Medicopolitical digest

At its meeting last week the Central Consultants and Specialists Committee decided to survey the extent of the problem. Mr James Johnson, who was re-elected unopposed as chairman, said that each year hospitals did less and less elective work for a longer period. The government’s two wishes that emergencies must be given priority and that waiting lists should be reduced were, he said, incompatible.

Speakers repeated the stories reported at the BMA council earlier in the month that the winter crisis had already started (11 October, p 956).

In Miss Connie Fozzard’s trust in Truro, half the list for elective surgery had been closed in August and it was proposed that there should be no non-urgent elective surgery for two weeks at Christmas. Miss Fozzard, a consultant obstetrician, expected that to creep into January.

Dr Tiz North, a consultant radiologist in Carshalton, said that during July and August up to a dozen patients had to wait overnight in the accident and emergency department and the elective waiting list now extended into the millennium.

The chief executive in Dr Penelope Thorpe’s trust (West Middlesex) has, she reported, appointed a hanging committee of three consultants to decide each week which elective cases should be allowed; as emergencies rose these would obviously go down.

Dr Joy Edelman, a consultant cardiologist in north east London, told the committee that one health authority had run out of money a month ago and would provide care packages only for people already in their own homes; this meant more bed blocking. "Within two or three weeks the whole area will be gummed up," she warned.

Dr Terry Morris, chairman of the Welsh CCSC, reported that he and his colleagues had been praised for dealing with emergencies during last winter’s crisis but were then criticised when league tables showed that waiting lists had risen.

The chairman of the negotiating subcommittee, Dr Peter Hawker, said, "It is too late to do anything this winter. Even if we had another 30 beds we have not got the money to appoint additional nurses."

Other speakers said that they were concerned about the effect on junior doctors’ training because they were getting insufficient surgical experience (see p 972).

• The committee will continue to advise consultants not to join the partnership scheme offered by the British United Provident Association although it has approved BUPA’s consultant recognition statement.

• Dr Michael Goodman, a consultant gastroenterologist in Manchester, was elected chairman of the general purposes subcommittee.

• The CCSC called on the BMA to withdraw its sponsorship of the Expert Witness Institute and to explore other ways of providing witness training.

View larger version (99K): [in this window] [in a new window]   The council of the BMA has awarded the association’s gold medal for distinguished merit to Sir James Black. Sir James was professor of analytical pharmacology at King’s College Hospital Medical School, 1984-93, and is now chancellor of Dundee University. He was jointly awarded the Nobel prize for medicine in 1988. The medal will be presented at the 1998 annual meeting UPPA

Private medical insurance grows
Spending on private medical insurance in Britain rose by 10% in 1996 to £1875m. Nearly all the spending came from higher prices, caused by increasing claims rates; the availability of new medical procedures; and the increased use of cover by policy holders.

The revenue of independent hospitals and clinics (excluding NHS pay beds) also increased by 10% last year to £1446m.

The information is contained in Laing’s Review of Private Healthcare 1997, which reports that the NHS continues to compete for private patients mainly from dedicated private patient units, which now have 1400 beds. The estimated revenue for 1996-7 was £252m, representing a 15% share of the private patient business.

Fees paid to doctors totalled an estimated £652m, representing an average gross revenue from private practice of £37 000 a year for the 17 500 consultants who practise privately.

Laing’s Review of Private Healthcare 1997 is available from Laing & Buisson, Lymehouse Studios, 38 Georgiana Street, London NW1 OEB, price £140.

Senior doctors consider early retirement
Some senior hospital doctors in Scotland are considering early retirement because of the pressure of work and the demanding nature of the NHS.

Despite the government’s insistence that early retirement among consultants is not a cause for concern (27 September, p 820), 80% of the respondents to a BMA survey of 2800 Scottish consultants, staff grade doctors, associate specialists, and clinical assistants said that they were seriously considering early retirement. There was a 35% response rate and just under half said that they had taken action, such as reviewing their financial affairs or buying added years.

BMA NOTICE
BMA council election 1998-2000
Nominations for candidates in the election of voting members to the council of the British Medical Association will be sought in the 22 November and 6 December issues of the BMJ. Some of the elections are restricted to members in a particular craft or region of the country. If you think that your entry in our medical records may be incorrect please contact the membership records department to ensure that you are properly listed and will receive the appropriate ballot papers.

Medicopolitical digest is prepared by Linda Beecham

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