Sir: W Alexander (letter, 17 March) has identified one pertinent aspect of the incipient NHS medical manpower crisis. At the bottom of all this is the fact that the old-style NHS medical staffing structure is no longer sustainable.
Even in the 15 years since I qualified, technical advances and rightly raised patient expectations mean that even a well-trained house officer or senior house officer cannot possibly manage medical and surgical emergencies until the consultant makes his ward round.
Many other factors, in particular the consequent intensity of work, have driven all doctors to move towards sustainable patterns of working. It is becoming rarer for consultants in hard-pressed specialties to do whole series of days on call and GPs have been forced to resort to out-of-hours centres etc.
As Paddy Ashdown has pointed out in relation to education, if the people want quality services they will have to pay for them. Health care is no exception.
Dr EVAN A BAYTON
Senior Registrar in Accident and Emergency Medicine
Warrington Hospital NHS TrustReuse content