Psychiatric Bulletin (2005) 29: 470. doi: 10.1192/pb.29.12.470-a
© 2005 The Royal College of Psychiatrists
Psychiatric Bulletin (2005) 29: 470
© 2005 The Royal College of Psychiatrists
Statutory role of the duty consultant
D.V. Riordan, Consultant General Adult Psychiatrist
New Craigs Hospital, Leachkin Road, Inverness IV3 8NP, e-mail:
Vincent.Riordan{at}hpct.scot.nhs.uk
Dr Husain (Psychiatric Bulletin, August 2005, 29, 316)
makes a very pertinent point in response to my proposal that duty consultants
be replaced by telephone advice. Some jurisdictions (most notably England and
Wales) may require a face-to-face interview with a senior psychiatrist before
a person can be detained. However, the question remains whether or not such
interviews contribute anything which could not have been achieved by other
means. By making ourselves available 24 h a day, are we not, as a profession,
effectively saying that we believe this to be clinically necessary?
Legislators have responded to this perceived necessity but in doing so have
paradoxically created the potential for the scenario described by Dr Husain,
of urgent patient care being delayed. We have created a statutory demand for
our services which is based on traditional working practices (prior to the
revolutionary changes in telecommunications and mental health nursing), rather
than on a rational appraisal of how best to utilise scarce resources and
optimise patient care.