Published: 11/08/2005, Volume II5, No. 5967 Page 10
I was attending a 60th birthday party on Saturday night after the news broke that Robin Cook had collapsed and died on a Scottish mountain, almost certainly of a heart attack. Like me he was 59 and in apparent good health.
Naturally the guests defiantly shouting '60 is the new 50' during the cutting of the cake took a keen interest in the medical implications of the former foreign secretary's brutally sudden death. Several of us took an extra piece of the deliciously creamy cake, too.
A cardiac surgeon among us said that of course there is a hereditary aspect to such things in Scotland, reinforced by lifestyle habits. Indeed.
Of the six senior Scottish Labour politicians who were important in their party's long march back to power, three have died the same way: John Smith, Donald Dewar and now Mr Cook. None were teetotal.
Lord Irvine, whose keen appetites are open to occasional criticism, survives in robust semi-retirement, as does sensible Lord Robertson.
Gordon Brown is the one still standing.
One of my Scots newspaper colleagues was asked by his head office on Sunday: 'Why does Westminster kill so many Scots politicians.' Hang on, he protested, It is the other way around.
Scotland still has the worst cardiac outcomes in western Europe, despite all the porridge and extra NHS spending. The Lib Dem McPolitician Sir Menzies Campbell QC had just told my chum how hereditary fried breakfast killed off his own parents.
Back at my party I asked my 60ish surgeon why so many junior doctors are facing unemployment this autumn? That is according to the British Medical Association, much amplified by the Daily Mail whose 'The Tragedy of Gaynor [Cook]: She's Fallen Apart Says His Ex-Wife' headline may rank as August's bitchiest.
The surgeon offered two answers not provided by the BMA or the Mail. Thanks to dietary changes and preventative pills (Mr Cook took them to lower his blood pressure), the level of cardiac surgery is falling dramatically. Lots of specialists in their 30s face serious unemployment, he added.
In any case there are doctors all over the EU (and beyond) who fancy working for the NHS. Juniors are badly treated and paid in, for instance, Germany. Many speak English; we do not do foreign languages. There is a lot of competition. No wonder the Mail is outraged that some Brits, exhausted by repeated failure to get a job, are thinking of heading for Englishspeaking New Zealand. Their training costs at least£250,000.
The BMA blames the government (so does the Mail! ) because of the Modernising Medical Careers policy (the new two-year foundation programme) and the specialist training that replaced the old registrar system.
It has halved the available number of posts for one thing, and senior house officers looking for specialist posts are also competing with the new entrants to the reformed system. What's more, ministers were warned of the looming problem long ago - as far back as 1999, says the BMA.
As you know, the Department of Health rejects both the claim and the figures which, the BMA suggests, will leave at least 2,000 young doctors, one third of the total now in the job market, struggling to get work. Five to ten thousand SHOs will be affected by August 2007.
I rang Dr Howard Stoate, the Labour MP-GP for Dartford who has just rejoined the Commons health select committee. He acknowledged a 'bottleneck' in the new arrangements. But, party loyalist that he is, remains unabashed.
'It is more a hospital administrative problem than a government problem, ' he says. The government has changed the training programme which gets younger medics on the specialism ladder.
Even the BMA agrees the changes are good. But many acute trusts have failed to set up the right mix of rotational training places.
'For one or two years there may be a lost tribe of doctors who fall out [of the system], ' Dr Stoate concedes.
When the NHS must expand capacity, that strikes me as an alarming conclusion.
I should add that Dr Stoate, who is 50, is a keen runner. I am not, but do not have a majority of just 706. .
Michael White is political editor of The Guardian.