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LETTERS: W A Holden Number of consultant posts has fallen BMJ 2006; 332: 1394-b [Full text]

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Whither Consultants to be

Nosa Akporehwe, Newcastle Upon Tyne NE2 4NR   (10 June 2006)

Whither Consultants to be 10 June 2006
Nosa Akporehwe, Locum Consultant Hunters Moor Regional Neurological Rehabilitation Centre, Newcastle Upon Tyne NE2 4NR Send response to journal: Re: Whither Consultants to be	In a desperate effort to offset the current NHS deficit of £1.3b, it appears nothing is sacrosanct including axing of frontline staff like nurses and doctors, closing of beds/hospitals and now emerging evidence suggesting consultants to be would have to brace themselves for an unscheduled trip to the job-centres to 'sign-on'. W.A. Holden, showed that the number of consultant posts may have effectively fallen using advertisements rate in the BMJ Careers, comparing number of consultant jobs advertised at a particular period this year and for a similar period last year [1]. Meaning that, there may be no new consultant posts for specialist registrars who have successfully completed their training, to move on to. This is supported by recent revelation by the president of the Royal college of surgeons, Bernard Ribeiro, that 37 cardiothoracic surgeons, 12 Neurosurgeons, 35 ENT surgeons are without jobs as a possible result of a 'vacancy freeze' adopted by NHS trusts to balance their books [2]. The figures for that of the medical specialties is yet to be released. Do not mind the huge sum of tax-payers' money used in the training of these highly skilled doctors. It is a well known secret that trusts across the country including those not in deficit, are not advertising vacancies even for very 'essential jobs' as a fall out of this financial crisis. The cost of its impact on patient care is apparently not now a priority. It is quite revealing that the NHS is doing its utmost to move away from a consultant-led NHS as we knew it, to a manager-led one, ignoring its own laudable battle-cry of a patient-centered service. And if this were the case, how come are we now seeing a proliferation of new consultants (italics mine)in the guise of manager consultants, nurse consultants, physiotherapist consultants, O.T. consultants amongst others? An NHS reform process that keeps its young and most highly skilled staff in the unemployment market can only represent in the words of a previous director in the strategy unit of the DOH, a 'creative destruction of the NHS'[3]. References 1. Holden W.A. Number of consultant posts has fallen. BMJ 2006;332:1394. 2. bma news (June 10 2006): 'Absudity' of jobless doctors. 3. Ham C. Creative destruction in the NHS. BMJ 2006;332: 984. Competing interests: I am doing a locum consultant job awaiting a substantive post.