Analysis: Our enviable reputation for quality of patient care is at stake

Scotland has an enviable reputation for the quality of patient care, medical innovation and teaching - our clinical colleagues are among the best in the world.

However, the quality of patient care depends on the sustained availability of these highly trained and motivated medical consultants.

Rising numbers of acutely ill patients, together with the demands of an aging population and the training requirements of the next generation of doctors, are among the main pressures on consultant physicians in Scotland today.

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The census demonstrates that the recent increase in consultant physician posts has been modest, and at a time of severe financial pressure it will be challenging to expand and develop the consultant workforce.

The census also shows the proportion of new female consultants continues to increase. The college recognises that many have trained flexibly and may wish to work less than full-time, as do an increasing number of their male colleagues. Workforce planning must take account of the impact of less-than-full-time working.

The European Working Time Directive has reduced the number of hours that trainee doctors can work, and when combined with the pressures to extend the working day, additional consultants will be required to deliver timely expert opinion to improve patient outcomes.

• Dr Neil Dewhurst is president of the Royal College of Physicians of Edinburgh.