Annex A > Chapter 13 - Pre-operative Care > Pre-operative management of care > Shortage of cardiologists with paediatric experience
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Shortage of cardiologists with paediatric experience
35 In 1988 a joint working party of the British Cardiac Society (BCS) and the Royal College of Physicians of London (RCP) was set up as a result of what they called `a perceived crisis in consultant staffing in paediatric cardiology in the United Kingdom' to look at the causes of the problems and make recommendations for the future. Their report [41] described the situation which confronted the profession in 1987 and 1988 as `very worrying'.
36 Asked why it was that this particular crisis had arisen at that time, Dr Robert Swanton, President of the BCS, commented:
`I cannot tell you very much about it. I was aware there was a shortage of Senior Registrars in paediatric cardiology at that time. The paper goes on to point out that they will not be able to fill further consultant posts and suggests making proleptic appointments to allow continuing training in the consultant grade.
`Why that shortage of Senior Registrars occurred, I do not know. I think it was obviously manpower planning problems. We were dealing at that time with a very small specialty in its own right, anyway, and I think manpower planning obviously was a big problem at that stage.' [42]
37 Specifically concerning the situation in the South West, Dr Swanton said:
`I think part of the problem was the shortage of large hospitals in this part of the country. I mean, I do not know the area terribly well, but as it stands at the moment, in Cornwall there is one large unit in Truro and then, coming more in this direction, we have Plymouth. There are just those two units. Until recently, Plymouth did not have cardiac surgery and this city was the only centre for cardiac surgery in the whole of the South West of the country.
`The population is certainly big enough to justify it, but for some reason the development did not occur. Whether that was a local issue amongst the physicians, I just do not know, but it is still a problem, as I said earlier, in other parts of the country at the moment. There are big geographical holes in cardiac service provision in the country. I do not want you to feel that the South West is alone by any means. There are huge black holes still.' [43]
38 The `British Heart Journal' published its fifth biennial survey, `Staffing in cardiology in the United Kingdom 1988', [44] which stated that:
`The United Kingdom, with Ireland, has fewer cardiologists than all other European countries with reliable figures.' [45]
39 This shortage was reflected in Bristol, where the situation up to 1987 was that only two cardiologists, Dr Joffe and Dr Jordan, were carrying out the whole of the cardiological workload between them. The appointment of Dr Martin to consultant cardiologist at that time was proleptic. He was appointed to the position with six months of his training in paediatrics to complete before he could become a paediatric cardiologist. [46]
40 Mr Wisheart commented on the situation:
`Q. So we have difficulty in attracting a paediatric cardiologist in the 1980s - there may have been a shortage of them nationally, we have been told.
`A. I would not be able to say off-the-cuff when there were shortages, but I think they would be able to recognise that in a very small specialty, there can be problems of attracting trainees into it and having trainees ready for consultant posts at the irregular intervals when they become available. It is quite difficult. I think that was a problem for paediatric cardiology.' [47]
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Footnotes
[41] BPCA 0001 0001 - 0004 ; `British Heart Journal' 1992; 68: 630-3
[44] `British Heart Journal' 1989; 62: 482-7
[45] BCS 0001 0018; `British Heart Journal' 1989; 62: 482-7