Frustrations voiced at failure to fill Belford surgeons’ jobs

FRUSTRATION and disappointment have been the reaction in Lochaber this week now that 15 months have passed since NHS Highland last advertised three vacant surgeons’ positions at the Belford Hospital in Fort William.

Health bosses have instead relied on £737,000 worth of locum cover to maintain services at the second busiest hospital in the Highlands.

An NHS Highland representative said: ‘NHS Highland has made strenuous and repeated efforts to recruit substantive consultant posts, particularly surgeons, at the Belford Hospital for a number of years. Since 2014, we have advertised for three substantive and five locum surgeons.

‘However, these repeated efforts to recruit consultants and the fact that we were unable to fill the posts made it clear that a different approach was required.’

In February 2017, NHS Highland bosses undertook a review of the job description in an attempt to make the vacant posts ‘more attractive for the potential recruitment and retention of consultants’.

However, since then, none of the vacant positions at the hospital has been advertised.

Retired Lochaber GP and non-executive member of NHS Highland board Michael Foxley said he was ‘extremely disappointed’ to see that nothing has been advertised after 15 months.

Dr Foxley also raised concerns over the possibility of NHS Highland developing rotational contracts whereby consultants at the Belford will rotate with other consultants at Raigmore Hospital in Inverness.

He said: ‘There’s been much talk about rotational positions at Raigmore but details of controls and how this will operate have not been made available yet.

‘Rotational contracts are a very good idea in theory but to be effective they must work in practice. It is easy for default staff to just remain in Raigmore.

‘The Belford is the busiest of the six rural hospitals in Highland because of traumas on mountains and roads. The post needs to be advertised along with promoting the qualities of life in Lochaber – it’s a safe place to live.’

While the job description review has been taking place over the last year, the hospital has been staffed by a regular team of locum consultant surgeons. But even recruiting locums has proved problematic, according to NHS Highland, as ‘modern surgeons tend to be more specialised’ and there are ‘very few generalist surgeons able to work in a rural general hospital’.

Retired Belford Hospital consultant surgeon, David Sedgwick, said that problems with recruitment stem from wider issues in medical and surgical training, in which junior surgeons are directed towards specialising in narrow fields.

He said: ‘There is a series of reasons why this problem has occurred. One is that there has been this increasing trend to have super specialists where surgeons don’t operate on certain parts of the body and only do certain operations. This has come about by a significant reduction in the number of hours of training for junior doctors.

‘Therefore, there is a push to centralise services to central hospitals, but this hasn’t taken account of services at rural hospitals in the Highlands and across other parts of the country. There needs to be a change in direction.’

Mr Sedgwick explained that unless there is a willingness to train general surgeons and encourage them to work at rural hospitals, the problems of recruitment will continue.

‘Politicians have got to put pressure on the profession for training surgeons to work in rural hospitals,’ he said. ‘Otherwise people will have to travel four hours to get an appendix out – it really is getting that bad.’

‘There’s got to be more encouragement for trainees to consider working in rural hospitals and I don’t think that’s there. Maybe even a financial incentive might work.’

Filling other consultant posts at Belford has also proved difficult for NHS Highland as one of the three physician posts has been vacant. Lochaber council leader, Andrew Baxter, expressed his frustration at the recruitment process at NHS Highland. He said: ‘This is not a new problem and I’m staggered it’s taken them a year and all that money to realise they need a different approach to recruitment, not just in Lochaber but across Highland. You’d think that when the NHS don’t have much money that they would want to find a solution to this as quickly as possible.’