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Speech: Chief Executive calls for action on NHS hospital consultant shortages

Speech by Eddie Saville, Hospital Consultants & Specialists Association General Secretary, to TUC Congress moving Motion 52 on the shortages of hospital consultants.

Colleagues, we all know there is a shortage of qualified professionals in many area of the NHS.

With the recent bout of junior doctors’ strikes, the role of the hospital consultant in stepping in to ensure continuity of safe care for all patients, especially in emergency departments, has been vital.

But the reality is, Congress, that there are just not enough hospital consultants - full stop.

We also know that the demand for NHS services is outstripping the supply in terms of the numbers of hospital consultants we have in many key specialities.

And, coupled with this, we have an ageing population who live with all manner of chronic illnesses.

In fact, there is a staffing crisis, with 40 per cent of hospital consultant vacancies remaining unfilled.

This was the stark evidence from a data census from the Royal College of Physicians.

In addition, to support this, is the latest evidence from NHS Improvement.

They set out clearly the hospital consultant shortages in some of the key specialist areas of practice such as emergency medicine, acute general medicine, diagnostic services, psychiatry and radiology.

These are some of the most demanding areas of medicine where work-life balance, working conditions and stress are the most challenging.

Also, the recent report by the Public Accounts Committee reported that there was an overall shortage of around 50,000 clinical staff in the NHS across the whole range of staff groups, including nurses, radiographers and midwives.

These gaps were by and large being filled by agency and locum staff at a much higher cost to the taxpayer, and adding further to the already critical financial pressure the NHS is under.

Now, workforce planning has never been an NHS strong point and we know that earlier in the year figures showed that the numbers of foundation year 2 doctors who have applied to start specialist training has fallen by nearly 10 per cent since 2013. This is an astonishing figure and steps must be taken to reverse this trend.

Congress, these were the consultants of tomorrow lost to us and our communities, and when you couple this with those consultants who have already gone and those who are heading for the exit doors for various reasons, including working overseas, early retirement and burnout, the position is a scary one to contemplate  

Congress, we also hear a lot these days about the seven-day NHS. The HCSA, like many other health unions, has no issues with the principles of a seven-day service, although we know we already have a seven-day service. 

However it must be a safe seven-day service, fully staffed, fully funded and delivered safely for both patients and staff.

With hospital consultant shortages running at such a high level, along with other staff groups in the NHS also running short, the notion of such a service with the current numbers seems a long way off.

And Congress, if the media think this is some kind of  union scare story, we saw just last month a hospital in the Midlands having to close its accident and emergency children’s unit because it did not have enough consultant paediatricians and specialist doctors to ensure safe care could be provided.

Imagine the fear from those in the local community who now have to travel much further to seek emergency care for their children.

So Congress, this is a serious problem for all of us. I agree wholeheartedly with the Public Accounts Committee who said in their report that trusts should prioritise retaining existing staff.

We are seeing well-trained staff flood out of the NHS.

So:

  • prioritise existing staff by raising morale,
  • prioritise existing staff by valuing them more
  • stop the continual restructuring which creates fear and insecurity
  • work in collaboration
  • and, most importantly, create an environment where negotiation and not imposition is the way forward.