Consultants' attitude of mind criticised

Consultants need to make “a culture change in their minds,” according to a parliamentary select committee in a report last week. It says that it is time that all consultants were aware of the need to work with others in the provision of complete and effective care.

The committee, which shadows the work of the health service ombudsman, was commenting on a case where a consultant surgeon in Walsall failed to tell anyone that he suspected cancer in a patient who died, although nurses reassured relatives about his recovery (BMJ 1994;309:1461). In their report the MPs say that they were appalled to come across such haphazard arrangements. It was the consultant's responsibility to ensure that effective communication of the suspected diagnosis took place. Dealing with patients suffering from terminal illness, and with their relatives, demands the utmost care and sensitivity, they state—recommending that all health authorities and trusts be reminded of the need for clear instructions on communicating with relatives through all stages of serious illness.

At the heart of the failings in the Walsall case was the unwillingness of the consultant and chief executive to accept the full extent of their responsibilities. The MPs conclude: “We see the need for a culture change in the minds of many of the consultants who appear before us.”

In another case they recommend a national initiative to train accident and emergency staff in the needs of mental health patients. This follows the death of …