Report of the Working Party on the Responsibilities of the Consultant Grade.

  • Great Britain. Working Party on the Responsibilities of the Consultant Grade
Date:
1969
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Working Party on the Responsibilities of the Consultant Grade. Source: Wellcome Collection.

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    two recognised training grades, but also suggested that the medical assistant grade should be replaced by a specialist grade in which doctors would exercise “‘a substantial degree of independent clinical judgment’’. This recommendation implied a reappraisal of the Platt Working Party’s concept of the role of the consultant. 8. There is a close similarity in the junior staffing structure proposed on the one hand by the Royal Commission on Medical Education and on the other by the Final Joint Report on the Negotiations between the Health Depart- ments and the National Health Service Hospital Doctors and Dentists. From the point of proposed vocational registration onwards, however, the career structure suggested by the Royal Commission differs substantiatly both from that in the Final Joint Report and from existing practice. A more detailed historical background to the present situation is provided in Appendix A. III. The Origins of the Existing Situation 9. The pre-1948 situation worked reasonably well at a time when consultant services were relatively sparse and unevenly distributed, and when specialty divisions were so broad that those who did not succeed in obtaining the position they sought still had acceptable career prospects in other forms of medical practice. It would be untenable now, as would be the situation where eligibility for consultant posts was confined to those able and willing to support themselves from their own resources for several years. Nevertheless, important elements of this concept still persist, particularly the acceptance of a period of apprentice- ship of undefined length with a high failure rate at the end of that period; and with succession to a vacancy as the only mark of the successful completion of the course. These features of the past have continued into the present system without the flexibility which existed when medicine was less complex so that outlets to alternative medical work were available at all levels of training. 10. Failure to reach a consultancy has now, as a result of the much higher degree of specialisation involved, much more serious consequences than before. The absence of any appropriate outlet for the skills that have been acquired means frustration for the doctor concerned and wastage for the community. Moreover, general practice now needs planned preparation just as much as the hospital specialties, and the work of any newly-qualified doctor should take account of this. 11. Long apprenticeship and selection involving a high failure rate at an increasing late stage are therefore vestiges of a previous system for which more effective alternatives have to be found. 12. The Platt Working Party accepted that the consultant’s position gave him the right and the opportunity to select work of the more difficult kind in his specialty, and to delegate the remainder to someone under his supervision. IV. The Difficulties in the Existing Situation 13. While at present some consultants assume ali or most of the medical work themselves, evidence made available to the Working Party shows that the amount and kind of delegation varies considerably and that the majority of consultants still have junior staff to whom delegation is possible. The range of
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