Sunday, 27 May 2007

Eye despair

This paper in Eye has looked at patients' preferences of surgeon for cataract surgery, it appears that if you ask a stupid set of questions then you get a stupid set of answers.

The found that only 70% of patients accepted that surgical trainees should operate as part of their training, meaning that 30% of people thought that surgical trainees should not be operating. One wonders how it would be possible to train a consultant surgeon if trainees were not allowed to operate? It seems that this 30% of patients are rather short sighted and arguably more than a little dim.

Only 57% of these patients were happy to be operated on by a surgical trainee supervised by the consultant. That leaves 43% of patients who were unwilling. The abstract finishes:

'If 'patient choice' extends to the choice of operating surgeon, then there are clear implications for the training of future UK ophthalmologists.'

Indeed, if 'patient choice' actually meant 'patient choice' then this would indeed be true. However as we well know, the government's idea of patient choice involves creating an inefficient internal market and rigging it so that they can push lots of patients away from named consultants' care towards unknown operators in ISTC portacabins. It is a mechanism for enforcing the privatising the NHS. This statement shows the absolute absurdity of real 'patient choice', as trainee surgeons have to learn and if trainee surgeons were not allowed to operate then we would fast run out of consultant surgeons.

As someone who has first hand experience of surgery in the NHS, I would much rather be operated on by a surgical trainee who was being supervised by a reputable consultant than by a unnamed foreign surgeon in an ISTC. The consultants of today actually deserve their title because they have been trained to a certain level. Unfortunately the government seems intent on destroying this and eroding the meaning of the word 'consultant'. Government reform gives patient no real choice to have care under a competent named consultant; it will force them to be treated by any of a large band of less competent generic sub consultants. This is the real 'patient choice' agenda, it is dumbed down lower quality care for anyone who can't afford to pay for a named consultant privately. What progress.


dreamingspire said...

I well remember that when my father needed an operation the consultant came round and asked if the the junior could do the operation, saying that he was very good (and so it proved). My father agreed, it went very well, and everyone one was satisfied. That was 35 years ago. The method for choosing that consultant, outside the local area, was personal recommendation (another family member was under the care of another consultant and a surgical instrument maker) - it cost 5 guineas and a black mark with the local GP. The operation was done within 2 weeks under the NHS when in the area where we lived it would have taken much longer to book it under the NHS.

Its essential to think about the patient.

Anonymous said...

My son is a junior doctor. He worked under diffent consultants while rotating. He tells me that many juniors are much better at operating than the consultants they work under because the probably worked with an excellent consultant to start with and kept the tradition. I can believe that and while I too always looked out for the consultant, I am now happy to be treated or operated on by a junior who holds his ethics, integrity and skill in high ground.

Garth Marenghi said...

I agree wholeheartedly with the above comments. It is such a shame that the personal touch is fast being wiped out of the NHS.

'Patient choice' is the pretence, however under the new system patients are simply pieces of meat rolled off a production line.