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Hospital Doctor Shortages

The NHS in Wales is short of almost 400 hospital doctors. That's bad news for current patients. It could also be storing up trouble for the future, as some fear it's affecting the training of the next generation of doctors. The causes are complex, the solutions varied - but one stands out as controversial. Is it time to shut hospital services to close the recruitment gap?

Last updated: 22 March 2010

First broadcast on ´óÏó´«Ã½ Radio Wales, Monday 22 March, 6.30pm

Jaden Griffiths from Merthyr Tydfil weighed only one and a half pounds when he was born after just 24 weeks of mum Andrea's pregnancy last summer.

To be given a chance of survival he needed the highest possible level of neo-natal intensive care - level 3 - care that was not available locally. Instead he had to be rushed to Bristol.

Andrea and husband Darren spent nine weeks at Jaden's Bristol bedside. It was a stressful time, made more so by the fact that potentially they could have been treated so much closer to home.

"In our health trust we've got the Royal Glamorgan Hospital and it's actually got facilities to be a level 3, but they haven't got enough middle grade doctors so it's down graded to a level 2," Andrea explains.

"He might not have had to go to Bristol anyway, he could have just gone to Llantrisant."

The problems Andrea experienced in accessing local services because of a lack of doctors is not an isolated problem.

Last summer two paediatric wards at Swansea had to be closed and then centralised at Morriston, because of a lack of doctors.

All told there are around 5 and a half thousand hospital doctors in Wales, but figures obtained by Eye on Wales show there are nearly 400 vacancies.

Most shifts will be filled by locum doctors but the situation is still a cause for concern on the wards. Dr Carys Jones is a trainee at Ysbyty Gwynedd in Bangor.

"It's something, I think, that has especially affected the medical directorate recently. In my team, in cardiology, we have been without some registrars for a few weeks."

"The registrar is quite useful, not quite as senior as a consultant but experienced enough to deal with most things that happen on the ward. So it was quite difficult without them there at the time."

The Welsh Assembly Government admits that the number of hospital doctor vacancies is a concern and says that is working to find ways to recruit and retain doctors in Wales.

But some people say it is not just a case of too few doctors in Wales - but too many services. Colin Ferguson is a consultant vascular surgeon who speaks for the Royal College of Surgeons in Wales

"We basically do not have enough doctors to throw at this problem. The only other solution to this problem is to amalgamate units and reduce the number of individual services that are available," he tells Eye on Wales.

"There are lots of small units in Wales and I think it does make both clinical and financial and economic and service sense for some of these units to be amalgamated into networks which are much more sustainable."

"People think that having all services on all sites is the right way forward. In practical terms, that's really not the safest way to provide these services and it is very much in patients' interests that we're trying to do this."


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