28 JANUARY 1989, Page 26

Fewer doctors, please

Sir: How refreshing that in all the recent publicity someone (Leading article, 7 Janu- ary) appreciates that our campaign for shorter hours need not necessarily cost more. We don't want more junior doctors, because there will be no career jobs for them in the future. We are trying to persuade people that having a hospital on every street corner has disadvantages that may outweigh the convenience. The dis- advantages are that small hospitals need the same nocturnal cover as large ones so that, for example, in one city we are told that there are 40 anaesthetists on duty at any time, covering as many as eight large and several smaller hospitals. Concentrat- ing acute services in these circumstances would mean that less than half this number of doctors would be needed to provide out of hours cover, and they would still be working fewer hours overall. These structural changes might need some initial investment, but land sales would pay for them in the long term.

Graeme McDonald

Chairman, Hospital Junior Staff Committee, British Medical Association, Tavistock Square, London SW1