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Better training, not bigger buildings, the need for NHS
AN eight-month old baby died in tragic circumstances, and this week a young doctor faces a decision by his peers that could end his career.
The hearing conducted by the General Medical Council will continue for several days, and while the question as to the degree of the doctor’s responsibility has still to be decided, we wish to comment on certain statements made in the tribunal that point to a wider issue.
They touch on apparent failures of medical training at the University College London Hospital and poor back-up by consultants.
Whatever the fiasco spawned last year by the online method of recruitment of young doctors applying for specialist training posts, the authors, the Department of Health, had set out to democratise an age-old, creaking system in which the future of junior medics had been decided by an old boys’ network of established consultants.
It was hoped that online recruitment would end this historic anomaly. And to some extent it did.
If young medics are to make their way in hospital medicine they know only too well they have to work in harmony with the very ones who can decide their future – consultants.
Outside bodies regulating trainings do exist, but in the end everything often turns on the relationship between a junior and his or her boss, the consultant.
This is a great responsibility, both for the consultant and the administrators of a hospital. The efficiency of the National Health Service can, to some extent, be measured by the way juniors are helped by the system.
Evidence before the tribunal so far points to a failure – a “systemic failure in the hospital” – to quote a witness at the tribunal.
The initial diagnosis of the baby was carried out – we have to point out – in the spanking new UCLH accident and emergency department, part of the new-look hospital rebuilt under a private finance initiative scheme.
In the end, it doesn’t matter how many millions you spend on bricks and mortar. Nor rhetoric by hospital administrators and politicians about the brave new world they have helped to bring about.
What counts in terms of training is good staffing ratios and dedicated consultants and hospital management teams.
Generally, there is a shortage of junior and senior doctors .
Health ministers will never admit this – but anyone who goes into a hospital between Friday and Sunday often experiences this.
All this is the unacceptable face of the NHS – and until more medics are recruited and fewer managers are appointed little will change.
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