I think "if only insert other healthcare so-called professional here would do their job properly" must be a fairly common theme. I know it is in my department. It's really worrying when: doctors of twenty-five years' experience can't get the basics right; SpRs pretend they can do things when they have no idea; a consultant unilaterally changes a protocol because "I read about it in yesterday's Sunday Times"... I'd love to be able to blog about all of this myself but I am in such a small specialised niche in healthcare that it would become obvious where I was and who I worked with and I wouldn't be working for much longer! So keep up the good work Tom, there are some healthcare professionals out there who have to live their everyday frustrations through your blog.

I have dealt with a lot of very crap GPs as a junior doctor, so I am sure what you say may be true. To give the benefit of the doubt though on-call GP services are being severely stretched now with the new GP contract (most GPs don't have to do any on-call work).

More doom and gloom....

I predict hospital medicine will also collapse just like GP on-call services, in the next 3-5 years. At this very moment initiatives like "Hospital At Night" and Foundation programmes are being put into place. Some explanation is in order

In the past, each department in a hospital left 1-2 doctors on-call at night to deal with their inpatients and to see new ones arriving from A&E. Now, hospitals are grouping departments together so that a core group of only 4-5 junior doctors (outside of A&E) run the hospital at night. These doctors will cover areas which they are not trained and will have to work very intensively since they deal with everything now. They have to be generalists now. These guys are meant to be the safety net now that the European Working Time Directive is in place.

However at the same time, Foundation programmes are the new way to boost numbers of specialised doctors (so that govt targets can be met) by speeding up junior doctor general experience and training (before beginning specialisation) from 3-5 years to 2 years.

So what happens is hospitals are building a safety net made up of junior doctors who need to be generalists while at the same time, the government are reducing the amount of doctors who are generalists.