Sunday, August 30, 2015

Women doctors could bring the NHS to its knees, says Dr Max

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This week the Royal College of Paediatrics and Child Health gave a stark warning that children’s wards face closure because so many paediatricians are now women and have gone on maternity leave or work part time. There simply aren’t enough senior doctors left to run departments any more.

Three-quarters of doctors training in paediatrics are women. The situation has become so bad in some areas that up to 63 per cent of shifts are being covered by locums.

In other specialities that attract women — such as general practice, where two-thirds of GPs are women — a similar staffing disaster is unfolding.

It’s affected mental health, too, which traditionally has always attracted female doctors. In my own department in the past year, four doctors out of eight have gone on maternity leave.

More and more women are coming into medicine — in some medical schools, as many as 80 per cent of students are now female, suggesting the problem is only going to get worse.

Of course, it wasn’t always like this. For years, women struggled to establish themselves as doctors. A law formally allowing them to enter the profession was not passed until 1876 and, even then, only a smattering graduated and went on to practice until well after World War II.

In the Sixties, just a quarter of medical students were female. Since then, though, the numbers rising up the ranks have rocketed. It’s predicted they’ll soon outnumber men.

But this creates challenges that, as yet, no one is addressing. Quite simply, the average male medical graduate will work full time, while the average female won’t.

In fact, a study of doctors 15 years after graduation showed that on average, after career breaks and part-time working are taken into account, women work 25 per cent less than their male counterparts.

That means, as more women enter the profession, you need more doctors. So have we seen a corresponding increase in the number of places at medical school? No.

It’s gone up slightly in recent years, but only to allow for the generally increased burden on the health service, not this fundamental demographic shift.

Areas of medicine that are not traditionally ‘family friendly’ due to the time commitments required face a particular struggle to fill posts. And I don’t just mean A&E and trauma surgery, where you need to be on constant call.

It’s also true of specialisms such as neurosurgery and orthopaedics, which can involve repeated, intensely complicated surgery — often over many years — that you can’t just dip in and out of.

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