Letter: Cost of night surgery

Sir: As a former clinical director of theatre services, I was intrigued to read your report on the possibility of operating around the clock (29 September). Although it is very tempting to "sweat the assets" of an expensive, high-tech resource, such an approach is not possible in the current economic climate for a number of reasons.

First, there are not enough beds to put the patients in. Secondly, there are significant problems with retention and recruitment of appropriately qualified theatre personnel. Thirdly, it is doubtful that there would be sufficient numbers of anaesthetists to cover the sessions and finally, there are not enough surgeons to go round.

There is no doubt that it makes sense to make more efficient use of a very expensive facility - a notion that might be expanded to the development of "twilight" clinics or more extensive weekend working. To pursue this path, however, without addressing the need for extra resources is short- sighted in the extreme.

GRAEME URWIN, FRCS

Consultant Urological Surgeon

York

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