Mr John Black, president of the Royal College of Surgeons, recently contacted the members and fellows about its campaign for an opt-out from the Working Time Directive. After describing trainees as exhausted and demoralised, he calls on surgeons to influence MPs and prospective parliamentary candidates in the run up to next year’s election.
Black writes: “The only way to circumvent this damaging legislation is political will…There are several avenues open to the next government to solve the problem, which we have pointed out repeatedly.
“It was encouraging to hear the shadow foreign secretary William Hague mention on national television the College’s concerns about EWTD, and that his party if elected intended to act. However we cannot predict the result of the election and now is the time for individual surgeons to make it clear to individual politicians of all parties just how important this issue is to surgical practice in the NHS.
“I am therefore asking you all to press our case with Members of Parliament and Prospective Parliamentary Candidates. The more who are approached…the more likely the issue is to rise up the political agenda and be solved, regardless of the result of the election. The critical tactic is to give them your personal experience of the attempts to reduce hours, and tell them how catastrophic it has been for patient care and for the training of future consultants…”
It concludes: “This personal approach to politicians is the latest step up in our campaign to free surgeons from the bonds of EWTD. The more Fellows and Members join in, the more likely we are to succeed.”
One surgeon - Mr Munchi Choksey, consultant neurosurgeon at University Hospitals Coventry and Warwickshire - was unimpressed by the communication. Here’s his reply to Mr Black:
“You raise some interesting issues. First, I would point out that trainees have never had it easier. When I began neurosurgical training in 1984 as a registrar (having passed the more difficult, unstructured, unpoliced and often unfair FRCS) there were 64 registrars and 16-18 senior registrars. There were about 100 consultants. There were virtually no new consultant posts - one per annum at the most.
“We all did 1:2 rotas, with no prospective cover, no compulsory time off for teaching, with a roughly 1 in 4 chance of making it through the system. You needed to publish original papers (24 in my case), and an MD was nearly de rigeur. Life was tough…
“By paying credence to the whining of trainees, you turn them into a bunch of sissies. Surgeons need to be tough; the public expects it. Trainees have always moaned.
“I agree that the implementation of 48-hour working has been a disaster. The Americans now regard British neurosurgical training as pitiable. Our traditional advantage - a wealth and depth of operative experience never equalled or exceeded in the developed world - has been thrown away.
“The best course of action: abandon EWTD, or get the next - hopefully Conservative government - to opt out. The Germans have done this de facto: which is very unusual as normally the Germans make the rules in Europe, the French protest about them, the British obey them and the Italians ignore them.
“Next, we must re-open the borders to trainees from the sub-continent. They speak English, have been brought up to be tough in a very British ex-colonial medical system, and would gain from the exposure to high-tech medicine.
“The reason the Royal Colleges have lost their traditional stranglehold on post-graduate medical education is partly due to their reluctance to stand up to the government and challenge their ridiculous, bureaucratic and arbitrary edicts that they produce with no evidence base whatsoever. There is not one shred of objective evidence that revalidation, for example, will produce better doctors. Where are the randomised controlled clinical studies? Why are you not fighting the rising, ever-metastasising, tide of poly-twaddle that is engulfing the profession, and destroying the very things that made British medicine admired the world over?
“When I came to Britain 40 years ago, the profession was solid, tough, difficult to enter, with high standards of internal discipline and complete control over patient care…You are the president of a great and august institution, with justifiable pride in its forebears. Were John Hunter to have read your letter, he would be turning in his grave.
“Get tough - your profession needs inspirational leadership. Yours sincerely…”
Do you think a more confrontational approach with government should be adopted? editorial@hospitaldr.co.uk
Fabulous comments Mr Choksey totally agree - the same comments apply to the RC of Physicians who have similarly demonstrated pitiful leadership, weak and ineffective dealings with this Government. Blair particularly was always intent on bringing down the profession and, with the Colleges assistance, lead to one of the few successes of his dictatorship. The FRCP in no longer the highly respected accolade it once was.