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NEWS ROUNDUP: Madeleine Brettingham Trusts should cut workload of senior physicians to retain them BMJ 2005; 331: 798 [Full text]

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Workload of Senior Physicians

Trishit Bandyopadhyay   (7 October 2005)

Consultants' hours of work

Austin A Leach   (7 November 2005)

Workload of Senior Physicians 7 October 2005
Trishit Bandyopadhyay, Physician - Tata Hospital Jamshedpur, India Send response to journal: Re: Workload of Senior Physicians	In a changing world the professionals need to adapt as well. Having worked both in UK and the USA before moving back to India, I found that consultants working in the UK had a cushy job for life supported by junior staff. This is not the case in other parts of similar developed countries. Consultants in the US have to pull their weight far more than their counterparts in UK. As the NHS is modernising to current needs of the population the consultants need to look closely at their working practices which is accountable and value for money. If the senior physicians cannot handle the workload probably it is time to bring in professionals from within or outside the country to fulfill the requirements. There is no shortage of talent worldwide ! Competing interests: None declared
Consultants' hours of work 7 November 2005
Austin A Leach, consultant anaesthetist Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP Send response to journal: Re: Consultants' hours of work	Editor The Federation of Royal Colleges of Physicians has stated that 6000 'consultant years' would be lost to the NHS (report from Madeleine Brettingham BMJ 8 Oct 2005: vol 331; p798) if consultants exercised their (agreed) option of retiring at 60 years of age. My curiosity was aroused. I calculated the hours I worked as a trainee between 1982 and 1991, working on-call rotas of between 1:2 and 1:5. I then calculated the hours I have worked as a consultant from 1991 to date, taking into account the extra hours I was required to spend on-call in the hospital for the two years it took to 'normalise' out-of-hours service commitments following the introduction of the Calman reforms to doctors' training. I have assumed 5 weeks' holiday per annum over the whole period. A 40 hour week (allowing 5 weeks' holiday) equates to 1880 hours per annum (one 'standard' year). As a trainee I worked just over 34000 hours. Many of these hours worked (around 50%) were paid at the old pre-Calman 'UMT' rate of one third of standard. As a consultant of 14 years I have yet to exceed that total, having contributed 32600 hours. The time I spent as a trainee works out to be the equivalent of 18.1 'standard' years, and my time as a consultant to 17.4 'standard' years. I need only work another 3.8 years at my current workload (which job plan and appraisal both agree that I contribute about 47 hours per week) to have reached the same number of hours that a person working 40 'standard years' (ie one 'standard career') would have worked. When I pass this milestone I will be 50 years old. This means that if I survive long enough to retire at age 60, the NHS will have received ten free 'consultant years' (equivalent to 12.4 'standard years') from me. Multiply this by the number of consultants working in the NHS (some of whom I know for a fact contribute more hours than I do) and the value for money gained by the NHS from its medical workers can be viewed in a new perspective. Rather than criticising, or even remarking upon, doctors who wish to retire at age 60, how about thanking them for their career-long selflessness? The Government's cynical attempts to hijack the NHS final salary pension scheme, particularly in the light of MPs' eagerness to reform their own pension arrangements, might be considered by some to appear both shameful and ungrateful. Competing interests: None declared