Guidelines or misguidance?

Trainees' hours are systematically reduced for fear of the European Working Time Directive There is no continuity, because of shift systems, to allow trainees to follow up and deal with the clinical consequences of their actions Consultants are inhibited from forceful condemnation of poor practice by fears of accusations over bullying or harrassment There is increasing micro-specialisation, making it impossible for trainees to maintain a holistic view of treatment of patient rather than condition Problems and responsibilities for postoperative infection are devolved to less educated wound care specialists whose activity is rarely, if ever, audited Every aspect of medical and surgical care is subject to guidelines and rules instead of allowing clinicians to think for themselves and take the fullest responsibility for their own actions.