Neurosurgeon quits over waiting lists

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A senior neurosurgeon today describes how he resigned as head of a hospital department after accountants forced its standards to plummet. Christopher Adams spent 20 years as head of the Department of Neurological Surgery at the Radcliffe Infirmary, Oxford.

He says that between 1972 and 1994, it increased the number of treatment procedures from 600 to more than 2,500, making it one of the most efficient and cheaply-run units in the country. But Mr Adams was instructed to form a waiting list of at least three months for sciatica patients to save money. This was despite evidence that early treatment for such patients produced better recovery. Up to then the unit had no waiting list.

Writing in the British Medical Journal, Mr Adams tells how his pleas for more resources fell on deaf ears: By the end of 1994, staff were exhausted and referring hospitals were becoming unhappy with delays in admitting patients and the way they were being discharged early.

In January this year, Mr Adams decided private patients would have to be removed to make more room for NHS patients, although this meant an inevitable fall in income. He wrote to the hospital chief executive complaining that the department had moved from being "efficient" to "hyperefficient", which was unsafe. When he received no reply, he resigned as lead consultant.

He blamed the problems on the accountancy rules of the market-driven NHS.

Commenting on his paper, BMA chairman Dr Sandy Macara said: "This is salutary and sad evidence of the validity of our criticism of the NHS 'reforms' which are having the reverse effect of what they were intended to achieve...It is perverse that a hospital unit which was particularly effective and efficient has suffered most because of the internal market.

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