...answering on Danny's post because he's been so nice to me!

The bit I didn't say was that their stipulation was not for the whole of the
post but for an unstipulated time when the chaps are new in their post and
vunerable.  The aims are laudable although smack of the hand-holding that
juniors these days need.  My point however is to ask should the RCS  dictate
to our Specialty how we should staff and run our Departments - is that not
for us (?BAEM) to decide?  Also,  as  noted by Andrew,  any requirement
should be consistent amongst all Departments.

It would be really good for improving quality of patient care if we could
all provide this level of cover - the practical problem is of course how do
we all do it (and do we,  as suggested, lose our good smaller Departments if
we can't?).  I'm lucky in that I've got excellent Staff Grades who share my
committment to the Department and to the provision of high quality care.
They however are in the job they love for the rest of their working life
and,  as they move into middle age and beyond  they will not be in a
position to work night shifts.  They would probably reluctantly leave if I
forced them into it and obtain less enjoyable work where their hours were
controllable.   So what about the SpRs?  Certainly with only one at present
that could not be my answer for total cover - yet I could do it for the
first week of this "vunerable"period.  I'd be reluctant as this strikes me
as SpR abuse - and sooner or later we'll be holding their hands too!

Guess I'll have to clone myself!

So I'll talk to the Staff and some way or other we'll cover the vunerable
period.  Like all these things I simply must exract every inch of good out
of it and use it to get more funding/staff/whatever.  But thanks for the
food-for-thought from those who've replied so far, which has been very
useful.  If anyone else has any comments I'll be most interested.

Thanks again,
Nick Jenkins
A&E Consultant
Abergavenny
http://www.ae-nevillhall.org.uk




-----Original Message-----
From: Danny McGeehan [mailto:[log in to unmask]]
Sent: 06 January 2003 20:58
To: [log in to unmask]
Subject: Re: SHO supervision at night


> Where does the list think we stand on this one and if it comes to arguing
it
> out would it be best done with Faculty,  BAEM, local STA or who?
> Thanks,
> Nick Jenkins
> A&E Consultant
> Abergavenny

I share your concern, it will kill off a lot of departments.  The first
group that did it were the aneasthetists about 20 years ago. Closed a third
of hospitals within 18 months.  I share your concern.  Middle grade cover is
difficult to recruit.  Many in our area are leaving to go into GP land and I
don't blame them.  They earn at least an extra 20k and less hassle.
Generous tax allowances and no hassle with HR.  Many PCT's are desperate to
recruit.  What with NHS Direct telling their patients to rock up to A & E.

Anyway the writing is on the wall and I suspect the hidden agenda may be to
close off the smaller DGH's.  The modernisation agency will be rubbing their
hands in glee.  Just think of the number of project managers and data input
clerks they can employ and sack a few A & E consultants.  They can even say
that they are improving the service and get a few exploding pie charts to
prove it.

I used to work with a very eminent Professor in a so-called Trauma Centre
not too far away from where I live who was advocating this very policy only
5 years ago.  He was recommending the closure of at least a third of all A &
E depts.  He didn't get a lot of opposition from the powers that be in the
speciality.  I often publically spoke out against him hence my move 16 miles
to the South.

I don't think there will be much support with the vested interests out
there.  What they will forget is that you Nick have provided a first rate
service to the people of Abergervenny.  I suspect we may have the same
problems in Stafford.  There is no way that we have the funding or could
recruit sufficient middle grade cover to provide a 24 hour service.  I
suspect that units like ours will go to a 18 hour service.  Close at 10 o'
clock at night and just take medical admissions.  I could then go and get a
job driving taxis or in B & Q.

You will probably have to move down to Newport for a night a week.  The spin
merchants from the various unelected agencies who purport to represent the
speciality that we all know too well will say how the service to the
patients has improved out of all recognition.

Don't forget the whole philiosophy of SHO training is about to change next
year with the foundation year.  They will no longer be the workforce of the
NHS but will have to be facilitated

If the worst comes to the worst you can always stand for parliament or even
President of the Faculty or Royal College.  Could do with some different
people on it for a change.

Danny McGeehan
---------------------------------------------------------------------------------------

This e-mail (and any attachments) is confidential and may contain personal views which are not the views of the Gwent Healthcare NHS Trust unless specifically stated. If you have received it in error, delete it from your system, do not use, copy or disclose the information in any way. Please notify the sender immediately of this error. Further communication will signify your consent to this.