Dr. Colm Henry:

We face a problem not only with putting consultants in obstetric and gynaecology posts but also with putting them in across disciplines, particularly in model 3 hospitals and the mental health area, and model 3 hospitals have mostly unscheduled disciplines. Some of this relates clearly to changing conditions for consultants but also fewer trainees want to work in smaller model 3 hospitals, in single-handed departments or small departments. Most trainees want to work in larger departments - we have surveys that confirm this - in urban centres where they can do more complex work.

Our approach to this, not just in obstetrics and gynaecology and colposcopy, is to consider it from a hospital group perspective in terms of how we can create a hospital group by departments. That, however, asks bigger questions of us as to the sustainability of providing so many unscheduled services in 27 unscheduled care hospitals. Clearly, these are questions we will have to address as part of manpower planning because these jobs simply are not as attractive as they used to be.