A History of Accident and Emergency Medicine, 1948–2004 by Henry Guly (auth.)

By Henry Guly (auth.)

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Example text

To achieve this required evidence and the committee resolved to write a memorandum to argue the case. Mr da Costa wrote the first draft and after a number of meetings and despite feelings, at times, of ‘being sidetracked by delaying tactics into “procedural” channels’ and that Mr Lewin, a neurosurgeon and chairman of the Subcommittee, ‘was blinded a little in his confidence in his own knowledge of casualty work’,20 the memorandum was prepared and presented to the CCSC in March 1964. In summary it stated: 1.

He also wrote probably the first textbook of casualty20 which he described as ‘the result of a seven-years’ study in the casualty department of a medium-sized, nonteaching provincial hospital’ and the many case histories which he describes show his day-to-day involvement in the department. 21 In two surveys of departments, the Nuffield team asked who was in charge. 9 Who was in charge? – Two surveys 1958 Specialty General surgeon Orthopaedic surgeon General and orthopaedic surgeon jointly Medical superintendent No consultant’s responsibility Medical SHMO Surgical SHMO Information not given Source: Nuffield Report.

In one hospital there was such unwillingness that there had been two mutinies by junior staff. The difficulty in filling posts in the early 1950s has been mentioned above. The situation was no different by 1958. The Nuffield Report notes that posts were often difficult to fill and a large number of posts were filled by overseas graduates. 5 Continued 37,284 16,000 57,200 New patients 53,110 87,000 Total patients 1 medical assistant 3 SHOs 1 orthopaedic SR (in accident unit) 3 SHOs (rotate with orthopaedics) 2 clinical assistants working sessions (number not stated) Cons.

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