> from: "Dunn Matthew Dr.
> subject: Re: Lack of change in trauma care
> as to the argument that maybe the trauma is coming in more after
> midnight- possibly true, but I'd consider the main advantage of consultant
> expansion to be that with a less frequent on call rota you can afford to
> come in from home for all the sick or seriously ill patients 24/7 (possibly
> with the day off after a night on call)- otherwise what are you doing?
Agreed, although I don't want to revisit the argument of "resident cover" versus "dashing in from home" styles of care; different styles will suit different departments. But as you suggest Matt, there are many consultants who provide "cover" from home after 5pm, but who never actually attend. Like you, I cannot see the point in this.
> Basically I don't think the argument that consultant numbers have not
> increased holds water.
I'm sure you're correct, but my feeling is that much of this expansion has not actually led to more out-of-hours care. I know of many departments where three or even four consultants all work from 9 to 5. This strikes me as wasteful. Admittedly I have come from a background where I used to "overlap" with my single consultant colleague for only 6 hours each week; perhaps that was the opposite extreme!
Basically I'm very happy to work until 10pm or beyond, I just don't believe we should get standard rates of pay for this. Speaking of pay, did anyone see BMJ news last week, where Thorpe quoted the standard week should be from 8am to 7pm? This seems a pretty poor place to start negotiations from doesn't it? I can understand how 9 to 5 can be stretched to 8 to 6, but an 11 hour day seems ridiculous. Should doctors consider it standard to finish lists or clinics at 7pm?
Adrian Fogarty
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