I confessed to a feeling of total impotence to a large group of senior surgeons recently. The occasion was the last meeting of Senate at which the Presidents and Vice-presidents of the four Royal Colleges of Surgeons were present, plus the Presidents of the Specialties that make up the Federation of Surgical Specialties Associations. At the start of the Senate meeting I confessed to this feeling of impotence, impotence at being unable to do anything about the lack of commitment by the Government to expand the consultant grade, except paradoxically in our own specialty.
Frank Dobson wrote in March 1999 in reply to a letter from Barry Jackson, President of the Royal College of Surgeons of England concerning the need for consultant expansion " With regard to consultant expansion ..there are no simple solutions. It must be for NHS Trusts and Health Authorities to determine at local level their future requirements for consultants, consistent with their duty to provide high quality services." which is to my mind another way of saying market forces. In this market though the purchaser is in effect the Government. We also know that the allocation for numbers of trainees in general surgery has actually been cut, despite SWAG recommending an expansion.
It is not that the Colleges are doing nothing. Pat Magee and I sit on a Manpower Workshop which is at present addressing this issue urgently and Barry Jackson has taken the opportunity wherever possible to explain to the media the need for more consultants. Consultants everywhere and in every specialty are overwhelmed by increased demands yet there is no commitment to expand their numbers. Rather tellingly, Non Consultant Career Grades have been expanded in surgery by some 600%. At the end of the Senate meeting it was suggested that as the Government appeared to be targeting cancer we should seize the opportunity to point out that most surgeons, and that of course includes thoracic surgeons are cancer surgeons. This was the opportunity for the whole of Senate to speak in unison but sadly it was not felt to be possible because the English problem was not the same as the Irish problem or the Scottish problem. I ended that, my last, attendance at Senate by saying that my sense of impotence had worsened.
However, by the time you read this I shall no longer be President and Jim Monro will be responsible for this valuable Society. I wish him every success in taking it forward in these extremely difficult times. I would like to express my very sincere thanks for all the help that I have received from the members and in particular the Executive during the period I have been Secretary and President. Thank you.
Last, I would like to thank Concorde Services for the support they have given to the Society, support which is particularly needed by the Officers of the Society. I expect we will begin to really appreciate how much that support was worth when we set up our office at the Royal College of Surgeons of England and run our affairs ourselves in April.
