The PMFA Journal co-editor, Andrew Burd, responds to the RCSEd warning issued in light of an NHS workforce survey results, which suggest that three-quarters of surgeons have considered an overseas move.

I am a Fellow of the Royal College of Surgeons of Edinburgh and I feel rather embarrassed by this limp swipe at NHS management.

'The research revealed that three-quarters of surgeons have considered an overseas move.' But the truth? RCSEd membership: 15,000. 253 responded and of these, 75% had thoughts about leaving the country or profession. 'In addition, 45% of surgeons surveyed said they are planning on leaving the workforce in the next five years, and of this group, 43% claimed this is because they are unhappy with the direction of the NHS.' I can understand when Professor Parks talks about belonging, but what I am hearing is that some of the largest units have just disintegrated into small factions; the QEH plastic surgeons in Birmingham, which is in a Trust with a very shaky reputation for bullying and harassment.

I can still remember the days when a hospital would have a medical staff committee. They were an important part of the hospital management because they would advise the executive staff on clinical matters. But then the management fought back, and do you remember the lies spread about white coats and infection? That was all part of the plan to emasculate doctors. And now there are monsters in management who will even force consultants to apologise to a mass murder for having expressed concerns regarding patient safety. It is past time to go to the managers and ask them to be thoughtful and considerate.

Now the primary option is to reconnect the network of professional support in the workplace. It is a real, tangible thing: 'A real focus on wellbeing for all NHS staff could also make a huge difference. Simple additions to the workplace like staff rooms, canteens, and availability of hot food would go some way to making healthcare workers feel more valued and could therefore improve retention.'

I think that management has lost its way quite some time ago and that is why I am rather disappointed at this RCSEd stance. Are doctors not amongst the brightest and the best in any hospital? We have let ourselves be pushed around too far, for too long. The RCSEd should be raising the flag for all surgeons to unite and demonstrate leadership in the creation of the new NHS. Now is the time. To be bold. To be brave. To be a surgeon for the NHS.

Andrew Burd (Prof)

The Chinese University of Hong Kong.

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