Letter: GPs with talking difficulties

Sir: Mr J N Johnson (Letters, 23 June) comments on evidence that surgeons in training often perform complex procedures for the first time without supervision. He explains that if the consultant was in the same operating theatre as the trainee surgeon then waiting lists would soar and hospitals would go bankrupt.

Implied in his statement is the view that in order to prevent the hospital from getting into debt some surgeons will not necessarily practise best practice in relation to some patients who happen to be under a trainee surgeon's knife. This is a remarkable view coming from a senior figure in the British Medical Association. It negates the fundamental basis of the professional responsibility of the consultant to the patient - for he or she is still the consultant's patient even though it is the trainee surgeon who is operating.

It may be that the pressures and distortions of the internal market have driven some doctors to behave as though they are accountants.

If a surgeon believes that he should be in the same operating theatre as the trainee who is carrying out a complex procedure for the first time - then it is absolutely clear where that surgeon should be. Impending bankruptcy not withstanding.

Dr GERALD de LACEY

Consultant Radiologist

Northwick Park and

St Mary's NHS Trust

Harrow, Middlesex