Whilst the report does contain some valid points e.g. continuity of care being lost,  these points are not incompatible with a 48 hour limit.  They are incompatible with a 48 hour limit and getting no extra staff to manage the shortfall.  The problems discussed in the report can all be handled if the shortfall in hours is plugged by a similar increase in staff.  I accept the training issues involved in getting these extra people to a required standard  by the European Working Time Regulations have been a long time coming and the underlying training issues could have been addressed by now if action had been taken earlier.

I also accept that the extra cost of employing these extra staff has to come from somewhere.  In the economic climate this money will not be forth coming.  If the problem of staffing had been fully addressed earlier, the budgets could have been adjusted during the better economic times and some projects delayed to reflect the increased cost of staffing.  For example, the NHS IT scheme could have have been delayed whilst the staff increases worked through the system.  As it stands, the NHS IT scheme has yet to produce the benefits it was portrayed as giving the NHS.  (I accept that hindsight is blinding my suggestion here.)

What does dismay me with regards to the BBC article and the RCS report, is that none of the patient BENEFITS are mentioned but the 48 hour wworking limit or the other aspects of the new working time regulations.  There is no mention of the errors being made from someone working the extreme long hours that were common practise before the regulations changed.  The RCS report suggests that 55-60 hours per week is common place.  60 hours per week would equate to working from 9am 7.30 pm, with 30 minutes for lunch 6 days a week.  Are the RCS and BBC suggesting that a person who has worked this length of shift for 6 consecutive days is just as good as they were at the start of Day 1?

I would like to think that being a surgeon would require immense amounts of skill and concentration.  I would like to think that this important staff group is allowed to work the hours that allows them to perform at their maximum.  I am not too sure how much of the argument is muddied by senior consultants who worked the long hours and feel everyone else has to in order to get anywhere in the profession.

I do find it worrying about that one trust has had 1000 + incidents in two years, which is getting close to two a day.

http://news.bbc.co.uk/1/hi/health/7271772.stm

The first story is a protest about the NHS refroms. As someone who works in the NHS, I do feel that we should focus on primary role of patient care rther than all of these targets. Taking care of this will take care of the rest. If we spend time working out which patient is getting close the the 4 hour A&E limit, it means less time is spent on actually treating the patients. This links to a story about making the NHS independent, removing the political tinkering. I do have reservations as this could mean an opening for more private sector involvement. My objection to greater private sector involvement is that they will do the same job and making a profit, why can’t the public sector perform to the same standards?

My second story is about the Papworth Hospital stopping transplants due to high mortality rates. It is sad to see such famous hospital suffer like this, I take heart from the fact that are brave enough to stand up and say this is not good enough. The pressure on the hospital most have been immense, equally, the pressure on them for their success rate. It was a tough decision but I think it was the right one.

http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalpdate_1027.pdf?section=4039