Published: 11/4/2002, Volume II2, No. 5800 Page 8

Unhappiness among doctors is international, and has existed in this country since the NHS was set up, according to a report by the NHS Confederation.

The report, The Problem of Unhappy Doctors: what are the causes and what can we do? , which came out of workshops run by the confederation and the British Medical Journal, says the main factors which lead to unhappiness are the loss of a culture of deference, increased public expectations, diminished control and increased accountability. It says workload and pay are unlikely to provide a sufficient explanation for the problems: evidence from Australia and the US shows that doctors can still be unhappy even if they have large earnings, long consultation times or small list sizes. The report suggests that doctors get poor support compared with best practice in nursing, and that doctors are not trained in a way that prepares them for complex organisations.

Report author, confederation policy director Nigel Edwards, said: 'Key parts of the workforce feel disenfranchised and alienated, and a health service staffed by demoralised doctors cannot flourish.'

The report calls for the development of leadership, management and team membership skills for doctors, and the provision of time and space in which they can take control of their working lives.

www. nhsconfed. org