Letter: Money the stumbling block to reform for doctors

Sir: I would like to respond to some of the points made in the article by Judy Jones on junior doctors' hours ('Just what the junior doctor ordered', 28 April). It is clear that the hours that junior doctors work, and their training, need urgent attention. However it is really not good enough to wheel out the usual cliches implying that consultants are the main stumbling block to reforming juniors' conditions.

It has been emphasised by surgeons for many years now that the only way to improve the hours that juniors work is to increase the number of consultants, but the money put in by the Government for this purpose is a drop in the ocean. No matter how much consultants want to increase their numbers, money is always the block.

The other point by Ms Jones, that juniors are doing all the work while consultants are safely tucked up in bed, cannot ring true in some of the more acute specialities. For example, last week I was on call five nights out of seven and was in the operating theatre after midnight on two days of the week. Despite this, it is still necessary to undertake routine work the following day.

If consultants are to perform more of the emergency work, it would be necessary for them to have time off the next day and this can not be achieved without increasing their numbers. Interesting comparisons have been made with other countries: there are fewer specialists per head of population by a considerable margin in this country.

Also it has been pointed out that juniors need to be trained more under direct supervision and that their training should be reduced. While I quite agree with this, there is little in the Government's health service reforms to encourage this scenario, particularly as the main priorities are to reduce waiting lists and increase productivity, something which is not compatible with the amount of time needed to train juniors under supervision.

It is about time that it is recognised that this country gets in general an extremely good deal for the salaries paid to consultants, and that very few of them receive the top merit awards that are always highlighted. The Government should be honest about the reasons for not attending more quickly to the scandal of junior doctors' conditions and not lay all the blame at the consultants' door.

Yours sincerely,

N. R. HULTON

Consultant Surgeon

The Royal Oldham Hospital

Oldham, Greater Manchester

30 April