Clinicians must lead

All NHS consultants can recall the day when the chairman of a consultant appointments committee told them that they were the successful candidate and that the hospital looked forward to their contribution to its life and development. All consultants begin their career with two major ambitions, firstly, to continue to be good doctors and provide their patients with the best possible individual care, and, secondly, to introduce new forms of medical care.

These laudable ambitions have driven medicine forwards for centuries. Their prime purpose is not, or should not be, self aggrandisement or worldly riches—they are the ambitions of our profession for better medicine, the sole purpose being better patient care and human health. But the ambitions can be achieved only if each one of us has sufficient independence to introduce or develop the ways and means necessary to fulfil them.

Over the past four years, while president of the Royal College of Surgeons and now chairman of the Joint Consultants Committee, I have observed a steady deterioration in hospital doctors' morale. Many …