Letter: Obstetrics in crisis
Friday 14 May 1999
Sir: I am partly if not largely responsible for the apparent surplus of trained specialists in obstetrics and gynaecology, and to some extent those in other specialities (letter, 12 May).
A few years ago there was a surplus of consultant posts over trained applicants in obstetrics and gynaecology in particular, but also in some other specialities. At that time politicians of all the main parties agreed that there was an urgent priority to train sufficient doctors to fill sufficient consultant posts to ensure that we had a consultant-based service. This means that the patient would normally be seen by a consultant or have a consultant in close contact with their care. This entailed a promise to fund sufficient additional consultant posts.
Since then these promises have vanished. The priority seems to be to reduce waiting lists and times, which can be measured, and ignore failures in acute care in general and the labour ward in particular, which are not scored and published. These may result in lost or damaged children.
Previously, because of a shortage of applicants, the "purchasers" removed offered funding for new consultant posts. The only way to avoid a repetition was to trust the politicians' promises and train sufficient doctors to meet an expansion agreed between the profession, the Department of Health and the health authorities. This we did. The promises are not being met; the public is about to lose the result of at least five years of intensive training in doctors not appointed to consultant posts.
Strong public pressure is needed for consultant expansion so that an acceptable level of care is provided, particularly in the labour ward.
JOHN ATKINS FRCOG
Swainby, North Yorkshire
The writer was formerly representative of the Academy of Royal Medical Colleges on the Speciality Workforce Advisory Group.
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