Another plea to the altruism of beleaguered clinicians in services already beset by resource and staff shortage, along with chronic demoralisation. No doubt Peter Kennedy (Psychiatric Bulletin, August 2003, 27, 281-283) has patient and not financial interest in mind as he proposes new roles for psychiatrists that in today's conditions will only see them covering larger patches and with greater caseloads.
The current shortage of doctors in psychiatry is the inevitable result of a long deterioration in terms and conditions of service. Peter Kennedy obscures this point and distracts our attention with petty argument focused on financial envy. He goes on to assert that moneys for worthwhile services are being frittered away and I am sure management can confirm this. Where are these worthwhile services? They are long overdue, but I do not think they will come, whether or not there are locums.
Locums are not the problem and for every ‘dodgy locum’ you could name, there would be more than ten times the number of stories relating to staff shortages that are not covered. While there may be doctors of mediocre performance, commitment to a local service does not render immunity!
Itinerancy is very antisocial and working as a locum difficult. It is no mean feat to arrive in a new work environment and within hours deal with complex issues requiring extensive local knowledge. There is no grace period or induction and performance is expected immediately, your next job depends on it! You may or may not be the focus of financial envy, but there seems no escape from the intellectual contempt with which substantive colleagues regard you.
There is a financial issue and it needs to be addressed. It is time for consultant psychiatrists to realise their bargaining power and take a locum!
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