National doctors shortage could reach crisis level

A NATIONAL shortage of doctors is set to worsen over the next two decades and demand could outstrip supply by about 10,500 by 2010, government medical advisers have warned.

The fixed annual limit of 4,000 on the UK medical student intake must be lifted to avert a crisis in the early years of the next century, according to the first report of the Medical Manpower Standing Advisory Committee.

Moreover, doctors must be more willing to devolve some of their traditional responsibilities. Nurses and radiographers could do many of the tasks claimed by doctors to free more time for treating patients. Junior doctors also do too much clerical work, administration of intravenous drugs and ante-natal care.

Regardless of efficiency improvements, the freeze on the annual medical student intake must be removed because of the trend towards earlier retirement among doctors, demographic changes, increased public expectations about doctors' services and extra workloads caused by recent legislation.

The committee's report says: 'The Patient's Charter has increased public awareness of the services that doctors provide. More consultation time will be needed to see and treat patients. The Children Act and the Mental Health Act are contributing to increased demands on general practice, paediatrics and psychiatry. As the average age of the population increases, there will be greater demand for GP services.' Over the next 20 years the UK's population is set to increase by 4.3 per cent to 60 million and over-75s by 12.5 per cent.

The advisory committee, chaired by Professor Colin Campbell, vice-chancellor of Nottingham University, received evidence from the medical Royal Colleges that the national shortage of consultants was already severe, particularly among cancer and urology specialists.

However, the advisory committee believes that the colleges' estimate that consultant numbers need to rise by at least half cannot be met, given contraints on spending and improvements in medical technologies. It also says that unless the NHS concedes pressures for more flexible medical working practices, notably more part-time working, drop-out rates will grow.

Senior hospital doctors are to carry out a survey of bed closures and cancelled operations in the NHS. The move by the British Medical Association's central consultants' and specialists' committee follows protests about financial crises in the NHS from several hospitals, including Winchester, Derby, Darlington and Cardiff.