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Improving working lives

Specialist Registrar & Honorary Research Fellow, Charing Cross Scheme and Imperial College, London.

Correspondence: E-mail: rafey.faruqui{at}imperial.ac.uk

I have read with interest Peter Kennedy's editorial on the issue of locum consultant psychiatrists (Psychiatric Bulletin, August 2003, 27, 281-282).

A healthy work environment, adequate support facilities, decent working conditions, appropriate workload, supportive colleague group and a receptive management are essential ingredients for maintaining good recruitment and retention of a highly-skilled workforce.

A pathological reliance on a locum consultant workforce on part of a NHS trust may be viewed as an indicator of deep-rooted problems, rather than the single most important issue in itself.

NHS trusts rely heavily on local and regional specialist registrar training schemes to attract new consultants. By the time trainees are near their completion date for award of the Certificate of Completion of Specialist Training, they usually have a good idea about strengths and weaknesses of potential prospective employers in the region. It does not come as a surprise when some trusts fail to attract and appoint new substantive consultants. Even popular employers often fail to attract a substantive workforce for their known ‘problematic’ posts. This is the work-culture where a market for locums thrives.

It would be unethical to call locum colleagues ‘mercanaries’ after contracting their services, whatever the agreed rate of pay may be. Senior managers should rather concentrate on better service and workforce planning to improve the working lives of their staff. This is the only light at the end of the tunnel, if the situation is to improve in the future. Any proposals to force the existing workforce to cover the workload of unfilled vacancies may cause more damage.

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