The Health service journal
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Many NHS consultants are working more than their contracted hours. Diaries kept by 32 consultants in one trust revealed an average working week of 50 hours. A pilot scheme rescheduling the work patterns in a haematology department to include a rest day has reduced the number of hours worked. The scheme is popular with consultants and could be transferable to other teams.
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Acute hospitals have suffered at least 15 years of neglect. Little attention has been given to the key role of support services. The structure of trusts hinders the development of clinical networks. The way consultants are employed hampers their involvement in the modernization agenda.
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The UK has a lower ratio of doctors to population than most other developed countries. The government's pledge to increase the number of doctors by 9,500 by 2004 will represent only a marginal increase. Reliance on doctors from other parts of Europe, as envisaged in the NHS plan, is not realistic. ⋯ The position of non-European overseas doctors in the NHS, and the low numbers achieving consultant status, needs a radical review. Institutionalised racism must be addressed. Future medical workforce planning must provide exchange and development opportunities for developing countries.