree, theres no continuity of care so often you can see doctors disappearing. While on the other hand thats not a big issue, I think -- You know over all you know, its continuity of care. Gratien David: How long did you, the doctors come to work with you during the training? Gordon Mazibrada: Four months. In every four months, they change and they just try staying here either one or two years depending on their rotation. Gratien David: Okay. And sometimes junior doctors say that because you know, the consultants are not very supportive. If you want to request flexible working or any changes, sometimes if they have to finish at five, consultants expect them to finish at five. If they go home probably five minutes earlier, they always check on them nor support them. Gordon Mazibrada: I mean, I dont know. Thats just -- cant comment on that, obviously not. So Ive never had a problem with my juniors in retrospect. But thats just the -- you know personal opinion or personal experience, for that you need to do proper research proper audit you know so individual comments are entered into statistics to say 100% support flexible hours. Bottom line is what are you replacing the flexible hours with you know who is that, who will be the next person to follow that and do the job -you see -- You know. This is the different type of service, you know. We have to be in, somebody has to be around all the time. You know, from the nursing point of view,

clinicians point of view. You cant just be very flexible but you have to be reason the rigid I dont think that you know, shifting hours little bit here and there, will you know, make a big difference. Gratien David: Because they feel that consultants, most of them they report to have worked long hours like you did and thatd be a hundred more hours if you were a junior doctor, eighty hours Gordon Mazibrada: Yeah. Thats why thats true. You know, I think I moved back and set it for generational consultants who preceded me who were constantly on call, you know. I mean, if you look at the numbers, numbers have increased, you see, in the last seven years, dramatically in terms of that consultant, you know, numbers so -- and physician numbers etc. So that theres not -- no doubt about it but then the workload is higher you see demand is high, you know. The number of task we do is high so . Gratien David: And they say that because they -- because you can solve it well for so long hours. They expect the juniors to be when they do have to work on, they have to forty-eight hours, you know. They dont sympathize with them because they think what the others are doing is nothing. Gordon Mazibrada: I cant comment on that so Gratien David: Yeah, thats it. Gordon Mazibrada: And thats just an opinion. Gratien David: Okay. So do you think the new working time derivative which came into force which where this people have been doing 48 hours a week. Has that had an impact on the staff of every level of the team? Gordon Mazibrada: Personally, I mean -- I cant comment on that, really. Because you know that -- you know about answer of 12 directly affected by that, it might, you see. I think we occasionally where we think SHLs on the rote etc but yeah, thats up, on the top of my head. I cant give you my corrected answers to that question the answer is yes but to what extent I dont know. I cant -Gratien David: You see, youve been having these staff shortages? Gordon Mazibrada: Yeah. We go and always like that so in an essential choice its not you know, the essential to be seen because of what they believe you know what part of thats the same with the registrars. Thats been a common problem, always, always, always, even before the working directive you see theres always somebody on study leave or sick leave or doing clinic instead of covering ward somewhere else you know, its always been like that, its never been perfect.

Gratien David: Okay. And do you think because of that staff had been forced to work overtime like in your case, youre working overtime? Gordon Mazibrada: I believe everybody works overtime, everybody. Gratien David: So its a lot of pressure on people. And have you also been required to work on sociable (ph) hours? Gordon Mazibrada: Well, we do long calls. You know, thats all. I dont know what you mean by that but I often stay longer that I should be staying. Gratien David: How work -- was that a mean to say having the training means? Gordon Mazibrada: I think you better need to speak to the trainees, you know, I wont be able to answer that question I wasnt affected at the time so. It didnt affect me so Gratien David: Okay. But as a consultant supervising or managing -Gordon Mazibrada: Well, thats a meeting a neurologist not such a big problem. I think its someone special to like it, with surgical specialties I think it might be a problem because theres a lot of handlers we dont have time forThey go home. Yeah. Gratien David: Okay. And so do you think because these duty doctors or people who have been working longer hours, now theyre working lesser hours. Do you think of having a good work-life balance now? Because -Gordon Mazibrada: I think it is -- difficult to say. Gratien David: Okay. Gordon Mazibrada: Yeah. Gratien David: And looking at the current economic climate, what sort of an impact do you think that may have on the future of work-life balance? All the cuts, trustees, you know, all the austerity measures, the trustees bringing in to place. Do you think, Gordon Mazibrada: Yeah. Gratien David: Do you think theres going to be a lot of -- do you think its going to put people off from making yourself flexible working or working part-time? Gordon Mazibrada: I think it will be. I think it will make something, pull them off very much but I mean, thats tremendous to see what will happen in the trust and which way for them to go.

Gratien David: Because senior managers say the other consultants can work part-time, that you could. But in case, in your case, it will affect your income because you have commitments. Gordon Mazibrada: I have commitments, yeah. I have to look for the kids, grow, etc. so Gratien David: So do you think some consultant will put your hours down. Because they say you cannot increase your hours when you want. When you face a vacancy you can increase your hours. So because of these force strict measures, do you think it is going to put people off from making use of these serve (ph)? Gordon Mazibrada: I do not know, I think if somebody you know the problem is here is that in these trust. They find all done these from the very beginning. I am paid ten pas (ph), some consultants they negotiated in better some old some senior consultants theyre paid 12th probably on 13th see, we do the same work or perhaps some a little bit less some a little bit more. With the new generation of consultants, we all get 10 pas. If I carefully count what how much I do, they will enact contrary to the trust and say okay well Im working 12 pas would you like to pay me. Nobody would do that you see. So the other thing that you can do is you know cut down if you can some hours of your self and then plea that time for whatever could work or no work. You see any with the climb climate and the new contracts; you cannot, -- wont be able to increase your program activities for more than you then. Okay so I will be getting more work of what you do. You can only negotiate in a sense that they say well I have work more than you pay me there from the extra time. So thats what the thing possibly can work. At least put that in the contract and say everyone is there and Im off you know to do more job. So I dont think they will be working more, will be acceptable you know for the trust and for the economic, for the clinic climate. Gratien David: Okay. Gordon Mazibrada: You should working while in formal way not you can say Im doing an extra can do that why I have to be paid for that. Gratien David: Doesnt happen. Gordon Mazibrada: Doesnt happen, no. Gratien David: Okay. Gordon Mazibrada: You see that its different with the GPA practices their fresh strictly speaking the non profile of the NHS, The independent enterprises. Gratien David: Okay.

Gordon Mazibrada: So their paid for what they do extra theyre paid for it no more extra you know. Gratien David: Okay. Gordon Mazibrada: And then they can decide what a few services you know right their own way and that will crack brand new comers reconnect to straight at the end. If I Gratien David: Okay. Gordon Mazibrada: I mean as you know Im in this post of national newspapers there is a GB in Bellingham area actually whose paid round 650,000 pounds per year and that is an NHS salary you see? We found it actually that we have a 10 BS contract thats it and sub-K1. Another will come and negotiate in the contracts you know we handle it very well, the NHS consultants sort of hospitable consultants. GBS handle it very well, extremely well you see. And you speak to any commission or GP doctor you know for 450,000 pounds sometimes for four working days. So whats saying is that you know the current climate will not change you know duties may get less and all the future but you know we dont know whats going to happen to NH all together. So any flexibility, theres no flexibility in the system in terms of the financial. You see theres no money you know for negotiate about. So the only thing you can do is that you can fit that you are a classroom maybe. You know in the position to get some extra time in a full self where you probably to a quarter. Gratien David: How do you get that extra time during the working week? Gordon Mazibrada: I belong to a little no time (ph) Gratien David: You have to close -- cancel some clinics for that? Gordon Mazibrada: No you cant cancel clinics just like that I think you know depends on what youre going to do I think You try to be very quick and finish early sitting down and doing whatever you want to do. Gratien David: So in case you have to do -- go to a bank or you got to do some personal work Gordon Mazibrada: No you cannot always do that you know Gratien David: Cause if he is tying his shoes this time of the night. Gordon Mazibrada: This is like the production line you cant just leave the place and comeback you know so.

Gratien David: Okay, so you got that sort of flexibility? Gordon Mazibrada: Part of, yes Gratien David: Okay, and so you have not a look at the flexible working policy at all? Gordon Mazibrada: No it means you know I mean no. Gratien David: Right. Gordon Mazibrada: Is there such a thing such as flexible working hours? Gratien David: Yes. Gordon Mazibrada: In this trust here? Gratien David: Yes that is right. it talks about starting from part time working to flexible working, working full day week and paid full time hours or doing a nine day fourth night so this will give work Monday to Friday and next week will work Monday to Thursday and Friday off, but your still working your full contracted hours? Is that something possible for you? Gordon Mazibrada: Well it is really interesting I think I would consider if I can squeeze two clinics in one day you know so I would, I mean thats what interesting actually so we maybe nothing to hold that for you and of. You know the kind of day (ph). The problem is that you see that the lot towards the day is the same stages that squeeze the whole amount in that kind of shorter period of time. Gratien David: Because you have to work so hard to get ready Gordon Mazibrada: Because you see if I say do that now to put that off. I say four out of five days somehow you do an excellent earning and on the day when Im not in there well be 10 times to 30 emails and thats it you see for example. So I need to catch up you know on Monday if I dont want to file on that, reach for that you know and other clients sits in for example. Gratien David: And theres nobody who can pick your emails up Gordon Mazibrada: No, those are my emails they are my decisions you know so Gratien David: Right. Gordon Mazibrada: Its not the importances; its not the job its about the patients you see here. You know I have to read all emails from peripheral MS nurses if they go asking about the patients whos in. So I have to know, look at the emails and look at the last letter you know I email and I got an email back and then I email again thats all. So its a

work related email this is how we communicate. So if I am not here for a day you know Ill have to do a little extra to go back work you know thats all. Gratien David: Do you think you want to earn the flexibility to work from home? Gordon Mazibrada: I dont, because I wouldnt mind that for example Wednesday I could do a work from home, I could take -- if I cannot have access to a computer so how can I access to the email and some receiving and I think I can access the you know extra AMRI system and then the pox and so on. So then perhaps I would consider if you know so that would be interesting. Because of Wednesday today is my admin day, strictly speaking I dont have to be here unless I have a patient in the ward. I can come here at nine o clock and see if I have any patients. Best answer you know I talked to the nurses and then go back home and do the admin call. Although I go -- beep me if I dont have to come then Ill stay home and do all the admin there you see? I can see we come here and collect all the things I need not all the letters, results and then if I have an access internet access at home so I can access the hospital system results, MRIs, you know investigations. And then the email system and I can do that from home. Gratien David: Because you can do it from home, because some consultants have a system. Gordon Mazibrada: Yeah. Gratien David: In the computer which they need to get access from Gordon Mazibrada: Yeah. Gratien David: They can access all their work email. So if you log on here. Gordon Mazibrada: Yeah. Gratien David: Youre desktop Gordon Mazibrada: Yeah Gratien David: It will also be the same at home also; they have a system on that. Gordon Mazibrada: Do they now (ph)? Gratien David: Yes, so probably they could help you to have a good work-life balance because you are a human being at the end of the day. Gordon Mazibrada: No, I agree in that. I would look involve pencil everything in our work is Gratien David: Thats -- yes

Gordon Mazibrada: I can have email access to all the you know and all the what is that in whats that language Gratien David: All the records and Gordon Mazibrada: Yeah all the systems Gratien David: Systems, yes we could Gordon Mazibrada: In terms of patients records and the imagery and my mouse and what considered call -Gratien David: Because I was speaking to another... Gordon Mazibrada: No every Wednesday but occasionally, theres nobody in the ward, if I dont have anything planned like no meetings etc. appointments, then I would actually consider staying at home. Gratien David: Because I was speaking to another consultant. Gordon Mazibrada: Yeah Gratien David: Says a bible geek (ph) Gordon Mazibrada: Yeah Gratien David: And he says he can actually -- he can work at home Gordon Mazibrada: Yeah Gratien David: Because hes got to stay Gordon Mazibrada: Is this a lab? Gratien David: It is a lab Gordon Mazibrada: It is a lab it is. Yeah. Gratien David: So you could probably try and negotiate back then and see, because as long as they know youre doing the job. Gordon Mazibrada: No I think I understand I think that they know that Im here or not. I can just leave here without participating -- is the work what you have to complete Gratien David: Yeah.

Gordon Mazibrada: Otherwise just trailing behind and the, you know so I fully understand that if I leave things unfinished, you know they just accumulate. So thats the finish, if I can have this test though you know at home then I am probably in well lets say 50% of the cases I will not come here on Wednesday. You see? Gratien David: Yeah, because if you see a work life balance research. Gordon Mazibrada: Yeah. Gratien David: Because of the there is a flexibility Gordon Mazibrada: Yeah Gratien David: Working from home is a flexibility Gordon Mazibrada: Yeah. Gratien David: So that takes a lot of stress out, the burnout Gordon Mazibrada: No, absolutely now so I think you know thats why you feel refreshed out from holidays. Gratien David: Yes. Gordon Mazibrada: battling initials of shock of back to work or catching up with the workload but I personally you know feel really very refreshed right after a holiday and to some extent that could perhaps happen with a sad working from home. You dont think more relaxed enough driving for example see though out that would help. You know I can see the point of that. Gratien David: Yeah, so and also it will have an okay (ph) effect because if you are positively influence that filters that would be a be manmade off Gordon Mazibrada: Yeah Absolutely Gratien David: It increase the very different work environment Gordon Mazibrada: Yeah Absolutely Gratien David: And theres probably you know serve -- thats what you know and the management is quite interested that you know I could see they sometimes work and say, there probably many clinicians (ph) are very flexible working Gordon Mazibrada: No I think, if I certainly I think this is something which I exert its fully acceptable and fully supported and there are means of to assure that and I think it as

of now definitely used you know say with no not any other day but Wednesdays. Once they actually would be cross. There is no point to work at home. In the morning comeback you know they have no for a clinic. I mean this purely my admin day and occasionally I have appointments, occasionally see patients, etc. So ah but other wise I think would consider that you know but not speak in behalf of and then you know half of the resident that would work here Gratien David: So you think it would be interesting, it will be good for the trust to communicate this other benefits to consultants Gordon Mazibrada: why wouldnt they thinking of a there is a scientific evidence that this something which we all need to kind of aim to -- you know aim for in term of you know if we balance and being refreshed and enthusiastic for a number (ph) years and not burned out and I think thats Gratien David: Because one consultant was telling me Gordon Mazibrada: Yeah. Gratien David: That if you go to another department where the calculations stress and they say like if that employee, if one employee work less than us. Gordon Mazibrada: Yeah Gratien David: Will that person you know who have been able to be and a good health you know Gordon Mazibrada: Yeah. Gratien David: Because they work longer hours it affects their health then you know this is some step -Gordon Mazibrada: Yeah. Gratien David: Should be probably approved Gordon Mazibrada: Yeah. Gratien David: Yeah Gordon Mazibrada: Im worrying at it Gratien David: Yeah Gordon Mazibrada: Yeah

Gratien David: And then so because in your case like youve been purely educated to work and you could see anything beyond in relation to well being. What is your overview on work-life balance? Gordon Mazibrada: I think this country is very poor you know and I can tell you example. I think it is the last options if I can afford to work three days a week for example part time. I would you know one day I could do something at home with my children I will do nothing right now some sport or whatever hobby. One day I will probably do a research one time research. You know some of you like that, so I will do that but you know I cant afford that expensive -- and you know everything is expensive you know kids they are expensive and so got something that I got a sounds like more -were not that well paid I can tell you when you spend all that hospital consultant salary its around 75,000 as recalled. I mean I got two colleagues, number colleagues was distinguished MS neurologist, he works in the UK his been around ten old years and 15 years still quite young probably his mid 40s and working very hard and now everybodys aware of him, his work and his research etc. And for some reason he has to move to Australia, hes moving in six months now and his salary there he is good working in a much smaller place a hospital wise and department wise he will build 150,000 pounds a year and thats nine to five anything extra hell be paid. Im sure hell be able to achieve very nice work Gratien David: Very nice work. Gordon Mazibrada: You know home balance is here because youre not being required to do extra you see. Gratien David: Yeah Gordon Mazibrada: And I didnt mention you would prime of work youre just relating thats the extra work you see. You know thats the kind of work you know my team and so I think its very difficult to talk about you know work-life balance if you are forced to work. You know to sustain the family, baby, bills you know etc. So the flexibility of so working part time just goes away because the salary withdraw and yes with that flexible work you will consider if not if it is you know supporting the children you know possible so I might be discussing them working from home Gratien David: and do you think -- you are from Italy no? Gordon Mazibrada: Sorry? Gratien David: Where are you from Italy or your -- ? Gordon Mazibrada: Croatia. Gratien David: Okay so do you think there you get a better work-life balance?

Gordon Mazibrada: I havent worked there for a while, so I cant I dont know Gratien David: Okay Gordon Mazibrada: I think its kind of difficult to comment Gratien David: Okay Gordon Mazibrada: You know about other countries Gratien David: Okay and do you think that if they have their own resources, probably have extended working hours Gordon Mazibrada: Yeah Gratien David: To give a lot of flexibility Gordon Mazibrada: Yeah, to give us the flexibility I think its -- I mean their issues -- I mean I for example would like to do a little more research that would be beneficial for me plus knowing I think for the trust for operations as a core I cant do it simply because there no time for that and this no flexibility on my contract you know to do that, To do more time for research, you see. Gratien David: And believe the consultants, the group of consultants you we were going you know. Do you think the environment doesnt support you to talk about flexible working, you know can I come late? Or everybody is just talking about Gordon Mazibrada: I think we will be all very supportive of each I think we all understand that were swamped on calls, were swamped in clinics you know we help each other in terms the patients, the individual patients thats not an issue. Because you know sometimes you give sometimes get through. Do something extra so its all fine now Gratien David: Okay, and because there are issue with junior doctors and I am almost finishing Gordon Mazibrada: Yeah. Gratien David: Issues that junior doctors Gordon Mazibrada: Yeah Gratien David: Because they are not really motivated. They are not Gordon Mazibrada: I think I would be very careful using that those words. You see I think its a Im not sure what they are you know it need to do almost like a research or

did you not say that you know is this one the part from in there? You know and the whole hospital, region you know nationwide etc. I dont know what the research or data in this. So I dont think its so much about the junior doctors and the senior doctors. There are issues and I think a many of the senior clinicians were complaining of you know being force to do you know basic house office type of work. Simply was theres nobody around. I dont think that it affects neurology (ph) so I dont know what to comment on that. Gratien David: But overall they feel the trust levels are very low? Gordon Mazibrada: Yeah Gratien David: Like they feel theyre not trusted. Gordon Mazibrada: Yeah. Gratien David: And so thats affect the morale they say. Gordon Mazibrada: Thats fair enough you know so. Gratien David: And the second thing they feel is -- appreciation is not there Gordon Mazibrada: Yeah. Gratien David: even if you put lot welfare, then they wont do it theres no appreciation, no recognition. Gordon Mazibrada: I mean thats a shame thats the general feeling obviously. Gratien David: Yeah, because thats what they say so Gordon Mazibrada: Yeah. Gratien David: So as we say it probably it differs from department to department. Gordon Mazibrada: Im sure. Gratien David: It is Gordon Mazibrada: It is different you know I think as far as I can tell you know have any problems with them before in chores and registrars (ph) Gratien David: Okay

Gordon Mazibrada: It tells a fasted being flexible and supportive you see, Maybe individual case its occasional from time to time that will be a problem of us all but then not this rule. Gratien David: Okay, thank you very Gordon for your time. [END]