Medical schools hit by drain of doctors to NHS

British Medical Association meeting in Istanbul

One in 10 professorial chairs in British medical schools are vacant and scores of other teaching posts are unfilled because universities can no longer afford to match NHS salaries for doctors.

Dr Sandy Macara, chairman of the British Medical Association's Council, yesterday appealed to the Prime Minister to intervene in the "unprecedented crisis" facing medical education.

Clinical academics - doctors who spend half their time on research and teaching, and half in hospitals - account for 10 per cent of the NHS medical workforce. They have traditionally been paid the same as their full-time NHS colleagues. A senior hospital consultant earns a basic salary of between pounds 43,000 and pounds 52,000 per annum.

However, funding per student has declined by almost a third since 1988 and has left universities unable to pay clinical academics the same as their hospital colleagues, the British Medical Association annual clinical meeting was told.

The pay rise to university staff in 1996 was 1.5 per cent, compared with around 3.8 per cent for NHS consultants and up to 5.3 per cent for more junior doctors. Some clinical academics have received their 1.5 per cent rise but many others have had nothing at all.

Negotiations over the past six years have left many clinical academics disillusioned and triggered a haemorrhage in staff from medical school departments. Dr Macara said this could only get worse. "A total of 57 chairs of clinical medicine are vacant, including some of the more prestigious appointments around the country," he added. A department without a professor is like "a headless chicken; he or she is the driving force behind it," Dr Macara said. Posts in anatomy and physiology, for example, which were previously held by doctors, are also now going to scientists with no clinical experience.

t Death and disability from a life-threatening form of brain haemorrhage could be avoided if more GPS and hospital doctors recognise the common warning sign, it was claimed.

A fifth of patients who suffer a sub-arachnoid haemorrhage had sought medical help for a sudden, agonising headache (SAH), the classic symptom, but were not referred to hospital immediately, Dr Christof Toulis, a trainee neurosurgeon from Walsgrave Hospital in Coventry told the BMA conference.

When these patients were eventually admitted to hospital, their condition was worse and their prognosis poorer than for those with SAH who had been referred immediately.

A sub-arachnoid haemorrhage occurs when a weak blood vessel ruptures in the brain. It affects 10 in 100,000 people. The bleeding and resulting build-up of pressure can cause devastating brain damage, leading to physical and mental disability, or death.

Initial leakage of blood is often accompanied by an SAH which can last a day or weeks, and if operated on at this stage and the weakness in the blood vessel repaired, neurological damage can be prevented.