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The College and the independent sector

  • Philip Sugarman (a1) and Seshagiri Rao Nimmagadda (a2)
Extract

Independent psychiatry beyond the National Health Service (NHS) is growing in the UK. However the history of the College can lead it to be NHS-centred in its outlook. Psychiatrists engaged in ‘private practice’ have at times been excluded from their collegiate peer group. We explore here the underlying and challenging issues of professional values, stigma, and occupational motivation. In the spirit of its commitment to raising standards, it is pleasing that the College is beginning to look beyond the NHS, supporting the professional development of non-NHS members, and including them in quality initiatives. We must all discover the value for patients in an open and independent perspective on what drives psychiatry in the UK.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The College and the independent sector

  • Philip Sugarman (a1) and Seshagiri Rao Nimmagadda (a2)
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eLetters

Moral Indignation

David J Ogden, Locum Consultant Psychiatrist
18 December 2007

Sugarman and Nimmagadda are to be congratulated on their tactful reproach to the stigma and disapprobation which may be directed towards psychiatrists not employed substantively within the NHS by their NHS peers; who after all occupy almost all of the positions of power within our institutions. It reminded me of a quote by Erich Fromm, the father of political psychology:

"There is perhaps no more dangerous feeling than moral indignation, since it permits envy or hatred to be acted out under the guise of virtue." ... More

Conflict of interest: None Declared

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Working in the Independent Sector

Prabhat Mahapatra, Consultant Psychiatrist
09 November 2007



Dear Editor,

Sugarman and Nimmagadda (Psychiatric Bulletin, November 2007, 31, 404-406) have highlighted a very topical issue. It is interesting that in spite of the fact that psychiatrists in general feel stigmatized and discriminated against, by their surgical and medical peers, there appears to be in existence a hierarchy amongst psychiatrists, where NHS psychiatrists are happy to stereotype psychiatrists working in the independent sector. The prejudice increases logarithmically when the independent psychiatrist happens to belong to an ethnic minority or works in an unfashionable specialty like Learning Disabilities.

Although psychiatrists working in the independent sector are perceived to be earning huge salaries and working in cushy jobs, they suffer from several disadvantaqes that may not be readily apparent to external observers. Independent psychiatrists do not enjoy the relative job security that NHS psychiatrists take for granted. The authors have rightly pointed out that independent psychiatrists do not benefit from the generous final salary NHS pension scheme. The performance of independent psychiatrists is rigorously monitored by their employers. They tend to work single handed without the help of trainees and end up providing a consultant delivered service, not unlike the American system. Working in the independent sector, they tend to be under increased scrutiny. The feeling of isolation and lack of a peer group is a huge problem.

The benefits in terms of remuneration are balanced by the personal costs, and a decision to work in the independent sector is often a difficult choice.

As Prof Hollins rightly alludes to in her commentary, this is a choice that senior trainees will increasingly have to make in the future with the expansion of the private sector and possible difficulties in obtaining NHS employment.

HOLLINS, S. (2007) Are they in or out? Commentary on … The College and the independent sector. Psychiatric Bulletin, 31, 407.



Dr P MahapatraConsultant PsychiatristCare PrinciplesDover Road, BarhamCanterbury CT4 6PWKentprabhat.mahapatra@careprinciples.com
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