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Last Updated: Thursday, 10 June, 2004, 05:23 GMT 06:23 UK
'Crisis' in organ transplant jobs
Organ for transplant
A lack of interest by junior doctors in organ transplant surgery has caused a recruitment crisis, the BBC has learned.

Department of Health officials, senior consultants, NHS managers and patient representatives have met to discuss the issue, Radio 4's Today programme says.

It says surgeons fear viable organs will be lost because no surgeon can be found to perform an operation.

Reporter Tom Feilder says the problem is most acute in renal surgery.

Potentially, there could be the effect that our transplant units are not open all the time and the possibility that organs will not be used
John Forsythe

Kidney transplant centres are locally managed within the NHS and hospital units tend to be small, leaving individual consultants facing long hours and unpredictable shift patterns.

And because organs must be used swiftly after they become available, this means surgeons often being called out during the night and over weekends.

One hospital in Plymouth was recently forced to advertise a vacant consultant's post three times before finding a suitable candidate.

Sharp focus

John Forsythe, vice-president of the British Transplantation Society, told the Today programme: "We have been aware of a problem in recruitment for some time, but it has been brought into sharp focus in the last little while because of a realisation that jobs are unfilled in some of the units in the UK.

"With increased regulation to do with hours of work, the European Working Time Directive and the new consultant contract, this problem is going to get worse."

Dr Forsythe said the society had passed a unanimous vote at its meeting on Wednesday warning that the present situation was unsustainable.

"Potentially, there could be the effect that our transplant units are not open all the time and the possibility that organs will not be used.

"At the moment, there's no evidence that's happened. We are trying in a professional way to plan for the future before such a drastic thing occurs."

Intense demands

Professor Peter Friend, a consultant renal surgeon at the Oxford Transplant Centre, said the demands of the job were very intense.

"Kidney transplantation is part of a very exciting form of surgery, it is right on the interface between science and medicine, the patients are complex, it is a very fulfilling job.

"But there is an image problem, and it is largely due to the fact that kidney transplant surgeons are seen to be over-worked, and perhaps in some senses, under-valued."

In a statement, the National Kidney Research Fund agreed that the problem was serious.

It said: "The knock-on effects of a lack of transplant surgeons is a situation that can not be sustained as they are felt by the surgeons themselves, as well as the patients they care for.

"For the surgeons, their on-call hours become very onerous with some experiencing an average of four out of every seven days.

"And for the patient there is concern that the well known lack of organs, coupled with the lack of transplant surgeons, does not help to improve people┐s chances of having a transplant."

Doctors' representatives are calling for:

  • More money for transplant specialists who have to work unpredictable hours
  • The merging of small transplant units into larger centres to allow greater flexibility with rotas
  • Increased exposure of junior doctors to transplantation at a time when they are making their career choices

A Department of Health spokesman said: "It is recognised that recruiting transplant surgeons is difficult, as transplantation surgery is often perceived as difficult, with a heavy out-of-hours commitment.

"There have been a number of initiatives to increase the number of transplant surgeons in training which, to date, have had limited success."

The spokesman said several initiatives were currently underway to try to maximise the donation of organs, and to increase the kidney transplant rate.

"This will produce more choice for patients but, as importantly, a successful and thriving transplant service will be attractive to more surgeons."

The BBC's Tom Fielden
"Fewer and fewer junior doctors view the field of transplant surgery as attractive option"

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