Who is responsible for quality of acute medical care?

EDITOR,—The attitudes of consultant physicians to the Calman proposals provide important information about the organisation of acute medical care in Britain.1 Recently, in response to such audits as the national confidential enquiry into perioperative deaths and the confidential enquiry into maternal deaths, many acute specialties have seen an increase in consultants' involvement in emergency care. General medical practice has escaped such scrutiny, and this together with the tendency to subspecialisation has apparently led to a system in which trainees provide most …