By Henry Guly (auth.)
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Extra resources for A History of Accident and Emergency Medicine, 1948–2004
Here he devoted his energies to running a very good department and organising teaching and research rather than becoming involved nationally with the organisation of casualty services. The first person to argue in the medical press that full time casualty consultants was the best way of managing casualty departments appears to have been Lamont, an SCO in Grimsby. 10 He felt that each casualty unit should have at its head a consultant of high attainment – ideally a man with surgical training and qualifications in industrial medicine whose ‘primary function … is to be a father figure to the young men who will make their career in the casualty service – translating into reality the platitude that casualty work can provide the young with invaluable experience’.
23 It is worth noting the orthopaedic surgeons’ objections and the SCO responses24 in some detail as it is important to understand orthopaedic objections. ● ● ● ● ● A career grade in casualty would deprive all other surgical units of the stimulus of emergency surgery. Response: One casualty consultant will not be able to do all emergency surgery and, if in a large department, probably will not have time to do much surgery at all except for any special interest. A casualty consultant invariably tends to set up a minor orthopaedic service and retains cases which should be referred.
Apart from these four reports dealing with accident and casualty services, Sir Robert Platt in his report on medical staffing9 recognised a requirement for consultant involvement but did not appear to feel that it needed much time: ‘the first principle in the staffing of casualty departments should be that one or more consultants should have a specified responsibility for casualty work, and a definite and sufficient part of their time allotted to its supervision. Much of the work is of a kind in which a policy for treatment can be defined reasonably closely and supervised by the senior staff concerned.
A History of Accident and Emergency Medicine, 1948–2004 by Henry Guly (auth.)