Letter: Consultants are hard at work too

Sir: You report a study in this week's British Medical Journal which shows that surgeons in training often perform complex procedures for the first time without supervision ("Trainee surgeons perform operations alone", 20 June).

These are clearly not ideal training conditions. They arise because of the relentless drive to reduce waiting lists and increase patient throughput. Each year hospitals are expected to take on three per cent more work with the same resources and this can only be achieved by having all the medical staff, senior and junior, working flat out.

Of course it would be much more satisfactory to have trainee and consultant in the same operating theatre but that would inevitably mean that waiting lists would soar and hospitals would go bankrupt. The BMA has never supported the internal market, this is one of its worrying effects. The "absent" consultant is not pursuing private practice as John Spiers, chairman of the Patients' Association alleges, but in the adjacent operating theatre working through another list.

J N JOHNSON

Chairman

Central Consultants and

Specialists Committee

British Medical Association

London WC1

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