Psychiatric Bulletin (2004) 28: 104. doi: 10.1192/pb.28.3.104-a
© 2004 The Royal College of Psychiatrists
Psychiatric Bulletin (2004) 28: 104
© 2004 The Royal College of Psychiatrists
In defence of locum consultant psychiatrists
Gareth H. Jones, Retired Consultant Psychiatrist
Bryn Capel, Caerffili CF83 3DF
Declaration of interest
I may do some locum work, at the rate the market will bear.
Correspondence:
E-mail:
gareth.jones1k{at}doctors.org.uk
Peter Kennedy (Psychiatric Bulletin, August 2003, 27,
281–282) has concerns about the quality and cost of locum consultants.
Quality would be best assessed by the Royal College of Psychiatrists, as with
CCSTs, perhaps by a retired consultant. The lack of a national database
represents a failure of management at the Department of Health, as does its
failure to establish a register of those other expensive wanderers, patients
with Munchausen syndrome.
Do I detect a note of envy at the £180k that locums receive? Fewer
would be needed if three sessions extra were paid to over-worked general
consultants. My impression is that home graduates tend to do less demanding
jobs in liaison psychiatry, cognitive–behavioural therapy, and eating
disorders, leaving the ‘dirty jobs’ to those qualified abroad. The
pits of medicine, namely psychiatry, geriatrics and inner-city GP posts, have
traditionally been filled by graduates of South Asia (Passage from India,
Guardian, 27 August 2003). Recruitment remains difficult, due to
under-financing and bed closures, against a doubling of the incidence of
schizophrenia in London (Boydell et al, 2003). If a similar increase
were to be found in epilepsy or diabetes, then extra resources, both in
hospital and community, would be made available.
How much are consultants worth? The answer is £450–500k, which
is the payment at direct treatment centres for surgical waiting lists.
