Dr. Donald Berwick, head of Medicare and Medicaid, has proclaimed himself a “romantic” about the UK’s NHS. Patients actually facing surgery in the UK can be forgiven for being a good deal less enamored of the system than our Dr. Berwick.


According to a devastating report in the Telegraph, senior doctors claim that “European rules are creating a generation of ‘lazy, clock-watching’ junior surgeons who lack the skills to operate safely.” In fairness, the rules in question are set by the European Union, not the NHS, but they do show what can happen when hospitals are managed by bureaucratic fiat, ever how well-intended those regulations might be, rather than people on the scene.


In this instance, the regulation was clearly well-intentioned-an EU directive limiting workers to a 48-hour week which the NHS adopted. A whopping 80 per cent of consultants polled by the Royal College of Surgeons said health care is worse because patients are frequently “handed” from shift to shift. A few highlights from the report:



Many consultants responding to the survey said the changes – which began in 2007 when a 56 hour maximum working week was introduced, following EU legislation – were already changing the attitude of young doctors, who were becoming too detached from the patients in their care.



Marjan Jahangiri, Professor of Cardiac Surgery at St George’s Hospital in London said: “We have created a generation of surgeons who lack technical skills and operate within a “clocking off” culture where they do not feel personal responsibility for their patient.”



The surgeon said the change in attitude was “as fundamental and dangerous” as the lack of expertise among junior doctors, who now received far less training than their predecessors.


Let’s hope this isn’t coming to a hospital near you soon.