Surge in consultants retiring hits NHS reform

Plans to expand the NHS have suffered a serious setback with a sudden 23 per cent rise in the number of senior hospital consultants retiring from the service.

The exodus has wiped out the gains from the Department of Health's international recruitment drive launched in August 2001. More than twice as many consultants took early retirement in 2001 as have joined the NHS from abroad in the past 18 months.

The total of 497 consultants who retired in 2001, up from 403 the previous year, was the highest for six years. The number taking early retirement doubled from 31 to 62, more than twice the 30 senior specialists so far recruited under the department's global recruitment and international fellowship schemes.

The findings are disclosed in the Department of Health's evidence to the Doctors' and Dentists' Pay Review Body.

While targets for recruiting nurses have been exceeded, with 40,000 extra working in the NHS since 1997, finding new consultants has proved much more difficult.

A ministerial source said: "Capacity building in the NHS is absolutely crucial – and there is a lot going on. But the worry is that we put a lot of money in and the system stays as it is." Under the NHS Plan, published in July 2000, the Government set a target of 7,500 extra consultants by 2004. Figures in the Government's review body evidence show that 3,130, less than half the target, had been recruited by March last year.

To boost recruitment of homegrown consultants, specialist training is to be cut from five years to four, more part-time and job-share posts are being created and flexible retirement options are being introduced. The global recruitment campaign has identified 900 doctors considered "suitable for appointment to the NHS", mostly from Spain, India, Austria and Germany, but only 22 have taken up jobs here so far. A further eight doctors have been appointed under the International Fellowship Scheme led by the heart surgeon Sir Magdi Yacoub, and 29 have accepted offers. The scheme is still a long way short of its target to recruit 450 fellows in the three years to February 2005.

The Department of Health review body evidence says: "Although progress in recruiting doctors from abroad through the national campaign has been slower than we had anticipated ... [it] is now picking up momentum."

The biggest fear is that falling morale among consultants, after the rejection of a new national contract last year, will accelerate the pace of early retirement. Consultants in England rejected the contract by two to one in a show of defiance over managerial interference, a "target-driven" culture and curbs on private practice.

Last week, the Department of Health announced it would implement the contract on a piecemeal basis through locally agreed deals – drawing criticism from the British Medical Association, which said consultants were "very wary of having clinical care dictated by political priorities".

* Hospital patients in Britain are three times more likely to suffer illness or injury as a result of malpractice, doctors' mistakes or infection than in the United States. A study by University College London estimated that 11 per cent of people were harmed during their stay, compared with 3.7 per cent in the US and 8 per cent in Australia.