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The silent centre of medicine


Continuity of care
Harold Lambert Physician
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Certainly the patients benefit from it and, again, to be fair, it's got two sides. If you see one patient and you're proprietorial about it you may make mistakes, which if seeing a few other people like a medical student or a professor or somebody or other might have put you right on. But from the ill patient it is extremely disturbing, specially as in a hospital they often just don't know who's who. And my old friend, Keith Sykes, who's the professor of anaesthetics, he was at Hammersmith for a long time and this is before even the current climate of time off duty and he said he counted that in one 24 hour period a patient in the intensive care unit had seen, one way or another, 25 doctors and it's... Good heavens. It's in a way inevitable because of the specialty and then, and then nowadays it's much more the case because of the off duty rotas which have... they're obviously a sharp contrast to our youth and quite rightly so but they've got to the point where people tell me that the juniors are driven off the wards if they're not on... at five o'clock so that the hospital doesn't have to pay them overtime and terrible stupid things like that but... so they, they don't see as much and I think, again, the anaesthetist sees most of the game and they... one or two people have told me that the newly appointed consultants just don't have as much surgical experience. I mean, they're going to go on getting it, it will be okay, but at that point they haven't seen as much stuff as they should do.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: Hammersmith Hospital, Keith Sykes

Duration: 1 minute, 41 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008