By Henry Guly (auth.)
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Additional resources for A History of Accident and Emergency Medicine, 1948–2004
This is undated but probably occurred in 1963 or 1964. Sixty-six SCOs responded to a questionnaire and 27 of their responses were analysed. Only three spent all their time in casualty, ten spent 50–80 per cent of their time in casualty and 14 less than 50 per cent of their time in casualty. In the time spent outside casualty, 22 did sessions in orthopaedics, 14 did sessions in orthopaedics with some spending time in casualty, general surgery and orthopaedics. Six had been SRs. Those who had been SRs could obtain consultant posts but this was uncommon and only ten ever became consultants, all in general surgery.
However consultant supervision (where it existed) was often little more than nominal. Many of the larger departments had SCOs who worked well but most were not given adequate responsibility for their departments. Junior staff was difficult to obtain and many departments relied on inexperienced preregistration HOs. Factual data is clearly important but the true meaning of these figures can only be understood with descriptive language. ’31 In the same year the BMJ in an editorial on the shortage of doctors, falling medical student numbers and high emigration rates quoted Lord Taylor in the House of Lords: ‘I cannot recommend your Lordships to go into such hospitals [non-teaching hospitals] as a casualty, for there is in many cases no casualty officer.
Response: This need not happen. The orthopaedic surgeons stressed the importance of separating out major and minor casualties. Response: It is important to avoid the duplication of services and major trauma may present with minor symptoms. A senior registrar should be in charge and a consultant could supervise for two sessions per week. Response: This was not in accordance with the Sir Robert Platt Report which said that a consultant should be the cornerstone of any service. Who Should Run A&E Departments?