§ Ms PrimaroloTo ask the Secretary of State for Health what percentage of all surgical interventions are provided by unsupervised junior hospital doctors; what evidence she has as to whether the quality of this care is good; and what evidence she has as to monitoring of these practices and the provision of quality control by non-clinical managers.
§ Mr. SackvilleDetailed operational issues are the responsibility of health authorities and national health service trusts. Information on which staff undertake surgical interventions is not available centrally.
Hospital consultants are responsible for ensuring that junior doctors do not undertake any surgical intervention which is beyond their competence and for providing adequate supervision. The report of the 1991–92 national 416W confidential enquiry into perioperative deaths—NCEPOD—published in 1993, commented that in some specialties, basic specialist trainees should not be left to work alone without suitable supervision and direction. NCEPOD has recommended that consultants and hospital managers at local level should work together to achieve this. Copies of the report are available in the Library.
Health authorities are now responsible for funding clinical audit through contracts, and non-clinical managers are therefore involved in deciding the agenda of topics for clinical audit.